Natural disasters represent major stressors, resulting in psychological distress and physiological responses such as increased cortisol. During pregnancy, this impacts not only maternal well‐being, but also fetal development. In 2018, Hurricane Florence caused extensive damage across the eastern United States. Studies indicated that compared to married pregnant women, unmarried pregnant women had higher risk of distress. Here we assess hair cortisol among a subsample of participants, and variations based on marital status. Methods We analyzed multiple stress measures among 37 participants who were pregnant during Hurricane Florence. We used questionnaires modeled on previous studies to assess hardship associated with the hurricane, psychological distress, sociodemographic characteristics, social support, and food security. We analyzed cortisol concentrations in proximal and distal hair sections, representing stress around the time of the disaster (distal) and 3–4 months following the disaster (proximal). We used linear regression to test relationships between hair cortisol and self‐report stress measures, and variations based on marital status. Results Self‐report measures of distress and hardship were similar among married and unmarried participants. Mean cortisol levels in distal and proximal sections were higher among unmarried participants. Controlling for confounding variables, hardship was not associated with hair cortisol. Distress predicted cortisol in distal sections (β = .482, p = .018), with a trend for proximal sections (β = .368, p = .055). Marital status was a significant predictor of distal (β = .388, p = .027) and proximal (β = .333, p = .047) hair cortisol, explaining 8.6%–11.7% of unique variance. Conclusions Preexisting and intersecting risk factors likely place unmarried pregnant individuals at risk of stress during and following a disaster.
ObjectivesThe effects of stress caused by natural disasters may be more pronounced in individuals with preexisting disadvantages. The degree of hardship and psychological distress associated with Hurricane Florence was assessed in 83 pregnant women. This research helps identify unmarried pregnant women as a group particularly at risk of distress following a natural disaster.MethodsWe assessed hardship associated with the hurricane using a questionnaire modeled on previous studies of stress due to natural disasters. We assessed distress using the Impact of Event Scale‐Revised. We assessed social support and household food security using validated questionnaires. We used hierarchical linear regression to test predictors of distress marital status. Finally, we analyzed interactions between marital status and hardship, social support, and food security to examine whether these variables explained differences in distress among married and unmarried women.ResultsResults indicated that unmarried women may be at higher risk of distress following natural disasters. Unmarried women were younger, had lower food security and education levels. We found no differences between experiences of hurricane‐related hardship based on marital status. However, unmarried women were likely to have higher levels of distress following the hurricane. Hardship was a significant predictor of distress, but food security and social support were not significant predictors.ConclusionsThis study identifies unmarried pregnant women as a high risk/vulnerable group that may need additional support during emergencies. Taken together, this study further assesses how socially disadvantaged members of society may be unequally impacted by natural disasters.
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