Increased Odds of Depression, Anxiety in Adults Displaced by Natural Disaster

The consequences of natural disaster may extend further than physical health, according to a new study published in JAMA Network Open.¹ Adults living in the US who were displaced due to natural disasters were found to have increased odds of depression and anxiety, with those permanently displaced having the highest odds.

US adults displaced due to natural disaster had higher odds of anxiety and depression | Image credit: bilanol - stock.adobe.com

Displacement due to natural disasters has been tied to anxiety, post-traumatic stress disorder, and depression² based on the implications of such displacement, like housing instability, decreased financial stability, and lack of resources from the community. Although there have been studies revolving around the association between displacement due to natural disaster and mental, these studies have not featured the US to a notable degree and include a small sample size. This study used the US Census Bureau Household Pulse Survey (HPS) to evaluate the association between disaster-induced displacement and duration of displacement with symptoms related to depression and anxiety.

The data from the online, cross-sectional HPS conducted from December 9, 2022, to October 30, 2023, was used for this study. Each survey was completed by 1 adult who responded to an email or text and lived in a house that was included in the HPS, with eligible participants having a telephone number or email address available that matched the contact frame.

The 2-item Patient Health Questionnaire (PHQ-2) and 2-item Generalized Anxiety Disorder (GAD-2) were used to evaluate outcomes for depression and anxiety. All symptoms reported were felt in the previous 2 weeks. Participants were asked, starting in December 2022, if they had been displaced from their home in the previous year. Participants were also asked the duration of time they spent displaced from their home in increments of less than 1 month, 1 to 6 months, more than 6 months, and never returned home. The reference group was made up of those who had not been displaced.

Sociodemographics were collected through self-report, including race and ethnicity, sex at birth, annual income, and marital status. Self-report was also used to collect data on functional disability.

There were 183,730,553 included in the sample, of which 1.3% had been displaced due to natural disaster. The mean (SD) age of the participants was 49.22 (16.65) years, and 51.4% were female at birth. Most of the participants identified as White (65.0%), 15.7% as Hispanic, 10.0% as Black, 5.1% as Asian, and 4.2% as other race or ethnicity.

Depression was reported in 44.2% of those who were displaced for more than 6 months compared with 21.6% in those who had not been displaced. Those aged 18 to 25 years had the highest prevalence of depression and anxiety compared with those of older age groups. Those who reported being another race or ethnicity or identified as gay, lesbian, or bisexual also had increased prevalence of depression or anxiety symptoms after being displaced.

A multivariable regression analysis was used to assess the association between symptoms of depression and anxiety and displacement due to natural disaster. Higher odds of having symptoms for both depression (OR, 1.77; 95% CI, 1.40-2.25) and anxiety (OR, 1.54; 95% CI, 1.22-1.94) were found in those who were displaced for more than 1 week but less than 1 month when compared with those who had not been displaced. People who never returned home had higher odds of depression (OR, 2.43; 95% CI, 1.70-3.49) and anxiety (OR, 3.04; 95% CI, 2.10-4.39).

Higher odds of anxiety symptoms (OR, 1.31; 95% CI, 1.28-1.35) were seen in those assigned female at birth when compared with males at birth; females at birth had lower odds of depression symptoms (OR, 0.96; 95% CI, 0.93-0.99) compared with males at birth. Those who identified as gay, lesbian, or bisexual; were not married; were a home renter; lived in the South; lived in larger households; or had functional disabilities all had higher odds of mental health symptoms.

There were some limitations to this study. The mean response rate for the study was 6.6%, which could introduce bias in responses. Self-reported measures were used in the survey for measures of exposure and outcomes. Causality could not be drawn due to the cross-sectional design of the study.

“Our study found that approximately 2.5 million US adults were displaced by natural disasters in the past year. The odds of experiencing depression and anxiety symptoms were significantly higher for the displaced population compared to the non-displaced population. Additionally, longer durations of displacement were associated with an increase in mental health risks," Ther Aung, PhD, said in a statement to The American Journal of Managed Care^®. "As climate change increases the severity and frequency of many of the natural disasters we examined, mental health services for displaced populations will become critical."

References

1. Aung TW, O’Donnell K, De Luca S, Gunzler D. Depression and anxiety symptoms in adults displaced by natural disasters. JAMA Netw Open. 2025;8(8):e2528546. doi:10.1001/jamanetworkopen.2025.28546

2. Schwartz RM, Liu B, Lieberman-Cribbin W, Taioli E. Displacement and mental health after natural disasters. Lancet Planet Health. 2017;1(8):e314. doi:10.1016/S2542-5196(17)30138-9