Building Bridges

I met up with David Abramson in his office at New York University’s College of Global Public Health recently to talk about his newly-launched research endeavor, the Program on Population Impact, Recovery, and Resiliency (PiR2). With this program he intends to build much needed bridges between the two distinct worlds he has straddled since he started working in the disaster research field ten years ago: the public health world of disaster preparedness and the disaster research world.

Why the acronym PiR2? “Because it describes the area of a circle and can be scaled to apply to small circles or large circles alike” said Abramson. “To me, it’s the model to strive for in assessing population recovery: consider all the people, institutions, resources, and relationships engaged in disaster preparedness and recovery within a community – the area within their circle – and be scientific about it.”

PiR2 applies both social science and public health theory and methods to the examination of disasters’ effects on human health and well-being. The program has two major components, Disaster ResearchWorks and the Population Impacts, Recovery, and Resiliency Data Lab.

The first component—Disaster ResearchWorks—encompasses rapid research efforts, post-disaster assessments, and the design and implementation of research-informed solutions. Its flagship project is the SHOREline program, a national high school-based youth-empowerment project in which “youth help youth recover from disaster.” SHOREline, which seeks to foster Skills, Hope, Opportunities and Resilience through Engagement among youth, was founded by Abramson and his colleague Lori Peek based upon a decade’s worth of Gulf Coast research about the impact of disasters on children.

The second component—the Data Lab—analyzes research data that Abramson and his teams have assembled in multiple disasters. Abramson is also planning to layer additional data on top of the survey data he has collected. This could include geospatial data that can vividly illustrate hazards and impacts, as well as social, demographic, and economic data that helps to more fully characterize the neighborhood environment.

Several large-scale, representative cohort studies and their associated data sets make up the heart of the Data Lab. These include the Gulf Coast Child and Family Health Study, a large cohort study of displaced households that Abramson began shortly after Hurricane Katrina; the Sandy Child and Family Health Study, a project which examines the potential long-term effects of Superstorm Sandy on New Jersey residents’ health and well-being; and two cohorts related to the Deepwater Horizon Oil Spill, the Gulf Coast Population Impact Project, and the Women and Their Children’s Health Study. Abramson is also poised to join colleagues in an NIH-funded program that includes his co-Principal Investigators from Tulane and Harvard, Mark VanLandingham and Mary Waters, as well as scholars from Brown, University of Michigan, University of Illinois, and Colorado State University to return to the Gulf Coast a decade after Katrina to explore long-term recovery.

By creating a comprehensive social science data lab, Abramson’s goal is to compare the cohort data he has collected over the past ten years across various geographic and social contexts. He wants to understand what is generalizable, what is common, and what is different across all of these disasters. By doing so, he hopes to answer questions such as: How can recovery be best measured? And, perhaps most importantly, what factors are most likely to contribute to a timely and successful recovery for individuals, households, and ultimately entire communities?

Research vs. Needs Assessments

The idea for the program was informed by Abramson’s difficulty finding funding for long-term studies, starting with his Katrina study.

“It is always a tough sell to any funder, to say right after a disaster, ‘I’d like to do a longitudinal study of recovery,’” Abramson said. “Funders tend to think, ‘There are people who are suffering right now, why would I fund a research study that takes years?’”

While searching for financial backing for his Katrina Gulf Coast study, Abramson was reminded how much funders—particularly foundations and other philanthropies—resist devoting their humanitarian contributions to disaster research. Instead, they prefer needs assessments that immediately address urgent problems.

When Abramson first spoke to Children’s Health Fund founder and president Dr. Irwin Redlener about his proposed Katrina study, Redlener, a pediatrician who has dedicated his career to providing medical care to some of the nation’s poorest and most medically underserved children, too was a little allergic to the word research. This forced Abramson to alter his proposal on the spot.

“My pitch to him was, ‘Well I can do both, I can do a needs assessment that immediately addresses some of the questions surrounding the most pressing issues right now for people who are affected by the disaster, and at the same time, when I talk to these people we can enroll them in a longitudinal study and begin to look at long-term trajectories of recovery,” Abramson explained.

Redlener “totally got it,” Abramson said and provided the financial backing for the study. The same approach also proved successful when Abramson needed funding for his subsequent studies that he launched after the Deepwater Horizon oil spill and Superstorm Sandy.

Over the years, Abramson has been careful to use similar questions and measures when he surveys populations who have been exposed to natural, technological, or man-made disasters. This practice allows him to compare the experiences of people affected by disasters across time and different events. “It is humbling to hear the similarities across disasters,” said Abramson, “and to be able to convey to communities, providers, and policy-makers that disaster impacts such as mental health effects are not unique to their neighborhood and their disaster, but have similar root causes and consequences. Contextualizing disasters this way can also help the media put a disaster in to perspective, as much as it may drive the development of common mitigation or recovery efforts influenced by such generalizable data.”

Sandy Child and Family Health Study

Over the years, Abramson has had the chance to observe the similarities across time and space, but also to see many differences. For instance, when I asked him about the variance he observed while conducting post-Katrina versus post-Sandy research, he said:

“Sandy was largely a middle class disaster,” Abramson said. “New Jersey is one of the wealthiest states, per capita, and quite different socially and culturally from the Gulf Coast states as well. It is very interesting to compare Sandy data to that of other disasters, because when we bring together all these datasets, you can distill the effects people endure regardless of income, regardless of class, and regardless of social strata.”

The Sandy Child and Family Health study, an ongoing project modeled on the Hurricane Katrina and Deepwater Horizon Oil Spill studies, examines the potential long-term effects of Superstorm Sandy on the health and well-being of New Jersey residents exposed to the storm. It also looks at the ongoing needs of affected residents and investigates how well people and households are recovering.

It is very interesting to compare Sandy data to that of other disasters, because when we bring together all these datasets, you can distill the effects people endure regardless of income, regardless of class, and regardless of social strata”

The project is co-led by Abramson and Donna VanAlst, a member of the School of Social Work faculty at Rutgers University. In addition to NYU and Rutgers, the study also involves academic partnerships with Columbia and Colorado State Universities, and is funded by Social Services Block Grant monies under the direction of the New Jersey State Health Department. The study team established a Public Partnership Group that includes the central governmental agencies involved in health and human services response and recovery (New Jersey’s Departments of Health, Children and Families. and Human Services).

“These state agencies want to understand the impacts of a storm like Sandy on their residents so they can prepare for future events,” said Abramson, “and they want to know what worked and what didn’t work. They are also determined to understand the hurricane’s lingering effects.”

Abramson and his team are producing four reports for the project, each building upon the other. The first report analyzes the impact of the disaster on residents’ homes, and the decisions they made leading up to the storm; the second report examines Sandy’s effect on residents’ health and well-being, the third report sheds light on unmet needs and service gaps; and the fourth report looks at how adults as well as children are recovering and what paths to recovery were facilitated or impeded.

Over a nine-month period a team of nearly three dozen New Jersey-based interviewers enrolled and interviewed the 1,000 randomly sampled residents in to the study. These respondents represent the attitudes and experiences of the 1,047,000 residents living in Sandy’s “Disaster Footprint” along the state’s eastern flank. Wave 1 of the data collection is complete, and Abramson and his team have now moved on to resurvey and the same residents for Wave 2 of the study.

SHOREline

Combining project-based learning, community service, and opportunities for high school-aged youth to build connections with local and national leaders, the SHOREline Project, which was launched in 2013, is intended to help young people within their own communities as they strive to help others.

Abramson and Peek, as part of a community engagement effort after the Deepwater Horizon oil spill, visited a number of communities to examine the disaster’s impact. Peek and Abramson had noted time and again in their research how much children and youth wanted to contribute to recovery and rebuilding efforts, but there often was no such space available for them to do so. Fortunately, as of late, there has been a considerable groundswell in the disaster science community to engage youth directly in their own empowerment and recovery.

Abramson and Peek seized upon the idea for a research-to-action project after they completed a four-state survey along the Gulf Coast exploring the impact of the oil spill on children’s health. Among the 1,437 parents and caregivers they surveyed, one in five reported that their children had experienced mental health distress since the oil spill and nearly the same number reported physical ailments such as skin or breathing problems. Beyond that, though, the two researchers heard many stories of forestalled futures and shortened horizons for a number of children in the Gulf Coast.

“We identified five different communities, and for each of these communities, we made a poster that was built on survey work done across four states,” Abramson said. “We went to these communities, and met with focus groups—kids, parents, teachers, community leaders, doctors, and nurses—and we showed them the poster and said ‘these are the numbers, tell us the story behind these numbers.’”

The interviews revealed that parents and community leaders worried about eroding safety nets for children and about the loss of local opportunities.

“One of the community leaders we interviewed summed it all up when she said, ‘The only thing for kids to do around here is to go fishing, get high, or get pregnant, and you can’t go fishing anymore,’” Abramson said. In fact, in this community nearly one in ten of every high school girl was pregnant.

“One of the community leaders we interviewed summed it all up when she said, ‘The only thing for kids to do around here is to go fishing, get high, or get pregnant, and you can’t go fishing anymore’”

The SHOREline program addresses this lack of opportunities for youth as well as responds to their own expressed desire to be engaged in their own recovery. So far, the program has been a huge success. After debuting in five high schools in the Gulf Coast, two New York City schools—the Urban Assembly School for Emergency Management and the Urban Assembly Maker Academy —have recently been added to the project. Peek and Abramson are also looking to add schools affected by flooding and fires in Colorado and Superstorm Sandy in New Jersey over coming months.

It doesn’t stop there. In order to create a sustainable model, Abramson and Peek are working with high school teachers, their Gulf Coast field team, and graduate students at Colorado State University to design a core curriculum while building up a network of high schools.

“We have big visions,” Abramson said. “In the nearby future we want to establish a national network of youth helping youth recover from disaster.”

This mission is one of the central themes of the new NYU program. “’Population impact’ has a double-meaning,” said Abramson. “It’s not only about the impact that disasters have on children and on communities. It’s also about the impact that communities and children can have on the world around them.”