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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.

Introduction: Over the past years, the Outaouais region (Quebec, Canada) and their residents have had to endure no less than five natural disasters (floods, tornadoes). These disasters are likely to have a variety of consequences on the physical and mental health of adolescents, as well as on their personal, family, school and social lives. The experiences of teenagers are also likely to vary depending on whether they live in rural or urban areas. Method: Data were collected via a self-administered questionnaire in February 2022. A total of 1307 teenagers from two high schools participated in the study by completing an online survey. The questionnaire measured various aspects of the youth's mental health using validated tests, such as manifestations of post-traumatic stress, anxiety and depression, as well as the presence of suicidal thoughts and self-harm. Other aspects of the youth's experience were measured, including their level of social support, school engagement, alcohol and drug use, and coping strategies. Results: One third of young students (n=1307) were experiencing depressive symptoms and suicidal thoughts, as well as significant daily stress. More than 25% of the students had moderate or severe anxiety and thoughts of self-harm. These problems were significantly more prevalent among youths with prior exposure to a natural disaster. The study data also revealed that youths living in rural areas had a more worrying profile than those living in urban areas. Conclusion: Similar to other studies (Ran et al., 2015; Stratta et al., 2014), our research data revealed that youths living in rural areas presented a more concerning profile than those residing in urban areas. It therefore seems important, in future studies and services, to focus more specifically on these teenagers to better understand their needs and to develop adapted services more likely to meet them.

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.

Les inondations de 2017 et 2019 au Québec ont affecté respectivement 293 et 240 municipalités. Ces inondations ont généré une cascade d’évènements stressants (stresseurs primaires et secondaires) qui ont eu des effets sur la santé mentale de la population et retardé le processus de rétablissement des individus. Cette période de rétablissement peut s’échelonner sur plusieurs mois voire plusieurs années. Cette étude s’inscrit dans la spécificité de la recherche mixte mise de l’avant à travers trois stratégies de recherche, réalisées de façon séquentielle : 1) sondage populationnelle réalisé auprès de 680 personnes, 2) analyse de documents produits par les organisations participant au processus de rétablissement social des sinistrés, ou sur des analyses externes portant sur ces interventions de rétablissement et 3) entrevues semi-dirigées auprès de 15 propriétaires occupants ayant complété une demande d’indemnisation à la suite des inondations de 2019 et auprès de 11 professionnels et gestionnaires participant au processus de rétablissement social. Les entrevues semi-dirigées et les questionnaires complétés par les personnes sinistrées lors des inondations de 2019 démontrent que les principales sources de stress ayant des impacts sur la santé et le bien-être des répondants sont : 1) l’absence d’avertissement et la vitesse de la montée des eaux; 2) l’obligation de se relocaliser et la peur d’être victime de pillage; 3) le manque de solidarité et d’empathie de la part de certains employés du MSP; 4) la gestion des conflits familiaux; 5) la gestion de problèmes de santé nouveaux ou préexistants; 6) la complexité des demandes d’indemnisation; 7) la lourdeur et les délais des travaux de nettoyage ou de restauration; 8) les indemnités inférieures aux coûts engendrés par l’inondation; 9) les pertes matérielles subies, particulièrement ceux d’une valeur de plus de 50 000 $; et 10) la diminution anticipée de la valeur de sa résidence. À cela s’ajoute l’insatisfaction à l’égard du programme d’indemnisation du gouvernement du Québec (PGIAF) qui fait plus que doubler la prévalence des symptômes de stress post-traumatique. Les inondations entraînent également une perte de satisfaction ou de bien-être statistiquement significative. La valeur monétaire de cette perte de jouissance peut être exprimée en équivalent salaires. En moyenne, cette diminution du bien-être équivaut à une baisse de salaire de 60 000$ pour les individus ayant vécu une première inondation et à 100 000$ pour les individus ayant vécu de multiples inondations. Ces résultats suggèrent que les coûts indirects et intangibles représentent une part importante des dommages découlant des inondations. Ce projet de recherche vise également à analyser l’application du PGIAF et son influence sur les stresseurs vécus par les sinistrés dans le contexte de la pandémie de COVID-19. La principale recommandation de cette étude repose sur une analyse de documents, un sondage populationnel et des entrevues semi-dirigées. Ainsi, s’attaquer à la réduction de principaux stresseurs nécessite 1) d’améliorer la gouvernance du risque d’inondation, 2) d’intensifier la communication et le support aux sinistrés, et 3) de revoir les mécanismes d’indemnisation existants.