199983 Toxic social environments: A model for understanding and responding to slow-motion technological disasters based on the case of amphibole-asbestos exposure in Libby, Montana

Wednesday, November 11, 2009: 1:30 PM

Rebecca J. W. Cline, PhD , School of Communication Studies, Kent State University, Kent, OH
Heather Orom, PhD , School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
Tanis Hernandez, MSW , Center for Asbestos Related Disease, Libby, MT
Lisa Berry-Bobovski, MA , Communication and Behavioral Oncology Program, Karmanos Cancer Institute, Detroit, MI
Brad Black, MD , Center for Asbestos Related Disease, Libby, MT
Ann G. Schwartz, PhD, MPH , Population Sciences, Karmanos Cancer Institute, Detroit, MI
John C. Ruckdeschel, MD , Nevada Cancer Institute, Las Vegas, NV
Background: Widespread amphibole-asbestos exposure in Libby, Montana created what EPA has called the worst environmental disaster in U.S. history. Lincoln County has the highest per capita asbestosis mortality rate of all U.S. counties. Like Love Canal, Libby represents “a different kind of disaster” (Levine, 1982). Significance: Slow-motion technological disasters (SMTDs) are on the rise. Nearly half of the U.S. population lives within a 10-mile radius of designated/proposed Superfund sites. Current models for disaster responses, based on rapid-onset disasters, do not apply well to SMTDs. Little is known about their impact on psychosocial responses and mitigating/exacerbating factors. Purpose: Using population-based survey results, we developed a model for understanding the role of the social environment in psychosocial responses of victims' whose health has been compromised by a SMTD. Our previous qualitative (focus group) research guided the survey design. Methods: We surveyed randomly-selected households (n=528) and ARD patients (n=68), in Libby. Questions/measures assessed perceived community/family conflict, stigma and social support processes, perceived health/QOL, and psychosocial adjustment. Results: Our composite findings suggest that intra-community conflict, stigma, and resulting diminished/failed social support comprise a negative social environment which likely influences psychosocial adjustment among ARD patients. Our model posits that: (a) severity of disease affects patients' psychosocial adjustment, and (b) the impact of severity of disease on psychosocial adjustment is exacerbated by negative aspects of patients' social environment. Conclusion: Identifying factors that affect psychosocial adjustment and are amenable to intervention is important to planning effective responses by agencies, communities, and health professionals caring for SMTD victims.

Learning Objectives:
At the conclusion of this session, the participant will be able to identify and understand: (1) important differences in community responses to rapid-onset natural disasters versus slow-motion technological disasters; (2) the dynamics associated with a toxic social environment that may emerge in slow-motion technological disasters, and (3) a theoretical model for understanding and responding to slow-motion technological disasters.

Keywords: Communication, Disasters

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: PhD and Pi for research project
Any relevant financial relationships? No

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.