Racial Differences in Posttraumatic Stress Disorder Vulnerability Following Hurricane Katrina Among a Sample of Adult Cigarette Smokers from New Orleans

Abstract

Although blacks are more likely than whites to experience posttraumatic stress disorder (PTSD) after a natural disaster, the reasons for this disparity are unclear. This study explores whether race is associated with PTSD after adjusting for differences in preexisting vulnerabilities, exposure to stressors, and loss of social support due to Hurricane Katrina using a representative sample of 279 black and white adult ever smokers who were present when Hurricane Katrina struck, and identified it as the most traumatic event in their lifetime. Multiple logistic regression models evaluated whether differential vulnerability (pre-hurricane physical and mental health functioning, and education level), differential exposure to hurricane-related stressors, and loss of social support deterioration reduced the association of race with PTSD. Blacks were more likely than whites to screen positive for PTSD (49% vs. 39% respectively, p=0.030). Although blacks reported greater pre-hurricane vulnerability (worse mental health functioning and lower educational attainment) and hurricane-related stressor exposure, and had less social support after the hurricane, only prehurricane mental health functioning attenuated the association of race with screening positive for PTSD. Thus, racial differences in pre-hurricane functioning, particularly poorer mental health, may partially explain racial disparities in PTSD after natural disasters, such as Hurricane Katrina. Future studies should examine these associations prospectively using representative cohorts of CORRESPONDING AUTHOR:

Thinking Across Generations: Unique Contributions of Maternal Early Life and Prenatal Stress to Infant Physiology

“…38 Similar to sex differences, racial differences are observed in lifespan stress-related health conditions linked to ANS function, including mental health and cardiovascular disease. 15,39,40 Identifying mechanistic markers underlying intergenerational racial disparities might illuminate intervention targets or, at the very least, validate similarities across racial groups.…”

Race differences in depression vulnerability following Hurricane Katrina.

“…Although evidence supports racial disparities in post-disaster PTSD (Alexander et al, 2016; Davis et al, 2012), empirical support for racial disparities in post-disaster depression is less conclusive. Among 292 pregnant women exposed to Hurricane Katrina (“Katrina”), African Americans were more likely than Caucasians to suffer from depression (Harville, Xiong, Pridjian, Elkind-Hirsch, & Buekens, 2009).…”

“…These hypotheses, which are the differential vulnerability hypothesis, differential exposure hypothesis, and social support deterioration hypothesis, have previously been assessed to understand racial disparities in PTSD (Alexander et al, 2016; Davis et al, 2012). …”

“…Prior to Hurricane Katrina, African Americans and Caucasians reported similar levels of social support. However, African Americans reported less social support post-disaster (Alexander et al, 2016). …”

“…To our knowledge, no research to date has systematically examined these hypotheses in post-disaster depression, although findings from post-disaster PTSD studies (Alexander et al, 2016; Davis et al, 2012) have suggested their utility in explaining differences between Caucasians and African Americans in psychological functioning in the aftermath of a disaster. The present study will evaluate post-disaster disparities in depressive symptoms among a population of ever smokers, who have substantially higher rates of depression than non-smokers (Luger, Suls, & Vander Weg, 2014; Fluharty et al, 2016).…”