A Longitudinal Analysis of Self-Rated Health Correlates and Predictors in Hurricane Survivors

Poor self-rated health (i.e., perceived health status relative to same-aged individuals) is associated with elevated all-cause mortality. Research examining post-disaster self-rated health is limited but could inform disaster theory and interventions. Identifying and subsequently mitigating individual and contextual determinants of self-rated health could address adverse, downstream effects.

The current study includes secondary analyses from a randomized controlled trial of a digital mental health intervention in a diverse sample of 1357 hurricane-affected adults (49.5% Latine ethnicity). We examined longitudinal relations between baseline (post-disaster) mental health outcomes, baseline social support, demographics, and baseline and follow-up self-rated health (calculated as a change score and 12-month follow-up score). We hypothesized those with elevated baseline psychopathology would be more likely to select the "fair/poor" health category (relative to "good/very good/excellent" self-rated health), and that greater social support would longitudinally predict improved self-rated health. Older individuals were also expected to select the "fair/poor" health category.

Individuals with higher baseline depressive symptoms and sleep disturbances were more likely to report "fair/poor" self-rated health at baseline and 12 months. Controlling for baseline self-rated health, depression remained a significant predictor of worse 12-month self-rated health in binary and ordinal logistic regressions. Social support did not predict baseline or 12-month self-rated health. Age and gender were non-significant moderators; no variables predicted change scores.

Depressive symptoms appear to be a key predictor of self-rated health one year post-disaster. Addressing depression post-disaster may mitigate adverse health outcomes.