Clay Lauren A, Papas Mia A, Gill Kimberly, Abramson David M
1D'Youville College,Health Services Administration,Buffalo,New York.
2Value Institute,Christiana Care Health System,Newark,Delaware.
Disaster Med Public Health Prep. 2018 Feb;12(1):47-56. doi: 10.1017/dmp.2017.35. Epub 2017 Jul 31.
Disaster recovery efforts focus on restoring basic needs to survivors, such as food, water, and shelter. However, long after the immediate recovery phase is over, some individuals will continue to experience unmet needs. Ongoing food insecurity has been identified as a post-disaster problem. There is a paucity of information regarding the factors that might place an individual at risk for continued food insecurity post disaster.
Using data from a sample (n=737) of households severely impacted by Hurricane Katrina, we estimated the associations between food insecurity and structural, physical and mental health, and psychosocial factors 5 years after Hurricane Katrina. Logistic regression models were fit and odds ratios (OR) and 95% CI estimated.
Nearly one-quarter of respondents (23%) reported food insecurity 5 years post Katrina. Marital/partner status (OR: 0.7, CI: 0.42, 0.99), self-efficacy (OR: 0.56, CI: 0.37, 0.84), sense of community (OR: 0.7, CI: 0.44, 0.98), and social support (OR: 0.59, CI: 0.39, 0.89) lowered the odds of food insecurity and explained most of the effects of mental health distress on food insecurity. Social support, self-efficacy, and being partnered were protective against food insecurity.
Recovery efforts should focus on fostering social-support networks and increased self-efficacy to improve food insecurity post disaster. (Disaster Med Public Health Preparedness. 2018;12:47-56).
灾难恢复工作侧重于为幸存者恢复基本需求，如食物、水和住所。然而，在即时恢复阶段结束很久之后，一些人仍会持续面临未满足的需求。持续存在的粮食不安全已被确认为灾后问题。关于可能使个人在灾后面临持续粮食不安全风险的因素，相关信息匮乏。
利用卡特里娜飓风严重影响的家庭样本（n = 737）的数据，我们估计了卡特里娜飓风过后5年粮食不安全与结构、身心健康及心理社会因素之间的关联。拟合了逻辑回归模型并估计了优势比（OR）和95%置信区间（CI）。
近四分之一的受访者（23%）报告在卡特里娜飓风过后5年存在粮食不安全问题。婚姻/伴侣状况（OR：0.7，CI：0.42，0.99）、自我效能感（OR：0.56，CI：0.37，0.84）、社区感（OR：0.7，CI：0.44，0.98）和社会支持（OR：0.59，CI：0.39，0.89）降低了粮食不安全的几率，并解释了心理健康困扰对粮食不安全的大部分影响。社会支持、自我效能感和有伴侣关系对粮食不安全具有保护作用。
恢复工作应侧重于建立社会支持网络并提高自我效能感，以改善灾后的粮食不安全状况。（《灾难医学与公共卫生防范》。2018年；12：47 - 56）
