Back to Annual Meeting

Back to Annual Meeting

Abstract #156322

• Audio (mp3) recording
• Multimedia recording

Heather Orom, PhD¹, Rebecca J. W. Cline, PhD², Lisa Berry-Bobovski, MA², Tanis Hernandez, MSW³, Brad Black, MD³, Ann G. Schwartz, PhD, MPH⁴, and John C. Ruckdeschel, MD¹. (1) Karmanos Cancer Institute, Hudson Webber Cancer Research Center, 4100 John R Street, Detroit, MI 48201, (2) Communication and Behavioral Oncology Program, Karmanos Cancer Institute, ROC 336 GE00PS, 4100 John R Street, Detroit, MI 48201, (313) 576-8703, cliner@karmanos.org, (3) Center for Asbestos Related Disease, 214 East 3rd Street, Libby, MT 59923, (4) Population Sciences, Karmanos Cancer Institute, Prentis Cancer Research Center, 110 East Warren Avenue, Detroit, MI 48201

Background: Amphibole asbestos exposure in Libby, Montana constitutes what EPA called the “worst environmental disaster” in U.S. history. More than 270 people have died; hundreds have asbestos-related diseases (ARD); given ARD's lengthy latency period, thousands remain at risk. Multiple generations within families have or are at risk for ARD. Local culture values familial relationships and community identity. Purpose: Using family systems theory, this study explored how family dynamics mediate public health consequences of a “slow-motion technological disaster.” Significance: Previous research addressed rapidly-striking natural disasters' psychosocial consequences and family-level responses to disease (e.g., cancer). Little is known about responses to slow-motion disasters, less about family-level roles/consequences. Methods: Nine focus groups and five interviews (n = 71) were conducted in Libby with people with ARD, family members of people with ARD, and people without ARD in their families. Results: Family members provide informal caregiving for people with ARD (e.g., provide home care, facilitate adherence, monitor symptoms); subsidize health care costs and influence ARD-related health behavior (risk reduction, surveillance, medical care-seeking). However, complex family dynamics interfere with family-level coping and health promotion responses, including: caregiver strain, likely affecting caregivers' psychological/physical health, observing prolonged illness/death while anticipating one's own; conflict; secrecy; family-related guilt/blame; and jeopardized family structure (e.g., conflict, divorce). In addition, community conflict around the disaster sometimes creates tensions between family and community loyalty. Conclusion: Interventions and policy responding to slow-motion disasters should provide healthcare, economic, and psychosocial support to those who most often bear the burden of providing informal care and support.

Learning Objectives:

• Describe family dynamics in response to a slow-motion technological disaster.
• Describe implications of these responses for the psychosocial and physical health of family members and the community.
• Identify how complex family dynamics may interfere with coping with a slow-motion technological disaster.

Keywords: Asbestos, Caregivers

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

• Audio (mp3) recording
• Multimedia recording