Background: We are in a period of history where natural disasters are increasing in both frequency and severity. They are having widespread impacts on communities, especially on vulnerable communities, those most affected who have the least ability to prepare or respond to a disaster. The ability to assemble and effectively manage Interagency Emergency Response Teams (IERTs) is critical to navigating the complexity and chaos found immediately following disasters. These teams play a crucial role in the multi-sectoral, multi-agency, multi-disciplinary, and inter-organisational response and are vital to ensuring the safety and well-being of vulnerable populations such as the young, aged, and socially and medically disadvantaged in disasters. Communication is key to the smooth operation of these teams. Most studies of the communication in IERTs during a disaster have been focussed at a macro-level of examining larger scale patterns and trends within organisations. Rarely found are micro-level analyses of interpersonal communication at the critical interfaces between collaborating agencies. This study set out to understand the experiences of those working at the interagency interfaces in an IERT set up by the Canterbury District Health Board to respond to the needs of the vulnerable people in the aftermath of the destructive earthquakes that hit Canterbury, New Zealand, in 2010-11. The aim of the study was to gain insights about the complexities of interpersonal communication (micro-level) involved in interagency response coordination and to generate an improved understanding into what stabilises the interagency communication interfaces between those agencies responding to a major disaster. Methods: A qualitative case study research design was employed to investigate how interagency communication interfaces were stabilised at the micro-level (“the case”) in the aftermath of the destructive earthquakes that hit Canterbury in 2010-11 (“the context”). Participant recruitment was undertaken by mapping which agencies were involved within the IERT and approaching representatives from each of these agencies. Data was collected via individual interviews using a semi-structured interview guide and was based on the “Critical Incident Technique”. Subsequently, data was transcribed verbatim and subjected to inductive analysis. This was underpinned theoretically by Weick’s “Interpretive Approach” and supported by Nvivo qualitative data analysis software. Results: 19 participants were interviewed in this study. Out of the inductive analysis emerged two primary themes, each with several sub-factors. The first major theme was destabilising/disruptive factors of interagency communication with five sub-factors, a) conflicting role mandates, b) rigid command structures, c) disruption of established communication structures, d) lack of shared language and understanding, and e) situational awareness disruption. The second major theme stabilising/steadying factors in interagency communication had four sub-factors, a) the establishment of the IERT, b) emergent novel communication strategies, c) establishment of a liaison role and d) pre-existing networks and relationships. Finally, there was a third sub-level identified during inductive analysis, where sub-factors from both primary themes were noted to be uniquely interconnected by emergent “consequences” arising out of the disaster context. Finally, findings were synthesised into a conceptual “Model of Interagency Communication at the Micro-level” based on this case study of the Canterbury earthquake disaster response. Discussion: The three key dimensions of The People, The Connections and The Improvisations served as a framework for the discussion of what stabilises interagency communication interfaces in a major disaster. The People were key to stabilising the interagency interfaces through functioning as a flexible conduit, guiding and navigating communication at the interagency interfaces and improving situational awareness. The Connections provided the collective competence, shared decision-making and prior established relationships that stabilised the micro-level communication at interagency interfaces. And finally, The Improvisations i.e., novel ideas and inventiveness that emerge out of rapidly changing post-disaster environments, also contributed to stabilisation of micro-level communication flows across interagency interfaces in the disaster response. “Command and control” hierarchical structures do provide clear processes and structures for teams working in disasters to follow. However, improvisations and novel solutions are also needed and often emerge from first responders (who are best placed to assess the evolving needs in a disaster where there is a high degree of uncertainty). Conclusion: This study highlights the value of incorporating an interface perspective into any study that seeks to understand the processes of IERTs during disaster responses. It also strengthens the requirement for disaster management frameworks to formally plan for and to allow for the adaptive responsiveness of local teams on the ground, and legitimise and recognise the improvisations of those in the role of emergent boundary spanners in a disaster response. This needs to be in addition to existing formal disaster response mechanisms. This study provides a new conceptual model that can be used to guide future case studies exploring stability at the interfaces of other IERTs and highlights the centrality of communication in the experiences of members of teams in the aftermath of a disaster. Utilising these new perspectives on stabilising communication at the interagency interfaces in disaster responses will have practical implications in the future to better serve the needs of vulnerable people who are at greatest risk of adverse outcomes in a disaster.
Following the 22nd February 2011, Mw 6.2 earthquake located along a previously unknown fault beneath the Port Hills of Christchurch, surface cracking was identified in contour parallel locations within fill material at Quarry Road on the lower slopes of Mount Pleasant. GNS Science, in the role of advisor to the Christchurch City Council, concluded that these cracks were a part of a potential rotational mass movement (named zone 11A) within the fill and airfall loess material present. However, a lack of field evidence for slope instability and an absence of laboratory geotechnical data on which slope stability analysis was based, suggested this conclusion is potentially incorrect. It was hypothesised that ground cracking was in fact due to earthquake shaking, and not mass movement within the slope, thus forming the basis of this study. Three soil units were identified during surface and subsurface investigations at Quarry Road: fill derived from quarry operations in the adjacent St. Andrews Quarry (between 1893 and 1913), a buried topsoil, and underlying in-situ airfall loess. The fill material was identified by the presence of organic-rich topsoil “clods” that were irregular in both size (∼10 – 200 mm) and shape, with variable thicknesses of 1 – 10 m. Maximum thickness, as indicated by drill holes and geophysical survey lines, was identified below 6 Quarry Road and 7 The Brae where it is thought to infill a pre-existing gully formed in the underlying airfall loess. Bearing strength of the fill consistently exceeded 300 kPa ultimate below ∼500 mm depth. The buried topsoil was 200 – 300 mm thick, and normally displayed a lower bearing strength when encountered, but not below 300 kPa ultimate (3 – 11 blows per 100mm or ≥100 kPa allowable). In-situ airfall loess stood vertically in outcrop due to its characteristic high dry strength and also showed Scala penetrometer values of 6 – 20+ blows per 100 mm (450 – ≥1000 kPa ultimate). All soils were described as being moist to dry during subsurface investigations, with no groundwater table identified during any investigation into volcanic bedrock. In-situ moisture contents were established using bulk disturbed samples from hand augers and test pitting. Average moisture contents were low at 9% within the fill, 11 % within the buried topsoil, and 8% within the airfall loess: all were below the associated average plastic limit of 17, 15, and 16, respectively, determined during Atterberg limit analysis. Particle size distributions, identified using the sieve and pipette method, were similar between the three soil units with 11 – 20 % clay, 62 – 78 % silt, and 11 – 20 % fine sand. Using these results and the NZGS soil classification, the loess derived fill and in-situ airfall loess are termed SILT with some clay and sand, and the buried topsoil is SILT with minor clay and sand. Dispersivity of the units was found using the Emerson crumb test, which established that the fill can be non- to completely dispersive (score 0 – 4). The buried topsoil was always non-dispersive (score 0), and airfall loess completely dispersive (score 4). Values for cohesion (c) and internal friction angle (φ) of the three soil units were established using the direct shear box at field moisture contents. Results showed all soil units had high shear strengths at the moisture contents tested (c = 18 – 24 kPa and φ = 42 – 50°), with samples behaving in a brittle fashion. Moisture content was artificially increased to 16% within the buried topsoil, which reduced the shear strength (c = 10 kPa, φ = 18°) and allowed it to behave plastically. Observational information indicating stability at Quarry Road included: shallow, discontinuous, cracks that do not display vertical offset; no scarp features or compressional zones typical of landsliding; no tilted or deformed structures; no movement in inclinometers; no basal shear zone identified in logged core to 20 m depth; low field moisture contents; no groundwater table; and high soil strength using Scala penetrometers. Limit equilibrium analysis of the slope was conducted using Rocscience software Slide 5.0 to verify the slope stability identified by observational methods. Friction, cohesion, and density values determined during laboratory were input into the two slope models investigated. Results gave minimum static factor of safety values for translational (along buried topsoil) and rotational (in the fill) slides of 2.4 – 4.2. Sensitivity of the slope to reduced shear strength parameters was analysed using c = 10 kPa and φ = 18° for the translational buried topsoil plane, and a cohesion of 0 kPa within the fill for the rotational plane. The only situation that gave a factor of safety <1.0 was in nonengineered fill at 0.5 m depth. Pseudostatic analysis based on previous peak ground acceleration (PGA) values for the Canterbury Earthquake Sequence, and predicted PGAs for future Alpine Fault and Hope Fault earthquakes established minimum factor of safety values between 1.2 and 3.3. Yield acceleration PGAs were computed to be between 0.8g and 1.6g. Based on all information gathered, the cracking at Quarry Road is considered to be shallow deformation in response to earthquake shaking, and not due to deep-seated landsliding. It is recommended that the currently bare site be managed by smoothing the land, installing contour drainage, and bioremediation of the surface soils to reduce surface water infiltration and runoff. Extensive earthworks, including removal of the fill, are considered unnecessary. Any future replacement of housing would be subject to site-specific investigations, and careful foundation design based on those results.
In the last century, seismic design has undergone significant advancements. Starting from the initial concept of designing structures to perform elastically during an earthquake, the modern seismic design philosophy allows structures to respond to ground excitations in an inelastic manner, thereby allowing damage in earthquakes that are significantly less intense than the largest possible ground motion at the site of the structure. Current performance-based multi-objective seismic design methods aim to ensure life-safety in large and rare earthquakes, and to limit structural damage in frequent and moderate earthquakes. As a result, not many recently built buildings have collapsed and very few people have been killed in 21st century buildings even in large earthquakes. Nevertheless, the financial losses to the community arising from damage and downtime in these earthquakes have been unacceptably high (for example; reported to be in excess of 40 billion dollars in the recent Canterbury earthquakes). In the aftermath of the huge financial losses incurred in recent earthquakes, public has unabashedly shown their dissatisfaction over the seismic performance of the built infrastructure. As the current capacity design based seismic design approach relies on inelastic response (i.e. ductility) in pre-identified plastic hinges, it encourages structures to damage (and inadvertently to incur loss in the form of repair and downtime). It has now been widely accepted that while designing ductile structural systems according to the modern seismic design concept can largely ensure life-safety during earthquakes, this also causes buildings to undergo substantial damage (and significant financial loss) in moderate earthquakes. In a quest to match the seismic design objectives with public expectations, researchers are exploring how financial loss can be brought into the decision making process of seismic design. This has facilitated conceptual development of loss optimisation seismic design (LOSD), which involves estimating likely financial losses in design level earthquakes and comparing against acceptable levels of loss to make design decisions (Dhakal 2010a). Adoption of loss based approach in seismic design standards will be a big paradigm shift in earthquake engineering, but it is still a long term dream as the quantification of the interrelationships between earthquake intensity, engineering demand parameters, damage measures, and different forms of losses for different types of buildings (and more importantly the simplification of the interrelationship into design friendly forms) will require a long time. Dissecting the cost of modern buildings suggests that the structural components constitute only a minor portion of the total building cost (Taghavi and Miranda 2003). Moreover, recent research on seismic loss assessment has shown that the damage to non-structural elements and building contents contribute dominantly to the total building loss (Bradley et. al. 2009). In an earthquake, buildings can incur losses of three different forms (damage, downtime, and death/injury commonly referred as 3Ds); but all three forms of seismic loss can be expressed in terms of dollars. It is also obvious that the latter two loss forms (i.e. downtime and death/injury) are related to the extent of damage; which, in a building, will not just be constrained to the load bearing (i.e. structural) elements. As observed in recent earthquakes, even the secondary building components (such as ceilings, partitions, facades, windows parapets, chimneys, canopies) and contents can undergo substantial damage, which can lead to all three forms of loss (Dhakal 2010b). Hence, if financial losses are to be minimised during earthquakes, not only the structural systems, but also the non-structural elements (such as partitions, ceilings, glazing, windows etc.) should be designed for earthquake resistance, and valuable contents should be protected against damage during earthquakes. Several innovative building technologies have been (and are being) developed to reduce building damage during earthquakes (Buchanan et. al. 2011). Most of these developments are aimed at reducing damage to the buildings’ structural systems without due attention to their effects on non-structural systems and building contents. For example, the PRESSS system or Damage Avoidance Design concept aims to enable a building’s structural system to meet the required displacement demand by rocking without the structural elements having to deform inelastically; thereby avoiding damage to these elements. However, as this concept does not necessarily reduce the interstory drift or floor acceleration demands, the damage to non-structural elements and contents can still be high. Similarly, the concept of externally bracing/damping building frames reduces the drift demand (and consequently reduces the structural damage and drift sensitive non-structural damage). Nevertheless, the acceleration sensitive non-structural elements and contents will still be very vulnerable to damage as the floor accelerations are not reduced (arguably increased). Therefore, these concepts may not be able to substantially reduce the total financial losses in all types of buildings. Among the emerging building technologies, base isolation looks very promising as it seems to reduce both inter-storey drifts and floor accelerations, thereby reducing the damage to the structural/non-structural components of a building and its contents. Undoubtedly, a base isolated building will incur substantially reduced loss of all three forms (dollars, downtime, death/injury), even during severe earthquakes. However, base isolating a building or applying any other beneficial technology may incur additional initial costs. In order to provide incentives for builders/owners to adopt these loss-minimising technologies, real-estate and insurance industries will have to acknowledge the reduced risk posed by (and enhanced resilience of) such buildings in setting their rental/sale prices and insurance premiums.
In major seismic events, a number of plan-asymmetric buildings which experienced element failure or structural collapse had twisted significantly about their vertical axis during the earthquake shaking. This twist, known as “building torsion”, results in greater demands on one side of a structure than on the other side. The Canterbury Earthquakes Royal Commission’s reports describe the response of a number of buildings in the February 2011 Christchurch earthquakes. As a result of the catastrophic collapse of one multi-storey building with significant torsional irregularity, and significant torsional effects also in other buildings, the Royal Commission recommended that further studies be undertaken to develop improved simple and effective guides to consider torsional effects in buildings which respond inelastically during earthquake shaking. Separately from this, as building owners, the government, and other stakeholders, are planning for possible earthquake scenarios, they need good estimates of the likely performance of both new and existing buildings. These estimates, often made using performance based earthquake engineering considerations and loss estimation techniques, inform decision making. Since all buildings may experience torsion to some extent, and torsional effects can influence demands on building structural and non-structural elements, it is crucial that demand estimates consider torsion. Building seismic response considering torsion can be evaluated with nonlinear time history analysis. However, such analysis involves significant computational effort, expertise and cost. Therefore, from an engineers’ point of view, simpler analysis methods, with reasonable accuracy, are beneficial. The consideration of torsion in simple analysis methods has been investigated by many researchers. However, many studies are theoretical without direct relevance to structural design/assessment. Some existing methods also have limited applicability, or they are difficult to use in routine design office practice. In addition, there has been no consensus about which method is best. As a result, there is a notable lack of recommendations in current building design codes for torsion of buildings that respond inelastically. There is a need for building torsion to be considered in yielding structures, and for simple guidance to be developed and adopted into building design standards. This study aims to undertaken to address this need for plan-asymmetric structures which are regular over their height. Time history analyses are first conducted to quantify the effects of building plan irregularity, that lead to torsional response, on the seismic response of building structures. Effects of some key structural and ground motion characteristics (e.g. hysteretic model, ground motion duration, etc.) are considered. Mass eccentricity is found to result in rather smaller torsional response compared to stiffness/strength eccentricity. Mass rotational inertia generally decreases the torsional response; however, the trend is not clearly defined for torsionally restrained systems (i.e. large λty). Systems with EPP and bilinear models have close displacements and systems with Takeda, SINA, and flag-shaped models yield almost the same displacements. Damping has no specific effect on the torsional response for the single-storey systems with the unidirectional eccentricity and excitation. Displacements of the single-storey systems subject to long duration ground motion records are smaller than those for short duration records. A method to consider torsional response of ductile building structures under earthquake shaking is then developed based on structural dynamics for a wide range of structural systems and configurations, including those with low and high torsional restraint. The method is then simplified for use in engineering practice. A novel method is also proposed to simply account for the effects of strength eccentricity on response of highly inelastic systems. A comparison of the accuracy of some existing methods (including code-base equivalent static method and model response spectrum analysis method), and the proposed method, is conducted for single-storey structures. It is shown that the proposed method generally provides better accuracy over a wide range of parameters. In general, the equivalent static method is not adequate in capturing the torsional effects and the elastic modal response spectrum analysis method is generally adequate for some common parameters. Record-to-record variation in maximum displacement demand on the structures with different degrees of torsional response is considered in a simple way. Bidirectional torsional response is then considered. Bidirectional eccentricity and excitation has varying effects on the torsional response; however, it generally increases the weak and strong edges displacements. The proposed method is then generalized to consider the bidirectional torsion due to bidirectional stiffness/strength eccentricity and bidirectional seismic excitation. The method is shown to predict displacements conservatively; however, the conservatism decreases slightly for cases with bidirectional excitation compared to those subject to unidirectional excitation. In is shown that the roof displacement of multi-storey structures with torsional response can be predicted by considering the first mode of vibration. The method is then further generalized to estimate torsional effects on multi-storey structure displacement demands. The proposed procedure is tested multi-storey structures and shown to predict the displacements with a good accuracy and conservatively. For buildings which twist in plan during earthquake shaking, the effect of P-Δλ action is evaluated and recommendations for design are made. P-Δλ has more significant effects on systems with small post- yield stiffness. Therefore, system stability coefficient is shown not to be the best indicator of the importance of P-Δλ and it is recommended to use post-yield stiffness of system computed with allowance for P-Δλ effects. For systems with torsional response, the global system stability coefficient and post- yield stiffness ration do not reflect the significance of P-Δλ effects properly. Therefore, for torsional systems individual seismic force resisting systems should be considered. Accuracy of MRSA is investigated and it is found that the MRSA is not always conservative for estimating the centre of mass and strong edge displacements as well as displacements of ductile systems with strength eccentricity larger than stiffness eccentricity. Some modifications are proposed to get the MRSA yields a conservative estimation of displacement demands for all cases.
Geosynthetic reinforced soil (GRS) walls involve the use of geosynthetic reinforcement (polymer material) within the retained backfill, forming a reinforced soil block where transmission of overturning and sliding forces on the wall to the backfill occurs. Key advantages of GRS systems include the reduced need for large foundations, cost reduction (up to 50%), lower environmental costs, faster construction and significantly improved seismic performance as observed in previous earthquakes. Design methods in New Zealand have not been well established and as a result, GRS structures do not have a uniform level of seismic and static resistance; hence involve different risks of failure. Further research is required to better understand the seismic behaviour of GRS structures to advance design practices. The experimental study of this research involved a series of twelve 1-g shake table tests on reduced-scale (1:5) GRS wall models using the University of Canterbury shake-table. The seismic excitation of the models was unidirectional sinusoidal input motion with a predominant frequency of 5Hz and 10s duration. Seismic excitation of the model commenced at an acceleration amplitude level of 0.1g and was incrementally increased by 0.1g in subsequent excitation levels up to failure (excessive displacement of the wall panel). The wall models were 900mm high with a full-height rigid facing panel and five layers of Microgird reinforcement (reinforcement spacing of 150mm). The wall panel toe was founded on a rigid foundation and was free to slide. The backfill deposit was constructed from dry Albany sand to a backfill relative density, Dr = 85% or 50% through model vibration. The influence of GRS wall parameters such as reinforcement length and layout, backfill density and application of a 3kPa surcharge on the backfill surface was investigated in the testing sequence. Through extensive instrumentation of the wall models, the wall facing displacements, backfill accelerations, earth pressures and reinforcement loads were recorded at the varying levels of model excitation. Additionally, backfill deformation was also measured through high-speed imaging and Geotechnical Particle Image Velocimetry (GeoPIV) analysis. The GeoPIV analysis enabled the identification of the evolution of shear strains and volumetric strains within the backfill at low strain levels before failure of the wall thus allowing interpretations to be made regarding the strain development and shear band progression within the retained backfill. Rotation about the wall toe was the predominant failure mechanism in all excitation level with sliding only significant in the last two excitation levels, resulting in a bi-linear displacement acceleration curve. An increase in acceleration amplification with increasing excitation was observed with amplification factors of up to 1.5 recorded. Maximum seismic and static horizontal earth pressures were recorded at failure and were recorded at the wall toe. The highest reinforcement load was recorded at the lowest (deepest in the backfill) reinforcement layer with a decrease in peak load observed at failure, possibly due to pullout failure of the reinforcement layer. Conversely, peak reinforcement load was recorded at failure for the top reinforcement layer. The staggered reinforcement models exhibited greater wall stability than the uniform reinforcement models of L/H=0.75. However, similar critical accelerations were determined for the two wall models due to the coarseness of excitation level increments of 0.1g. The extended top reinforcements were found to restrict the rotational component of displacement and prevented the development of a preliminary shear band at the middle reinforcement layer, contributing positively to wall stability. Lower acceleration amplification factors were determined for the longer uniform reinforcement length models due to reduced model deformation. A greater distribution of reinforcement load towards the top two extended reinforcement layers was also observed in the staggered wall models. An increase in model backfill density was observed to result in greater wall stability than an increase in uniform reinforcement length. Greater acceleration amplification was observed in looser backfill models due to their lower model stiffness. Due to greater confinement of the reinforcement layers, greater reinforcement loads were developed in higher density wall models with less wall movement required to engage the reinforcement layers and mobilise their resistance. The application of surcharge on the backfill was observed to initially increase the wall stability due to greater normal stresses within the backfill but at greater excitation levels, the surcharge contribution to wall destabilising inertial forces outweighs its contribution to wall stability. As a result, no clear influence of surcharge on the critical acceleration of the wall models was observed. Lower acceleration amplification factors were observed for the surcharged models as the surcharge acts as a damper during excitation. The application of the surcharge also increases the magnitude of reinforcement load developed due to greater confinement and increased wall destabilising forces. The rotation of the wall panel resulted in the progressive development of shears surface with depth that extended from the backfill surface to the ends of the reinforcement (edge of the reinforced soil block). The resultant failure plane would have extended from the backfill surface to the lowest reinforcement layer before developing at the toe of the wall, forming a two-wedge failure mechanism. This is confirmed by development of failure planes at the lowest reinforcement layer (deepest with the backfill) and at the wall toe observed at the critical acceleration level. Key observations of the effect of different wall parameters from the GeoPIV results are found to be in good agreement with conclusions developed from the other forms of instrumentation. Further research is required to achieve the goal of developing seismic guidelines for GRS walls in geotechnical structures in New Zealand. This includes developing and testing wall models with a different facing type (segmental or wrap-around facing), load cell instrumentation of all reinforcement layers, dynamic loading on the wall panel and the use of local soils as the backfill material. Lastly, the limitations of the experimental procedure and wall models should be understood.
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.
