Mapping the Mental Health of Residents After the 2013 Boston Marathon Bombings.

Postdisaster mental health is typically assessed and treated on an individual basis. Ecological assessments, however, can be a more cost-effective means to identify and promote mental health after a disaster. In this study, the spatial patterning of acute stress scores, probable posttraumatic stress disorder (PTSD), and fears and worries among a representative sample of Boston metropolitan area participants (N = 788) was examined using data collected 2-4 weeks to 2 years after the 2013 Boston Marathon bombings. Findings indicate significant clustering of acute stress scores, Moran's I = 0.24, z = 2.91, p = .004; fears and worries, Moran's I = 0.25, z = 2.39, p = .017; and probable PTSD at Wave 2, Moran's I = 0.49, z = 5.16; p < .001, and at Wave 5, Moran's I = 0.26, z = 2.51, p = .012, in the Boston metropolitan area, with high distress clusters found near downtown Boston and the attack site. These results suggest that disaster mental health is not uniformly distributed across space. Instead, patterns emerge to identify persons and neighborhoods at risk for poor mental health outcomes.