Chronic stress may often lead to a variety of mental and physiological disorders, and stress effects are the primary concern after traumatic injury and exposure to infectious diseases or toxic agents from disaster events. We developed a conceptual model to address the question of whether degradation of ecosystem services (ES) by natural and human-made or influenced disasters such as recent hurricanes and the Deepwater Horizon oil catastrophe leads to acute and chronic stress that results in short- and long-term negative health outcomes in people. An interdisciplinary team with expertise in data mining, ecology, ecosystem services, ecotoxicology, landscape ecology, mental health, psychiatry, and stress physiology utilized the Driver-Pressure-State-Ecosystem Service-Response model of Kelble et al. (2013), the mental health framework of Palinkas (2012) and McEwen’s (1993 and subsequent papers) allostatic load model of chronic stress as starting points for model development, augmented via expert workshops and peer review.
Results/Conclusions
Our conceptual model connects effects of disasters to changes in specific ecosystem components (e.g., water quality, biodiversity, fishery populations) with resulting degradation of multiple ES such as commercial and recreational fishing, tourism, and sense of place. The model further connects degraded ES to acute and chronic stress in people and links those stresses to a variety of negative mental, physical and behavioral health outcomes. Using this framework, one can trace potential for stress-related health effects from a disaster all the way to one or more specific health outcomes. For example, one could begin with an oil spill, consider fear of contamination of fishery species, which in turn leads to degradation of commercial and recreational fishery ES. Those ES injuries produce acute and chronic stress via loss of employment, income, and way of life. Increased and repeated stress effects lead to greater allostatic load (stress-related physiological dysregulations) as modified by a variety of socio-economic, demographic, and community factors, which in turn cause or exacerbate a variety of disorders such as depression, substance abuse, and cardiovascular disease. We conclude that the model provides a robust framework for identifying, unraveling, and understanding linkages, associations, and perhaps cause-and-effect relationships that connect a given disaster to environmental changes that cascade via diminished ecosystem benefits to human maladies associated with increased and chronic stress. New information resulting from application of the model should help improve disaster management, pre- and post-disaster data collection, and treatment for victims.