New Zealand has a long tradition of using light timber frame for construction of its domestic dwellings. After the most recent earthquakes (e.g. Canterbury earthquakes sequence), wooden residential houses showed satisfactory life safety performance. However, poor performance was reported in terms of their seismic resilience. Although numerous innovative methods to mitigate damage have been introduced to the New Zealand community in order to improve wooden house performance, these retrofit options have not been readily taken up. The low number of retrofitted wooden-framed houses leads to questions about whether homeowners are aware of the necessity of seismic retrofitting their houses to achieve a satisfactory seismic performance. This study aims to explore different retrofit technologies that can be applied to wooden-framed houses in Wellington, taking into account the need of homeowners to understand the risk, likelihood and extent of damage expected after an event. A survey will be conducted in Wellington about perceptions of homeowners towards the expected performance of their wooden-framed houses. The survey questions were designed to gain an understanding of homeowners' levels of safety and awareness of possible damage after a seismic event. Afterwards, a structural review of a sample of the houses will be undertaken to identify common features and detail potential seismic concerns. The findings will break down barriers to making improvements in the performance of wooden-framed houses and lead to enhancements in the confidence of homeowners in the event of future seismic activity. This will result in increased understanding and contribute towards an accessible knowledge base, which will possibly increase significantly the use of these technologies and avoid unnecessary economic and social costs after a seismic event.
This paper reports on a service-learning public journalism project in which postgraduate journalism students explore ways to engage with and report on diverse communities. Media scholars have argued that news media, and local newspapers in particular, must re-engage with their communities. Likewise, journalism studies scholars have urged educators to give journalism students greater opportunities to reflect on their work by getting out among journalism’s critics, often consumers or citizens concerned about content and the preparation of future journalists. The challenge for journalism educators is to prepare students for working in partnership with communities while also developing their ability to operate reflectively and critically within the expectations of the news media industry and wider society. The aim of this project has been to help students find ways to both listen and lead in a community, and also reflect on the challenges and critiques of community journalism practices. The project began in 2013 with stories about residents’ recovery following the devastating 2011 Canterbury earthquakes, and aimed to create stories that could contribute to community connection and engagement, and thereby resilience and recovery. The idea was inspired by research about post-disaster renewal that indicated that communities with strong social capital and social networks were more resilient and recovered more quickly and strongly. The project’s longer-term aim has been to explore community journalism practices that give greater power to citizens and communities by prioritising listening and processes of engagement. Over several months, students network with a community group to identify subjects with whom they will co-create a story, and then complete a story on which they must seek the feedback of their subject. Community leaders have described the project as a key example of how to do things “with people not to people”, and an outstanding contribution to the community-led component of Canterbury’s recovery. Analysis of student reflections, which are a key part of each year’s project, reveals the process of engaging with communities has helped students to map community dynamics, think more critically about source relationships, editorial choices and objectivity norms, and to develop a perspective on the diverse ways they can go about their journalism in the future. Each year, students partner with different groups and organisations, addressing different themes each time the project runs. For 2016, the programme proposes to develop the project in a new way, by not just exploring a community’s stories but also exploring its media needs and it aims to work with Christchurch’s new migrant Filipino community to develop the groundwork for a community media and/or communication platform, which Filipino community leaders say is a pressing need. For this iteration, journalism students will be set further research tasks aimed at deepening their ‘public listening’: they will conduct a survey of community members’ media use and needs as well as qualitative research interviews. It is hoped that the data collected will strengthen students’ understanding of their own journalism practice, as well as form the basis for work on developing media tools for minority groups who are generally poorly represented in mainstream media. In 2015, the journalism programme surveyed its community partners and held follow-up interviews with 13 of 18 story subjects to elicit further feedback on its news content and thereby deepen understanding of different community viewpoints. The survey and interview data revealed the project affected story subjects in a number of positive and interesting ways. Subjects said they appreciated the way student reporters took their time to build relationships and understand the context of the community groups with which they were involved, and contrasted this with their experience of professional journalists who had held pre-conceived assumptions about stories and/or rushed into interviews. As a direct consequence of the students’ approach, participants said they better trusted the student journalists to portray them accurately and fairly. Most were also encouraged by the positive recognition stories brought and several said the engagement process had helped their personal development, all of which had spin-offs for their community efforts. The presentation night that wraps up each year’s project, where community groups, story subjects and students come together to network and share the final stories, was cited as a significant positive aspect of the project and a great opportunity for community partners to connect with others doing similar work. Community feedback will be sought in future projects to inform and improve successive iterations.
New Zealand has experienced several strong earthquakes in its history. While an earthquake cannot be prevented from occurring, planning can reduce its consequences when it does occur. This dissertation research examines various aspects of disaster risk management policy in Aotearoa New Zealand.
Chapter 2 develops a method to rank and prioritise high-rise buildings for seismic retrofitting in Wellington, the earthquake-prone capital city of New Zealand. These buildings pose risks to Wellington’s long-term seismic resilience that are of clear concern to current and future policymakers. The prioritization strategy we propose, based on multi-criteria decision analysis (MCDA) methods, considers a variety of data on each building, including not only its structural characteristics, but also its location, its economic value to the city, and its social importance to the community around it. The study demonstrates how different measures, within four general criteria – life safety, geo-spatial location of the building, its economic role, and its socio-cultural role – can be operationalized into a viable framework for determining retrofitting/demolition policy priorities.
Chapter 3 and chapter 4 analyse the Residential Red Zone (RRR) program that was implemented in Christchurch after the 2011 earthquake. In the program, approximately 8,000 homeowners were told that their homes were no longer permittable, and they were bought by the government (through the Canterbury Earthquake Recovery Authority).
Chapter 3 examines the subjective wellbeing of the RRR residents (around 16000 people) after they were forced to move. We consider three indicators of subjective wellbeing: quality of life, stress, and emotional wellbeing. We found that demographic factors, health conditions, and the type of government compensation the residents accepted, were all significant determinants of the wellbeing of the Red Zone residents. More social relations, better financial circumstances, and the perception of better government communication were also all associated positively with a higher quality of life, less stress, and higher emotional wellbeing.
Chapter 4 concentrates on the impact of this managed retreat program on RRR residents’ income. We use individual-level comprehensive, administrative, panel data from Canterbury, and difference in difference evaluation method to explore the effects of displacement on Red Zone residential residents. We found that compared to non-relocated neighbours, the displaced people experience a significant initial decrease in their wages and salaries, and their total income. The impacts vary with time spent in the Red Zone and when they moved away. Wages and salaries of those who were red-zoned and moved in 2011 were reduced by 8%, and 5.4% for those who moved in 2012. Females faced greater decreases in wages and salaries, and total income, than males. There were no discernible impacts of the relocation on people’s self-employment income.
Natural disasters are increasingly disruptive events that affect livelihoods, organisations, and economies worldwide. Research has identified the impacts and responses of organisations to different types of natural disasters, and have outlined factors, such as industry sector, that are important to organisational vulnerability and resilience. One of the most costly types of natural disasters in recent years has been earthquakes, and yet to date, the majority of studies have focussed on the effects of earthquakes in urban areas, while rural organisational impact studies have primarily focused on the effects of meteorological and climatic driven hazards. As a result, the likely impacts of an earthquake on rural organisations in a developed context is unconstrained in the literature. In countries like New Zealand, which have major earthquakes and agricultural sectors that are significant contributors to the economy, it is important to know what impacts an earthquake event would have on the rural industries, and how these impacts compare to that of a more commonly analysed, high-frequency event. In September of 2010, rural organisations in Canterbury experienced the 4 September 2010 Mw 7.1 `Darfield' earthquake and the associated aftershocks, which came to be known as the Canterbury earth- quake sequence. The earthquake sequence caused intense ground shaking, creating widespread critical service outages, structural and non-structural damage to built infrastructure, as well as ground surface damage from ooding, liquefaction and surface rupture. Concurrently on September 18 2010, rural organisations in Southland experienced an unseasonably late snowstorm and cold weather snap that brought prolonged sub-zero temperatures, high winds and freezing rain, damaging structures in the City of Invercargill and causing widespread livestock losses and production decreases across the region. This thesis documents the effects of the Canterbury earthquake sequence and Southland snowstorm on farming and rural non-farming organisations, utilizing comparable methodologies to analyse rural organisational impacts, responses and recovery strategies to natural disasters. From the results, a short- term impact assessment methodology is developed for multiple disasters. Additionally, a regional asset repair cost estimation model is proposed for farming organisations following a major earthquake event, and the use of social capital in rural organisational recovery strategies following natural disasters is analysed.
Research on responses to trauma has historically focused on the negative repercussions of a struggle with adversity. However, more recently, researchers have begun to examine posttraumatic growth: the positive psychological change that emerges from the struggle with a potentially traumatic event. Associations have been found between posttraumatic growth and greater peritraumatic distress, greater objective severity of trauma exposure, greater perceived stressfulness of events, social support, female gender, cognitive and behavioural responses to trauma, and personality measures. Posttraumatic growth has been measured typically in individuals with varying levels of posttraumatic stress disorder symptoms and other psychological difficulties, such as depression and anxiety. Although some theory and research posits that higher resilience would prohibit posttraumatic growth, no studies have examined posttraumatic growth in a resilient sample. The Canterbury earthquake sequence of 2010 and 2011 involved potentially traumatic events that saw the community struggle with a variety of challenges. However, in the midst of earthquake destruction, some positive initiatives emerged, driven by locals. The Gap Filler project (using city spaces left empty from fallen buildings for art and interactive community projects) and the Student Volunteer Army (groups of volunteers coordinated to help others in need) are examples of this. In this context, it seemed likely that posttraumatic growth was occurring and might be seen in individuals who were coping well with challenges. Culture is theorised to influence the posttraumatic growth process (Calhoun, Cann, & Tedeschi, 2010), and the nature of the trauma undergone is also likely to influence the process of growth. The current thesis measures posttraumatic growth quantitatively and qualitatively in a New Zealand sample. It measures and describes posttraumatic growth in a resilient population after the earthquake sequence of 2010 and 2011 in Canterbury, New Zealand. Findings are used to test current models of posttraumatic growth for individuals coping well after trauma and to elaborate on mechanisms proposed by models such as the comprehensive model of posttraumatic growth (Calhoun et al., 2010) and the organismic valuing theory of growth through adversity (Joseph & Linley, 2005). Correlates of posttraumatic growth are examined and likely supporting factors of posttraumatic growth are identified for this population. Study 1 used quantitative analysis to explore correlates of posttraumatic growth and found that greater posttraumatic growth related to greater peritraumatic distress, greater perceived stressfulness of earthquake events, greater objective stressfulness of earthquake events, greater difficulty with stressful life events, less satisfaction with social support, and female gender. Findings from Study 1 give important detail about the nature of distress included in the comprehensive model of posttraumatic growth (Calhoun et al., 2010) for this population. Levels of posttraumatic growth were lower than those in North American studies but similar to those in a Chinese study. The current sample, however, showed lower endorsement of Relating to Others than the Chinese study, perhaps because of cultural differences. Study 2 used qualitative analysis to examine the experience of posttraumatic growth in the sample. The theme of ‘a greater sense of community’ was found and adds to the comprehensive model of posttraumatic growth, in that an expression of posttraumatic growth (a greater connection with others) can inform ongoing social processing in the posttraumatic growth process. Having a formal or informal role in earthquake recovery appeared to influence self-concept and reflection; this elaborates on the influence of role on reflection in Calhoun et al.’s model. Findings illustrate possible mechanisms of the organismic valuing process theorised by Joseph and Linley (2005). Implications include the importance of providing opportunities for individuals to take on a role after a crisis, encouraging them to act to respond to difficulties, and encouraging them to meet personal needs for relatedness, competence, and autonomy. Finding positive aspects to a difficult situation, as well as acknowledging adversity, can be supported in future to help individuals process their traumas. As a society, we can help individuals cope with adversity by providing ways they can meet their needs for relatedness, competence, and autonomy. Community groups likely provide opportunities for members to act in ways that meet such needs. This will allow them to effectively act to meet their needs in times of crisis.
Though generally considered “natural” disasters, cyclones and earthquakes are increasingly being associated with human activities, incubated through urban settlement patterns and the long-term redistribution of natural resources. As society is becoming more urbanized, the risk of human exposure to disasters is also rising. Architecture often reflects the state of society’s health: architectural damage is the first visible sign of emergency, and reconstruction is the final response in the process of recovery. An empirical assessment of architectural projects in post-disaster situations can lead to a deeper understanding of urban societies as they try to rebuild. This thesis offers an alternative perspective on urban disasters by looking at the actions and attitudes of disaster professionals through the lens of architecture, situated in recent events: the 2010 Christchurch earthquake, the 2010 Haiti earthquake, and the 2005 Hurricane Katrina. An empirical, multi-hazard, cross-sectional case study methodology was used, employing grounded theory method to build theory, and a critical constructivist strategy to inform the analysis. By taking an interdisciplinary approach to understanding disasters, this thesis positions architecture as a conduit between two divergent approaches to disaster research: the hazards approach, which studies the disaster cycles from a scientific perspective; and the sociological approach, which studies the socially constructed vulnerabilities that result from disasters, and the elements of social change that accompany such events. Few studies to date have attempted to integrate the multi-disciplinary perspectives that can advance our understanding of societal problems in urban disasters. To bridge this gap, this thesis develops what will be referred to as the “Rittelian framework”—based on the work of UC Berkeley’s architecture professor Horst Rittel (1930-1990). The Rittelian framework uses the language of design to transcend the multiple fields of human endeavor to address the “design problems” in disaster research. The processes by which societal problems are addressed following an urban disaster involve input by professionals from multiple fields—including economics, sociology, medicine, and engineering—but the contribution from architecture has been minimal to date. The main impetus for my doctoral thesis has been the assertion that most of the decisions related to reconstruction are made in the early emergency recovery stages where architects are not involved, but architects’ early contribution is vital to the long-term reconstruction of cities. This precipitated in the critical question: “How does the Rittelian framework contribute to the critical design decisions in modern urban disasters?” Comparative research was undertaken in three case studies of recent disasters in New Orleans (2005), Haiti (2010) and Christchurch (2010), by interviewing 51 individuals who were selected on the basis of employing the Rittelian framework in their humanitarian practice. Contextualizing natural disaster research within the robust methodological framework of architecture and the analytical processes of sociology is the basis for evaluating the research proposition that architectural problem solving is of value in addressing the ‘Wicked Problems’ of disasters. This thesis has found that (1) the nuances of the way disaster agents interpret the notion of “building back better” can influence the extent to which architectural professionals contribute in urban disaster recovery, (2) architectural design can be used to facilitate but also impede critical design decisions, and (3) framing disaster research in terms of design decisions can lead to innovation where least expected. This empirical research demonstrates how the Rittelian framework can inform a wider discussion about post-disaster human settlements, and improve our resilience through disaster research
From 2010, Canterbury, a province of Aotearoa New Zealand, experienced three major disaster events. This study considers the socio-ecological impacts on cross-sectoral suicide prevention agencies and their service users of the 2010 – 2016 Canterbury earthquake sequence, the 2019 Christchurch mosque attacks and the COVID-19 pandemic in Canterbury. This study found the prolonged stress caused by these events contributed to a rise in suicide risk factors including anxiety, fear, trauma, distress, alcohol misuse, relationship breakdown, childhood adversity, economic loss and deprivation. The prolonged negative comment by the media on wellbeing in Canterbury was also unhelpful and affected morale. The legacy of these impacts was a rise in referrals to mental health services that has not diminished. This adversity in the socio-ecological system also produced post-traumatic growth, allowing Cantabrians to acquire resilience and help-seeking abilities to support them psychologically through the COVID-19 pandemic. Supporting parental and teacher responses, intergenerational support and targeted public health campaigns, as well as Māori family-centred programmes, strengthened wellbeing. The rise in suicide risk led to the question of what services were required and being delivered in Canterbury and how to enable effective cross-sectoral suicide prevention in Canterbury, deemed essential in all international and national suicide prevention strategies. Components from both the World Health Organisation Suicide Prevention Framework (WHO, 2012; WHO 2021) and the Collective Impact model (Hanleybrown et al., 2012) were considered by participants. The effectiveness of dynamic leadership and the essential conditions of resourcing a supporting agency were found as were the importance of processes that supported equity, lived experience and the partnership of Māori and non-Māori stakeholders. Cross-sectoral suicide prevention was found to enhance the wellbeing of participants, hastening learning, supporting innovation and raising awareness across sectors which might lower stigma. Effective communication was essential in all areas of cross-sectoral suicide prevention and clear action plans enabled measurement of progress. Identified components were combined to create a Collective Impact Suicide Prevention framework that strengthens suicide prevention implementation and can be applied at a local, regional and national level. This study contributes to cross-sectoral suicide prevention planning by considering the socio- ecological, policy and practice mitigations required to lower suicide risk and to increase wellbeing and post-traumatic growth, post-disaster. This study also adds to the growing awareness of the contribution that social work can provide to suicide prevention and conceptualises an alternative governance framework and practice and policy suggestions to support effective cross-sectoral suicide prevention.
Sewerage systems convey sewage, or wastewater, from residential or commercial buildings through complex reticulation networks to treatment plants. During seismic events both transient ground motion and permanent ground deformation can induce physical damage to sewerage system components, limiting or impeding the operability of the whole system. The malfunction of municipal sewerage systems can result in the pollution of nearby waterways through discharge of untreated sewage, pose a public health threat by preventing the use of appropriate sanitation facilities, and cause serious inconvenience for rescuers and residents. Christchurch, the second largest city in New Zealand, was seriously affected by the Canterbury Earthquake Sequence (CES) in 2010-2011. The CES imposed widespread damage to the Christchurch sewerage system (CSS), causing a significant loss of functionality and serviceability to the system. The Christchurch City Council (CCC) relied heavily on temporary sewerage services for several months following the CES. The temporary services were supported by use of chemical and portable toilets to supplement the damaged wastewater system. The rebuild delivery agency -Stronger Christchurch Infrastructure Rebuild Team (SCIRT) was created to be responsible for repair of 85 % of the damaged horizontal infrastructure (i.e., water, wastewater, stormwater systems, and roads) in Christchurch. Numerous initiatives to create platforms/tools aiming to, on the one hand, support the understanding, management and mitigation of seismic risk for infrastructure prior to disasters, and on the other hand, to support the decision-making for post-disaster reconstruction and recovery, have been promoted worldwide. Despite this, the CES in New Zealand highlighted that none of the existing platforms/tools are either accessible and/or readable or usable by emergency managers and decision makers for restoring the CSS. Furthermore, the majority of existing tools have a sole focus on the engineering perspective, while the holistic process of formulating recovery decisions is based on system-wide approach, where a variety of factors in addition to technical considerations are involved. Lastly, there is a paucity of studies focused on the tools and frameworks for supporting decision-making specifically on sewerage system restoration after earthquakes. This thesis develops a decision support framework for sewerage pipe and system restoration after earthquakes, building on the experience and learning of the organisations involved in recovering the CSS following the CES in 2010-2011. The proposed decision support framework includes three modules: 1) Physical Damage Module (PDM); 2) Functional Impact Module (FIM); 3) Pipeline Restoration Module (PRM). The PDM provides seismic fragility matrices and functions for sewer gravity and pressure pipelines for predicting earthquake-induced physical damage, categorised by pipe materials and liquefaction zones. The FIM demonstrates a set of performance indicators that are categorised in five domains: structural, hydraulic, environmental, social and economic domains. These performance indicators are used to assess loss of wastewater system service and the induced functional impacts in three different phases: emergency response, short-term recovery and long-term restoration. Based on the knowledge of the physical and functional status-quo of the sewerage systems post-earthquake captured through the PDM and FIM, the PRM estimates restoration time of sewer networks by use of restoration models developed using a Random Forest technique and graphically represented in terms of restoration curves. The development of a decision support framework for sewer recovery after earthquakes enables decision makers to assess physical damage, evaluate functional impacts relating to hydraulic, environmental, structural, economic and social contexts, and to predict restoration time of sewerage systems. Furthermore, the decision support framework can be potentially employed to underpin system maintenance and upgrade by guiding system rehabilitation and to monitor system behaviours during business-as-usual time. In conjunction with expert judgement and best practices, this framework can be moreover applied to assist asset managers in targeting the inclusion of system resilience as part of asset maintenance programmes.
The city of Ōtautahi/Christchurch experienced a series of earthquakes that began on September 4th, 2010. The most damaging event occurred on February 22nd, 2011 but significant earthquakes also occurred on June 13th and December 23rd with aftershocks still occurring well into 2012. The resulting disaster is the second deadliest natural disaster in New Zealand’s history with 185 deaths. During 2011 the Canterbury earthquakes were one of the costliest disasters worldwide with an expected cost of up to $NZ30 billion. Hundreds of commercial buildings and thousands of houses have been destroyed or are to be demolished and extensive repairs are needed for infrastructure to over 100,000 homes. As many as 8,900 people simply abandoned their homes and left the city in the first few months after the February event (Newell, 2012), and as many as 50,000 may leave during 2012. In particular, young whānau and single young women comprised a disproportionate number of these migrants, with evidence of a general movement to the North Island. Te Puni Kōkiri sought a mix of quantitative and qualitative research to examine the social and economic impacts of the Christchurch earthquakes on Māori and their whānau. The result of this work will be a collection of evidence to inform policy to support and assist Māori and their whānau during the recovery/rebuild phases. To that end, this report triangulates available statistical and geographical information with qualitative data gathered over 2010 and 2011 by a series of interviews conducted with Māori who experienced the dramatic events associated with the earthquakes. A Māori research team at Lincoln University was commissioned to undertake the research as they were already engaged in transdisciplinary research (began in the May 2010), that focused on quickly gathering data from a range of Māori who experienced the disaster, including relevant economic, environmental, social and cultural factors in the response and recovery of Māori to these events. Participants for the qualitative research were drawn from Māori whānau who both stayed and left the city. Further data was available from ongoing projects and networks that the Lincoln research team was already involved in, including interviews with Māori first responders and managers operating in the CBD on the day of the February event. Some limited data is also available from younger members of affected whānau. Māori in Ōtautahi/Christchurch City have exhibited their own culturally-attuned collective responses to the disaster. However, it is difficult to ascertain Māori demographic changes due to a lack of robust statistical frameworks but Māori outward migration from the city is estimated to range between 560 and 1,100 people. The mobility displayed by Māori demonstrates an important but unquantified response by whānau to this disaster, with emigration to Australia presenting an attractive option for young Māori, an entrenched phenomenon that correlates to cyclical downturns and the long-term decline of the New Zealand economy. It is estimated that at least 315 Māori have emigrated from the Canterbury region to Australia post-quake, although the disaster itself may be only one of a series of events that has prompted such a decision. Māori children made up more than one in four of the net loss of children aged 6 to 15 years enrolled in schools in Greater Christchurch over the year to June 2011. Research literature identifies depression affecting a small but significant number of children one to two years post-disaster and points to increasing clinical and organisational demands for Māori and other residents of the city. For those residents in the eastern or coastal suburbs – home to many of the city’s Māori population - severe damage to housing, schools, shops, infrastructure, and streets has meant disruption to their lives, children’s schooling, employment, and community functioning. Ongoing abandonment of homes by many has meant a growing sense of unease and loss of security, exacerbated by arson, burglaries, increased drinking, a stalled local and national economy, and general confusion about the city’s future. Māori cultural resilience has enabled a considerable network of people, institutions, and resources being available to Māori , most noticeably through marae and their integral roles of housing, as a coordinating hub, and their arguing for the wider affected communities of Christchurch. Relevant disaster responses need to be discussed within whānau, kōhanga, kura, businesses, communities, and wider neighbourhoods. Comprehensive disaster management plans need to be drafted for all iwi in collaboration with central government, regional, and city or town councils. Overall, Māori are remarkably philosophical about the effects of the disaster, with many proudly relishing their roles in what is clearly a historic event of great significance to the city and country. Most believe that ‘being Māori’ has helped cope with the disaster, although for some this draws on a collective history of poverty and marginalisation, features that contribute to the vulnerability of Māori to such events. While the recovery and rebuild phases offer considerable options for Māori and iwi, with Ngāi Tahu set to play an important stakeholder in infrastructural, residential, and commercial developments, some risk and considerable unknowns are evident. Considerable numbers of Māori may migrate into the Canterbury region for employment in the rebuild, and trades training strategies have already been established. With many iwi now increasingly investing in property, the risks from significant earthquakes are now more transparent, not least to insurers and the reinsurance sector. Iwi authorities need to be appraised of insurance issues and ensure sufficient coverage exists and investments and developments are undertaken with a clear understanding of the risks from natural hazards and exposure to future disasters.
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.
