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About the Authors:
Robert J. Ursano
Affiliation: Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
Jodi B. A. McKibben
Affiliation: Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
Dori B. Reissman
Affiliation: National Institute for Occupational Safety and Health, Office of the Director, Washington, D.C., United States of America
Xian Liu
Affiliation: Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
Leming Wang
Affiliation: Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
Robert J. Sampson
Affiliation: Department of Sociology, Harvard University, Cambridge, Massachusetts, United States of America
Carol S. Fullerton
* E-mail: [email protected]
Affiliation: Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
Introduction
State and local public health workers play a critical role as first responders. Concern over public health response to natural disasters increased in the aftermath of the 2004 Asian tsunami, Hurricane Katrina, and the 2010 earthquakes in Haiti and Chile. Public health workers living in disaster-affected communities experience the direct effect of disasters, and at the same time are responsible for providing care to others. Public health workers exposed to disasters have high rates of acute and longer-term posttraumatic distress and posttraumatic stress disorder (PTSD) [1]–[4]. Few studies have addressed the psychological consequences of disaster in a large population of public health workers [2], [5]–[8]. Further, the possibility of community-level characteristics such as collective efficacy, defined as social cohesion among neighbors along with their willingness to intervene for the common good [9], mitigating the impact of such psychological consequences following disasters has not been addressed.
Multiple community characteristics influence health outcomes [9], [10]. The majority of studies of disaster mental health, which address neighborhood and social processes, measure and analyze them as individual-level variables [11], [12]. Collective efficacy can be both an individual-level perception and a community-level capacity. At the community level, the willingness of community members to intervene for the common good depends on mutual trust and solidarity among neighbors [13]. Collective efficacy is associated with neighborhood poverty, violence, and disadvantage [9], [14]–[18]. Specifically, increases in community collective efficacy are related to...