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Introduction: In July 2013, a train derailment caused the death of 47 people and destroyed the downtown area in the city of Lac-Mégantic (Quebec, Canada). This tragedy had several impacts on this small community. Method: Three years after this disaster, we used a representative population-based survey conducted among 800 adults (including 265 seniors aged 65 or above) to assess the physical and mental health of seniors. Results: Several differences were observed in seniors’ physical and mental health based on their level of exposure to the tragedy. Nearly half of seniors highly exposed to the train derailment (41.7%) believe that their health has deteriorated in the past 3 years. The majority of seniors highly exposed to the train derailment (68.7%) also show symptoms of posttraumatic stress disorders. Seniors highly or moderately exposed to the tragedy were also more likely to have found positive changes in their personal and social life as compared with nonexposed seniors. Discussion: A technological disaster such as a train derailment still had negative impacts on seniors’ physical and mental health 3 years later. Conclusion: Public health authorities must tailor prevention and promotion programs to restore health and well-being in this population.

Plus aucune communauté n’est à l’abri des catastrophes naturelles et technologiques et de plus en plus les intervenants du domaine du social sont appelés à intervenir lors de ces situations. Malheureusement, plusieurs d’entre eux interviennent pendant et après une catastrophe sans avoir reçu une formation de base sur l’intervention en situation de crise macrosociale. Pourtant, ce type d’intervention exige des habiletés de base qui doivent s’acquérir à la fois dans les maisons d’enseignement et lors de formations continues. De plus, en cas de désastre naturels ou technologiques, certains groupes d’individus, dont les personnes âgées, sont plus vulnérables que d’autres parce qu’elles n’ont pas facilement accès aux ressources de la communauté. Par exemple, plusieurs personnes âgées, surtout celles présentant des incapacités physiques ou cognitives et celles à faible revenu n’ont, en général, pas de voitures à leur disponibilité, ce qui peut nuire à leur évacuation lors d’inondations, de tremblements de terre ou d’ouragans. De plus, plusieurs aînés habitent dans de vieux logements moins bien construits pour faire face à des chocs de toutes sortes. Les personnes âgées et particulièrement celles présentant des incapacités physiques ou cognitives, celles à faibles revenus ou sans réseau de soutien social font parties des groupes à risque de subir des blessures, de mourir ou de développer des problèmes de santé post-désastre. Le décès d’un nombre important de personnes âgées pendant l’ouragan Katrina et la vague de chaleur de l’été 2003 en Europe, a malheureusement démontré que plusieurs communautés sont très mal préparées à protéger et secourir, en cas de catastrophe, les aînés et plus particulièrement les personnes âgées vulnérables. De plus, plusieurs études ont fait ressortir qu’à la suite d’un désastre, les personnes âgées reçoivent proportionnellement moins d’aide que les personnes plus jeunes (Fernandez et al 2002), soit parce qu’elles ne sont pas priorisées par les autorités locales ou parce qu’elles-mêmes hésitent à informer leurs proches et les organismes publics ou communautaires de leurs besoins de soutien. Tout individu, quel que soit son âge a un important besoin de soutien social pendant et après un désastre afin d’atténuer les effets du stress et surmonter les obstacles qui se présenteront. On pense par exemple à l’interruption des services essentiels comme l’eau potable ou l’électricité, la lourdeur démocratique, l’endettement, les négociations avec des entrepreneurs quelque peu malhonnêtes, etc. À ce sujet, plusieurs chercheurs considèrent les désastres comme une suite d’événements stressants pouvant occasionner de nombreuses difficultés aux individus (Murphy, 1986). Cette communication permettra de présenter les résultats de nos études effectuées sur les conséquences des désastres sur la santé physique et psychologique des aînés ainsi que sur divers aspects de leur vie (vie personnelle, conjugale, familiale et sociale). En explicitant les sentiments et les difficultés que ces personnes éprouvent lors de catastrophes, les intervenants du domaine du social seront alors mieux outiller pour intervenir auprès de ce groupe cible. Cette communication a donc pour but de présenter les principaux faits saillants et les recommandations de la recension des écrits scientifiques que nous avons dernièrement complété et des faits saillants des diverses études que nous avons réalisées jusqu’à maintenant auprès des personnes âgées à la suite de deux types de désastres : inondation et tempête de verglas. Cette communication a pour but de sensibiliser les participants à l’importance de tenir compte, pour les intervenants du social, des spécificités des aînés lors de l’application des mesures d’urgence et lors de la période de rétablissement des communautés.

Cette recension a pour objectifs de documenter les approches et les principes d'intervention recommandés dans les écrits pour intervenir auprès des jeunes en contexte de catastrophe, de décrire des techniques, des stratégies, des programmes et des types d'intervention ayant déjà été mis en place auprès d'enfants et d'adolescents en contexte de catastrophe et d'identifier les facteurs ayant contribué à l'efficacité des interventions.

Purpose The current pandemic and ongoing climate risks highlight the limited capacity of various systems, including health and social ones, to respond to population-scale and long-term threats. Practices to reduce the impacts on the health and well-being of populations must evolve from a reactive mode to preventive, proactive and concerted actions beginning at individual and community levels. Experiences and lessons learned from the pandemic will help to better prevent and reduce the psychosocial impacts of floods, or other hydroclimatic risks, in a climate change context. Design/methodology/approach The present paper first describes the complexity and the challenges associated with climate change and systemic risks. It also presents some systemic frameworks of mental health determinants, and provides an overview of the different types of psychosocial impacts of disasters. Through various Quebec case studies and using lessons learned from past and recent flood-related events, recommendations are made on how to better integrate individual and community factors in disaster response. Findings Results highlight the fact that people who have been affected by the events are significantly more likely to have mental health problems than those not exposed to flooding. They further demonstrate the adverse and long-term effects of floods on psychological health, notably stemming from indirect stressors at the community and institutional levels. Different strategies are proposed from individual-centered to systemic approaches, in putting forward the advantages from intersectoral and multirisk researches and interventions. Originality/value The establishment of an intersectoral flood network, namely the InterSectoral Flood Network of Québec (RIISQ), is presented as an interesting avenue to foster interdisciplinary collaboration and a systemic view of flood risks. Intersectoral work is proving to be a major issue in the management of systemic risks, and should concern communities, health and mental health professionals, and the various levels of governance. As climate change is called upon to lead to more and more systemic risks, close collaboration between all the areas concerned with the management of the factors of vulnerability and exposure of populations will be necessary to respond effectively to damages and impacts (direct and indirect) linked to new meteorological and compound hazards. This means as well to better integrate the communication managers into the risk management team.

Purpose The current pandemic and ongoing climate risks highlight the limited capacity of various systems, including health and social ones, to respond to population-scale and long-term threats. Practices to reduce the impacts on the health and well-being of populations must evolve from a reactive mode to preventive, proactive and concerted actions beginning at individual and community levels. Experiences and lessons learned from the pandemic will help to better prevent and reduce the psychosocial impacts of floods, or other hydroclimatic risks, in a climate change context. Design/methodology/approach The present paper first describes the complexity and the challenges associated with climate change and systemic risks. It also presents some systemic frameworks of mental health determinants, and provides an overview of the different types of psychosocial impacts of disasters. Through various Quebec case studies and using lessons learned from past and recent flood-related events, recommendations are made on how to better integrate individual and community factors in disaster response. Findings Results highlight the fact that people who have been affected by the events are significantly more likely to have mental health problems than those not exposed to flooding. They further demonstrate the adverse and long-term effects of floods on psychological health, notably stemming from indirect stressors at the community and institutional levels. Different strategies are proposed from individual-centered to systemic approaches, in putting forward the advantages from intersectoral and multirisk researches and interventions. Originality/value The establishment of an intersectoral flood network, namely the InterSectoral Flood Network of Québec (RIISQ), is presented as an interesting avenue to foster interdisciplinary collaboration and a systemic view of flood risks. Intersectoral work is proving to be a major issue in the management of systemic risks, and should concern communities, health and mental health professionals, and the various levels of governance. As climate change is called upon to lead to more and more systemic risks, close collaboration between all the areas concerned with the management of the factors of vulnerability and exposure of populations will be necessary to respond effectively to damages and impacts (direct and indirect) linked to new meteorological and compound hazards. This means as well to better integrate the communication managers into the risk management team.

Introduction:In July 2013, a train carrying 72 cars of crude oil derailed in the town of Lac-Mégantic (Eastern Townships, Quebec, Canada). This disaster provoked a major conflagration, explosions, 47 deaths, the destruction of 44 buildings, the evacuation of one-third of the local population, and an unparalleled oil spill. Notwithstanding the environmental impact, many citizens of this town and in surrounding areas have suffered and continue to suffer substantial losses as a direct consequence of this catastrophe.Problem:To tailor public health interventions and to meet the psychosocial needs of the community, the Public Health Department of Eastern Townships has undertaken repeated surveys to monitor health and well-being over time. This study focuses on negative psychosocial outcomes one and two years after the tragedy.Methods:Two cross-sectional surveys (2014 and 2015) were conducted among large random samples of adults in Lac-Mégantic and surrounding areas (2014: n = 811; 2015: n = 800), and elsewhere in the region (2014: n = 7,926; 2015: n = 800). A wide range of psychosocial outcomes was assessed (ie, daily stress, main source of stress, sense of insecurity, psychological distress, excessive drinking, anxiety or mood disorders, psychosocial services use, anxiolytic drug use, gambling habits, and posttraumatic stress symptoms [PSS]). Exposure to the tragedy was assessed using residential location (ie, six-digit postal code) and intensity of exposure (ie, intense, moderate, or low exposure; from nine items capturing human, material, or subjective losses). Relationships between such exposures and adverse psychosocial outcomes were examined using chi-squares and t-tests. Distribution of outcomes was also examined over time.Results:One year after the disaster, an important proportion of participants reported human, material, and subjective losses (64%, 23%, and 54%, respectively), whereas 17% of people experienced intense exposure. Participants from Lac-Mégantic, particularly those intensely exposed, were much more likely to report psychological distress, depressive episode, anxiety disorders, and anxiolytic drug use, relative to less-exposed ones. In 2015, 67% of the Lac-Mégantic participants (76% of intensely exposed) reported moderate to severe PSS. Surprisingly, the use of psychosocial services in Lac-Mégantic declined by 41% from 2014 to 2015.Conclusion:The psychosocial burden in the aftermath of the Lac-Mégantic tragedy is substantial and persistent. Public health organizations responding to large-scaling disasters should monitor long-term psychosocial consequences and advocate for community-based psychosocial support in order to help citizens in their recovery process.