Factors Associated with Complicated Grief Following a Railway Tragedy

On July 6, 2013, a train with 72 crude oil tank cars derailed in the heart of Lac-Mégantic, a small municipality of 6,000 inhabitants located in Québec (Canada). This tragedy killed 47 people. Technological disasters are rarely studied in bereavement research, and train derailments even less. The goal of this article is to increase our understanding of the bereavement consequences of technological disasters. Specifically, we aim to identify the factors that lead to the experience complicated grief and distinguish from the protective factors. A representative population-based survey was conducted among 268 bereaved people, three and a half years after the train accident. Of these, 71 people (26.5%) experienced complicated grief. People with complicated grief (CG) differ significantly from those without CG in terms of psychological health, perception of physical health, alcohol use and medication, as well as social and professional relationships. Hierarchical logistic regression analysis identified four predictive factors for CG: level of exposure to the disaster, having a negative perception of the event, as well as having a paid job and low-income increase the risk of CG. The importance of having health and social practitioners pay attention to these factors of CG are discussed along with future directions for research.

Explanatory Matrices on the Causes of a Tailing Dam Collapse in Brazil: The (Dis)Articulation of Epistemes

Mining tailing dam ruptures are increasingly common events in South America. Due to their high potential degree for avoidance, they are considered to be technological disasters and often have a considerable impact on local populations and communities, as well as affecting the ecosystem. The failure of the Fundão dam in 2015 in the Brazilian State of Minas Gerais (is) considered one of the largest socioenvironmental disasters in the country's history. Different explanations for the causes of the disaster were put forward by various social actors. This article critically analyzes these discourses through the theoretical-methodological reference of the social theory of discourse, with the aim of understanding the various discursive contexts of the causes of the breach of the dam. The analysis and understanding of these explanatory matrices suggested that different discourses present different epistemological approaches to the causes of the disaster, related to aspects such as sociohistorical, political, ideological, and asymmetric relations of power. The statements had different emphases, being associated with distinct epistemic positions that were often not in convergence.  Moreover, certain terms and approaches reinforce or minimize processes of vulnerability experienced by the affected populations. These discourses present consents, dissents, and contradictions and when systematically integrated can improve the planning of risk management and broaden the understanding related to technological disaster occurrence.

Medium-Term Effects of a Train Derailment on the Physical and Psychological Health of Men

In July 2013, the derailment of a train caused the death of 47 people and the destruction of Lac-Mégantic's downtown area (Canada). Three years after this event, a population survey was conducted among a representative sample of 800 adults, including 282 men. Several significant differences were observed among respondents of a survey based on their level of exposure to this tragedy, including their physical (changes in physical health) and psychological health (post-traumatic stress disorder, mood and anxiety disorders, psychological distress, signs of depression, consultation of social workers and psychologists) as well as their use of prescribed (anxiolytics and antidepressants) and nonprescribed drugs. Such results can be explained by the nature, magnitude, and cause of the event.

Seniors Who Experienced the Lac-Mégantic Train Derailment Tragedy: What Are the Consequences on Physical and Mental Health?

Introduction: In July 2013, a train derailment caused the death of 47 people and destroyed the downtown area in the city of Lac-Mégantic (Quebec, Canada). This tragedy had several impacts on this small community. Method: Three years after this disaster, we used a representative population-based survey conducted among 800 adults (including 265 seniors aged 65 or above) to assess the physical and mental health of seniors. Results: Several differences were observed in seniors' physical and mental health based on their level of exposure to the tragedy. Nearly half of seniors highly exposed to the train derailment (41.7%) believe that their health has deteriorated in the past 3 years. The majority of seniors highly exposed to the train derailment (68.7%) also show symptoms of posttraumatic stress disorders. Seniors highly or moderately exposed to the tragedy were also more likely to have found positive changes in their personal and social life as compared with nonexposed seniors. Discussion: A technological disaster such as a train derailment still had negative impacts on seniors' physical and mental health 3 years later. Conclusion: Public health authorities must tailor prevention and promotion programs to restore health and well-being in this population.

Predictors of Individual Resilience Characteristics Among Individuals Ages 65 and Older in Post-Disaster Settings

OBJECTIVE

Literature explores which factors most impact resilience and how these factors impact an individual and communities' ability to cope with disaster. Less research has focused on how age impacts resilience. This research adapts several previous conceptual models used to investigate resilience. To investigate the unique vulnerabilities faced by older individuals in post-disaster settings, this analysis was undertaken to investigate predictors of individual resilience.

METHODS

Data for the study were derived from the Centers for Disease Control and Prevention (CDC) Gulf States Population Survey (GSPS). The final sample included 5,713 adult residents from 4 gulf-coast states. Multiple linear regression was used for the analysis.

RESULTS

All models (demographic, health, social, and combined) acted as significant predictors of individual resilience. Health and social resilience models accounted for more of the variance in resilience scores. In all models, age was negatively associated with resilience scores. Being female was protective across all models. The results of the model testing indicate inequitable disaster mitigation, with social and health indicators explaining the most variance in the resilience levels.

CONCLUSION

This research provides practitioners with the knowledge they need to focus their interventions on the areas where it is most needed to empower resilient individuals. (Disaster Med Public Health Preparedness. 2019;13:256-264).

Disaster complexity and the Santiago de Compostela train derailment

This disaster complexity case study examines Spain's deadliest train derailment that occurred on July 24, 2013 on the outskirts of Santiago de Compostela, Galicia, Spain. Train derailments are typically survivable. However, in this case, human error was a primary factor as the train driver powered the Alvia train into a left curve at more than twice the posted speed. All 13 cars came off the rails with many of the carriages careening into a concrete barrier lining the curve, leading to exceptional mortality and injury. Among the 224 train occupants, 80 (36%) were killed and all of the remaining 144 (4%) were injured. The official investigative report determined that this crash was completely preventable.

The public health response during and after the Lac-Mégantic train derailment tragedy: a case study

On July 6^th 2013, a train derailment occurred in the small town of Lac-Mégantic, Quebec, Canada, causing a major human and environmental disaster. In this case study, we comprehensively describe and analyze actions taken by the Public Health Department of the Eastern Townships, in close collaboration with community-based organizations, during both the impact phase emergency response and the post-impact recovery operations that continued for months. Due to the complexity of the event, public health actions needed to be broadly diversified. Preventive measures targeted chemical, physical, biological, and psychosocial hazards in the short-, medium- and long-term. Our analyses yielded valuable lessons that will improve and inform our response to future events while serving as a basis for developing a conceptual framework for public health emergency preparedness.

Meaning, Resilience, and Traumatic Stress After the Deepwater Horizon Oil Spill: A Study of Mississippi Coastal Residents Seeking Mental Health Services

The present study examines the relationship between resilience, perceived meaning in life, and traumatic stress symptoms among coastal residents of Mississippi directly affected by the Deepwater Horizon oil spill (also known as the Gulf oil spill). The study was conducted as part of a larger project that assessed the spill's effect on the mental health of individuals seeking therapeutic services. Multiple regression analyses were conducted to determine if resilience and perceived meaning are significant predictors of scores from a measure of posttraumatic stress. Descriptive data, reliability coefficients, and correlations were also calculated. Higher levels of resilience and meaning together were predictive of fewer posttraumatic stress symptoms after controlling for the effect of the spill. Resilience and meaning appeared to be similar predictors of lower posttraumatic stress scores, and meaning appears to be an important facet of what makes a person resilient.

A Typology of Communication Dynamics in Families Living a Slow-Motion Technological Disaster

With increasing numbers of communities harmed by exposures to toxic substances, greater understanding of the psychosocial consequences of these technological disasters is needed. One community living the consequences of a slow-motion technological disaster is Libby, Montana, where, for nearly 70 years, amphibole asbestos-contaminated vermiculite was mined and processed. Former mine employees and Libby area residents continue to cope with the health consequences of occupational and environmental asbestos exposure and with the psychosocial challenges accompanying chronic and often fatal asbestos-related diseases (ARD). Nine focus groups were conducted with Libby area residents. Transcripts were analyzed to explore patterns of family communication about ARD. The following five patterns emerged: Open/Supportive, Silent/Supportive, Open/Conflictual, Silent/Conflictual, and Silent/Denial. Open/Supportive communication included encouragement to be screened for ARD, information about ARD and related disaster topics, and emotional support for people with ARD. In contrast, communication patterns characterized by silence or conflict have the potential to hinder health-promoting communication and increase psychological distress.

Prediction of unmet primary care needs for the medically vulnerable post-disaster: an interrupted time-series analysis of health system responses

Disasters serve as shocks and precipitate unanticipated disturbances to the health care system. Public health surveillance is generally focused on monitoring latent health and environmental exposure effects, rather than health system performance in response to these local shocks. The following intervention study sought to determine the long-term effects of the 2005 chlorine spill in Graniteville, South Carolina on primary care access for vulnerable populations. We used an interrupted time-series approach to model monthly visits for Ambulatory Care Sensitive Conditions, an indicator of unmet primary care need, to quantify the impact of the disaster on unmet primary care need in Medicaid beneficiaries. The results showed Medicaid beneficiaries in the directly impacted service area experienced improved access to primary care in the 24 months post-disaster. We provide evidence that a health system serving the medically underserved can prove resilient and display improved adaptive capacity under adverse circumstances (i.e., technological disasters) to ensure access to primary care for vulnerable sub-groups. The results suggests a new application for ambulatory care sensitive conditions as a population-based metric to advance anecdotal evidence of secondary surge and evaluate pre- and post-health system surge capacity following a disaster.