We propose to assess (1) mental health outcomes (including: depression, generalized anxiety disorder, PTSD, alcohol abuse, panic), (2) protective and risk factors associated with these outcomes, and (3) mental health service utilization patterns and unmet service needs in an over-sample of 1200 older adults (age 60 and over) and a comparison sample of 300 younger adults (age 21-59) residing in Florida disaster sites. The Florida Hurricanes present a unique opportunity to study the acute clinical disorder phenotypes, risk and protective factors, including genetic protective factors, and subsequent service needs of a group of older adults who were disproportionately represented as disaster victims relative to the US population. Specifically, older adults resided in the areas most severely affected by the hurricanes at population density levels approximately twice that of the average US county. As such, a large and relatively easily accessible (in terms of random screening of households successfully resulting in identifying an older adult respondent) group of affected older adults is available. We will employ Random Digit Dialing Methodology to rapidly collect random samples of data in areas of Florida affected by hurricanes. Data will be collected in the form of 20 or 25 minute telephone interviews with 1500 adults in FL whose primary residence was in the state prior to Hurricane Charlie. The survey will include measurement of cognitive and memory status, Demographics, Hurricane Exposure Characteristics, Lifetime and Recent Exposure to Potentially Traumatic Events, Resource Loss, Coping Strategies, Acute Reactions & Panic, Emotional Disorder Phenotypes, and Services Utilization. In addition to interview data, saliva samples will collected from a subset of 1000 respondents for genetic analyses to permit gene x environment interaction analyses, based on prior research indicating protective and risk factors following traumatic events associated with particular genotypes. The overarching goal of this project is to document the acute impact of these repeated disasters on older adults while scientifically informing the development and improvement of services for older adults.
