Robyn Gershon
Robyn Gershon
Scroll
Clinical Professor of Epidemiology
-
Professional overview
-
Dr. Gershon is an interdisciplinary occupational and environmental health and safety researcher with extensive experience in the areas of disaster preparedness, healthcare safety, and risk assessment and management in high-risk work occupations. She earned her doctorate in Public Health from Johns Hopkins University, School of Public Health, where she was on faculty for several years.
Subsequently, Dr. Gershon was a Professor at the Mailman School of Public Health at Columbia University, with a joint appointment in the School of Nursing.
At the Mailman School, she also served as the Associate Dean for Research and was the Director of the Mentoring Program. Her most recent faculty appointment prior to joining NYU GPH was Professor of Epidemiology and Biostatistics and the Philip R. Lee Institute for Health Policy Studies at University of California, San Francisco (UCSF). She was also an Adjunct Professor in the UCSF School of Nursing, as well as at UC Berkeley where she taught public health disaster courses.
Dr. Gershon and her team conducted numerous ground breaking studies to develop and test new metrics of preparedness. Importantly, Dr. Gershon’s work has influenced the adoption of safe work practices and regulatory control measures, such as national needlestick prevention guidelines and high-rise building fire safety laws. Her numerous research studies encompass a wide range of topics, including, (to name a few): bloodborne pathogen exposure; hospital safety climate; psychosocial work stress in law enforcement; “ability and willingness” of essential workforce employees to report to duty during natural and man-made disasters; preparedness of responders for terrorist incidents; emergency high–rise building evacuation- (including the World Trade Center Evacuation Study); emergency preparedness of the elderly and disabled; mass fatality management infrastructure in the US; adherence to emergency public health measures among the general public; hearing loss risk in subway ridership; and noise exposure in urban populations.
Dr. Gershon recently completed a four-year, longitudinal intervention NIH-funded study on motivation and persistence in pursuing STEM research careers among underrepresented doctoral students. (the BRIDGE Project).
As a committed advocate for junior faculty and graduate students, Dr. Gershon will play an active role in research mentorship and advisement.
-
Education
-
BS, Medical Technology, Quinnipiac University, Hamden, CTMHS, Medical Microbiology, Quinnipiac University, Hamden, CTDrPH, Environmental and Occupational Health, Johns Hopkins University, Baltimore, MD
-
Honors and awards
-
Recipient, American Society of Safety Engineers, Membership Award, Oakland, CA (2016)Recipient, John L. Ziegler Capstone Mentor Award, Global Health Sciences, University of California San Francisco (2015)Recipient, City of New York Fire Commissioner's Special Commendation Certificate of Appreciation (2006)Recipient, Survivors' Salute, World Trade Center Survivors' Network (2006)Recipient, Annual International Sharps Injury Prevention Award (2005)Delta Omega (Public Health) Honorary Society (1997)Phi Theta Kappa Honor Society (Microbiology) (1976)Lambda Tau Mu Honor Society (Laboratory Science) (1976)
-
Areas of research and study
-
Disaster HealthDisaster Impact and RecoveryDisaster PreparednessEnvironmental Public Health ServicesEpidemiologyHealthcare SafetyOccupational HealthRisk Assessment and Management
-
Publications
Publications
Adverse Effects of the Deepwater Horizon oil spill Amid Cumulative Disasters: A Qualitative Analysis of the Experiences of Children and Families
AbstractMeltzer, G. Y., Merdjanoff, A. A., Gershon, R. R., Fothergill, A., Peek, L., & Abramson, D. M. (n.d.).Publication year
2024Journal title
Journal of Child and Family StudiesVolume
33Issue
6Page(s)
1995-2011AbstractLimited research has examined the ramifications of the Deepwater Horizon oil spill (DHOS) on children and their families. This study builds on secondary data analysis and representative survey findings from the multi-method, multi-phase Gulf Coast Population Impact (GCPI) project. Specifically, this phase of the GCPI research draws on in-depth, semi-structured interview and focus group data to illuminate the social conditions that influenced poor child health outcomes in the aftermath of the DHOS and amid other disasters. These qualitative data were collected two years after the spill with caregivers, teachers, faith- and community-based leaders in five highly impacted Gulf Coast communities. Exploratory qualitative analysis revealed that children were affected by the DHOS and other related challenges through exposure to familial stress emerging from livelihood disruptions. Such disruptions were the result of ongoing poverty, damage to the fishing industry, and exposure to cumulative and compounding environmental disasters. In cases of severe familial stress, children may have experienced toxic stress because of caregivers’ displaced distress; ambiguous loss through caregivers’ physical and/or emotional absence; and the children’s recognition of their families’ dire financial situations. Toxic stress was most often expressed through acute and chronic physiological, emotional, and behavioral health challenges. This study expands current understandings of the impact of technological disasters and cumulative environmental disasters on children and families. It underscores the importance of investing in harm prevention strategies to reduce threats to the health and wellbeing of young people living in ecologically and socioeconomically insecure environments prone to intensifying technological and climate-fueled disasters.Association of Victimization by Sex among Public Facing Bus and Subway Transit Workers, New York City
AbstractVlahov, D., Hagen, D., Cziner, M., Merdjanoff, A., Sherman, M. F., & Gershon, R. (n.d.).Publication year
2024Journal title
Journal of Urban HealthVolume
101Issue
5Page(s)
934-941AbstractFederal data indicate that assaults on transit workers resulting in fatalities or hospitalizations tripled between 2008 and 2022. The data indicated a peri-pandemic surge of assault-related fatalities and hospitalizations, but assaults with less dire outcomes were not recorded. In collaboration with the Transport Workers Union, Local 100, we conducted an online survey in late 2023 through early 2024 of New York City public-facing bus and subway workers that focused on their work experiences during the 2020–2023 period of the COVID-19 pandemic. Items for this analysis on victimization included measures of physical and sexual assault/harassment, verbal harassment/intimidation, theft, and demographic characteristics (e.g., sex, race, work division). We estimated separate modified Poisson models for each of the four outcomes, yielding prevalence ratios (PRs) and 95% confidence intervals (CIs). Potential interactions between variables with strong main effects in the adjusted model were further examined using product terms. Among 1297 respondents, 89.0% reported any victimization; respondents also reported physical assault (48.6%), sexual assault/harassment (6.3%), verbal harassment/intimidation (48.7%), and theft on the transit system (20.6%). Physical assault was significantly more common among women in the bus division compared to female subway workers, male bus workers, and male subway workers (adjusted PR (aPR) = 3.54; reference = male subway workers; Wald test p <.001). With the same reference group, sexual assault/harassment was more frequently reported among female subway workers (aPR = 5.15; Wald test, p <.001), but verbal assault/intimidation and experiencing theft were least common among women in the bus division (aPR = 0.22 and 0.13, respectively; Wald tests, p <.001). These data point to the need for greater attention to record and report on victimization against workers in both buses and subway.Barriers and Facilitators to Vaccine Equity Amidst the COVID-19 Vaccine Rollout in the United States
AbstractPiltch-Loeb, R., Nuñez Sahr, J., Nelson, L. R. E., Vlahov, D., & Gershon, R. R. (n.d.).Publication year
2024Journal title
International journal of environmental research and public healthVolume
21Issue
12AbstractState and local health departments were responsible for ensuring equitable distribution of the COVID-19 vaccine. This qualitative study aimed to identify the challenges, strategies, disappointments, and successes in achieving equity for hard-to-reach and at-risk populations. Using a purposive sampling strategy, 16 individuals affiliated with health departments across nine states, each holding leadership roles in vaccine distribution, were interviewed between late 2021 and mid-2022. The key factors promoting vaccine equity included (1) inviting community members to serve on vaccine advisory groups to participate in decision-making; (2) utilizing pre-existing community relationships and spaces to facilitate the planning and distribution of the vaccine; and (3) establishing and building upon community outreach to support accessibility and uptake of the vaccine. The barriers included (1) a lack of clarity on vaccine prioritization criteria; (2) language/communication access; and (3) the initial focus on mass vaccination sites for vaccine delivery. The stakeholders also highlighted potential facilitators for increasing equity in future vaccine rollouts. Overall, community engagement emerged as a critical factor in ensuring equity during disaster response efforts.Temporal Trends of Early COVID-19 Infections in New York City Transit Workers and Residents: March 01, 2020–May 02, 2020
AbstractCziner, M., Hawkins, D., Rosen, J., Hagen, D., Merdjanoff, A., Vlahov, D., & Gershon, R. (n.d.).Publication year
2024Journal title
Journal of Urban HealthAbstractThe continuity of public transportation was necessary during the COVID-19 pandemic so that essential workers could report for duty. Therefore, it is important to consider COVID-19’s impact on transit workers themselves. We described COVID-19 incidence rates over time in New York City (NYC) transit workers and the NYC general population during March–May, 2020. NYC transit COVID-19 cases were abstracted from occupational injury and illness logs, and health department data was used to ascertain NYC resident cases. COVID-19 rates among transit workers peaked during the week of March 22–28 (429.8 cases/100,000 workers). The peak in transit workers occurred 1–2 weeks before the general public’s peak (March 29–April 4: 368.8 cases/100,000 people; April 5–11: 357.8 cases/100,000 people). These data suggest that NYC transit workers may have been impacted by COVID-19 earlier than the general public. Thus, improving early detection and response of respiratory disease outbreaks may be vital to protecting transit workers.Associations Between COVID-19 Vaccine Hesitancy and Socio-Spatial Factors in NYC Transit Workers 50 Years and Older
AbstractMeltzer, G. Y., Harris, J., Hefner, M., Lanternier, P., Gershon, R. R., Vlahov, D., & Merdjanoff, A. A. (n.d.).Publication year
2023Journal title
International Journal of Aging and Human DevelopmentVolume
96Issue
1Page(s)
76-90AbstractThis analysis investigates how age, race/ethnicity, and geographic location contributed to vaccine hesitancy in a sample of 645 New York City (NYC) Transport Workers Union (TWU), Local 100 members surveyed in August 2020. Union members ages 50+ were 46% less likely to be vaccine hesitant than their younger counterparts (OR 0.64; 95% CI 0.42, 0.97). Non-Whites (OR 3.95; 95% 2.44, 6.39) and those who did not report their race (OR 3.10; 95% CI 1.87, 5.12) were significantly more likely to be vaccine hesitant than Whites. Those who were not concerned about contracting COVID-19 in the community had 1.83 greater odds (95% CI 1.12, 2.98) of being vaccine hesitant than those who were concerned. Older respondents tended to reside in Queens while vaccine hesitant and non-White respondents were clustered in Brooklyn. General trends observed in COVID-19 vaccine hesitancy persist in a population of high risk, non-healthcare essential workers.Examining the effects of cumulative environmental stressors on Gulf Coast child and adolescent health
AbstractMeltzer, G. Y., Merdjanoff, A. A., Xu, S., Gershon, R., Emrich, C. T., & Abramson, D. M. (n.d.).Publication year
2023Journal title
Population and EnvironmentVolume
45Issue
3AbstractThis study examines how community-level cumulative environmental stress affects child and adolescent emotional distress and chronic health conditions both directly and indirectly through stressors at the household, family, and individual levels. Data comes from the Women and their Children’s Health (WaTCH) Study, which sought to understand the health implications of exposure to the 2010 Deepwater Horizon oil spill (DHOS) among a cohort of 596 mothers with children ages 10 to 17 in southeastern Louisiana. Community-level environmental stress was measured using a newly developed geospatial index. Household-level stressors included previous hurricane impacts, impacts of DHOS, degree of financial difficulty, and degree of housing physical decay. Family stressors included maternal depression, self-rated physical health, and degree of parenting stress. Child stress was based on perceived stress; child mental health was based on serious emotional disturbance; and child physical health was based on diagnosis of chronic illness. Structural equation modeling used weighted least squares means and variance and theta parameterization. Results showed a significant negative direct path between community-level cumulative environmental stress and child/adolescent serious emotional disturbance and chronic illness. However, the indirect relationship through household, family, and individual-level stressors was significant and positive for both child/adolescent serious emotional disturbance and chronic illness. These findings point to the centrality of the household and family in determining child and adolescent physical and mental health outcomes in communities exposed to frequent disasters and ongoing environmental stressors.Vicarious Trauma: Exploring the Experiences of Qualitative Researchers Who Study Traumatized Populations
AbstractSmith, E., Pooley, J. A., Holmes, L., Gebbie, K., & Gershon, R. (n.d.).Publication year
2023Journal title
Disaster medicine and public health preparednessVolume
17Issue
1AbstractObjective: A substantial body of research exists regarding vicarious trauma (VT) exposure among helping professionals across disciplines and settings. There is limited research, however, on exposure to VT in qualitative researchers studying traumatized populations. The objective of this study was to explore the experiences of qualitative researchers who study traumatized populations and to identify potential protective strategies for reducing the risk of VT. Methods: The study utilized a qualitative methodological design. Focus groups and in-depth interviews were conducted using a semi-structured script. Thematic analysis was conducted to identify both risk factors and protective factors associated with VT. A sample of 58 research participants were recruited using a multimodal recruitment strategy. Results: Using thematic analysis, the following key themes emerged: exposure to primary trauma, the impact of stigma, organizational context, individual context, and research context. The opportunity for posttraumatic growth was also identified. Conclusion: Qualitative researchers of traumatized populations need to recognize the potential for VT and implement appropriate protection strategies from the risk of VT. The development of policies and guidelines that recognize the importance of both self-care and plan for researcher safety and well-being is a potential strategy for building researcher resilience and preventing VT.Are local offices of emergency management prepared for people with disabilities? Results from the FEMA Region 9 Survey
AbstractGershon, R. R., Muska, M. A., Zhi, Q., & Kraus, L. E. (n.d.).Publication year
2021Journal title
Journal of Emergency ManagementVolume
19Issue
1Page(s)
7-20AbstractObjective: To assess disaster planning of local Offices of Emergency Management (OEM) with respect to people with disabilities (PWD). Design: A cross-sectional study of local OEM from Federal Emergency Management Agency (FEMA) Region 9 (N = 61) was conducted using an internetbased survey. The primary outcome was the adoption of emergency management recommendations by the Department of Justice (DOJ) and FEMA in applying Title II of the Americans with Disabilities Act (ADA). Results: OEM implementation of ADA requirements was generally suboptimal. While 63 percent reported that plans addressed the needs of PWD, only 41 percent reported detailed operating procedures for PWD. Training of staff to ensure that they were knowledgeable on the ADA requirements for inclusivity was rarely conducted. While accessible shelters and transportation were often identified, accessible communication strategies, including emergency notifications, were often lacking; only 28 percent of OEMs reported availability of sign language interpreters at shelters. Shelters often allowed service animal access (62 percent), but fewer allowed access to personal assistants (39 percent). Engagement of the disability community, from plan development to community drills, was uncommon. While more than half (59 percent) of OEM felt clear about their responsibilities in providing equal access to PWD, only 23 percent reported having qualified staff and other resources necessary in order to meet those responsibilities. Participants cited the need for more training on the ADA requirements in order to better meet the needs of PWD. Conclusion: Strategies for improvement to assure inclusiveness of PWD in all phases of emergency management are needed.Impact of occupational exposure to COVID-19 on the physical and mental health of an essential workgroup: New York City transit workers
AbstractGershon, R. R., Merdjanoff, A. A., Meltzer, G. Y., Piltch-Loeb, R., Rosen, J., Nwankwo, E. M., Medina, P., Vlahov, D., & Sherman, M. F. (n.d.).Publication year
2021Journal title
Journal of Emergency ManagementVolume
19Issue
9Page(s)
133-146AbstractBackground and purpose: Early on in the COVID-19 pandemic, New York City (NYC) vowed to “keep the subways running” despite the lack of plans in place for protecting the health and well-being of transit workers. This study was designed to assess the impact of employment during the early phase of the pandemic on this essential frontline workforce. Methods, settings, and study participants: A convenience sample of members (stratified by job title) of the NYC Transport Workers Union, Local 100, was recruited in August 2020 to participate in an anonymous, cross-sectional, internet-based survey. Results: The demographics of the sample participants (N = 645) reflected union membership, ie, 82 percent male, 29 percent Black; 27 percent Hispanic, and 59 percent ≥age 50 years. At the time of the “NYC Pause” (March 22, 2020) when mandatory stay-at-home orders were issued, transit workers had limited worksite protections. Many reported a lack of such basics as face masks (43 percent), hand sanitizer (40 percent), and disposable gloves (34 percent). A high proportion (87 percent) were concerned about getting infected at work. Lack of certain protections was significantly associated with both fear of contagion at work and mental health symptoms. Nearly 24 percent of participants reported a history of COVID-19 infection. Self-reported infection was significantly correlated with lack of certain protections, including respiratory masks (p < 0.001), disposable gloves (p < 0.001), and hand sanitizer (p < 0.001). Infection was also significantly associated with mental health symptoms (p < 0.001). By August 2020, despite participants reporting that many worksite protections were then in place, 72 percent of workers were still fearful for their safety at work, eg, because of potential exposure due to passengers not wearing masks, and risk of verbal abuse and physical assault by passengers angered when asked to wear face masks. Workers who were fearful for their safety at work were more than six times more likely to report mental health symptoms (p < 0.001). Conclusions: Lack of worksite protections before “NYC Pause” (March 22, 2020) was significantly associated with self-reported infection, fear, and mental health symptoms in TWU, Local 100 members. To reduce the risk of adverse impacts associated with bioevents in all essential work groups, and across all essential occupational settings, infection control preparedness, early recognition of risk, and implementation of tailored risk reduction strategies are imperative. Pandemic preparedness is fundamental to protecting the health and well-being of essential workers and crucial in controlling the spread of disease in the community. Bioevent preparedness for all essential frontline workgroups will also help reduce occupational health inequities. Workers at risk, regardless of setting, deserve and have the right to equal protections under federal and state law.Comorbid posttraumatic stress disorder and lower respiratory symptoms in disaster survivors: Qualitative results of a 17-year follow-up of World Trade Center disaster survivors
AbstractGargano, L. M., Gershon, R. R., Ogunyemi, A., Dorlette, D., Petrsoric, L. J., & Cone, J. E. (n.d.).Publication year
2019Journal title
Progress in Disaster ScienceVolume
4AbstractA better understanding of the experiences of disaster survivors with post-traumatic stress disorder (PTSD) and serious comorbid medical conditions may lead to improvements in treatment, and help reduce the public health and healthcare burden of affected individuals. The purpose of this qualitative study was threefold; first, to explore the relationship between PTSD and lower respiratory symptoms (LRS); second, to identify factors influencing self-management and treatment of both disorders; and third, to determine the impact of these comorbidities on quality of life. The goal was to identify strategies to improve coordination of medical and mental health management in order to reduce the symptomatic burden of these two health conditions. In-depth, semi-structured qualitative interviews were conducted among 34 World Trade Center Health Registry (WTCHR) rescue/recovery workers and community members with both active LRS (self-reported history of cough, wheeze or shortness of breath) and report of PTSD diagnosis on their 2015–2016 survey. Thematic analysis identified 14 themes grouped into six main categories: relationship between LRS and PTSD, impact of symptoms on quality of life, medical management, symptom management strategies, current health status, and exposure history and symptoms. Participants spoke of a wide range of both symptom triggers and management strategies, including self-management and some maladaptive management behaviors such as smoking and alcohol consumption. Participants also spoke of feeling like there were gaps in their healthcare, particularly for mental health. In addition, many spoke to a lack of coordinated care between physical and mental health. The majority of participants did not feel that there was a link between their PTSD and LRS, and among them a large portion also reported a lack of control over their symptoms. Proactive and collaborative planning steps at multiple levels (healthcare, public health, disaster management) are needed to prevent adverse impacts of disasters. Because of the increasing trend in disasters (both natural and man-made), with potentially wide-ranging exposures, it is important to plan for the complex treatment of PTSD and other co-morbidities.Construction trade and extraction workers: A population at high risk for drug use in the United States, 2005–2014
AbstractOmpad, D. C., Gershon, R. R., Sandh, S., Acosta, P., & Palamar, J. J. (n.d.).Publication year
2019Journal title
Drug and alcohol dependenceVolume
205AbstractObjective: To estimate prevalence of past-month marijuana, cocaine, and nonmedical prescription opioid (NPO) use and determine employment-related correlates of drug use among construction trade/extraction workers (CTEW). Methods: We analyzed ten years of data (2005–2014) from 293,492 adults (age≥18) in the National Survey on Drug Use and Health, comparing CTEW and non-CTEW. Results: CTEW were 5.6% (n = 16,610) of the sample. Compared to non-CTEW, CTEW were significantly more likely to report past-month marijuana (12.3% vs. 7.5%), cocaine (1.8% vs. 0.8%), and/or NPO use (3.4% vs. 2.0%; Ps<.001). Among CTEW, past-week unemployment and working for >3 employers was associated with increased odds of marijuana and NPO use. Missing 1–2 days in the past month because the participant did not want to go into work was associated with increased odds for use of marijuana, cocaine, and NPO use. Missing 3–5 days of work in the past month because sick or injured was associated with double the odds (aOR = 2.00 [95% CI: 1.33–3.02]) of using NPO. Having written drug policies was associated with reduced odds for cocaine use, and workplace tests for drug use during hiring and random drug testing were also associated with lower odds of marijuana use. Conclusions: CTEW are a high-risk population for drug use. Precarious employment is associated with higher prevalence of drug use while some workplace drug policies were associated with lower prevalence. Coupled with reports of high overdose mortality among CTEW, these findings suggest that prevention and harm reduction programming is needed to prevent drug-related morbidity and mortality among CTEW.The influence of social supports on graduate student persistence in biomedical fields
AbstractEstrada, M., Zhi, Q., Nwankwo, E., & Gershon, R. (n.d.).Publication year
2019Journal title
CBE life sciences educationVolume
18Issue
3AbstractPathways to biomedical careers are not being pursued with equal vigilance among all students. Emerging research shows that historically underrepresented (HU) students who maintain a strong science identity are more likely to persist. However, the influence of social support on persistence is less studied, especially as it relates to science identity among doctoral students. To fill this gap, a 1-year study to assess similarities and differences among 101 HU and majority biomedical doctoral students was conducted to measure the extent to which 1) they report equivalent experiences of social support, science identity, and intentions to persist; 2) their experiences of social support predict intentions to persist 1 year later; and 3) science identity mediates the relationship between social support and intentions to persist in biomedical career pathways. Data were collected using online surveys. Results indicated that science identity significantly mediated the relationship between professional network support and persistence a year later for majority students. In contrast, for HU students, science identity mediated the relationship between instrumental, psychosocial, friend and family support, and persistence a year later. These study results provide evidence that reinforcing mentoring programs and support systems will be beneficial, especially for HU students.Adherence to Emergency Public Health Measures for Bioevents: Review of US Studies
AbstractGershon, R. R., Zhi, Q., Chin, A. F., Nwankwo, E. M., & Gargano, L. M. (n.d.).Publication year
2018Journal title
Disaster medicine and public health preparednessVolume
12Issue
4Page(s)
528-535AbstractThe frequency of bioevents is increasing worldwide. In the United States, as elsewhere, control of contagion may require the cooperation of community members with emergency public health measures. The US general public is largely unfamiliar with these measures, and our understanding of factors that influence behaviors in this context is limited. The few previous reviews of research on this topic focused on non-US samples. For this review, we examined published research on the psychosocial influences of adherence in US sample populations. Of 153 articles identified, only 9 met the inclusion criteria. Adherence behaviors were categorized into 2 groups: self-protective behaviors (personal hygiene, social distancing, face mask use, seeking out health care advice, and vaccination) and protecting others (isolation, temperature screening, and quarantine). A lack of uniformity across studies regarding definitions and measures was noted. Only 5 of the 9 articles reported tests of association between adherence with emergency measures and psychosocial factors; perceived risk and perceived seriousness were found to be significantly associated with adherence or adherence intentions. Although it is well documented that psychosocial factors are important predictors of protective health behaviors in general, this has not been rigorously studied in the context of bioevents. (Disaster Med Public Health Preparedness. 2018;12:528-535)Protective factors, Post-Traumatic Stress Disorder and World Trade Center evacuees
Hosakote, S., Nwankwo, E. M., Zhi, Q., & Gershon, R. (n.d.).Publication year
2018Journal title
Journal of Emergency ManagementAdherence to emergency public heath measures for bio events: review of US studies
Gershon, R., Zhi, Q., Chin, A. F., Nwankwo, E. M., & Gargano, L. M. (n.d.).Publication year
2017Journal title
Disaster Medicine and Public Health PreparednessPage(s)
1Emergency Preparedness Safety Climate and Other Factors Associated with Mental Health Outcomes among World Trade Center Disaster Evacuees
AbstractSherman, M. F., Gershon, R. R., Riley, H. E., Zhi, Q., Magda, L. A., & Peyrot, M. (n.d.).Publication year
2017Journal title
Disaster medicine and public health preparednessVolume
11Issue
3Page(s)
326-336AbstractObjective We examined psychological outcomes in a sample of participants who evacuated from the World Trade Center towers on September 11, 2011. This study aimed to identify risk factors for psychological injury that might be amenable to change, thereby reducing adverse impacts associated with emergency high-rise evacuation. Methods We used data from a cross-sectional survey conducted 2 years after the attacks to classify 789 evacuees into 3 self-reported psychological outcome categories: long-term psychological disorder diagnosed by a physician, short-term psychological disorder and/or memory problems, and no known psychological disorder. Results After nonmodifiable risk factors were controlled for, diagnosed psychological disorder was more likely for evacuees who reported lower emergency preparedness safety climate scores, more evacuation challenges (during exit from the towers), and evacuation-related physical injuries. Other variables associated with increased risk of psychological disorder outcome included gender (female), lower levels of education, preexisting physical disability, preexisting psychological disorder, greater distance to final exit, and more information sources during egress. Conclusions Improving the emergency preparedness safety climate of high-rise business occupancies and reducing the number of egress challenges are potential strategies for reducing the risk of adverse psychological outcomes of high-rise evacuations. Focused safety training for individuals with physical disabilities is also warranted.Enabling a Disaster-Resilient Workforce: Attending to Individual Stress and Collective Trauma
AbstractRaveis, V. H., VanDevanter, N., Kovner, C. T., & Gershon, R. (n.d.).Publication year
2017Journal title
Journal of Nursing ScholarshipVolume
49Issue
6Page(s)
653-660AbstractPurpose: Superstorm Sandy forced the evacuation and extended shutdown of New York University Langone Medical Center. This investigation explored how nurses were impacted by the disasters and how they can best be supported in their nursing responsibilities. Design: Sequential mixed methods were used to explore the psychosocial issues nurses experienced throughout the course of this natural disaster and its lingering aftermath. Methods: In-depth interviews were conducted from April to June 2013 with a subsample of nurses who participated in the evacuation deployment (n = 16). An anonymous, Internet-based cross-sectional survey sent to all registered nurses employed at the hospital at the time of the storm explored storm impact and recovery. Between July and September 2013, 528 surveys were completed. Findings: The qualitative data revealed challenges in balancing professional obligations and personal concerns. Accounts described dealing in the immediate recovery period with unexpected job changes and resultant work uncertainty. The storm's lingering aftermath did not signify restoration of their predisaster lifestyle for some, but necessitated coping with this massive storm's long-lasting impact on their personal lives and communal loss. Conclusions: Nurses working under the rapidly changing, uncontrolled, and potentially dangerous circumstances of a weather-related disaster are also experiencing concerns about their families’ welfare and worries about personal loss. These multiple issues increase the psychosocial toll on nurses during a disaster response and impending recovery. Clinical Relevance: Awareness of concerns and competing demands nurses experience in a disaster and aftermath can inform education and services to enable nurses to perform their critical functions while minimizing risk to patients and themselves.Health care emergency preparedness: changes on the horizon
Gershon, R., & Zhi, Q. (n.d.).Publication year
2017Journal title
Journal of the Association of Occupational Health Professionals in HealthcarePage(s)
20Mass-Fatality Incident Preparedness among Faith-Based Organizations
AbstractZhi, Q., Merrill, J. A., & Gershon, R. R. (n.d.).Publication year
2017Journal title
Prehospital and Disaster MedicineVolume
32Issue
6Page(s)
596-603AbstractIntroduction Members of faith-based organizations (FBOs) are in a unique position to provide support and services to their local communities during disasters. Because of their close community ties and well-established trust, they can play an especially critical role in helping communities heal in the aftermath of a mass-fatality incident (MFI). Faith-based organizations are considered an important disaster resource and partner under the National Response Plan (NRP) and National Response Framework; however, their level of preparedness and response capabilities with respect to MFIs has never been evaluated. The purpose of this study was threefold: (1) to develop appropriate measures of preparedness for this sector; (2) to assess MFI preparedness among United States FBOs; and (3) to identify key factors associated with MFI preparedness. Problem New metrics for MFI preparedness, comprised of three domains (organizational capabilities, operational capabilities, and resource sharing partnerships), were developed and tested in a national convenience sample of FBO members. Methods Data were collected using an online anonymous survey that was distributed through two major, national faith-based associations and social media during a 6-week period in 2014. Descriptive, bivariate, and correlational analyses were conducted. Results One hundred twenty-four respondents completed the online survey. More than one-half of the FBOs had responded to MFIs in the previous five years. Only 20% of respondents thought that roughly three-quarters of FBO clergy would be able to respond to MFIs, with or without hazardous contamination. A higher proportion (45%) thought that most FBO clergy would be willing to respond, but only 37% thought they would be willing if hazardous contamination was involved. Almost all respondents reported that their FBO was capable of providing emotional care and grief counseling in response to MFIs. Resource sharing partnerships were typically in place with other voluntary organizations (73%) and less likely with local death care sector organizations (27%) or Departments of Health (DOHs; 32%). Conclusions The study suggests improvements are needed in terms of staff training in general, and specifically, drills with planning partners are needed. Greater cooperation and inclusion of FBOs in national planning and training will likely benefit overall MFI preparedness in the US.Psychosocial Influences on Disaster Preparedness in San Francisco Recipients of Home Care
AbstractGershon, R. R., Portacolone, E., Nwankwo, E. M., Zhi, Q., Qureshi, K. A., & Raveis, V. H. (n.d.).Publication year
2017Journal title
Journal of Urban HealthVolume
94Issue
5Page(s)
606-618AbstractDisasters disproportionately impact certain segments of the population, including children, pregnant women, people living with disabilities and chronic conditions and those who are underserved and under-resourced. One of the most vulnerable groups includes the community-dwelling elderly. Post-disaster analyses indicate that these individuals have higher risk of disaster-related morbidity and mortality. They also have suboptimal levels of disaster preparedness in terms of their ability to shelter-in-place or evacuate to a shelter. The reasons for this have not been well characterized, although impaired health, financial limitations, and social isolation are believed to act as barriers to preparedness as well as to adaptability to changes in the environment both during and in the immediate aftermath of disasters. In order to identify strategies that address barriers to preparedness, we recently conducted a qualitative study of 50 elderly home care recipients living in San Francisco. Data were collected during in-home, in-person interviews using a semi-structured interview guide that included psychosocial constructs based on the social cognitive preparedness model and a new 13-item preparedness checklist. The mean preparedness score was 4.74 (max 13, range 1–11, SD. 2.11). Over 60 % of the participants reported that they had not made back-up plans for caregiver assistance during times of crisis, 74 % had not made plans for transportation to a shelter, 56 % lacked a back-up plan for electrical equipment in case of power outages, and 44 % had not prepared an emergency contacts list—the most basic element of preparedness. Impairments, disabilities, and resource limitations served as barriers to preparedness. Cognitive processes that underlie motivation and intentions for preparedness behaviors were lacking. There were limitations with respect to critical awareness of hazards (saliency), self-efficacy, outcome expectancy, and perceived responsibility. There was also a lack of trust in response agencies and authorities and a limited sense of community. Participants wanted to be prepared and welcomed training, but physical limitations kept many of them home bound. Training of home care aides, the provision of needed resources, and improved community outreach may be helpful in improving disaster outcomes in this vulnerable segment of the population.Resilience to post-traumatic stress among World Trade Center survivors: A mixed-methods study
AbstractGargano, L. M., Hosakote, S., Zhi, Q., Qureshi, K. A., & Gershon, R. R. (n.d.).Publication year
2017Journal title
Journal of Emergency ManagementVolume
15Issue
5Page(s)
275-284AbstractThe purpose of this study was to identify individual characteristics, behaviors, and psychosocial factors associated with symptoms of post-traumatic stress disorder (PTSD) among World Trade Center (WTC) disaster evacuation survivors. The study utilized a mixed-method design. In-depth interviews were conducted using a prepared script. PTSD was assessed using the PTSD checklist-civilian (PCL-C; a score ≥ 50 indicates probable PTSD). Thematic analysis was conducted to identify factors associated with PTSD. A purposive sample of 29 WTC evacuees was recruited using a multimodal recruitment strategy. Eligibility included: history of evacuation from the WTC (Tower 1 and/or Tower 2) on September 11, 2001, and decisional capacity for informed consent. Five participants had PCL-C scores ≥ 50. Thematic analysis identified resiliency factors (protective for PTSD), including leadership, taking action based on “gut” feelings (to evacuate), social support (staying in a group), going on “automatic survival” mode, and previous training on emergency response. Risk factors for PTSD included lack of emergency response training, lack of sense of urgency, poor physical condition, lack of communication skills, lack of direction, peri-event physical injury, peri-event traumatic exposure (horror), and moral injury (guilt and remorse). Several modifiable factors that may confer resilience were identified. In particular, the role of emergency response training in preventing disaster-related mental illness should be explored as a possible strategy for enhancing resilience to disaster events.Self-reported Preparedness to Respond to Mass Fatality Incidents in 38 State Health Departments
AbstractMerrill, J., Zhi, Q., & Gershon, R. R. (n.d.).Publication year
2017Journal title
Journal of Public Health Management and PracticeVolume
23Issue
1Page(s)
64-72AbstractContext: Public health departments play an important role in the preparation and response to mass fatality incidents (MFIs). Objective: To describe MFI response capabilities of US state health departments. Design: The data are part of a multisector cross-sectional study aimed at 5 sectors that comprise the US mass fatality infrastructure. Data were collected over a 6-week period via a self-administered, anonymous Web-based survey. Setting: In 2014, a link to the survey was distributed via e-mail to health departments in 50 states and the District of Columbia. Participants: State health department representatives responsible for their state's MFI plans. Measures: Preparedness was assessed using 3 newly developed metrics: organizational capabilities (n = 19 items); operational capabilities (n = 19 items); and resource-sharing capabilities (n = 13 items). Results: Response rate was 75% (n = 38). Among 38 responses, 37 rated their workplace moderately or well prepared; 45% reported MFI training, but only 30% reported training on MFI with hazardous contaminants; 58% estimated high levels of staff willingness to respond, but that dropped to 40% if MFIs involved hazardous contaminants; and 84% reported a need for more training. On average, 76% of operational capabilities were present. Resource sharing was most prevalent with state Office of Emergency Management but less evident with faith-based organizations and agencies within the medical examiner sector. Conclusion: Overall response capability was adequate, with gaps found in capabilities where public health shares responsibility with other sectors. Collaborative training with other sectors is critical to ensure optimal response to future MFIs, but recent funding cuts in public health preparedness may adversely impact this critical preparedness element. In order for the sector to effectively meet its public health MFI responsibilities as delineated in the National Response Framework, resources to support training and other elements of preparedness must be maintained.Are We Ready for Mass Fatality Incidents? Preparedness of the US Mass Fatality Infrastructure
AbstractMerrill, J. A., Orr, M., Chen, D. Y., Zhi, Q., & Gershon, R. R. (n.d.).Publication year
2016Journal title
Disaster medicine and public health preparednessVolume
10Issue
1Page(s)
87-97AbstractObjective To assess the preparedness of the US mass fatality infrastructure, we developed and tested metrics for 3 components of preparedness: organizational, operational, and resource sharing networks. Methods In 2014, data were collected from 5 response sectors: medical examiners and coroners, the death care industry, health departments, faith-based organizations, and offices of emergency management. Scores were calculated within and across sectors and a weighted score was developed for the infrastructure. Results A total of 879 respondents reported highly variable organizational capabilities: 15% had responded to a mass fatality incident (MFI); 42% reported staff trained for an MFI, but only 27% for an MFI involving hazardous contaminants. Respondents estimated that 75% of their staff would be willing and able to respond, but only 53% if contaminants were involved. Most perceived their organization as somewhat prepared, but 13% indicated not at all. Operational capability scores ranged from 33% (death care industry) to 77% (offices of emergency management). Network capability analysis found that only 42% of possible reciprocal relationships between resource-sharing partners were present. The cross-sector composite score was 51%; that is, half the key capabilities for preparedness were in place. Conclusions The sectors in the US mass fatality infrastructure report suboptimal capability to respond. National leadership is needed to ensure sector-specific and infrastructure-wide preparedness for a large-scale MFI.Coping Behavior and Risk of Post-Traumatic Stress Disorder among Federal Disaster Responders
AbstractLoo, G. T., Dimaggio, C. J., Gershon, R. R., Canton, D. B., Morse, S. S., & Galea, S. (n.d.).Publication year
2016Journal title
Disaster medicine and public health preparednessVolume
10Issue
1Page(s)
108-117AbstractBackground Our knowledge about the impact of coping behavior styles in people exposed to stressful disaster events is limited. Effective coping behavior has been shown to be a psychosocial stress modifier in both occupational and nonoccupational settings. Methods Data were collected by using a web-based survey that administered the Post-Traumatic Stress Disorder (PTSD) Checklist-Civilian, General Coping Questionnaire-30, and a supplementary questionnaire assessing various risk factors. Logistic regression models were used to test for the association of the 3 coping styles with probable PTSD following disaster exposure among federal disaster responders. Results In this sample of 549 study subjects, avoidant coping behavior was most associated with probable PTSD. In tested regression models, the odds ratios ranged from 1.19 to 1.26 and 95% confidence intervals ranged from 1.08 to 1.35. With control for various predictors, emotion-based coping behavior was also found to be associated with probable PTSD (odds ratio=1.11; 95% confidence interval: 1.01-1.22). Conclusion This study found that in disaster responders exposed to traumatic disaster events, the likelihood of probable PTSD can be influenced by individual coping behavior style and other covariates. The continued probability of disasters underscores the critical importance of these findings both in terms of guiding mental health practitioners in treating exposed disaster responders and in stimulating future research.Experiences and psychological impact of deployment for West Africa Ebola among U.S. volunteer health care workers
Gershon, R., Dernehl, L. A., Nwankwo, E. M., Zhi, Q., & Qureshi, K. A. (n.d.).Publication year
2016Journal title
PLoS Currents