268859 Resilience and Vulnerability of Childbearing Women Living Through Disaster Recovery

Tuesday, October 30, 2012 : 5:30 PM - 5:50 PM

Veronica Barcelona, MSN, MPH, RN, APHN-BC , School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
Gloria Giarratano, APRN, CNS, PhD , School of Nursing, Louisiana State University Health Sciences Center, New Orleans, LA
Emily W. Harville, PhD , School of Public Health and Tropical Medicine Dept of Epidemiology, Tulane University, New Orleans, LA
Jane Savage, RN, PhD, CNE, LCCE, FACCE , Nursing, Loyola Unviversity of New Orleans, New Orleans, LA
Robert Maupin, MD , School of Medicine, Maternal-Fetal Section, Louisiana State University Health Sciences Center, New Orleans, LA
     
Background: The Hurricane Katrina disaster provides a model to study pregnant women affected by a chronic stressful life course. Women in this study lived through a catastrophic disaster, family and home disruption, and a move back to a recovering New Orleans. Data is needed to describe personal, social, and environmental issues impacting women's health outcomes, including utilization of programs such as Healthy Start and Nurse-Family Partnership.

Methods: Cross-sectional data was collected from interviews with prenatal women (N=269, 24-40 weeks gestation). Measures analyzed included disaster exposure, depression (Edinburgh Depression Scale), post-traumatic stress disorder (Post-traumatic Checklist), overall stress (Perceived Stress Scale), social support and use of social programs. Linear regression was used to model mental health outcomes, with adjustment for race, marital status, education, employment, age, and smoking.

Results: Women were predominately African American (68%), single (71%) and with income <$5,000/year (57%). Disaster exposure was moderately high: 28% walked through flood waters; 63% had some or enormous damage to their homes. Mental health measures indicated 52% scored “at risk” for depression (EDS>8), while 11% were likely experiencing PTSD. Women who reported low social support scored significantly higher on depression, PTSD and overall stress (p<0.01) and were more likely to smoke and use drugs. All women were enrolled in traditional prenatal care, but only 30% accessed resources at Healthy Start, with 6% enrolled in the Nurse-Family Partnership.

Conclusion: Public health nurses in post-disaster communities need to facilitate social support networks and prenatal care that includes mental health assessment and utilization of community resources.

Learning Areas:
Diversity and culture
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related nursing

Learning Objectives:
Describe psychosocial and public health care variables that can modify mental health outcomes for pregnant women living in a long-term post-disaster recovery community. Describe the relationship between social support and mental health outcomes among women living in New Orleans and still disrupted from the 2005 Hurricane Katrina disaster.

Keywords: Disasters, Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Ms. Barcelona has is a public health nurse, with a primary focus on maternal-child health issues in Latina/Hispanic women. She has worked in Latin America with PAHO and the US State Department and a local hospital in the UK. She has an MSN/MPH from Johns Hopkins University, and is ANCC Certified as an Advanced Public Health Nurse. She has taught in a BSN Nursing program, and is now a PhD student Epidemiology at Tulane University.
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.

Back to: 4424.0: Partnering with Communities for Disaster Management