Author ORCID Identifier
https://orcid.org/0009-0002-5434-8996
Date Available
4-22-2027
Year of Publication
2025
Document Type
Graduate Capstone Project
Degree Name
Master of Public Health (M.P.H.)
College
Public Health
Department/School/Program
Public Health
Faculty
Dr. Anna Hoover
Committee Member
Dr. Jay Christian
Faculty
Dr. Florence Fulk
Faculty
Dr. Rachel Hogg-Graham
Abstract
Objective: To examine the association between federally declared disasters and mental health outcomes at the county level in Kentucky from 2016 to 2019, using average poor mental health days as the outcome. A secondary objective was to explore how underlying socioeconomic factors, such as income inequality and unemployment, might influence or confound this relationship.
Methods: This ecological study used county-level BRFSS data to analyze average poor mental health days over a four-year period across 120 Kentucky counties. Disaster exposure was categorized as 0, 1, or 2+ FEMA disaster declarations. County-level covariates, including income inequality and unemployment rate (sourced from 2021 County Health Rankings), were examined visually. A one-way ANOVA tested for significant differences in mean poor mental health days across disaster exposure categories.
Results: Counties with 2+ disasters had significantly higher average poor mental health days (mean = 5.77) than those with 0 (mean = 4.61) or 1 disaster (mean = 4.87); F(2, 117) = 10.03, p < .001. Not all high-burden counties experienced disasters, suggesting other contributing factors. Covariate maps revealed that high unemployment and income inequality also aligned with worse mental health outcomes.
Conclusion: The findings could suggest a cumulative mental health impact from repeated disasters, compounded by underlying socioeconomic stressors. Public health strategies should prioritize both disaster-related and structural factors when addressing mental health in vulnerable communities.
Recommended Citation
Stroud, Chloe, "Analyzing Poor Mental Health Days in Kentucky Counties Declared FEMA Disaster Zones from 2016-2019" (2025). Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.). 456.
https://uknowledge.uky.edu/cph_etds/456
