Institute for the Environment, University of North Carolina Chapel Hill, Chapel Hill, NC 27517, USA.
Samuel Centre for Social Connectedness, Montréal, QC H3A 0G4, Canada.
Int J Environ Res Public Health. 2023 Nov 21;20(23):7090. doi: 10.3390/ijerph20237090.
Public works environmental disasters such as the Flint water crisis typically occur in disenfranchised communities with municipal disinvestment and co-occurring risks for poor mental health (poverty, social disconnection). We evaluated the long-term interplay of the crisis and these factors with substance use difficulties five years after the crisis onset. A household probability sample of 1970 adults living in Flint during the crisis was surveyed about their crisis experiences, use of substances since the crisis, and risk/resilience factors, including prior potentially traumatic event exposure and current social support. Analyses were weighted to produce population-representative estimates. Of the survey respondents, 17.0% reported that substance use since the crisis contributed to problems with their home, work, or social lives, including 11.2% who used despite a doctor's warnings that it would harm their health, 12.3% who used while working or going to school, and 10.7% who experienced blackouts after heavy use. A total of 61.6% of respondents reported using alcohol since the crisis, 32.4% using cannabis, and 5.2% using heroin, methamphetamine, or non-prescribed prescription opioids. Respondents who believed that exposure to contaminated water harmed their physical health were more likely to use substances to the detriment of their daily lives (RR = 1.32, 95%CI: 1.03-1.70), as were respondents with prior potentially traumatic exposure (RR = 2.99, 95%CI: 1.90-4.71), low social support (RR = 1.94, 95%CI: 1.41-2.66), and PTSD and depression (RR's of 1.78 and 1.49, respectively, -values < 0.01). Public works disasters occurring in disenfranchised communities may have complex, long-term associations with substance use difficulties.
公共工程环境灾难，如弗林特水危机，通常发生在市政投资不足和同时存在贫困、社会脱节等不良心理健康风险的被剥夺权利社区。我们评估了危机和这些因素与危机发生五年后物质使用困难之间的长期相互作用。对居住在弗林特的 1970 名成年人进行了一项家庭概率抽样调查，调查他们在危机期间的危机经历、危机后物质使用情况以及风险/恢复力因素，包括先前潜在创伤性事件暴露和当前社会支持情况。分析结果经过加权处理，以产生具有代表性的人口估计值。在调查对象中，17.0%的人报告说，自危机以来的物质使用对他们的家庭、工作或社会生活造成了问题，包括 11.2%的人不顾医生的警告，即使用会损害他们的健康，12.3%的人在工作或上学时使用，10.7%的人在大量使用后出现昏迷。共有 61.6%的受访者报告自危机以来使用过酒精，32.4%使用过大麻，5.2%使用过海洛因、冰毒或非处方处方类阿片类药物。认为接触污染水对身体健康有害的受访者更有可能使用物质来损害日常生活（RR = 1.32，95%CI：1.03-1.70），而先前经历过潜在创伤性暴露的受访者（RR = 2.99，95%CI：1.90-4.71）、社会支持度低（RR = 1.94，95%CI：1.41-2.66）以及 PTSD 和抑郁（RR 值分别为 1.78 和 1.49，p 值均 < 0.01）的受访者也是如此。在被剥夺权利的社区发生的公共工程灾难可能与物质使用困难存在复杂的、长期的关联。
