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Research papers, University of Canterbury Library

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.

Videos, UC QuakeStudies

A video of a presentation by Garry Williams during the fourth plenary of the 2016 People in Disasters Conference. Williams is the Programme Manager of the Ministry of Education's Greater Christchurch Education Renewal Programme. The presentation is titled, "Education Renewal: A section response to the February 2011 Christchurch earthquake".The abstract for this presentation reads as follows: The Canterbury earthquakes caused a disaster recovery situation unparalleled in New Zealand's history. In addition to widespread damage to residential dwellings and destruction of Christchurch's central business district, the earthquakes damaged more than 200 schools from Hurunui in the north, to the Mackenzie District in the east, and Timaru in the south. The impact on education provision was substantial, with the majority of early childhood centres, schools and tertiary providers experiencing damage or subsequent, with the majority of early childhood centres, schools and tertiary providers experiencing damage or subsequent operational issues caused by the ensuing migration of people. Following the February earthquake, over 12,000 students had left the school they had been attending and enrolled elsewhere - often at a school outside the region. Shortened school days and compression of teaching into short periods meant shift-sharing students engaged in the curriculum being delivered in more diverse ways. School principals and staff reported increased fatigue and stress and changes in student behaviours, often related to repeated exposure to and ongoing reminders of the trauma of the earthquakes. While there has been a shift from direct, trauma-related presentations to the indirect effects of psychological adversity and daily life stresses, international experiences tells us that psychological recovery generally lags behind the immediate physical recovery and rebuilding. The Ministries of Health and Education and the Canterbury District Health Board have developed and implemented a joint action plan to address specifically the emerging mental health issues for youth in Canterbury. However, the impact of vulnerable and stressed adults on children's behaviour contributes to the overall impact of ongoing wellbeing issues on the educational outcomes for the community. There is substantial evidence supporting the need to focus on adults' resilience so they can support children and youth. Much of the Ministry's work around supporting children under stress is through supporting the adults responsible for teaching them and leading their schools. The education renewal programme exists to assist education communities to rebuild and look toward renewal. The response to the earthquakes provides a significant opportunity to better meet the needs and aspirations of children and youth people. All the parents want to see their children eager to learn, achieving success, and gaining knowledge and skills that will, in time, enable them to become confident, adaptable, economically independent adults. But this is not always the case, hence our approach to education renewal seeks to address inequities and improve outcome, while prioritising actions that will have a positive impact on learners in greatest need of assistance.

Audio, Radio New Zealand

RON MARK to the Prime Minister: Does he stand by all his statements; if so, how? ANDREW LITTLE to the Prime Minister: Does he stand by his statement that “if you see house prices rising, you might say the Government needs to do more” and “we take responsibility, we need to do a better job of it”? SARAH DOWIE to the Minister of Finance: What international reports has he received showing New Zealand’s economic growth remains robust? Hon ANNETTE KING to the Minister of Health: On what date was the Ministry of Health first made aware of data manipulation of the six-hour Emergency Department target by district health boards? CHRIS BISHOP to the Minister for Economic Development: What recent announcements has the Government made regarding support for earthquake-affected businesses? METIRIA TUREI to the Minister for Building and Housing: Ka tū a ia i runga i te mana o tana kōrero, “The proportion of New Zealanders living in rental homes is not changing dramatically and owner-occupiers will remain the dominant living arrangement for most Kiwi families into the future” i te mea, ā, e ai ki ngā tatauranga hou, nō mai anō i te tau Kotahi mano, iwa rau, rima tekau mā tahi, i taka ai te hunga whiwhi i tōna ake whare, ki raro rā nō? Translation: Does he stand by his statement that “The proportion of New Zealanders living in rental homes is not changing dramatically and owner-occupiers will remain the dominant living arrangement for most Kiwi families into the future” given that home ownership is at its lowest level since 1951, according to the latest census? STUART SMITH to the Minister for Primary Industries: What recent announcements has he made regarding support for earthquake-affected primary sectors? GRANT ROBERTSON to the Minister of Finance: Does he agree with the Prime Minister’s statement that Treasury forecasts are “a load of nonsense, because they can’t get predications in 44 days right, let alone 44 years”? ALFRED NGARO to the Minister for Building and Housing: What additional Auckland housing projects did he announce during last week’s recess, and what are the latest reports on the growth in construction across Auckland showing? Dr MEGAN WOODS to the Minister responsible for the Earthquake Commission: Is he confident EQC will be employing the necessary resource to process and settle claims, from both the Canterbury earthquake sequence and the earthquake sequence of a fortnight ago, after 16 December; if so, why? DAVID SEYMOUR to the Minister of Police: What reassurance can she give to Epsom residents concerned that their Community Policing Centre will cease to operate after 24 years? IAN McKELVIE to the Minister of Commerce and Consumer Affairs: What announcements has he made recently that support the continued growth of the New Zealand wine export market?