title: Displacement, county social cohesion, and depression after a large-scale traumatic event.
abstract: BACKGROUND
  Depression is a common and potentially debilitating consequence of traumatic events. Mass traumatic events cause wide-ranging disruptions to community characteristics, influencing the population risk of depression. In the aftermath of such events, population displacement is common. Stressors associated with displacement may increase risk of depression directly. Indirectly, persons who are displaced may experience erosion in social cohesion, further exacerbating their risk for depression.
  
  
  METHODS
  Using data from a population-based cross-sectional survey of adults living in the 23 southernmost counties of Mississippi (N = 708), we modeled the independent and joint relations of displacement and county-level social cohesion with depression 18-24 months after Hurricane Katrina.
  
  
  RESULTS
  After adjustment for individual- and county-level socio-demographic characteristics and county-level hurricane exposure, joint exposure to both displacement and low social cohesion was associated with substantially higher log-odds of depression (b = 1.34 [0.86-1.83]). Associations were much weaker for exposure only to low social cohesion (b = 0.28 [-0.35-0.90]) or only to displacement (b = 0.04 [-0.80-0.88]). The associations were robust to additional adjustment for individually perceived social cohesion and social support.
  
  
  CONCLUSIONS
  Addressing the multiple, simultaneous disruptions that are a hallmark of mass traumatic events is important to identify vulnerable populations and understand the psychological ramifications of these events.
authors: Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, 2nd Floor Tower, Ann Arbor, MI, 48109-2029, USA, felicele@umich.edu.
authors: Félice
authors: F
authors: Lê
authors: Melissa
authors: M
authors: Tracy
authors: Fran H
authors: FH
authors: Norris
authors: Sandro
authors: S
authors: Galea
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D055867:Cyclonic Storms; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008922:Mississippi / Q000453:epidemiology; D012111:Residence Characteristics; D012307:Risk Factors; D057566:Self Report; D012931:Social Environment; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
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