Food access, social connectedness, and allostatic load after a natural disaster: a mixed-methods study

De Diego Research Foundation, San Juan PR

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Abstract

PROJECT SUMMARY Natural disasters impose extensive stressors in a society. A major stressor is privation in access to adequate quantity and quality of food and water. The allostatic load model posits that brain stimuli (e.g. memories) from such stressors overloads multi-system physiological stress responses, first in the primary neuroendocrine and inflammatory fast-responders and then in cardiometabolic pathways; yet adaptive mechanisms may occur as the brain-body adjusts to this new state. Adaptation to post-disaster stress may ensue as an afflicted society recovers together through social connectedness. Post-disaster research has seldom studied food access privation stress and coping social connection strategies deployed to mitigate these, much less in association to time-sensitive physiological responses that predict long-term disease. Most studies assessing post-disaster stress have been retrospective assessments long after the event or have not measured multiple markers that could validate the time-sensitive allostatic load mechanisms. Thus, there is a gap in knowledge on how food access stress activates allostatic mechanisms shortly after a disaster, and how potential adaptation against this stress is gained from social connectedness. The island-wide devastation caused by hurricanes Irma and Maria in Puerto Rico (PR) provides a unique and timely opportunity to address these gaps in a minority population. Our overall goal is to identify levels of influence on which food/water privation operated as stressor after hurricane Maria among PR adults, as well as domains of influence where social connectedness strategies moderated such stressor, and how these trigger time-sensitive adverse or adaptive allostatic responses. The central hypothesis is that higher food/water privations will be associated with higher allostatic load, but this will be mitigated for those with high social support. The project will use a concurrent transformative mixed- methods design combining quantitative data collected from the island-wide cohort ?PROSPECT: Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic disease Trends?, with narrative interviews among adults and food establishment stakeholders to triangulate findings as well as raise advocacy for better food access. Our specific aims are to (1) estimate access to food/water and association with allostatic load; (2) determine moderating role of social connectedness on the association of food/water privations and allostatic load; and (3) qualitatively assess memories of food/water privation and coping through social connectedness in individuals and food establishment stakeholders, and determine association with acute physiological stress. This project will identify priority needs and timely best-practices for adequate post-disaster access to food and water, and concomitant social coping strategies that will sustain optimal physiological well-being in PR and disaster-prone areas. This is paramount for Puerto Ricans, a minority community with multiple social and health disparities and at high-risk for natural disasters. A home-grown team of Puerto Rican expert researchers will lead this project to answer NIMHD?s priorities of clarifying and solving time-pressing disparities.