Coping with oil spills: oil exposure and anxiety among residents of Gulf Coast states after the Deepwater Horizon Oil Spill

In April 2010, a fatal explosion on the Deepwater Horizon drilling rig in the Gulf of Mexico resulted in the largest marine oil spill in history. This research describes the association of oil exposure with anxiety after the Deepwater Horizon Oil Spill and evaluates effect modification by self-mastery, emotional support and cleanup participation. To assess the impacts of the Deepwater Horizon Oil Spill, the Centers for Disease Control and Prevention (CDC) conducted the Gulf States Population Survey (GSPS), a random-digit-dial telephone cross-sectional survey completed between December 2010 and December 2011 with 38,361 responses in four different Gulf Coast states: Louisiana, Florida, Alabama and Mississippi. Anxiety severity was measured using the Generalised Anxiety Disorder (GAD) symptom inventory. We used Tobit regression to model underlying anxiety as a function of oil exposure and hypothesised effect modifiers, adjusting for socio-demographics. Latent anxiety was higher among those with direct contact with oil than among those who did not have direct contact with oil in confounder-adjusted models [β = 2.84, 95% confidence interval (CI): 0.78, 4.91]. Among individuals with direct contact with oil, there was no significant interaction between participating in cleanup activities and emotional support for anxiety (p = 0.20). However, among those with direct contact with oil, in confounder-adjusted models, participation in oil spill cleanup activities was associated with lower latent anxiety (β = −3.55, 95% CI: −6.15, −0.95). Oil contact was associated with greater anxiety, but this association appeared to be mitigated by cleanup participation

Reducing public health risk during disasters: identifying social vulnerabilities

All regions of the US experience disasters; many of these disasters are responsible for negative public health consequences, such as increased morbidity and mortality. Previous research has demonstrated that populations with higher levels of social vulnerability are more likely to experience negative consequences to disasters. Social vulnerability is defined as the characteristics of a person or group in terms of their capacity to anticipate, cope with, resist and recover from the impact of a discrete and identifiable event in nature or society. Because the impacts from a disaster are expressed differentially across and within communities, emergency managers must be aware of the social vulnerabilities within their community to mitigate risk. The purpose of this study was to understand how emergency managers are currently identifying social vulnerabilities within their populations. I used a qualitative research paradigm to understand their approach and to inform a plan for change. Key informant interviews were conducted with emergency managers and a follow-up workshop with additional stakeholders was conducted to gain a deeper understanding of the barriers and facilitators to current approaches. Findings suggest that despite the need to identify social vulnerabilities, currently emergency managers lacked the awareness of how to and the technical capacity to adequately identify at-risk populations. Although public health tools have been developed to aid emergency planners in identifying at-risk populations, the majority of emergency managers were not aware of these tools and none had used them. My plan for change proposes the development of a guidance document to provide emergency managers with critical information, strategies, and resources they need to improve their ability to identify at-risk populations. To institutionalize the approaches outlined in the guidance, new behaviors and policy should also be introduced. Because vulnerability is an important cross-cutting preparedness topic it should be addressed by multiple national preparedness frameworks and should be a required public health preparedness core capability. Through these approaches and opportunities for change, public health and emergency management can begin to effectively mitigate vulnerabilities and reduce losses and enhance outcomes for a broader population of those at risk.Doctor of Public Healt