In September 2010 and February 2011 the Canterbury region of New Zealand was struck by two powerful earthquakes, registering magnitude 7.1 and 6.3 respectively on the Richter scale. The second earthquake was centred 10 kilometres south-east of the centre of Christchurch (the region’s capital and New Zealand’s third most populous urban area, with approximately 360,000 residents) at a depth of five kilometres. 185 people were killed, making it the second deadliest natural disaster in New Zealand’s history. (66 people were killed in the collapse of one building alone, the six-storey Canterbury Television building.) The earthquake occurred during the lunch hour, increasing the number of people killed on footpaths and in buses and cars by falling debris. In addition to the loss of life, the earthquake caused catastrophic damage to both land and buildings in Christchurch, particularly in the central business district. Many commercial and residential buildings collapsed in the tremors; others were damaged through soil liquefaction and surface flooding. Over 1,000 buildings in the central business district were eventually demolished because of safety concerns, and an estimated 70,000 people had to leave the city after the earthquakes because their homes were uninhabitable. The New Zealand Government declared a state of national emergency, which stayed in force for ten weeks. In 2014 the Government estimated that the rebuild process would cost NZ$40 billion (approximately US$27.3 billion, a cost equivalent to 17% of New Zealand’s annual GDP). Economists now estimate it could take the New Zealand economy between 50 and 100 years to recover. The earthquakes generated tens of thousands of insurance claims, both against private home insurance companies and against the New Zealand Earthquake Commission, a government-owned statutory body which provides primary natural disaster insurance to residential property owners in New Zealand. These ranged from claims for hundreds of millions of dollars concerning the local port and university to much smaller claims in respect of the thousands of residential homes damaged. Many of these insurance claims resulted in civil proceedings, caused by disputes about policy cover, the extent of the damage and the cost and/or methodology of repairs, as well as failures in communication and delays caused by the overwhelming number of claims. Disputes were complicated by the fact that the Earthquake Commission provides primary insurance cover up to a monetary cap, with any additional costs to be met by the property owner’s private insurer. Litigation funders and non-lawyer claims advocates who took a percentage of any insurance proceeds also soon became involved. These two factors increased the number of parties involved in any given claim and introduced further obstacles to resolution. Resolving these disputes both efficiently and fairly was (and remains) central to the rebuild process. This created an unprecedented challenge for the justice system in Christchurch (and New Zealand), exacerbated by the fact that the Christchurch High Court building was itself damaged in the earthquakes, with the Court having to relocate to temporary premises. (The High Court hears civil claims exceeding NZ$200,000 in value (approximately US$140,000) or those involving particularly complex issues. Most of the claims fell into this category.) This paper will examine the response of the Christchurch High Court to this extraordinary situation as a case study in innovative judging practices and from a jurisprudential perspective. In 2011, following the earthquakes, the High Court made a commitment that earthquake-related civil claims would be dealt with as swiftly as the Court's resources permitted. In May 2012, it commenced a special “Earthquake List” to manage these cases. The list (which is ongoing) seeks to streamline the trial process, resolve quickly claims with precedent value or involving acute personal hardship or large numbers of people, facilitate settlement and generally work proactively and innovatively with local lawyers, technical experts and other stakeholders. For example, the Court maintains a public list (in spreadsheet format, available online) with details of all active cases before the Court, listing the parties and their lawyers, summarising the facts and identifying the legal issues raised. It identifies cases in which issues of general importance have been or will be decided, with the expressed purpose being to assist earthquake litigants and those contemplating litigation and to facilitate communication among parties and lawyers. This paper will posit the Earthquake List as an attempt to implement innovative judging techniques to provide efficient yet just legal processes, and which can be examined from a variety of jurisprudential perspectives. One of these is as a case study in the well-established debate about the dialogic relationship between public decisions and private settlement in the rule of law. Drawing on the work of scholars such as Hazel Genn, Owen Fiss, David Luban, Carrie Menkel-Meadow and Judith Resnik, it will explore the tension between the need to develop the law through the doctrine of precedent and the need to resolve civil disputes fairly, affordably and expeditiously. It will also be informed by the presenter’s personal experience of the interplay between reported decisions and private settlement in post-earthquake Christchurch through her work mediating insurance disputes. From a methodological perspective, this research project itself gives rise to issues suitable for discussion at the Law and Society Annual Meeting. These include the challenges in empirical study of judges, working with data collected by the courts and statistical analysis of the legal process in reference to settlement. September 2015 marked the five-year anniversary of the first Christchurch earthquake. There remains widespread dissatisfaction amongst Christchurch residents with the ongoing delays in resolving claims, particularly insurers, and the rebuild process. There will continue to be challenges in Christchurch for years to come, both from as-yet unresolved claims but also because of the possibility of a new wave of claims arising from poor quality repairs. Thus, a final purpose of presenting this paper at the 2016 Meeting is to gain the benefit of other scholarly perspectives and experiences of innovative judging best practice, with a view to strengthening and improving the judicial processes in Christchurch. This Annual Meeting of the Law and Society Association in New Orleans is a particularly appropriate forum for this paper, given the recent ten year anniversary of Hurricane Katrina and the plenary session theme of “Natural and Unnatural Disasters – human crises and law’s response.” The presenter has a personal connection with this theme, as she was a Fulbright scholar from New Zealand at New York University in 2005/2006 and participated in the student volunteer cleanup effort in New Orleans following Katrina. http://www.lawandsociety.org/NewOrleans2016/docs/2016_Program.pdf
Many contemporary urban communities are challenged by increased flood risks and rising temperatures, declining water quality and biodiversity, and reduced mental, physical, cultural and social wellbeing. The development of urban blue-green infrastructure (BGI), defined as networks of natural and semi-natural blue-green spaces which enable healthy ecosystem processes, has been identified as one approach to mitigate these challenges and enable more liveable cities. Multiple benefits associated with urban BGI have been identified, including reduced flood risk and temperatures, improved water quality and biodiversity, enhanced mental and physical wellbeing, strengthened social cohesion and sense of place, and the facilitation of cultural connections and practices. However, socio-cultural benefits have tended to be neglected in BGI research and design, resulting in a lack of awareness of how they may be maximised in BGI design. As such, this research sought to understand how BGI can best be designed to enable liveable cities. Four questions were considered: (i) what benefits are associated with urban BGI, (ii) how does the design process influence the benefits achieved by BGI, (iii) what challenges are encountered during BGI design, and (iv) how might the incorporation of communities and Indigenous knowledge into BGI research and design enhance current understandings and applications of urban BGI? To address these questions, a mixed methods case study approach was employed in Ōtautahi Christchurch and Kaiapoi. The four selected case studies were Te Oranga Waikura, Wigram Basin, Te Kuru and the Kaiapoi Honda Forest. The cases are all council owned urban wetlands which were primarily designed or retrofitted to reduce urban flood risks following the Canterbury Earthquake Sequence. To investigate BGI design processes in each case, as well as how communities interact with, value and benefit from these spaces. BGI projects were found to be designed by interdisciplinary design teams driven by stormwater engineers, landscape architects and ecologists which prioritised bio-physical outcomes. Further, community and Indigenous engagement approaches closely resembled consultation, with the exception of Te Kuru which employed a co-design approach between councils and Indigenous and community groups. This co-design approach was found to enhance current understandings and applications of urban BGI, while uncovering multiple socio-cultural values to be incorporated into design, such as access to cultural healing resources, increased community connections to water, and facilitating cultural monitoring methodologies and citizen science initiatives. Communities frequently identified the opportunity to connect with natural environments and enhanced mental and physical wellbeing as key benefits of BGI. Conversely, strengthened social cohesion, sense of place and cultural connections were infrequently identified as benefits, if at all. This finding indicates a disconnect between the bio-physical benefits which drive BGI design and the outcomes which communities value. As such, there is a need for future BGI design to more fully consider and design for socio- cultural outcomes to better enable liveable cities. To better design BGI to enhance urban liveability, this research makes three key contributions. First, there is a need to advance current approaches to transdisciplinary design to better account for the full scope of perspectives and values associated with BGI. Second, there is a need to transition towards relational co-design with Indigenous and community groups and knowledge. Third, it is important to continue to monitor, reflect on and share both positive and negative BGI design experiences to continually improve outcomes. The incorporation of social and cultural researchers, knowledges and perspectives into open and collaborative transdisciplinary design teams is identified as a key method to achieve these opportunities.
This article discusses the use of radio after major earthquakes in Christchurch, New Zealand, in 2010 and 2011. It draws on archival sources to retrospectively research post-quake audiences in the terms people used during and soon after the earthquakes through personal narratives and Twitter. Retrospective narratives of earthquake experiences affirm the value of radio for communicating the scale of disaster and comforting listeners during dislocation from safe home spaces. In the narratives radio is often compared with television, which signifies electricity supply and associated comfort but also visually confirms the city’s destruction. Twitter provides insights into radio use from within the disaster period, but its more global reach facilitates reflection on online and international radio from outside the disaster-affected area. This research demonstrates the value of archival audience research, and finds that the combination of online radio and Twitter enables a new form of participatory disaster spectatorship from afar.
This research examines the connection between accessibility and resilience in post-earthquake Christchurch. This research will provide my community partner with a useful evidence base to help show that increased accessibility does create a more resilient environment. This research uses an in-depth literature review along with qualitative interview approach discussing current levels of accessibility and resilience in Christchurch and whether or not the interview participants believe that increased accessibility in Christchurch will make our city more resilient to future disasters. This research is important because it helps to bridge the connection between accessibility and resilience by showing how accessibility is an important aspect of making a city resilient. In Christchurch specifically, it is a great time to create an accessible and inclusive environment in the post-earthquake rebuild state the city is currently in. Showing that an accessible environment will lead to a more resilient city is important will potentially lead to accessible design being included in the rebuild of places and spaces in Christchurch. In theory, the results of this research show that having an accessible environment leads to universal inclusiveness which in turn, leads to a resilient city. An overarching theme that arose during this research is that accessibility is a means to inclusion and without inclusion a society cannot be resilient. In practice, the results show that for Christchurch to become more accessible and inclusive for people with disabilities, there needs to not only be an increase the accessibility of places and spaces but accessibility to the community as well. Having accessible infrastructure and communities will lead to increased social and urban resilience, especially for individuals with disabilities. This research is beneficial because it helps to bridge the connection between accessibility and resilience. Resilience is important because it help cities prepare for, respond to and recover from disasters and this research helps to show that accessibility is an important part of creating resilience. Some questions still remain unresolved mainly looking into normalising accessibility and deciphering how to prove that accessibility is an issue that effects everybody, not just individuals with disabilities.
This research examines the connection between accessibility and resilience in post-earthquake Christchurch. This research will provide my community partner with a useful evidence base to help show that increased accessibility does create a more resilient environment. This research uses an in-depth literature review along with qualitative interview approach discussing current levels of accessibility and resilience in Christchurch and whether or not the interview participants believe that increased accessibility in Christchurch will make our city more resilient to future disasters. This research is important because it helps to bridge the connection between accessibility and resilience by showing how accessibility is an important aspect of making a city resilient. In Christchurch specifically, it is a great time to create an accessible and inclusive environment in the post-earthquake rebuild state the city is currently in. Showing that an accessible environment will lead to a more resilient city is important will potentially lead to accessible design being included in the rebuild of places and spaces in Christchurch. In theory, the results of this research show that having an accessible environment leads to universal inclusiveness which in turn, leads to a resilient city. An overarching theme that arose during this research is that accessibility is a means to inclusion and without inclusion a society cannot be resilient. In practice, the results show that for Christchurch to become more accessible and inclusive for people with disabilities, there needs to not only be an increase the accessibility of places and spaces but accessibility to the community as well. Having accessible infrastructure and communities will lead to increased social and urban resilience, especially for individuals with disabilities. This research is beneficial because it helps to bridge the connection between accessibility and resilience. Resilience is important because it help cities prepare for, respond to and recover from disasters and this research helps to show that accessibility is an important part of creating resilience. Some questions still remain unresolved mainly looking into normalising accessibility and deciphering how to prove that accessibility is an issue that effects everybody, not just individuals with disabilities.
Research on responses to trauma has historically focused on the negative repercussions of a struggle with adversity. However, more recently, researchers have begun to examine posttraumatic growth: the positive psychological change that emerges from the struggle with a potentially traumatic event. Associations have been found between posttraumatic growth and greater peritraumatic distress, greater objective severity of trauma exposure, greater perceived stressfulness of events, social support, female gender, cognitive and behavioural responses to trauma, and personality measures. Posttraumatic growth has been measured typically in individuals with varying levels of posttraumatic stress disorder symptoms and other psychological difficulties, such as depression and anxiety. Although some theory and research posits that higher resilience would prohibit posttraumatic growth, no studies have examined posttraumatic growth in a resilient sample. The Canterbury earthquake sequence of 2010 and 2011 involved potentially traumatic events that saw the community struggle with a variety of challenges. However, in the midst of earthquake destruction, some positive initiatives emerged, driven by locals. The Gap Filler project (using city spaces left empty from fallen buildings for art and interactive community projects) and the Student Volunteer Army (groups of volunteers coordinated to help others in need) are examples of this. In this context, it seemed likely that posttraumatic growth was occurring and might be seen in individuals who were coping well with challenges. Culture is theorised to influence the posttraumatic growth process (Calhoun, Cann, & Tedeschi, 2010), and the nature of the trauma undergone is also likely to influence the process of growth. The current thesis measures posttraumatic growth quantitatively and qualitatively in a New Zealand sample. It measures and describes posttraumatic growth in a resilient population after the earthquake sequence of 2010 and 2011 in Canterbury, New Zealand. Findings are used to test current models of posttraumatic growth for individuals coping well after trauma and to elaborate on mechanisms proposed by models such as the comprehensive model of posttraumatic growth (Calhoun et al., 2010) and the organismic valuing theory of growth through adversity (Joseph & Linley, 2005). Correlates of posttraumatic growth are examined and likely supporting factors of posttraumatic growth are identified for this population. Study 1 used quantitative analysis to explore correlates of posttraumatic growth and found that greater posttraumatic growth related to greater peritraumatic distress, greater perceived stressfulness of earthquake events, greater objective stressfulness of earthquake events, greater difficulty with stressful life events, less satisfaction with social support, and female gender. Findings from Study 1 give important detail about the nature of distress included in the comprehensive model of posttraumatic growth (Calhoun et al., 2010) for this population. Levels of posttraumatic growth were lower than those in North American studies but similar to those in a Chinese study. The current sample, however, showed lower endorsement of Relating to Others than the Chinese study, perhaps because of cultural differences. Study 2 used qualitative analysis to examine the experience of posttraumatic growth in the sample. The theme of ‘a greater sense of community’ was found and adds to the comprehensive model of posttraumatic growth, in that an expression of posttraumatic growth (a greater connection with others) can inform ongoing social processing in the posttraumatic growth process. Having a formal or informal role in earthquake recovery appeared to influence self-concept and reflection; this elaborates on the influence of role on reflection in Calhoun et al.’s model. Findings illustrate possible mechanisms of the organismic valuing process theorised by Joseph and Linley (2005). Implications include the importance of providing opportunities for individuals to take on a role after a crisis, encouraging them to act to respond to difficulties, and encouraging them to meet personal needs for relatedness, competence, and autonomy. Finding positive aspects to a difficult situation, as well as acknowledging adversity, can be supported in future to help individuals process their traumas. As a society, we can help individuals cope with adversity by providing ways they can meet their needs for relatedness, competence, and autonomy. Community groups likely provide opportunities for members to act in ways that meet such needs. This will allow them to effectively act to meet their needs in times of crisis.
Collective identity construction in organisations engaged in an inter-organisational collaboration (IOC), especially temporary IOCs set up in disaster situations, has received scant attention in the organisational studies literature yet collective identity is considered to be important in fostering effective IOC operations. This doctoral study was designed to add to our understanding about how collective identity is constituted throughout the entire lifespan of a particular temporary coopetitive (i.e., simultaneously collaborative and competitive) IOC formed in a post-disaster environment. To achieve this purpose, a qualitative case study of the Stronger Christchurch Infrastructure Rebuild Team (SCIRT), a time-bound coopetition formed to repair the horizontal infrastructure in Christchurch, New Zealand after the devastating 2011 Canterbury earthquakes, was undertaken. Using data from semi-structured interviews, field observations, and organisational documents and other artefacts, an inductive analytic method was employed to explore how internal stakeholders engaged with and co- constructed a collective SCIRT identity and reconciled this with their home organization identity. The analysis revealed that the SCIRT collective identity was an ongoing process, involving the interweaving of social, temporal, material and geospatial dimensions constructed through intersecting cycles of senior managers’ sensegiving and employees’ sensemaking across SCIRT’s five and a half years of existence. Senior management deliberately undertook identity work campaigns that used organisational rituals, artefacts, and spatial design to disseminate and encourage a sense of “we are all SCIRT”. However, there was no common sense of “we-ness”. Identification with SCIRT was experienced differently among different groups of employees and across time. Employees’ differing senses of collective identity were accounted for by their past, present, and anticipated future relationships with their home organisation, and also (re)shaped by the geosocial environments in which they worked. The study supports previous research claiming that collective identity is a process of recursive sensegiving and sensemaking between senior managers and employees. However, it extends the literature by revealing the imbricated nature of collective identity, how members’ sense of “who we are” can change across the entire lifetime of a temporary IOC, and how sociomateriality, temporality, and geosocial effects strongly intervene in employees’ emerging senses of collective identity. Moreover, the study demonstrates how the ongoing identity work can be embedded in a time-space frame that further accentuates the influence of temporality, especially the anticipated future, organisational rituals, artefacts, and the geosocial environment. The study’s primary contribution to theory is a processual model of collective identity that applies specifically to a temporary IOC involving coopetition. In doing so, it represents a more finely nuanced and situational model than existing models. At a practical level, this model suggests that managers need to appreciate that organisational artefacts, rituals, and the prevailing organisational geosocial environment are inextricably linked in processes that can be manipulated to enhance the construction of collective identity.
The Canterbury earthquake sequence (2010-2011) was the most devastating catastrophe in New Zealand‘s modern history. Fortunately, in 2011 New Zealand had a high insurance penetration ratio, with more than 95% of residences being insured for these earthquakes. This dissertation sheds light on the functions of disaster insurance schemes and their role in economic recovery post-earthquakes. The first chapter describes the demand and supply for earthquake insurance and provides insights about different public-private partnership earthquake insurance schemes around the world. In the second chapter, we concentrate on three public earthquake insurance schemes in California, Japan, and New Zealand. The chapter examines what would have been the outcome had the system of insurance in Christchurch been different in the aftermath of the Canterbury earthquake sequence (CES). We focus on the California Earthquake Authority insurance program, and the Japanese Earthquake Reinsurance scheme. Overall, the aggregate cost of the earthquake to the New Zealand public insurer (the Earthquake Commission) was USD 6.2 billion. If a similar-sized disaster event had occurred in Japan and California, homeowners would have received only around USD 1.6 billion and USD 0.7 billion from the Japanese and Californian schemes, respectively. We further describe the spatial and distributive aspects of these scenarios and discuss some of the policy questions that emerge from this comparison. The third chapter measures the longer-term effect of the CES on the local economy, using night-time light intensity measured from space, and focus on the role of insurance payments for damaged residential property during the local recovery process. Uniquely for this event, more than 95% of residential housing units were covered by insurance and almost all incurred some damage. However, insurance payments were staggered over 5 years, enabling us to identify their local impact. We find that night-time luminosity can capture the process of recovery; and that insurance payments contributed significantly to the process of local economic recovery after the earthquake. Yet, delayed payments were less affective in assisting recovery and cash settlement of claims were more effective than insurance-managed repairs. After the Christchurch earthquakes, the government declared about 8000 houses as Red Zoned, prohibiting further developments in these properties, and offering the owners to buy them out. The government provided two options for owners: the first was full payment for both land and dwelling at the 2007 property evaluation, the second was payment for land, and the rest to be paid by the owner‘s insurance. Most people chose the second option. Using data from LINZ combined with data from Stats NZ, the fourth chapter empirically investigates what led people to choose this second option, and how peer effect influenced the homeowners‘ choices. Due to climate change, public disclosure of coastal hazard information through maps and property reports have been used more frequently by local government. This is expected to raise awareness about disaster risks in local community and help potential property owners to make informed locational decision. However, media outlets and business sector argue that public hazard disclosure will cause a negative effect on property value. Despite this opposition, some district councils in New Zealand have attempted to implement improved disclosure. Kapiti Coast district in the Wellington region serves as a case study for this research. In the fifth chapter, we utilize the residential property sale data and coastal hazard maps from the local district council. This study employs a difference-in-difference hedonic property price approach to examine the effect of hazard disclosure on coastal property values. We also apply spatial hedonic regression methods, controlling for coastal amenities, as our robustness check. Our findings suggest that hazard designation has a statistically and economically insignificant impact on property values. Overall, the risk perception about coastal hazards should be more emphasized in communities.
Natural hazard disasters often have large area-wide impacts, which can cause adverse stress-related mental health outcomes in exposed populations. As a result, increased treatment-seeking may be observed, which puts a strain on the limited public health care resources particularly in the aftermath of a disaster. It is therefore important for public health care planners to know whom to target, but also where and when to initiate intervention programs that promote emotional wellbeing and prevent the development of mental disorders after catastrophic events. A large body of literature assesses factors that predict and mitigate disaster-related mental disorders at various time periods, but the spatial component has rarely been investigated in disaster mental health research. This thesis uses spatial and spatio-temporal analysis techniques to examine when and where higher and lower than expected mood and anxiety symptom treatments occurred in the severely affected Christchurch urban area (New Zealand) after the 2010/11 Canterbury earthquakes. High-risk groups are identified and a possible relationship between exposure to the earthquakes and their physical impacts and mood and anxiety symptom treatments is assessed. The main research aim is to test the hypothesis that more severely affected Christchurch residents were more likely to show mood and anxiety symptoms when seeking treatment than less affected ones, in essence, testing for a dose-response relationship. The data consisted of mood and anxiety symptom treatment information from the New Zealand Ministry of Health’s administrative databases and demographic information from the National Health Index (NHI) register, when combined built a unique and rich source for identifying publically funded stress-related treatments for mood and anxiety symptoms in almost the whole population of the study area. The Christchurch urban area within the Christchurch City Council (CCC) boundary was the area of interest in which spatial variations in these treatments were assessed. Spatial and spatio-temporal analyses were done by applying retrospective space-time and spatial variation in temporal trends analysis using SaTScan™ software, and Bayesian hierarchical modelling techniques for disease mapping using WinBUGS software. The thesis identified an overall earthquake-exposure effect on mood and anxiety symptom treatments among Christchurch residents in the context of the earthquakes as they experienced stronger increases in the risk of being treated especially shortly after the catastrophic 2011 Christchurch earthquake compared to the rest of New Zealand. High-risk groups included females, elderly, children and those with a pre-existing mental illness with elderly and children especially at-risk in the context of the earthquakes. Looking at the spatio-temporal distribution of mood and anxiety symptom treatments in the Christchurch urban area, a high rates cluster ranging from the severely affected central city to the southeast was found post-disaster. Analysing residential exposure to various earthquake impacts found that living in closer proximity to more affected areas was identified as a risk factor for mood and anxiety symptom treatments, which largely confirms a dose-response relationship between level of affectedness and mood and anxiety symptom treatments. However, little changes in the spatial distribution of mood and anxiety symptom treatments occurred in the Christchurch urban area over time indicating that these results may have been biased by pre-existing spatial disparities. Additionally, the post-disaster mobility activity from severely affected eastern to the generally less affected western and northern parts of the city seemed to have played an important role as the strongest increases in treatment rates occurred in less affected northern areas of the city, whereas the severely affected eastern areas tended to show the lowest increases. An investigation into the different effects of mobility confirmed that within-city movers and temporary relocatees were generally more likely to receive care or treatment for mood or anxiety symptoms, but moving within the city was identified as a protective factor over time. In contrast, moving out of the city from minor, moderately or severely damaged plain areas of the city, which are generally less affluent than Port Hills areas, was identified as a risk factor in the second year post-disaster. Moreover, residents from less damaged plain areas of the city showed a decrease in the likelihood of receiving care or treatment for mood or anxiety symptoms compared to those from undamaged plain areas over time, which also contradicts a possible dose-response relationship. Finally, the effects of the social and physical environment, as well as community resilience on mood and anxiety symptom treatments among long-term stayers from Christchurch communities indicate an exacerbation of pre-existing mood and anxiety symptom treatment disparities in the city, whereas exposure to ‘felt’ earthquake intensities did not show a statistically significant effect. The findings of this thesis highlight the complex relationship between different levels of exposure to a severe natural disaster and adverse mental health outcomes in a severely affected region. It is one of the few studies that have access to area-wide health and impact information, are able to do a pre-disaster / post-disaster comparison and track their sample population to apply spatial and spatio-temporal analysis techniques for exposure assessment. Thus, this thesis enhances knowledge about the spatio-temporal distribution of adverse mental health outcomes in the context of a severe natural disaster and informs public health care planners, not only about high-risk groups, but also where and when to target health interventions. The results indicate that such programs should broadly target residents living in more affected areas as they are likely to face daily hardship by living in a disrupted environment and may have already been the most vulnerable ones before the disaster. Special attention should be focussed on women, elderly, children and people with pre-existing mental illnesses as they are most likely to receive care or treatment for stress-related mental health symptoms. Moreover, permanent relocatees from affected areas and temporarily relocatees shortly after the disaster may need special attention as they face additional stressors due to the relocation that may lead to the development of adverse mental health outcomes needing treatment.
