Social Disparities in Youth Following Disaster: The Unfair Burden of Cumulative Trauma and Prolonged Recovery

Background and Purpose: Disasters and their subsequent recovery can result in negative behavioral health outcomes, with youth being particularly vulnerable. Trauma symptoms in children and adolescents tend to decrease over time; however, with prolonged exposure, such as extended periods of recovery, increased stressors, and additional traumas, negative psychological symptoms may persist, develop, or increase. Social disparities exacerbate these complex response patterns, representing immediate and chronic consequences of trauma as well as characteristics of the individual’s social environment.  Traumatic exposure and adverse childhood events have long standing physical and behavioral health consequences that carry into adulthood, yet we have limited information on longitudinal recovery factors and ways to mitigate negative influence. The purpose of this study is to improve our understanding long term recovery and effects of disaster, traumatic experiences, demographics and family concerns on youth well-being post disaster. 

 

Methods: A multi-wave longitudinal community sample of over 30,000 youth age 10-18 were screened over a ten-year period following Hurricane Katrina in 2005 through 2015.  Annual screenings were conducted by the schools to guide school-based mental health recovery needs and services.  The screenings consisted of demographics, disaster and recovery information, additional traumas, current stressors and a posttraumatic stress symptom scale.  School level data was also used to understand how community indicators (median income, single headed households, etc.) contribute to symptoms. 

 

Results: Preliminary results revealed that over 40% of children met the cut-off for posttraumatic stress following Hurricane Katrina.  Consistent with existing studies, these numbers decrease overtime with increases following additional traumas, disasters, or stressors.  Child race, income, stressors, and other (non-disaster) traumas contributed to a greater degree than disaster exposure to increased or prolonged posttraumatic stress symptoms.

 

Conclusions and Implications: Many children are at an unfair advantage following disaster due to social disparities and chronic stress.  Screenings allow for targeting services to those most in need, which are often the most underserved. Following disasters funding and acceptance of mental health services tend to increase, allowing for opportunities to address not only disaster related concerns, but also preventative toward other behavioral health issues.  We argue that proper screening at the school level should occur even in times of non-disaster as a method to understand who may be at risk and changes in mental health status.  These screenings should be followed by a variety of school-based mental health services—ranging from general psychoeducation, preventive self-efficacy programs, to treatment.  Policy efforts are needed to make children’s mental health a constant priority, especially for underserved and disadvantaged youth, and not just during times of crisis.