title: Psychosocial effects of the 2001 UK foot and mouth disease epidemic in a rural population: qualitative diary based study.
abstract: OBJECTIVE
  To understand the health and social consequences of the 2001 foot and mouth disease epidemic for a rural population.
  
  
  METHODS
  Longitudinal qualitative analysis.
  
  
  METHODS
  North Cumbria, the worst affected area in Britain.
  
  
  METHODS
  Purposive sample of 54 respondents divided in six demographically balanced rural occupational and population groups.
  
  
  METHODS
  3071 weekly diaries contributed over 18 months; 72 semistructured interviews (with the 54 diarists and 18 others); 12 group discussions with diarists
  
  
  RESULTS
  The disease epidemic was a human tragedy, not just an animal one. Respondents' reports showed that life after the foot and mouth disease epidemic was accompanied by distress, feelings of bereavement, fear of a new disaster, loss of trust in authority and systems of control, and the undermining of the value of local knowledge. Distress was experienced across diverse groups well beyond the farming community. Many of these effects continued to feature in the diaries throughout the 18 month period.
  
  
  CONCLUSIONS
  The use of a rural citizens' panel allowed data capture from a wide spectrum of the rural population and showed that a greater number of workers and residents had traumatic experiences than has previously been reported. Recommendations for future disaster management include joint service reviews of what counts as a disaster, regular NHS and voluntary sector sharing of intelligence, debriefing and peer support for front line workers, increased community involvement in disposal site or disaster management, and wider, more flexible access to regeneration funding and rural health outreach work.
authors.affiliation: Institute for Health Research, Lancaster University, Lancaster LA1 4YT. m.mort@lancaster.ac.uk
authors.forename: Maggie
authors.initials: M
authors.lastname: Mort
authors.forename: Ian
authors.initials: I
authors.lastname: Convery
authors.forename: Josephine
authors.initials: J
authors.lastname: Baxter
authors.forename: Cathy
authors.initials: C
authors.lastname: Bailey
mesh_terms: D000382:Agricultural Workers' Diseases / Q000453:epidemiology / Q000523:psychology; D000818:Animals; D001007:Anxiety / Q000453:epidemiology; D001294:Attitude to Health; D004196:Disease Outbreaks; D004739:England / Q000453:epidemiology; D005536:Foot-and-Mouth Disease / Q000453:epidemiology / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008499:Medical Records; D009784:Occupational Diseases / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life; D012423:Rural Health; D012934:Social Isolation; D013315:Stress, Psychological / Q000453:epidemiology*; D035502:Trust