This research attempts to understand how the Christchurch rebuild is promoting urban liveability in the Central City, focussing on the influence of communities and neighbourhoods in this area. To do this, gathering the perceptions of Christchurch residents through surveys, a focus group and semi-structured interviews was carried out to see what aspects they believe contribute to creating more liveable places. These methods revealed that there are pockets of neighbourhoods and communities in the inner-city, but no overall sense of community. Results from the semi-structured interviews reinforced this; the current buyers of inner-city property are in the financial position to be able to do this, and they seem to be purchasing in this area due to convenience and investment rather than to join the existing communities in the area. Analysing the survey responses from Central City residents revealed contrasting results. Those currently living in the area felt there is a sense of community in the inner-city, but these are found in pockets of neighbourhoods around the Central City rather than in the overall area. The focus group revealed that community is further prioritised later in life, and that many of the community groups in the inner-city predominantly consist of those who have lived there since before the Christchurch Earthquake Series. However, participants of all three methods believed that the Central City is slowly becoming a lively and vibrant place. To improve urban liveability in the inner-city, it seems that prioritisation of the needs of current inner-city residents is required. Improving these neighbourhoods, whether it be through the implementation of services or providing more communal spaces, is needed to create stronger communities. The feelings of place, connectedness, and belonging that arise from being part of a community or well-connected neighbourhood can improve mental health and wellbeing, ultimately enhancing the overall health of the population as well as the perceived urban liveability of the area.
Lincoln University was commissioned by the Avon-Otakaro Network (AvON) to estimate the value of the benefits of a ‘recreation reserve’ or ‘river park’ in the Avon River Residential Red Zone (ARRRZ). This research has demonstrated significant public desire and support for the development of a recreation reserve in the Avon River Residential Red Zone. Support is strongest for a unique natural environment with native fauna and flora, healthy wetlands and rivers, and recreational opportunities that align with this vision, such as walking, cycling and water-based sporting and leisure activities. The research also showed support for a reserve that promotes and enables community interaction and wellbeing, and is evident in respondents’ desires for community gardens, regular festivals and markets, and the physical linking of the CBD with eastern suburbs through a green corridor. There is less support for children’s playgrounds, sports fields or open grassed areas, all of which could be considered as more typical of an urban park development. Benefits (willing to pay) to Christchurch residents (excluding tourists) of a recreation reserve could be as high as $35 million each year. Savings to public health costs could be as high as $50.3 million each year. The incorporation or restoration of various ecosystems services, including water quality improvements, flood mitigation and storm water management could yield a further $8.8 million ($19, 600) per hectare/year at 450 ha). Combined annual benefits of a recreational reserve in the ARRRZ are approximately $94.1 million per annum but this figure does not include potentially significant benefits from, for example, tourism, property equity gains in areas adjacent to the reserve, or the effects of economic rejuvenation in the East. Although we were not able to provide costing estimates for park attributes, this study does make available the value of benefits, which can be used as a guide to the scope of expenditure on development of each park attribute.
After a disaster, cities experience profound social and environmental upheaval. Current research on disasters describes this social disruption along with collective community action to provide support. Pre-existing social capital is recognised as fundamental to this observed support. This research examines the relationship between sense of place for neighbourhood, social connectedness and resilience. Canterbury residents experienced considerable and continued disruption following a large and protracted sequence of earthquakes starting in September 2010. A major aftershock on 22 February 2011 caused significant loss of life, destruction of buildings and infrastructure. Following this earthquake some suburbs of Christchurch showed strong collective action. This research examines the features of the built environment that helped to form this cooperative support. Data were collected through semi-structured interviews with 20 key informants followed by 38 participants from four case study suburbs. The objectives were to describe the community response of suburbs, to identify the key features of the built environment and the role of social infrastructure in fostering social connectedness. The last objective was to contribute to future planning for community resilience. The findings from this research indicated that social capital and community competence are significant resources to be called upon after a disaster. Features of the local environment facilitated the formation of neighbourhood connections that enabled participants to cope, manage and to collectively solve problems. These features also strengthened a sense of belonging and attachment to the home territory. Propinquity was important; the bumping and gathering places such as schools, small local shops and parks provided the common ground for meaningful pre-existing local interaction. Well-defined geography, intimate street typology, access to quality natural space and social infrastructure helped to build the local social connections and develop a sense of place. Resourceful individuals and groups were also a factor, and many are drawn to live near the inner city or more natural places. The features are the same well understood attributes that contribute to health and wellbeing. The policy and planning framework needs to consider broader social outcomes, including resilience in new and existing urban developments. The socio-political structures that provide access to secure and stable housing and local education should also be recognised and incorporated into local planning for resilience and the everyday.
Background Up to 6 years after the 2011 Christchurch earthquakes, approximately one-third of parents in the Christchurch region reported difficulties managing the continuously high levels of distress their children were experiencing. In response, an app named Kākano was co-designed with parents to help them better support their children's mental health.Objective The objective of this study was to evaluate the acceptability, feasibility, and effectiveness of Kākano, a mobile parenting app to increase parental confidence in supporting children struggling with their mental health.Methods A cluster-randomized delayed access controlled trial was carried out in the Christchurch region between July 2019 and January 2020. Parents were recruited through schools and block randomized to receive immediate or delayed access to Kākano. Participants were given access to the Kākano app for 4 weeks and encouraged to use it weekly. Web-based pre- and postintervention measurements were undertaken.Results A total of 231 participants enrolled in the Kākano trial, with 205 (88.7%) participants completing baseline measures and being randomized (101 in the intervention group and 104 in the delayed access control group). Of these, 41 (20%) provided full outcome data, of which 19 (18.2%) were for delayed access and 21 (20.8%) were for the immediate Kākano intervention. Among those retained in the trial, there was a significant difference in the mean change between groups favoring Kākano in the brief parenting assessment (F<sub>1,39</sub>=7, P=.012) but not in the Short Warwick-Edinburgh Mental Well-being Scale (F<sub>1,39</sub>=2.9, P=.099), parenting self-efficacy (F<sub>1,39</sub>=0.1, P=.805), family cohesion (F<sub>1,39</sub>=0.4, P=.538), or parenting sense of confidence (F<sub>1,40</sub>=0.6, P=.457). Waitlisted participants who completed the app after the waitlist period showed similar trends for the outcome measures with significant changes in the brief assessment of parenting and the Short Warwick-Edinburgh Mental Well-being Scale. No relationship between the level of app usage and outcome was found. Although the app was designed with parents, the low rate of completion of the trial was disappointing.Conclusions Kākano is an app co-designed with parents to help manage their children's mental health. There was a high rate of attrition, as is often seen in digital health interventions. However, for those who did complete the intervention, there was some indication of improved parental well-being and self-assessed parenting. Preliminary indications from this trial show that Kākano has promising acceptability, feasibility, and effectiveness, but further investigation is warranted.Trial registration Australia New Zealand Clinical Trials Registry ACTRN12619001040156; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377824&isReview=true
The aim of this thesis was to examine the spatial and the temporal patterns of anxiety and chest pain resulting from the Canterbury, New Zealand earthquaeks. Three research objectives were identified: examine any spatial or termporal clusters of anxiety and chest pain; examine the associations between anxiety, chest pain and damage to neighbourhood; and determine any statistically significant difference in counts of anxiety and chest pain after each earthquake or aftershock which resulted in severe damage. Measures of the extent of liquefaction the location of CERA red-zones were used as proxy measures for earthquake damage. Cases of those who presented to Christchurch Public Hospital Emergency Department with either anxiety or chest pain between May 2010 and April 2012 were aggregated to census area unit (CAU) level for analysis. This thesis has taken a unique approach to examining the spatial and spatio-temporal variations of anxiety and chest pain after an earthquake and offers unique results. This is the first study of its kind to use a GIS approach when examining Canterbury specific earthquake damage and health variables at a CAU level after the earthquakes. Through the use of spatio-termporal scan modelling, negative and linear regression modelling and temporal linear modelling with dummy variables this research was able to conclude there are significant spatial and temporal variations in anxiety and chest pain resulting from the earthquakes. The spatio-termporal scan modelling identified a hot cluster of both anxiety and chest pain within Christchurch at the same time the earthquakes occurred. The negative binomial model found liquefaction to be a stronger predictor of anxiety than the Canterbury Earthquake Recovery Authority's (CERA) land zones. The linear regression model foun chest pain to be positively associated with all measures of earthquake damage with the exception of being in the red-zone. The temporal modelling identified a significant increase in anxiety cases one month after a major earthquake, and chest pain cases spiked two weeks after an earthquake and gradually decreased over the following five weeks. This research was limited by lack of control period data, limited measures of earthquake damage, ethical restrictions, and the need for population tracking data. The findings of this research will be useful in the planning and allocation of mental wellbeing resources should another similar event like the Canterbury Earthquakes occur in New Zealand.
Christchurch has experienced a series of over 13,500 earthquakes between September 2010 and January 2012. Some children who have been exposed to earthquakes may experience post-traumatic stress disorder symptoms (PTSD) including difficulty concentrating, feeling anxious, restlessness and confusion. Other children may be resilient to the effects of disaster. Western models of resilience relate to a child’s social support and their capacity to cope. The Māori model of wellbeing relates to whanau (family), wairua (spiritual connections), tinana (the physical body) and hinengaro (the mind and emotions). Children’s concepts of helping, caring and learning may provide insight into resilience without introducing the topic of earthquakes into the conversation, which in itself may provoke an episode of stress. Many researchers have studied the effects of earthquakes on children. However, few studies have examined positive outcomes and resilience or listened to the children’s voices. The objective of this study was to listen to the voices of children who experienced the Canterbury earthquake period in order to gain a deeper understanding of the ideas associated resilience. Individual interviews were conducted with 17 five-year-old participants during their first term of primary school. After the interviews, the teacher shared demographic information and reports on the children’s stress and coping. Six children were identified as New Zealand European and eleven children identified as New Zealand Māori. Children had different views of helping, caring and learning. Themes of resilience from Western and Kaupapa Māori models were identified in transcripts of the children's voices and drawings. Māori children voiced more themes of resilience associated with the Western model, and in the Tapa Whā model, Māori children's transcripts were more likely to be inclusive of all four components of well-being. How five-year-old children, having experienced an earthquake disaster during their preschool years, talk or draw pictures about helping, caring and learning can provide insight into resilience, especially in situations where it is not advisable to re-traumatise children by discussing the disaster event. Future research should interview parents/caregivers and whānau to gain further insights. Considering information from both a Western and a Tapa Whā perspective can also provide new insights into resilience in young children. A limitation of this study is that qualitative studies are not always free from a researcher’s interpretation and are, therefore, subjective.
Aotearoa has undoubtedly some of the most beautiful landscapes in the world, a privilege for its inhabitants. However, as our cities have developed post-colonisation, the connection between the natural environment and its occupants has diminished. Designers play a vital role within an ever evolving world to progress the built environment in a way that reflects and restores vital values that have been deprioritised. Future practice should prioritise diversity, care for the land, enhancement of community space, and sustainable practices.
This research sets out to demonstrate that new design methodologies can encourage kaitiakitanga, whilst meeting the needs of urban public space. Initially through critical analysis and literature based research, a study of Ōtautahi Christchurch, the South Island’s largest city, was undertaken. The principles of a ‘15 minute city’ were also explored and applied to the city, establishing issues within the built environment that drove the overall research direction.
Through the tools of critical reflection and a research through design methodology, a design toolkit was constructed. This toolkit sets out to provide designers with a simple streamlined method of developing urban interventions that are sustainable and beneficial for human well-being. The toolkit incorporates an abstraction of the ‘15 minute city’ ideology and introduces the concepts of evolving green transportation routes within cities. Ōtautahi Christchurch, a city with a significant history of earthquake-caused damage, was chosen as the primary site for the application of this research’s proposed toolkit. The city becomes a canvas for an urban rebuild that explores and aims to set a precedent for a progressive 21st-century city.
A key finding as the toolkit research developed was the idea of a ‘temporary’ phase or intervention, being added to traditional design methodologies prior to permanent building. The research explains how this temporary phase could more actively engage diverse user groups and create active conversations between communities and designers.
The refined toolkit sets outs proposed timeline phases, methods of site analysis and development of design drivers. Alongside this, a modular architectural system establishes a design proposal for the temporary phase of an individual site within an evolving green route. This outcome provides further opportunity for realistic testing, which would actively involve communities and aims to shift our priorities within urban development. The introduction of the ‘temporary’ phase is beneficial in mitigating psychological implications on people and limiting physical impacts on the landscape.
The final design stage of the thesis applied the toolkit process to three sites in Ōtautahi Christchurch. Through a holistic lens, the toolkit framework set out methods to collate information that provides guidance for development on the sites. While some layers are initiated simply by recognising site characteristics, others are informed through software such as GIS.
Connected by a proposed green transport route, the three initial sites are developed with temporary interventions that utilise the modular design set out previously in the research. Contextualising the interventions on real world sites tested the flexibility of the system and allowed for critical reflection on the applicability of the toolkit to Aotearoa.
The research concludes by identifying future research opportunities and speculates on possible applications of its findings within the real world. Temporary Permanence highlights the significant role that we, as designers, have in shifting urban priorities to create more holistic, sustainable, and inclusive cities for people and the planet.
As a global phenomenon, many cities are undergoing urban renewal to accommodate rapid growth in urban population. However, urban renewal can struggle to balance social, economic, and environmental outcomes, whereby economic outcomes are often primarily considered by developers. This has important implications for urban forests, which have previously been shown to be negatively affected by development activities. Urban forests serve the purpose of providing ecosystem services and thus are beneficial to human wellbeing. Better understanding the effect of urban renewal on city trees may help improve urban forest outcomes via effective management and policy strategies, thereby maximising ecosystem service provision and human wellbeing. Though the relationship between certain aspects of development and urban forests has received consideration in previous literature, little research has focused on how the complete property redevelopment cycle affects urban forest dynamics over time. This research provides an opportunity to gain a comprehensive understanding of the effect of residential property redevelopment on urban forest dynamics, at a range of spatial scales, in Christchurch, New Zealand following a series of major earthquakes which occurred in 2010 – 2011. One consequence of the earthquakes is the redevelopment of thousands of properties over a relatively short time-frame. The research quantifies changes in canopy cover city-wide, as well as, tree removal, retention, and planting on individual residential properties. Moreover, the research identifies the underlying reasons for these dynamics, by exploring the roles of socio-economic and demographic factors, the spatial relationships between trees and other infrastructure, and finally, the attitudes of residential property owners. To quantify the effect of property redevelopment on canopy cover change in Christchurch, this research delineated tree canopy cover city-wide in 2011 and again in 2015. An object-based image analysis (OBIA) technique was applied to aerial imagery and LiDAR data acquired at both time steps, in order to estimate city-wide canopy cover for 2011 and 2015. Changes in tree canopy cover between 2011 and 2015 were then spatially quantified. Tree canopy cover change was also calculated for all meshblocks (a relatively fine-scale geographic boundary) in Christchurch. The results show a relatively small magnitude of tree canopy cover loss, city-wide, from 10.8% to 10.3% between 2011 and 2015, but a statistically significant change in mean tree canopy cover across all the meshblocks. Tree canopy cover losses were more likely to occur in meshblocks containing properties that underwent a complete redevelopment cycle, but the loss was insensitive to the density of redevelopment within meshblocks. To explore property-scale individual tree dynamics, a mixed-methods approach was used, combining questionnaire data and remote sensing analysis. A mail-based questionnaire was delivered to residential properties to collect resident and household data; 450 residential properties (321 redeveloped, 129 non- redeveloped) returned valid questionnaires and were identified as analysis subjects. Subsequently, 2,422 tree removals and 4,544 tree retentions were identified within the 450 properties; this was done by manually delineating individual tree crowns, based on aerial imagery and LiDAR data, and visually comparing the presence or absence of these trees between 2011 and 2015. The tree removal rate on redeveloped properties (44.0%) was over three times greater than on non-redeveloped properties (13.5%) and the average canopy cover loss on redeveloped properties (52.2%) was significantly greater than on non-redeveloped properties (18.8%). A classification tree (CT) analysis was used to model individual tree dynamics (i.e. tree removal, tree retention) and candidate explanatory variables (i.e. resident and household, economic, land cover, and spatial variables). The results indicate that the model including land cover, spatial, and economic variables had the best predicting ability for individual tree dynamics (accuracy = 73.4%). Relatively small trees were more likely to be removed, while trees with large crowns were more likely to be retained. Trees were most likely to be removed from redeveloped properties with capital values lower than NZ$1,060,000 if they were within 1.4 m of the boundary of a redeveloped building. Conversely, trees were most likely to be retained if they were on a property that was not redeveloped. The analysis suggested that the resident and household factors included as potential explanatory variables did not influence tree removal or retention. To conduct a further exploration of the relationship between resident attitudes and actions towards trees on redeveloped versus non-redeveloped properties, this research also asked the landowners from the 450 properties that returned mail questionnaires to indicate their attitudes towards tree management (i.e. tree removal, tree retention, and tree planting) on their properties. The results show that residents from redeveloped properties were more likely to remove and/or plant trees, while residents from non- redeveloped properties were more likely to retain existing trees. A principal component analysis (PCA) was used to explore resident attitudes towards tree management. The results of the PCA show that residents identified ecosystem disservices (e.g. leaf litter, root damage to infrastructure) as common reasons for tree removal; however, they also noted ecosystem services as important reasons for both tree planting and tree retention on their properties. Moreover, the reasons for tree removal and tree planting varied based on whether residents’ property had been redeveloped. Most tree removal occurred on redeveloped properties because trees were in conflict with redevelopment, but occurred on non- redeveloped properties because of perceived poor tree health. Residents from redeveloped properties were more likely to plant trees due to being aesthetically pleasing or to replace trees removed during redevelopment. Overall, this research adds to, and complements, the existing literature on the effects of residential property redevelopment on urban forest dynamics. The findings of this research provide empirical support for developing specific legislation or policies about urban forest management during residential property redevelopment. The results also imply that urban foresters should enhance public education on the ecosystem services provided by urban forests and thus minimise the potential for tree removal when undertaking property redevelopment.
During 2010 and 2011, major earthquakes caused widespread damage and the deaths of 185 people in the city of Christchurch. Damaged school buildings resulted in state intervention which required amendment of the Education Act of 1989, and the development of ‘site sharing agreements’ in undamaged schools to cater for the needs of students whose schools had closed. An effective plan was also developed for student assessment through establishing an earthquake impaired derived grade process. Previous research into traditional explanations of educational inequalities in the United Kingdom, the United States of America, and New Zealand were reviewed through various processes within three educational inputs: the student, the school and the state. Research into the impacts of urban natural disasters on education and education inequalities found literature on post disaster education systems but nothing could be found that included performance data. The impacts of the Canterbury earthquakes on educational inequalities and achievement were analysed over 2009-2012. The baseline year was 2009, the year before the first earthquake, while 2012 is seen as the recovery year as no schools closed due to seismic events and there was no state intervention into the education of the region. National Certificate of Educational Achievement (NCEA) results levels 1-3 from thirty-four secondary schools in the greater Christchurch region were graphed and analysed. Regression analysis indicates; in 2009, educational inequalities existed with a strong positive relationship between a school’s decile rating and NCEA achievement. When schools were grouped into decile rankings (1-10) and their 2010 NCEA levels 1-3 results were compared with the previous year, the percentage of change indicates an overall lower NCEA achievement in 2010 across all deciles, but particularly in lower decile schools. By contrast, when 2011 NCEA results were compared with those of 2009, as a percentage of change, lower decile schools fared better. Non site sharing schools also achieved higher results than site sharing schools. State interventions, had however contributed towards student’s achieving national examinations and entry to university in 2011. When NCEA results for 2012 were compared to 2009 educational inequalities still exist, however in 2012 the positive relationship between decile rating and achievement is marginally weaker than in 2009. Human ethics approval was required to survey one Christchurch secondary school community of students (aged between 12 and 18), teachers and staff, parents and caregivers during October 2011. Participation was voluntary and without incentives, 154 completed questionnaires were received. The Canterbury earthquakes and aftershocks changed the lives of the research participants. This school community was displaced to another school due to the Christchurch earthquake on 22 February 2011. Research results are grouped under four geographical perspectives; spatial impacts, socio-economic impacts, displacement, and health and wellbeing. Further research possibilities include researching the lag effects from the Canterbury earthquakes on school age children.
Natural hazard disasters often have large area-wide impacts, which can cause adverse stress-related mental health outcomes in exposed populations. As a result, increased treatment-seeking may be observed, which puts a strain on the limited public health care resources particularly in the aftermath of a disaster. It is therefore important for public health care planners to know whom to target, but also where and when to initiate intervention programs that promote emotional wellbeing and prevent the development of mental disorders after catastrophic events. A large body of literature assesses factors that predict and mitigate disaster-related mental disorders at various time periods, but the spatial component has rarely been investigated in disaster mental health research. This thesis uses spatial and spatio-temporal analysis techniques to examine when and where higher and lower than expected mood and anxiety symptom treatments occurred in the severely affected Christchurch urban area (New Zealand) after the 2010/11 Canterbury earthquakes. High-risk groups are identified and a possible relationship between exposure to the earthquakes and their physical impacts and mood and anxiety symptom treatments is assessed. The main research aim is to test the hypothesis that more severely affected Christchurch residents were more likely to show mood and anxiety symptoms when seeking treatment than less affected ones, in essence, testing for a dose-response relationship. The data consisted of mood and anxiety symptom treatment information from the New Zealand Ministry of Health’s administrative databases and demographic information from the National Health Index (NHI) register, when combined built a unique and rich source for identifying publically funded stress-related treatments for mood and anxiety symptoms in almost the whole population of the study area. The Christchurch urban area within the Christchurch City Council (CCC) boundary was the area of interest in which spatial variations in these treatments were assessed. Spatial and spatio-temporal analyses were done by applying retrospective space-time and spatial variation in temporal trends analysis using SaTScan™ software, and Bayesian hierarchical modelling techniques for disease mapping using WinBUGS software. The thesis identified an overall earthquake-exposure effect on mood and anxiety symptom treatments among Christchurch residents in the context of the earthquakes as they experienced stronger increases in the risk of being treated especially shortly after the catastrophic 2011 Christchurch earthquake compared to the rest of New Zealand. High-risk groups included females, elderly, children and those with a pre-existing mental illness with elderly and children especially at-risk in the context of the earthquakes. Looking at the spatio-temporal distribution of mood and anxiety symptom treatments in the Christchurch urban area, a high rates cluster ranging from the severely affected central city to the southeast was found post-disaster. Analysing residential exposure to various earthquake impacts found that living in closer proximity to more affected areas was identified as a risk factor for mood and anxiety symptom treatments, which largely confirms a dose-response relationship between level of affectedness and mood and anxiety symptom treatments. However, little changes in the spatial distribution of mood and anxiety symptom treatments occurred in the Christchurch urban area over time indicating that these results may have been biased by pre-existing spatial disparities. Additionally, the post-disaster mobility activity from severely affected eastern to the generally less affected western and northern parts of the city seemed to have played an important role as the strongest increases in treatment rates occurred in less affected northern areas of the city, whereas the severely affected eastern areas tended to show the lowest increases. An investigation into the different effects of mobility confirmed that within-city movers and temporary relocatees were generally more likely to receive care or treatment for mood or anxiety symptoms, but moving within the city was identified as a protective factor over time. In contrast, moving out of the city from minor, moderately or severely damaged plain areas of the city, which are generally less affluent than Port Hills areas, was identified as a risk factor in the second year post-disaster. Moreover, residents from less damaged plain areas of the city showed a decrease in the likelihood of receiving care or treatment for mood or anxiety symptoms compared to those from undamaged plain areas over time, which also contradicts a possible dose-response relationship. Finally, the effects of the social and physical environment, as well as community resilience on mood and anxiety symptom treatments among long-term stayers from Christchurch communities indicate an exacerbation of pre-existing mood and anxiety symptom treatment disparities in the city, whereas exposure to ‘felt’ earthquake intensities did not show a statistically significant effect. The findings of this thesis highlight the complex relationship between different levels of exposure to a severe natural disaster and adverse mental health outcomes in a severely affected region. It is one of the few studies that have access to area-wide health and impact information, are able to do a pre-disaster / post-disaster comparison and track their sample population to apply spatial and spatio-temporal analysis techniques for exposure assessment. Thus, this thesis enhances knowledge about the spatio-temporal distribution of adverse mental health outcomes in the context of a severe natural disaster and informs public health care planners, not only about high-risk groups, but also where and when to target health interventions. The results indicate that such programs should broadly target residents living in more affected areas as they are likely to face daily hardship by living in a disrupted environment and may have already been the most vulnerable ones before the disaster. Special attention should be focussed on women, elderly, children and people with pre-existing mental illnesses as they are most likely to receive care or treatment for stress-related mental health symptoms. Moreover, permanent relocatees from affected areas and temporarily relocatees shortly after the disaster may need special attention as they face additional stressors due to the relocation that may lead to the development of adverse mental health outcomes needing treatment.
