Varshney Karan, Makleff Shelly, Krishna Revathi N, Romero Lorena, Willems Julie, Wickes Rebecca, Fisher Jane
Global and Women's Health Unit, Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Ian Potter Library, Alfred Health, Melbourne, VIC, Australia.
Glob Ment Health (Camb). 2023 Apr 13;10:e24. doi: 10.1017/gmh.2023.13. eCollection 2023.
Natural hazards are increasing because of climate change, and they disproportionately affect vulnerable populations. Prior reviews of the mental health consequences of natural hazard events have not focused on the particular experiences of vulnerable groups. Based on the expected increase in fires and droughts in the coming years, the aim of this systematic review is to synthesize the global evidence about the mental health of vulnerable populations after experiencing natural hazards. We searched databases such as Ovid MEDLINE, EMBASE, CINAHL and Ovid PsycInfo using a systematic strategy, which yielded 3,401 publications. We identified 18 eligible studies conducted in five different countries with 15,959 participants. The most common vulnerabilities were living in a rural area, occupying a low socioeconomic position, being a member of an ethnic minority and having a medical condition. Common experiences reported by vulnerable individuals affected by drought included worry, hopelessness, isolation and suicidal thoughts and behaviors. Those affected by fire reported experiencing posttraumatic stress disorder (PTSD) and anger. These mental health problems exacerbated existing health and socioeconomic challenges. The evidence base about mental health in vulnerable communities affected by natural hazards can be improved by including standardized measures and comparison groups, examining the role of intersectional vulnerabilities, and disaggregating data routinely to allow for analyses of the particular experiences of vulnerable communities. Such efforts will help ensure that programs are informed by an understanding of the unique needs of these communities.
由于气候变化，自然灾害正在增加，而且它们对弱势群体的影响尤为严重。先前对自然灾害事件心理健康后果的综述并未关注弱势群体的特殊经历。基于未来几年火灾和干旱预计会增加的情况，本系统综述的目的是综合全球范围内关于弱势群体经历自然灾害后心理健康状况的证据。我们采用系统检索策略在诸如Ovid MEDLINE、EMBASE、CINAHL和Ovid PsycInfo等数据库中进行检索，共获得3401篇文献。我们确定了在五个不同国家开展的18项符合条件的研究，涉及15959名参与者。最常见的弱势群体特征包括居住在农村地区、社会经济地位较低、属于少数民族以及患有某种疾病。受干旱影响的弱势群体报告的常见经历包括担忧、绝望、孤立以及自杀念头和行为。受火灾影响的人群报告经历了创伤后应激障碍（PTSD）和愤怒情绪。这些心理健康问题加剧了现有的健康和社会经济挑战。通过纳入标准化测量方法和对照组、研究交叉弱势群体的作用以及定期对数据进行分类以分析弱势群体的特殊经历，可以改进受自然灾害影响的弱势群体心理健康状况的证据基础。此类努力将有助于确保项目基于对这些社区独特需求的理解而制定。
