title: Depressive Symptom Severity and Community Collective Efficacy following the 2004 Florida Hurricanes.
abstract: There is a lack of research investigating community-level characteristics, such as community collective efficacy, mitigating the impact of disasters on psychological health, specifically depression. We examined the association of community collective efficacy with depressive symptom severity in Florida public health workers (n = 2249) exposed to the 2004 hurricane season using a multilevel approach. Cross-sectional anonymous questionnaires were distributed electronically to all Florida Department of Health (FDOH) personnel that assessed depressive symptom severity and collective efficacy nine months after the 2004 hurricane season. Analyses were conducted at the individual level and community level using zip codes. The majority of participants were female (81.9%), and ages ranged from 20 to 78 years (median = 49 years). The majority of participants (73.4%) were European American, 12.7% were African American, and 9.2% were Hispanic. Using multilevel analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with significantly lower depressive symptom severity (b = -0.09 [95% CI: -0.13, -0.04] and b = -0.09 [95% CI: -0.12, -0.06], respectively) even after adjusting for individual sociodemographic variables, community socioeconomic characteristics, individual injury/damage, and community storm damage. Lower levels of depressive symptom severity were associated with communities with high collective efficacy. Our study highlights the possible importance of programs that enrich community collective efficacy for disaster communities.
authors.affiliation: Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America.
authors.forename: Carol S
authors.initials: CS
authors.lastname: Fullerton
authors.affiliation: Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ursano
authors.affiliation: Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America.
authors.forename: Xian
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Psychology, West Chester University, West Chester, Pennsylvania, United States of America.
authors.forename: Jodi B A
authors.initials: JB
authors.lastname: McKibben
authors.affiliation: Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America.
authors.forename: Leming
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America.
authors.forename: Dori B
authors.initials: DB
authors.lastname: Reissman
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D004190:Disasters; D005260:Female; D005431:Florida; D006801:Humans; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D012111:Residence Characteristics; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult