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.
A video of a keynote presentation by Professor Jonathan Davidson during the fifth plenary of the 2016 People in Disasters Conference. The presentation is titled, "Resilience in People".The abstract for this presentation reads as follows: Resilience is the ability to bounce back or adapt successfully in the face of change, and is present to varying degrees in everybody. For at least 50 years resilience has been a topic of study in medical research, with a marked increase occurring in the past decade. In this presentation the essential features of resilience will be defined. Among the determining or mediating factors are neurobiological pathways, genetic characteristics, temperament, and environment events, all of which will be summarized. Adversity, assets, and adjustment need to be taken into account when assessing resilience. Different approaches to measuring the construct include self-rating scales which evaluate: traits and copying, responses to stress, symptom ratings after exposure to actual adversity, behavioural measures in response to a stress, e.g. Trier Test, and biological measures in response to stress. Examples will be provided. Resilience can be a determinant of health outcome, e.g. for coronary heart disease, acute coronary syndrome, diabetes, Human Immunodeficiency Virus (HIV) positive status and successful aging. Total score and individual item levels of resilience predict response to dug and psychotherapy in post-traumatic stress disorder and depression. Studies have repeatedly demonstrated that resilience is modifiable. Different treatments and interventions can increase resilience in a matter of weeks, and with an effect size larger than the effect size found for the same treatments on symptoms of illness. There are many ways to enhance resilience, ranging from 'Outward Bound' to mindfulness-based meditation/stress reduction to wellbeing therapy and antidepressant drugs. Treatments that reduce symptoms of depression and anxiety recruit resiliency processes at the same time. Examples will be given.
Tsunami have the potential to cause significant disruptions to society, including damage to infrastructure, critical to the every-day operation of society. Effective risk management is required to reduce the potential tsunami impacts to them. Christchurch city, situated on the eastern coast of New Zealand’s South Island, is exposed to a number of far-field tsunami hazards. Although the tsunami hazard has been well identified for Christchurch city infrastructure, the likely impacts have not been well constrained. To support effective risk management a credible and realistic infrastructure impact model is required to inform risk management planning. The objectives of this thesis are to assess the impacts on Christchurch city infrastructure from a credible, hypothetical far-field tsunami scenario. To achieve this an impact assessment process is adopted, using tsunami hazard and exposure measures to determine asset vulnerability and subsequent impacts. However, the thesis identified a number of knowledge gaps in infrastructure vulnerability to tsunami. The thesis addresses this by using two approaches: a tsunami damage matrix; and the development of tsunami fragility functions. The tsunami damage matrix pools together tsunami impacts on infrastructure literature, and post-event field observations. It represents the most comprehensive ‘look-up’ resource for tsunami impacts to infrastructure to date. This damage matrix can inform the assessment of tsunami impacts on Christchurch city infrastructure by providing a measure of damage likelihood at various hazard intensities. A more robust approach to tsunami vulnerability of infrastructure are fragility functions, which are also developed in this thesis. These were based on post-event tsunami surveys of the 2011 ‘Tohoku’ earthquake tsunami in Japan. The fragility functions are limited to road and bridge infrastructure, but represent the highest resolution measure of vulnerability for the given assets. As well as providing a measure of damage likelihood for a given tsunami hazard intensity, these also indicate a level of asset damage. The impact assessment process, and synthesized vulnerability measures, are used to run tsunami impact models for Christchurch infrastructure to determine the probability of asset damage occurring and to determine if impact will reach or exceed a given damage state. The models suggest that infrastructure damage is likely to occur in areas exposed to tsunami inundation in this scenario, with significant damage identified for low elevation roads and bridges. The results are presented and discussed in the context of the risk management framework, with emphasis on using risk assessment to inform risk treatment, monitoring and review. In summary, this thesis A) advances tsunami vulnerability and impact assessment methodologies for infrastructure and B) provides a tsunami impact assessment framework for Christchurch city infrastructure which will inform infrastructure tsunami risk management for planners, emergency managers and lifelines groups.
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.
This report provides an initial overview and gap analysis of the multi-hazards interactions that might affect fluvial and pluvial flooding (FPF) hazard in the Ōpāwaho Heathcote catchment. As per the terms of reference, this report focuses on a one-way analysis of the potential effects of multi-hazards on FPF hazard, as opposed to a more complex multi-way analysis of interactions between all hazards. We examined the relationship between FPF hazard and hazards associated with the phenomena of tsunamis; coastal erosion; coastal inundation; groundwater; earthquakes; and mass movements. Tsunamis: Modelling research indicates the worst-case tsunami scenarios potentially affecting the Ōpāwaho Heathcote catchment are far field. Under low probability, high impact tsunami scenarios waves could travel into Pegasus Bay and the Avon-Heathcote Estuary Ihutai, reaching the mouth and lower reaches of the Heathcote catchment and river, potentially inundating and eroding shorelines in sub-catchments 1 to 5, and temporarily blocking fluvial drainage more extensively. Any flooding infrastructure or management actions implemented in the area of tsunami inundation would ideally be resilient to tsunami-induced inundation and erosion. Model results currently available are a first estimate of potential tsunami inundation under contemporary sea and land level conditions. In terms of future large tsunami events, these models likely underestimate effects in riverside sub-catchments, as well as effects under future sea level, shoreline and other conditions. Also of significance when considering different FPF management structures, it is important to be mindful that certain types of flood structures can ‘trap’ inundating water coming from ocean directions, leading to longer flood durations and salinization issues. Coastal erosion: Model predictions indicate that sub-catchments 1 to 3 could potentially be affected by coastal erosion by the timescale of 2065, with sub-catchments 1-6 predicted to be potentially affected by coastal erosion by the time scale of 2115. In addition, the predicted open coast effects of this hazard should not be ignored since any significant changes in the New Brighton Spit open coast would affect erosion rates and exposure of the landward estuary margins, including the shorelines of the Ōpāwaho Heathcote catchment. Any FPF flooding infrastructure or management activities planned for the potentially affected sub-catchments needs to recognise the possibility of coastal erosion, and to have a planned response to the predicted potential shoreline translation. Coastal inundation: Model predictions indicate coastal inundation hazards could potentially affect sub-catchments 1 to 8 by 2065, with a greater area and depth of inundation possible for these same sub-catchments by 2115. Low-lying areas of the Ōpāwaho Heathcote catchment and river channel that discharge into the estuary are highly vulnerable to coastal inundation since elevated ocean and estuary water levels can block the drainage of inland systems, compounding FPF hazards. Coastal inundation can overwhelm stormwater and other drainage network components, and render river dredging options ineffective at best, flood enhancing at worst. A distinction can be made between coastal inundation and coastal erosion in terms of the potential impacts on affected land and assets, including flood infrastructure, and the implications for acceptance, adaptation, mitigation, and/or modification options. That is, responding to inundation could include structural and/or building elevation solutions, since unlike erosion, inundation does not necessarily mean the loss of land. Groundwater: Groundwater levels are of significant but variable concern when examining flooding hazards and management options in the Ōpāwaho Heathcote catchment due to variability in soils, topographies, elevations and proximities to riverine and estuarine surface waterbodies. Much of the Canterbury Plains part of the Ōpāwaho Heathcote catchment has a water table that is at a median depth of <1m from the surface (with actual depth below surface varying seasonally, inter-annually and during extreme meteorological events), though the water table depth rapidly shifts to >6m below the surface in the upper Plains part of the catchment (sub-catchments 13 to 15). Parts of Waltham/Linwood (sub-catchments 5 & 6) and Spreydon (sub-catchment 10) have extensive areas with a particularly high water table, as do sub-catchments 18, 19 and 20 south of the river. In all of the sub-catchments where groundwater depth below surface is shallow, it is necessary to be mindful of cascading effects on liquefaction hazard during earthquake events, including earthquake-induced drainage network and stormwater infrastructure damage. In turn, subsidence induced by liquefaction and other earthquake processes during the CES directly affected groundwater depth below surface across large parts of the central Ōpāwaho Heathcote catchment. The estuary margin of the catchment also faces increasing future challenges with sea level rise, which has the potential to elevate groundwater levels in these areas, compounding existing liquefaction and other earthquake associated multi-hazards. Any increases in subsurface runoff due to drainage system, development or climate changes are also of concern for the loess covered hill slopes due to the potential to enhance mass movement hazards. Earthquakes: Earthquake associated vertical ground displacement and liquefaction have historically affected, or are in future predicted to affect, all Ōpāwaho Heathcote sub-catchments. During the CES, these phenomena induced a significant cascades of changes in the city’s drainage systems, including: extensive vertical displacement and liquefaction induced damage to stormwater ‘greyware’, reducing functionality of the stormwater system; damage to the wastewater system which temporarily lowered groundwater levels and increased stormwater drainage via the wastewater network on the one hand, creating a pollution multi-hazard for FPF on the other hand; liquefaction and vertical displacement induced river channel changes affected drainage capacities; subsidence induced losses in soakage and infiltration capacities; changes occurred in topographic drainage conductivity; estuary subsidence (mainly around the Ōtākaro Avon rivermouth) increased both FPF and coastal inundation hazards; estuary bed uplift (severe around the Ōpāwaho Heathcote margins), reduced tidal prisms and increased bed friction, producing an overall reduction the waterbody’s capacity to efficiently flush catchment floodwaters to sea; and changes in estuarine and riverine ecosystems. All such possible effects need to be considered when evaluating present and future capacities of the Ōpāwaho Heathcote catchment FPF management systems. These phenomena are particularly of concern in the Ōpāwaho Heathcote catchment since stormwater networks must deal with constraints imposed by stream and river channels (past and present), estuarine shorelines and complex hill topography. Mass movements: Mass movements are primarily a risk in the Port Hills areas of the Ōpāwaho Heathcote catchment (sub-catchments 1, 2, 7, 9, 11, 16, 21), though there are one or two small but susceptible areas on the banks of the Ōpāwaho Heathcote River. Mass movements in the form of rockfalls and debris flows occurred on the Port Hills during the CES, resulting in building damage, fatalities and evacuations. Evidence has also been found of earthquake-triggered tunnel gully collapsesin all Port Hill Valleys. Follow-on effects of these mass movements are likely to occur in major future FPF and other hazard events. Of note, elevated groundwater levels, coastal inundation, earthquakes (including liquefaction and other effects), and mass movement exhibit the most extensive levels of multi-hazard interaction with FPF hazard. Further, all of the analysed multi-hazard interactions except earthquakes were found to consistently produce increases in the FPF hazard. The implications of these analyses are that multihazard interactions generally enhance the FPF hazard in the Ōpāwaho Heathcote catchment. Hence, management plans which exclude adjustments for multi-hazard interactions are likely to underestimate the FPF hazard in numerous different ways. In conclusion, although only a one-way analysis of the potential effects of selected multi-hazards on FPF hazard, this review highlights that the Ōpāwaho Heathcote catchment is an inherently multi- hazard prone environment. The implications of the interactions and process linkages revealed in this report are that several significant multi-hazard influences and process interactions must be taken into account in order to design a resilient FPF hazard management strategy.
