Abstract
BACKGROUND: Natural disasters, including earthquakes, tsunamis, tornadoes, and hurricanes, are traumatic events that simultaneously affect the lives of many people. Although much is known about the effects that natural disasters have on mental health, little is known about how natural disasters affect physical health. These analyses add to the literature by examining the ways in which four types of disaster exposure (geographic, peri-traumatic stress, personal and property loss, and poststorm hardship) experienced by older people during and after Hurricane Sandy affected functional limitations. METHODS: We analyzed five waves of data from the ORANJ BOWL panel ("Ongoing Research on Aging in New Jersey: Bettering Opportunities for Wellness in Life") using multilevel mixed-effects models. RESULTS: We found that although peri-traumatic stress and poststorm hardship each had independent effects on functional limitations, the effects of peri-traumatic stress dominated and were evident 6 years after the hurricane. Geographic exposure and personal/property loss were not associated with functional limitations. CONCLUSIONS: These findings add important information to what is known about older people who experience a natural disaster and suggest opportunities for intervention. Finding that an individual's emotional response during the disaster plays an important role in the development of functional limitations suggests that reduction of exposure to traumatic stress during a storm (ie, evacuation from a storm area) may be important for older people. Likewise, interventions immediately after a disaster that target older people who experience high levels of peri-traumatic distress may be needed in order to alleviate functional limitations before they develop.