Dataset Information

Impact of repeat flooding on mental health and health-related quality of life: a cross-sectional analysis of the English National Study of Flooding and Health.

ABSTRACT: OBJECTIVE:To assess the association between flooding/repeat flooding and: (1) psychological morbidity (anxiety, depression, post-traumatic stress disorder (PTSD)) and (2) health-related quality of life (HRQoL) at 6?months post-flooding. DESIGN:Cross-sectional analysis of data from the English National Study of Flooding and Health. SETTING:Cumbria, England. PARTICIPANTS:Questionnaires were sent to 2500 residential addresses at 6?months post-flooding; 590 people responded. OUTCOMES:Probable depression was assessed using the Patient Health Questionnaire, probable anxiety using the Generalised Anxiety Disorder scale and probable PTSD using the short-form PTSD checklist (PCL-6). HRQoL was assessed using the EQ-5D-5L. Mental health outcomes were analysed using logistic regression; HRQoL dimensions using ordinal regression; and summary index/Visual Analogue Scale scores using linear regression. RESULTS:One hundred and nineteen participants had been flooded, over half of whom were experiencing a repeat flooding event (54%; n=64). Mental health outcomes were elevated among flooded compared with unaffected participants (adjusted OR for probable depression: 7.77, 95%?CI: 1.51 to 40.13; anxiety: 4.16, 95%?CI: 1.18 to 14.70; PTSD: 14.41, 95%?CI: 3.91 to 53.13). The prevalence of depression was higher among repeat compared with single flooded participants, but this was not significant after adjustment. There was no difference in levels of anxiety or PTSD. Compared with unaffected participants, those flooded had lower EQ-5D-5L index scores (adjusted coefficient: -0.06, 95%?CI: -0.12 to -0.01) and lower self-rated health scores (adjusted coefficient: -6.99, 95%?CI: -11.96 to -2.02). There was, however, little difference in HRQoL overall between repeat and single flooded participants. CONCLUSIONS:Interventions are needed to help minimise the impact of flooding on people's mental health and HRQoL.

SUBMITTER: French CE

PROVIDER: S-EPMC6830640 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Impact of repeat flooding on mental health and health-related quality of life: a cross-sectional analysis of the English National Study of Flooding and Health.

French Clare E CE Waite Thomas D TD Armstrong Ben B Rubin G James GJ Beck Charles R CR Oliver Isabel I

BMJ open 20191102 11

<h4>Objective</h4>To assess the association between flooding/repeat flooding and: (1) psychological morbidity (anxiety, depression, post-traumatic stress disorder (PTSD)) and (2) health-related quality of life (HRQoL) at 6 months post-flooding.<h4>Design</h4>Cross-sectional analysis of data from the English National Study of Flooding and Health.<h4>Setting</h4>Cumbria, England.<h4>Participants</h4>Questionnaires were sent to 2500 residential addresses at 6 months post-flooding; 590 people respon ...[more]

PMID: 31678948

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Project description:BackgroundFacial appearance and expressions influence social interaction. Hemifacial spasm (HFS), blepharospasm (BPS), and blepharospasm-oromandibular dystonia (BOD) are common forms of craniofacial movement disorders. Few studies have focused on the mental burden and quality of life (QoL) in patients with craniofacial movement disorders. Therefore, this study investigated mental health and QoL in these patients.MethodsThis cross-sectional study included 90 patients with craniofacial movement disorders (HFS, BPS, and BOD; 30 patients per group) and 30 healthy individuals without craniofacial movement disorders (control group) recruited from October 2019 to November 2020. All participants underwent QoL and mental health evaluations for depression, anxiety, and stigma using the 36-item Short Form Health Survey (SF-36), Hamilton Anxiety Rating Scale (HAMA), Hamilton Rating Scale for Depression-24 (HAMD-24) and a questionnaire related to stigma.ResultsDepression was diagnosed in 37 (41.11%) patients, whereas 30 patients (33.33%) had anxiety. HAMA scores were significantly higher in the BPS and BOD groups than in the control group. Nineteen patients (21.11%) experienced stigma and SF-36 scores were lower in various dimensions in the movement disorders groups compared to healthy controls. The role-physical and social function scores were significantly lower in the movement disorders groups than in the control group all p < 0.05. The vitality scores of the BPS group and mental health scores of the BPS and BOD groups were significantly lower than those of the control group. Correlation analysis showed that the eight dimensions of SF-36 correlated with education level, disease duration, HAMD score, and HAMA score (all p < 0.05). Regression analysis demonstrated that the HAMD score correlated with general health, vitality, social function, role-emotional, and mental health (all p < 0.05). The HAMA score correlated with body pain after adjusting for education level and disease duration.ConclusionThis study highlights the significant frequency of mental symptoms, including depression, anxiety, and stigma, which lower QoL in patients with craniofacial movement disorders.

Project description:ObjectiveTo compare oral health in the US and England and to assess levels of educational and income related oral health inequalities between both countries.DesignCross sectional analysis of US and English national surveys.SettingNon-institutionalised adults living in their own homes.ParticipantsOral health measures and socioeconomic indicators were assessed in nationally representative samples: the Adult Dental Health Survey 2009 for England, and the US National Health and Nutrition Examination Survey 2005-08. Adults aged ≥25 years were included in analyses with samples of 8719 (England) and 9786 (US) for analyses by education, and 7184 (England) and 9094 (US) for analyses by income.Main outcome measuresNumber of missing teeth, self rated oral health, and oral impacts on daily life were outcomes. Educational attainment and household income were used as socioeconomic indicators. Age standardised estimates of oral health were compared between countries and across educational and income groups. Regression models were fitted, and relative and absolute inequalities were measured using the relative index of inequality (RII) and the slope index of inequality (SII).ResultsThe mean number of missing teeth was significantly higher in the US (7.31 (standard error 0.15)) than in England (6.97 (0.09)), while oral impacts were higher in England. There was evidence of significant social gradients in oral health in both countries, although differences in oral health by socioeconomic position varied according to the oral health measure used. Consistently higher RII and SII values were found in the US than in England, particularly for self rated oral health. RII estimates for self rated oral health by education were 3.67 (95% confidence interval 3.23 to 4.17) in the US and 1.83 (1.59 to 2.11) in England. In turn, SII values were 42.55 (38.14 to 46.96) in the US and 18.43 (14.01 to 22.85) in England.ConclusionsThe oral health of US citizens is not better than the English, and there are consistently wider educational and income oral health inequalities in the US compared with England.

Project description:BackgroundFlooding is expected to increase due to climate change, population growth and urban development. The longer-term mental health impacts of flooding are not well understood. In 2015, the English National Study of Flooding and Health was established to improve understanding of the impact of flooding on health and inform future public health action.MethodsWe used 3 years of data from the English National Study of Flooding and Health. Participants who had consented to follow up were sent a questionnaire. Participants were classified into either "unaffected", "disrupted" or "flooded" according to their exposure. Logistic regression models were used to calculate adjusted odds ratios for probable depression, anxiety and post-traumatic stress disorder (PTSD) in each exposure group. The Wald test was used to assess the difference in probable mental health outcomes for those who did and did not experience "persistent damage" to their home. Conditional logistic regression was conducted to assess change in prevalence over the 3 years and to identify possible determinants of recovery.ResultsEight hundred nineteen individuals were included in the final analysis - 119 were classified as unaffected, 421 disrupted and 279 flooded. Overall, 5.7% had probable depression, 8.1% had probable anxiety and 11.8% had probable PTSD, with higher prevalence in the flooded group compared with the unaffected group. After adjustment for potential confounders, probable mental health outcomes were higher in the flooded group compared to the unaffected group, significantly for probable depression (aOR 8.48, 95% CI 1.04-68.97) and PTSD (aOR 7.74, 95% CI 2.24-26.79). Seventy-seven (9.4%) participants reported experiencing persistent damage to their home, most commonly damp (n = 40) and visible mould (n = 26) in liveable rooms. Of the 569 participants who responded at all 3 years, a significant reduction in prevalence for all probable mental health outcomes was observed in the flooded group.ConclusionsFlooding can have severe long-lasting consequences on mental health in affected populations. If these problems are not identified and treated early, they may persist for years. Further research is necessary to develop and evaluate interventions to increase resilience in at risk populations and to ensure timely access to support services following flooding.

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Project description:BackgroundParasitic infections are still of considerable public health relevance, notably among children in low- and middle-income countries. Measures to assess the magnitude of ill-health in infected individuals, however, are debated and patient-based proxies through generic health-related quality of life (HrQoL) instruments are among the proposed strategies. Disability estimates based on HrQoL are still scarce and conflicting, and hence, there is a need to strengthen the current evidence-base.MethodologyBetween November 2011 and February 2012, a national school-based cross-sectional survey was conducted in Côte d'Ivoire. Children underwent parasitological and clinical examination to assess infection status with Plasmodium and helminth species and clinical parameters, and responded to a questionnaire interview incorporating sociodemographic characteristics, self-reported morbidity, and HrQoL. Validity analysis of the HrQoL instrument was performed, assessing floor and ceiling effects, internal consistency, and correlation with morbidity scores. Multivariate regression models were applied to identify significant associations between HrQoL and children's parasitic infection and clinical status.Principal findingsParasitological examination of 4,848 children aged 5-16 years revealed Plasmodium spp., hookworm, Schistosoma haematobium, Schistosoma mansoni, Ascaris lumbricoides, and Trichuris trichiura prevalences of 75.0%, 17.2%, 5.7%, 3.7%, 1.8%, and 1.3%, respectively. Anemic children showed a significant 1-point reduction in self-rated HrQoL on a scale from 0 to 100, whereas no significant negative association between HrQoL and parasite infection was observed. The 12-item HrQoL questionnaire proofed useful, as floor and ceiling effects were negligible, internally consistent (Cronbach's alpha = 0.71), and valid, as revealed by significant negative correlations and associations with children's self-reported and clinically assessed morbidity.Conclusions/significanceOur results suggest that HrQoL tools are not sufficiently sensitive to assess subtle morbidities due to parasitic infection in Ivorian school-aged children. However, more advanced morbid sequelae (e.g., anemia), were measurable by the instrument's health construct. Further investigations on health impacts of parasitic infection among school-aged children and refinement of generic HrQoL questionnaires are warranted.

Dataset Information

Impact of repeat flooding on mental health and health-related quality of life: a cross-sectional analysis of the English National Study of Flooding and Health.

Publications

Impact of repeat flooding on mental health and health-related quality of life: a cross-sectional analysis of the English National Study of Flooding and Health.

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