So, thank you all for coming
This afternoon's lecture is sponsored by the Psychology Program the Sustainability Program
the
Stockton Center on Successful Aging and with funding from
the School of Social and Behavioral Sciences
I'm going without notes because I've been so involved with all the cool stuff going on earlier today, but
Something just clicked and telling you about the whole event
I really wanted you to perhaps give a round of applause for our colleague
Zori Kalibatseva who's put the whole program together
She's done an extraordinary job
I've been here for 35 years and it's been the best undergraduate psychology conference we've had in that time
So this our panel today is entitled "Graying Green: Climate Change for an Aging World"
and we have two experts in this field who will kind of share the podium today
We're going to start with Dr. Rachel Pruchno Rachel's been to Stockton a few times before wearing different hats
she's the director of research at the New Jersey Institute for Successful Aging and
an endowed professor of
medicine at Rowan University
She's she she runs a very extensive longitudinal study and even used students from intro to psych know that
Collecting data over time can be really time-consuming and costly there aren't very many studies
That study people over a long period of time and Dr. Pruchno
Orange Bowl study of New older New Jersey residents is one of them. I
Happen to be have been randomly selected
as one of their
5,500 subjects and I see from looking at her website that they'll be getting hold of me again fairly soon
To find out how much trouble I have getting the class on time getting up out of my chair. How's the arthritis?
And how do I sleep?
But it's a really important study and the part we'll hear about today is what was the impact of Hurricane Sandy?
Upon the people who lived through it who are a part of her research
If you were here for Dr. Brown's study in this in the morning, you heard about how
Her pathway to being a researcher
in psychology started with a lot of data collected by some other people in Chile after a large tsunami in
Chile and how did people adjust to that and post-traumatic stress and so on and so forth without further ado I'd like to invite
Dr. Rachel Pruchno know to come forward and share her information with us. I'm gonna talk to you about
Hurricane Sandy and what happened to older people when this hurricane hit?
So
First, you know, what do we know about disasters?
Well, 20 percent of people, you know
Why our disasters important 20 percent of people in the United States will experience a natural disaster in the course of their lifetime?
That's a lot of people
What we know
Really is is is based on very short-term. We know a little bit about the short-term effects
We know about mortality following a disaster we know about
PTSD following a disaster but most of the studies that have been done so far
Look at just a year or you know, maybe two years after the disaster
So we really don't know whether disasters have any longer-term effects
Um some studies say that older people who when faced with disasters are more resilient than younger people
but other research says that that older people are
The resilient other people other research say that older people are more vulnerable
The some research done in
2008 with an earthquake show that people 65 and older had a higher risk of PTSD than younger people so
there seems to be some evidence that that
Vulnerability or resilience is really linked to pre disaster characteristics. Perhaps linked to gender or marital status or income
and the people that are that are at
greater risk for being vulnerable to the effects of a hurricane
May have some functional disability to start with or or lack some psychological resources before
But the bottom line, is that there a lot that we don't know about
What happens to older people in the face of a disaster?
Couple of
concerns and limitations of previous studies
First of all, most of the studies that have been done were based on small convenient samples that were identified after the disaster
So it's really hard to do a disaster research because we don't know when these disasters are going to happen
So so usually what happens is a disaster happens and then there's a research project that gets developed after the fact
These studies are usually cross-sectional the time between when the disaster happens and when we can talk to people
It's all over the boards. Some people can get in as quickly as within a month
That's the shortest and then you know
Sometimes it's up to four years later that we're asking people about what your experiences were like during the disaster
A big problem with disaster studies. Is that that because we recruit people
After the fact we don't know about them before the disaster happens
And so if we don't know about them before the disaster happens, so so if we're talking to somebody and they're depressed or they're experiencing
Anxiety, we don't know if they were like that before
I think they may have or or was there depression or anxiety a function of the disaster? We don't know
And the other thing we don't know is we don't anything we don't know what exposure means what does it mean to be exposed to?
to a hurricane or to an earthquake or you know, sometimes we study people who are in the kit in certain catchment area
But you might be in this catchment area and not be exposed
So so there's this whole issue of what does it mean to be exposed to a disaster?
is is sort of mucking up the
science
So
Becoming a disaster researcher or a climate maven. What do you need? I didn't set out to be a disaster researcher
I was not a disaster researcher and I'll tell you how it came to be
But so to be a disaster researcher, you have to have two things. You have to have some data
And you have to have a disaster
so I'm going to tell you a little bit about the data because for me I some data before the disaster happened, so
Let me introduce you a little bit to the Orange Bowl study. So Orange Bowl stands for ongoing research on Aging in New Jersey
bettering opportunities for wellness in life
So back in 2006 we started recruiting
people for this panel
The in order to be eligible for the panel people were 50 to 74. They were living in, New Jersey
And they agreed believe it or not
They agreed that they were cold called randomly digit randomly dialing. We cold called people
And we got five thousand six hundred and eighty eight people Dave who Dave is one of them
To agree to participate in an hour-long interview on the phone and and I have to tell you, you know
And I think about when I look back at at this development of this panel
When we were sort of fantasizing and thinking about how to make this happen
And somebody suggested that we do this I said you've got to be kidding. You know, how we gonna get people
Well people really agree to do it and they did
What's really amazing is that of course we had to dial a lot of numbers and talk to a lot of people
You know, have you get hung up on a lot
but but but this panel is is pretty amazing that not only did people agree to participate in the study, but
Many of them have agreed to continue participating in the panel and and it really is
Is an incredible wealth of data
So here's a little snapshot of what these people look like when we talked to them back in 2006
The mean age was was about 61 years old
About 64 percent were women. You can see the marital status about half were married and a half weren't
Mean age of education is about 14 and a half years and and that's a little bit higher than the
average in New Jersey but that is typical of people that tend to want to participate in research are better educated and
About 12% of the sample was african-american
The rest were mostly white
So we had this data in 2006 and
The the panel itself was funded
The initial panel was funded by the University of Medicine and Dentistry of New Jersey
an institution that doesn't exist anymore. It was merged with
Rowan University a few years ago
But so so my
charge my goal in life was to
Keep the panel going
The idea was that we would that the the institution funded this startup for this project
And then the the goal was to get the NIH the National Institute on Aging
particularly interested in
this panel, so
It took a while and a disaster to get the NIH interested in my panel but in
2012 Halloween weekend, October 29th
Hurricane Sandy hit and hurricane sandy hit as you know, New Jersey and New York very hard
It was the largest Atlantic hurricane
117 people died
There were thousands of injuries many homes were damaged
In addition to this hurricane eight million people lost power for weeks because that year there was an early snowstorm
So it was really cold and people didn't have power and they didn't have heat
Sixty five billion dollars of damage
But because because I had data about these people before the hurricane in fact
We had talked with many of these people twice at baseline and then in in 2011
We were in this amazing, we went this amazing opportunity to look at the effects of the disaster on a large group of older people
Right as I said earlier
If you don't know anything about the people before the hurricane
happens and then you collect data only after you don't know whether the what you're seeing after was a function of the
Disaster or whether they were always that way. Well, we knew we knew who was depressed and we knew who was functionally
Disabled and we knew who had social support and who didn't so that we knew a lot about these people before
So what I'm going to do now is take you on a little tour of
Some of the findings from Orange Bowl and we've done a lot of different kinds of analyses over the years
But I'm gonna start with an early study that we did. This was a qualitative study, and I'm usually not a qualitative researcher
But we learned a lot we we we identified 20 people from Orange Bowl
from this big panel of five thousand six hundred
eighty eight people
We identified 20 people who experienced the most home damage and we wanted a look at what effects did this?
experience have on these
16 women and four men
So we did
qualitative interviews sort of semi structured interviews
And we we wanted them to talk about
Some of the challenges that they faced and and we we had them talk about some of the physical
challenges some of the social challenges and some of the financial challenges and you know
Here's a list of some of the physical challenges that that people talked about
So they talked about power and heat loss. They talked about troubles getting in and out of their homes
Cleaning up from this hurricane the repairs
The lack of information trouble accessing food because many of them were trapped in their homes
flooding disconnected phones and health problems
And I want to give you a little bit of an example. These are some quotes from the qualitative interviews that we did
So this 58 year old woman said it was so cold and so dark
We just hunkered down and stayed in our home. It was so cold
We were using anything we could find we found sterno floating in the water
We popped the top from the sterno and warmed our fingers over that
Clean up
The tree came from the second floor down to the first floor bathroom
the night of the storm. I went to the bathroom
I couldn't open the light there was water dripping out of the light fixture
So I had a lot of damage I had to fix the ceilings and I had to clean the rug upstairs dry
Up all the water up all the water in the rug and downstairs. It was a mess.
This was a 69 year old woman
And
To give you some idea of some of the health issues that some some of these people were were
had health problems before that the storm and and these were
Exacerbated as a function of this storm. Here's one example. This is a quote from a 73 year old abandoned
My wife started going downhill, I guess depression it affected her
She's had a shunt because she had water in the brain at one time.
So we thought maybe that wasn't working right or whatever
We called an ambulance and we took her to the hospital to test
and everything and all the tests showed. The shunt was working
Okay, and possibly she had a stroke or something and nobody really gave me an answer
We were afraid something might happen to her. She wasn't walking steady
and it continued it was just getting worse
She fell down and she hit her head on the wall. They did all kinds of cat scans and this and that and nobody
Have yet to this minute turned around and told me you know, whatever it is.
They were all agreeing to brain damage.
I attributed it to that damn storm
And of course as you can imagine there were emotional challenges
People were distressed. They were surprised they were worried. They felt powerless
And
As you would expect there were financial challenges
So older people just like younger people experienced financial challenges as a function of the storm
for many of these older people it was a real
Challenge because they they were living on fixed incomes. So they were the damages and and
negotiating fixing things on a fixed income
There were foregone vacations many didn't have insurance and many worried about selling their home
So we looked at what kind of support did these people get from their families and friends and and we found that
families, you know when crisis happens families are usually there and friends are usually there
and and we found in these interviews that people talked about
getting physical support from families
They got they had a place to stay they were checking in with family
and they were getting reassurance from their families
But what we heard that we didn't expect to hear was the incredible role that neighbours played
so families were important, but
The even though the physical support that neighbors provided they're much greater type of tasks
They put neighbors provided a place to stay. They checked in on these older people. They helped them clean up
They shared food they shared their home they visited
and there was a lot of
Socio-emotional support that were provided by neighbors
and sometimes these people really didn't know their neighbors before
but something about this crisis brought the neighbors together
that the neighbors and the older people together, so
Here's a few comments. So so one 71 year old woman said, you know neighbors were nice to each other
I do have to say young people all helpful. Somebody really needed help they helped each other.
So that was a good thing
Another person said another woman said
more friendly because we spent a lot of time outside just talking about the storm
but yeah, it did bring us closer
a 66 year old woman said everybody was very helpful.
If they saw you struggling with appliances or carpet people would stop and help you and
Another woman said with my neighborhood like everybody it didn't matter if he knew anybody
He would walk and talk to someone on the street and say are you okay? Because nobody was okay
So interestingly though over time that incredible neighborliness that pulled people together
dissipated over time as the storm, you know, cleanup happened people went back to their lives and and and
The the closeness that had brought people together that necessity
Sort of dispersed and people got back to routine. So
One one woman said we were extremely tight. We were all on the street together
When my husband got hurt they were all right there supportive of me
We were always friendly anyways
but we're even more so directly after the storm
now that people have rebuilt and they're moving back in the people that came back I'd
Say went back to how it was before
In another analysis
We had the opportunity to do something very interesting because we had this large panel
We were able to
identical that we measured after the storm was PTSD Post-Traumatic Stress Disorder and
Although very few people experienced experienced what could be thought of as clinical PTSD
There were 44 people out of this whole big orange bowl dataset who profiled as having PTSD
after Hurricane Sandy
So what we were able to do because we had this big sample is we were able to match these people
We matched with people who did not experience PTSD
so we matched him on gender on storm exposure and on geography where they were living
We worked with a geographer and we we plotted where each of these 44 people were living
and then we matched them with
each person was matched with a
gender exposure and and geography based
pair
What we found here is that six years before the storm we were able to identify
characteristics of people who did and people who did not develop PTSD after the storm
So six years before sandy people who develop PTSD
Were poorer they had less positive effect
They were in poorer health
They had less social social support. They were not working
They were more depressed and had more negative effect.
They had more functional disabilities and chronic health problems and more pain
so
What's interesting about these analyses is that you know
You know when the next disaster
strikes
It tells us that that these are the people that we really need to worry about and we really need to make sure
That that that these people are supported
you know to be able to to know is six years before that that this would happen
I mean these characteristics are identifiable before a disaster strikes
In another set of analyses we looked at successful aging and here what we did was we look we
Assess these five thousand six hundred and eighty-eight people multiple times. We followed them
many of them four times over nine years and what we found
Was that over time
Subjective and objective
Successful aging and what that is subjective successful aging is
we asked people to rate on a scale of one to ten to their success
the extent to which they have been aging successfully the objective indicators of
successful aging were
illnesses and pain and functional disabilities so over time
For the whole sample the the the the the average person in the sample both
objective and subjective
Successful aging declined, okay
But the people who were exposed to Hurricane sandy
experienced sharper declines involved subjective and objective
successful aging so this hurricane had a dramatic
Long-term effect on the way these people aged
And in a recent a
Now so we were really interested in so so what is it about exposure?
What what what kind of exposure is is really critical to in this case?
predicting depression five years after the storm
We looked at four different kinds of exposure. We looked at people who were living in the FEMA counties that were most hard-hit
okay, that was one one definition of exposure a second one was this Perry trauma stress so
we asked people how
Did they feel in immediate danger during the storm? Did they feel distressed during the storm?
Then we asked about personal and property loss
Personal injury and home damage and friends or family killed her or harmed by the storm
and then we asked about
Post storm hardships. So because of Hurricane sandy, did you stop working?
Did you have to leave your home with was your home moldy? Did you lose income?
and we were really looking at
What effects each of these?
Exposures had on depression and we were looking we were so
charting depression over a five year period of time
So what's interesting is that we found that each one of these?
Exposures and an independent effect on depression. So the more the more exposure the more depressed
but when we put all than all of these exposures together the the
exposure variable that had the most
Significant effect on Depression was the Perry trauma stress. It was in the moment feeling distressed or
That they were that they were in immediate danger of the storm
So that tells us a lot about you know, if we if we sort of think about okay when the next storm happens
You know the people that we need to worry about
Are the people who are
Feeling threatened in the moment of the storm and some of the other research has shown that you know
we need to sort of it's the exposures is personal or property loss or
some of the hardships that come afterwards but what we found wasn't it was the the
experience in the moment that causes people to be just
Depressing and you know
I think yet you would expect short-term
But I was just really surprised to see that
that this expose these exposure variables at such long-term effects
And whereas actually
have found that similar findings for functional disability and
Their too it's as Perry trauma stress that predicts functional disability five years later
so really powerful effects of these
of this natural disaster
So what have we learned some but not all older people exposed to a disaster experienced long-term effects
we learned about the importance of neighbors and
We learned that the type of exposure matters in it and and that it's really important to to measure the exposure
In this, you know more fine-grained manner
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