This book is the result of an investigation into the vulnerability of the infrastructure serving metropolitan Christchurch (including Lyttelton). The work was undertaken by the Christchurch Engineering Lifelines Group and the objectives are: to identify the vulnerability of engineering lifeline services to damage from earthquakes, flooding, tsunami and meteorological hazards; to identify practical engineering strategies for reducing the risk or impact of such damage and for providing for reinstatement following such events; and to communicate the issues to people involved in the management of these services and to raise the awareness of the public to their importance.
Interagency Emergency Response Teams (IERTs) play acrucial role in times of disasters. Therefore it is crucial to understand more thoroughly the communication roles and responsibilities of interagency team members and to examine how individual members communicate within a complex, evolving, and unstable environment. It is also important to understand how different organisational identities and their spatial geographies contribute to the interactional dynamics. Earthquakes hit the Canterbury region on September, 2010 and then on February 2011 a more devastating shallow earthquake struck resulting in severe damage to the Aged Residential Care (ARC) sector. Over 600 ARC beds were lost and 500 elderly and disabled people were displaced. Canterbury District Health Board (CDHB) set up an interagency emergency response team to address the issues of vulnerable people with significant health and disability needs who were unable to access their normal supports due to the effects of the earthquake. The purpose of this qualitative interpretive study is to focus on the case study of the response and evacuation of vulnerable people by interagencies responding to the event. Staff within these agencies were interviewed with a focus on the critical incidents that either stabilised or negatively influenced the outcome of the response. The findings included the complexity of navigating multiple agencies communication channels; understanding the different hierarchies and communication methods within each agency; data communication challenges when infrastructures were severely damaged; the importance of having the right skills, personal attributes and understanding of the organisations in the response; and the significance of having a liaison in situ representing and communicating through to agencies geographically dispersed from Canterbury. It is hoped that this research will assist in determining a future framework for interagency communication best practice and policy.
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.
The Canterbury earthquakes of 2010-2012 have been generation shaping. People living and working in and around the city during this time have had their lives and social landscapes changed forever. The earthquake response, recovery and rebuild efforts have highlighted unheralded social strengths and vulnerabilities within individuals, organisations, communities and country writ large. It is imperative that the social sciences stand up to be counted amongst the myriad of academic research, commentary and analysis.
This thesis examines the opportunities for young citizens in Christchurch to be engaged in city planning post-disaster. This qualitative study was conducted eight years after the 2010-2011 earthquakes and employed interviews with 18 young people aged between 12-24 years old, 14 of whom were already actively engaged in volunteering or participating in a youth council. It finds that despite having sought out opportunities for youth leadership and advocacy roles post-disaster, young people report frustration that they are excluded from decision-making and public life. These feelings of exclusion were described by young people as political, physical and social. Young people felt politically excluded from decision-making in the city, with some youth reporting that they did not feel listened to by decision-makers or able to make a difference. Physical exclusion was also experienced by the young people I interviewed, who reported that they felt excluded from their city and neighbourhood. This ranged from feeling unwelcome in certain parts of the city due to perceived social stratification, to actual exclusion from newly privatised areas in a post-quake recovery city. Social exclusion was reported by young people in the study in regard to their sense of marginalisation from the wider community, due to structural and social barriers. Among these, they observed a sense of prejudice towards them and other youth due to their age, class and/or ethnicity. The barriers to their participation and inclusion, and their aspirations for Christchurch post-disaster are discussed, as well as the implications of exclusion for young people’s wellbeing and sense of belonging. Results of this study contribute to the literature that challenges the sole focus on children and young peoples’ vulnerability post-disaster, reinforcing their capacity and desire to contribute to the recovery of their city and community (Peek, 2008). This research also challenges the narrative that young people are politically apathetic (Norris, 2004; Nissen, 2017), and adds to our understandings of the way that disasters can concentrate power amongst certain groups, in this case excluding young people generally from decision-making and public life. I conclude with some recommendations for a more robust post-disaster recovery in Christchurch, in ways that are more inclusive of young people and supportive of their wellbeing.
The affect that the Christchurch Earthquake Sequence(CES) had on Christchurch residents was severe, and the consequences are still being felt today. The Ōtākaro Avon River Corridor (OARC) was particularly impacted, a geographic zone that had over 7,000 homes which needed to be vacated and demolished. The CES demonstrated how disastrous a natural hazard can be on unprepared communities. With the increasing volatility of climate change being felt around the world, considering ways in which communities can reduce their vulnerabilities to natural hazards is vital. This research explores how communities can reduce their vulnerabilities to natural hazards by becoming more adaptable, and in particular the extent to which tiny homes could facilitate the development of adaptive communities. In doing so, three main themes were explored throughout this research: (1) tiny homes, (2) environmental adaptation and (3) community adaptability. To ensure that it is relevant and provides real value to the local community, the research draws upon the local case study of the Riverlution Tiny House Village(RTHV), an innovative community approach to adaptable, affordable, low-impact, sustainable living on margins of land which are no longer suitable for permanent housing. The main findings of the research are that Christchurch is at risk of climate change and natural hazards and it is therefore important to consider ways in which communities can stay intact and connected while adapting to the risks they face. Tiny homes provide an effective way of doing so, as they represent a tangible way that people can take adaptation into their own hands while maintaining a high-quality lifestyle.
Organisations locate strategically within Business Districts (CBDs) in order to cultivate their image, increase their profile, and improve access to customers, suppliers, and services. While CBDs offer an economic benefit to organisations, they also present a unique set of hazard vulnerabilities and planning challenges for businesses. As of May 2012, the Christchurch CBD has been partially cordoned off for over 14 months. Economic activity within the cordoned CBD, which previously contained 6,000 businesses and over 51,000 workers, has been significantly diminished and organisations have been forced to find new ways of operating. The vulnerabilities and resilience of CBDs not only influences outcomes for CBD organisations, but also the broader interconnected (urban/regional/national) system. A CBD is a hub of economic, social, and built infrastructure within a network of links and nodes. When the hub is disrupted all of the people, objects, and transactions that usually flow into and out of the hub must be redirected elsewhere. In an urban situation this means traffic jams in peripheries of the city, increased prices of commercial property, and capital flight; all of which are currently being faced in Canterbury. This report presents the lessons learned from organisations in CBDs affected by the Canterbury earthquakes. Here we focus on the Christchurch CBD; however, several urban town centres were extensively disrupted by the earthquakes. The statistics and discussion presented in this report are based on the results of an ongoing study conducted by Resilient Organisations (www.resorgs.org.nz). The data was captured using two questionnaire surveys of Canterbury organisations (issued November 2010 and May 2011), interviews with key informants, and in-depth case studies of organisations. Several industry sectors were sampled, and geographic samples of organisations in the Christchurch CBD, Lyttelton, and the Kaiapoi town centre were also collected. Results in this report describing “non-CBD organisations” refer to all organisations outside of the Christchurch CBD, Lyttelton, and Kaiapoi town centres.
The purpose of this research is to investigate men’s experiences of the 2016 7.8 magnitude Kaikōura earthquake and Tsunami. While, research into the impacts of the earthquake has been conducted, few studies have examined how gender shaped people’s experiences of this natural hazard event. Analysing disasters through a gender lens has significantly contributed to disaster scholarship in identifying the resilience and vulnerabilities of individuals and communities pre- and post-disaster (Fordham, 2012; Bradshaw, 2013). This research employs understandings of masculinities (Connell, 2005), to examine men’s strengths and challenges in responding, recovering, and coping following the earthquake. Qualitative inquiry was carried out in Northern Canterbury and Marlborough involving 18 face-to-face interviews with men who were impacted by the Kaikōura earthquake and its aftermath. Interview material is being analysed using thematic and narrative analysis. Some of the preliminary findings have shown that men took on voluntary roles in addition to their fulltime paid work resulting in long hours, poor sleep and little time spent with family. Some men assisted wives and children to high ground then drove into the tsunami zone to check on relatives or to help evacuate people. Although analysis of the findings is currently ongoing, preliminary findings have identified that the men who participated in the study have been negatively impacted by the 2016 Kaikōura earthquake. A theme identified amongst participants was an avoidance to seek support with the challenges they were experiencing due to the earthquake. The research findings align with key characteristics of masculinity, including demonstrating risky behaviours and neglecting self or professional care. This study suggests that these behaviours affect men’s overall resilience, and thus the resilience of the wider community.
The purpose of this research is to investigate men’s experiences of the 2016 7.8 magnitude Kaikōura earthquake and Tsunami. While, research into the impacts of the earthquake has been conducted, few studies have examined how gender shaped people’s experiences of this natural hazard event. Analysing disasters through a gender lens has significantly contributed to disaster scholarship in identifying the resilience and vulnerabilities of individuals and communities pre- and post-disaster (Fordham, 2012; Bradshaw, 2013). This research employs understandings of masculinities (Connell, 2005), to examine men’s strengths and challenges in responding, recovering, and coping following the earthquake. Qualitative inquiry was carried out in Northern Canterbury and Marlborough involving 18 face-to-face interviews with men who were impacted by the Kaikōura earthquake and its aftermath. Interview material is being analysed using thematic and narrative analysis. Some of the preliminary findings have shown that men took on voluntary roles in addition to their fulltime paid work resulting in long hours, poor sleep and little time spent with family. Some men assisted wives and children to high ground then drove into the tsunami zone to check on relatives or to help evacuate people. Although analysis of the findings is currently ongoing, preliminary findings have identified that the men who participated in the study have been negatively impacted by the 2016 Kaikōura earthquake. A theme identified amongst participants was an avoidance to seek support with the challenges they were experiencing due to the earthquake. The research findings align with key characteristics of masculinity, including demonstrating risky behaviours and neglecting self or professional care. This study suggests that these behaviours affect men’s overall resilience, and thus the resilience of the wider community.
For the people of Christchurch and its wider environs of Canterbury in New Zealand, the 4th of September 2010 earthquake and the subsequent aftershocks were daunting. To then experience a more deadly earthquake five months later on the 22nd of February 2011 was, for the majority, overwhelming. A total of 185 people were killed and the earthquake and continuing aftershocks caused widespread damage to properties, especially in the central city and eastern suburbs. A growing body of literature consistently documents the negative impact of experiencing natural disasters on existing psychological disorders. As well, several studies have identified positive coping strategies which can be used in response to adversities, including reliance on spiritual and cultural beliefs as well as developing resilience and social support. The lifetime prevalence of severe mental health disorders such as posttraumatic stress disorder (PTSD) occurring as a result of experiencing natural disasters in the general population is low. However, members of refugee communities who were among those affected by these earthquakes, as well as having a past history of experiencing traumatic events, were likely to have an increased vulnerability. The current study was undertaken to investigate the relevance to Canterbury refugee communities of the recent Canterbury Earthquake Recovery Authority (CERA) draft recovery strategy for Christchurch post-earthquakes. This was accomplished by interviewing key informants who worked closely with refugee communities. These participants were drawn from different agencies in Christchurch including Refugee Resettlement Services, the Canterbury Refugee Council, CERA, and health promotion and primary healthcare organisations, in order to obtain the views of people who have comprehensive knowledge of refugee communities as well as expertise in local mainstream services. The findings from the semi-structured interviews were analysed using qualitative thematic analysis to identify common themes raised by the participants. The key informants described CERA’s draft recovery strategy as a significant document which highlighted the key aspects of recovery post disaster. Many key informants identified concerns regarding the practicality of the draft recovery strategy. For the refugee communities, some of those concerns included the short consultation period for the implementation phase of the draft recovery strategy, and issues surrounding communication and collaboration between refugee agencies involved in the recovery. This study draws attention to the importance of communication and collaboration during recovery, especially in the social reconstruction phase following a disaster, for all citizens but most especially for refugee communities.
The Canterbury earthquakes, which started with the 7.1 magnitude event on September 4, 2010, caused significant damage in the region. The September 4 earthquakes brought substantial damage to land, buildings, and infrastructure, while the 6.3 magnitude earthquake on February 22, 2011 (and its subsequent aftershocks), brought even greater property damage, but also significant loss of life in addition to the region. Thousands were injured, and 185 persons died. A national State of Emergency was declared and remained in effect until April 30, 2011. A significant number of people required immediate assistance and support to deal with loss, injury, trauma experiences, and property damages. Many had to find alternate accommodation as their houses were too damaged to stay in. Of those affected, many were already vulnerable, and others had been too traumatized by the events to effectively deal with the challenges they were faced with. A number of human service organizations in the region, from both government and non-government sectors, joined forces to be able to more effectively and efficiently help those in need. This was the start of what would become known as the Earthquake Support Coordination Service. The aim of this report is to present an evaluation of the Earthquake Support Coordination Service and its collaborative organization, based on documentation and interviews with key stakeholders of the service. The aim is also to evaluate the service based on perspectives gathered among the clients as well as the coordinators working in the service. The final aim is to offer a reflection on the service model, and on what factors enabled the service, as well as recommendations regarding aspects of the service which may require review, and aspects which may be useful in other contexts.
Recent tsunami events have highlighted the importance of effective tsunami risk management strategies (including land-use planning, structural and natural mitigation, warning systems, education and evacuation planning). However, the rarity of tsunami means that empirical data concerning reactions to tsunami warnings and evacuation behaviour is rare when compared to findings for evacuations from other hazards. More knowledge is required to document the full evacuation process, including responses to warnings, pre-evacuation actions, evacuation dynamics, and the return home. Tsunami evacuation modelling has the potential to inform evidence-based tsunami risk planning and response. However, to date, tsunami evacuation models have largely focused on the timings of evacuations, rather than behaviours of those evacuating. In this research, survey data was gathered from coastal communities in Banks Peninsula and Christchurch, New Zealand, relating to behaviours and actions during the November 14th 2016 Kaikōura earthquake tsunami. Survey questions asked about immediate actions following the earthquake shaking, reactions to tsunami warnings, pre-evacuation actions, evacuation dynamics and details on congestion. This data was analysed to characterise trends and identify factors that influenced evacuation actions and behaviour, and was further used to develop a realistic evacuation model prototype to evaluate the capacity of the roading network in Banks Peninsula during a tsunami evacuation. The evacuation model incorporated tsunami risk management strategies that have been implemented by local authorities, and exposure and vulnerability data, alongside the empirical data collected from the survey. This research enhances knowledge of tsunami evacuation behaviour and reactions to tsunami warnings, and can be used to refine evacuation planning to ensure that people can evacuate efficiently, thereby reducing their tsunami exposure and personal risk.
Small, tight-knit communities, are complex to manage from outside during a disaster. The township of Lyttelton, New Zealand, and the communities of Corsair Bay, Cass Bay, and Rapaki to the east, are especially more so difficult due to the terrain that encloses them, which caused them to be cut-off from Christchurch, the largest city in the South Island, barely 10 km away, after the Mw 7.1 Darfield Earthquake and subsequent Canterbury Earthquake Sequence. Lyttelton has a very strong and deep-rooted community spirit that draws people to want to be a part of Lyttelton life. It is predominantly residential on the slopes, with retail space, service and light industry nestled near the harbour. It has heritage buildings stretching back to the very foundation of Canterbury yet hosts the largest, modern deep-water port for the region. This study contains two surveys: one circulated shortly before the Darfield Earthquake and one circulated in July 2011, after the Christchurch and Sumner Earthquakes. An analytical comparison of the participants’ household preparedness for disaster before the Darfield Earthquake and after the Christchurch and Sumner Earthquakes was performed. A population spatiotemporal distribution map was produced that shows the population in three-hourly increments over a week to inform exposure to vulnerability to natural hazards. The study went on to analyse the responses of the participants in the immediate period following the Chrsitchurch and Sumner Earthquakes, including their homeward and subsequent journeys, and the decision to evacuate or stay in their homes. Possible predictors to a decision to evacuate some or all members of the household were tested. The study also asked participants’ views on the events since September 2010 for analysis.
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.
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.
