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Mental health and associated risk factors of Puerto Rico Post-Hurricane María

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

Mental health disorders have an increased prevalence in communities that experienced devastating natural disasters. Maria, a category 5 hurricane, struck Puerto Rico on September 20, 2017, weakening the island’s power grid, destroying buildings and homes, and limiting access to water, food, and health care services. This study characterized sociodemographic and behavioral variables and their association with mental health outcomes in the aftermath of Hurricane Maria.

Methods

A sample of 998 Puerto Ricans affected by Hurricane Maria was surveyed between December 2017 and September 2018. Participants completed a 5-tool questionnaire: Post-Hurricane Distress Scale, Kessler K6, Patient Health Questionnaire 9, Generalized Anxiety Disorder (GAD) 7, and Post-Traumatic Stress Disorder checklist for DSM-V. The associations of sociodemographic variables and risk factors with mental health disorder risk outcomes were analyzed using logistic regression analysis.

Results

Most respondents reported experiencing hurricane-related stressors. Urban respondents reported a higher incidence of exposure to stressors when compared to rural respondents. Low income (OR = 3.66; 95% CI = 1.34–11.400; p < 0.05) and level of education (OR = 4.38; 95% CI = 1.20–15.800; p < 0.05) were associated with increased risk for severe mental illness (SMI), while being employed was correlated with lower risk for GAD (OR = 0.48; 95% CI = 0.275–0.811; p < 0.01) and lower risk for SIM (OR = 0.68; 95% CI = 0.483–0.952; p < 0.05). Abuse of prescribed narcotics was associated with an increased risk for depression (OR = 2.94; 95% CI = 1.101–7.721; p < 0.05), while illicit drug use was associated with increased risk for GAD (OR = 6.56; 95% CI = 1.414–39.54; p < 0.05).

Conclusion

Findings underline the necessity for implementing a post-natural disaster response plan to address mental health with community-based social interventions.

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Data Availability

The datasets generated for this study can be found in the Mendeley Data, http://dx.doi.org/10.17632/9rhgdh3cdn.1.

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Acknowledgements

The authors thank Dr. Andrea Lopez-Cepero and Dr. Raymond Tremblay for statistical and research guidance. Additionally, we thank Dr. Estela Estapé and Dr. Martha García for the project design and review guidelines. We thank Sara Kurtevski, Melissa Milian-Rodriguez, Anamaris Torres-Sanchez, and Melissa Matos-Rivera, who helped in the recruitment of participants. The research was supported by the American Psychiatric Association Helping Hands Grant–2018_SJB_01.

Author information

Author notes

  1. Marina Stukova, Gina Cardona and Adriana Tormos contributed equally to this work.

Authors and Affiliations

  1. San Juan Bautista School of Medicine, PO Box 4968, Caguas, PR, 00726-4968, USA

    Marina Stukova, Andy Vega, Grisel Burgos, Yaritza Inostroza-Nieves & Yonatan Carl

  2. Universidad Central del Caribe School of Medicine, Bayamón, PR, USA

    Gina Cardona & Adriana Tormos

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  1. Marina Stukova
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  2. Gina Cardona
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  4. Andy Vega
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  6. Yaritza Inostroza-Nieves
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  7. Yonatan Carl
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Contributions

All co-authors have both contributed substantially and approved this manuscript before submission.

Corresponding authors

Correspondence to Yaritza Inostroza-Nieves or Yonatan Carl.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The San Juan Bautista School of Medicine Institutional Review Board (Approval num. SJBSM IRB# 22-2018) reviewed and approved the administration protocol. All participants were 18 years old or older and provided written informed consent for participate in the study. All methods were performed in accordance with the relevant guidelines and regulations.

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We can attest that this paper is neither presently under consideration at another publication nor will be while it is under consideration by Social Psychiatry and Psychiatric Epidemiology.

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Stukova, M., Cardona, G., Tormos, A. et al. Mental health and associated risk factors of Puerto Rico Post-Hurricane María. Soc Psychiatry Psychiatr Epidemiol 58, 1055–1063 (2023). https://doi.org/10.1007/s00127-023-02458-4

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  • DOI: https://doi.org/10.1007/s00127-023-02458-4

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