Psychosocial Health and Well-Being After A Mortality Shock

We investigate the short- and long-run impacts of unexpected mortality on psychosocial health in the context of a large-scale high-mortality natural disaster, the 2004 Indian Ocean earthquake and tsunami. The effects of the tsunami-related mortality measured at the community level are contrasted with the effects of individual-specific loss of close kin using population-representative longitudinal survey data from the Study of the Tsunami Aftermath and Recovery. In the short-run, two years post-tsunami, both community and individual-level mortality exposures are significant predictors of elevated depression and post-traumatic stress symtoms. In the longer-run, ten years post-tsunami, individual-level exposures are slightly attenuated but remain significant predictors of both psychosocial health measures; in contrast, community-level mortality predicts post-traumatic stress but not depression symptoms. Mortality is linked to smaller household sizes in the short- and long-run and to less social support in the long-run, although the latter effect differs substantially for males and females. The estimates adjust for other tsunami exposure measures and, in the individual-level analyses, we compare people living in the same community at the time of the tsunami who were exposed to the same community-level mortality rate.