SAMHSA

Disaster Technical Assistance Center 

Supplemental Research Bulletin

Women and Disasters

October 2020
CONTENTS

INTRODUCTION 3

PREPAREDNESS 3

EFFECTS OF DISASTER ON WOMEN 4

Post-disaster Distress 4

Posttraumatic Stress Disorder (PTSD) 4

Major Depression 5

Substance Use Disorders 5

Posttraumatic Growth 6

Pregnant Women 6

Effects on Pregnant Women 6

Effects on Offspring 7

Older Adult Women 8

Violence Against Women 8

Intimate Partner Violence (IPV) 8

RISK AND PROTECTIVE FACTORS 9

Risk Factors for Lack of Preparedness 9

Post-disaster Distress, PTSD, and Depression: Risk and Protective Factors 9

Risk and Protective Factors for Pregnant Women 10

Risk Factors for Violence Against Women and IPV 10

APPROACHES TO SUPPORT WOMEN AND ADDRESS IDENTIFIED NEEDS 10

Pregnant Women 10

Women at Risk of Experiencing GBV or IPV 11

CONCLUSION 12

REFERENCES 13

The focus of the Supplemental Research Bulletin is to provide an overview of the current literature on a specific 

topic and make it easy to understand for disaster behavioral health professionals who are not otherwise exposed 

to the research. The product aims to assist professionals and paraprofessionals involved in all-hazards planning, 

disaster behavioral health response and recovery, and/or Crisis Counseling Assistance and Training Program 

grant activities.
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INTRODUCTION

This issue of the Supplemental Research Bulletin focuses on women and disasters. It covers research on 

how women experience disasters—both women in general and subgroups, such as pregnant women and 

older women. It considers disaster preparedness among women, effects of disaster on women, and risk 

and protective factors. It touches on approaches for disaster behavioral health programs to ensure they 

meet the needs of pregnant women and women at risk of gender-based violence (GBV).

In 2002, a review of disaster behavioral health research was published that encompassed research 

conducted over 20 years on 61,396 survivors of natural and human-caused disasters. The researchers 

identified several factors that increased the likelihood of adverse outcomes (such as psychological 

problems and distress) among disaster survivors. One of those factors, among adults, was female gender 

(Norris et al., 2002). Throughout the history of disaster behavioral health research, people have tended to 

think that women are more vulnerable to adverse mental health consequences of disaster than are men. 

We chose to focus on women and disasters in this Supplemental Research Bulletin to delve deeper into 

whether that is true.

We also selected this topic because of need. In recent years, disasters have become more frequent. Over 

the past 5 years, the United States has been affected by at least 10 “billion-dollar” natural disasters per 

year—so called because each resulted in economic damages of more than $1 billion (National Centers 

for Environmental Information, 2019). In 2018 the world was affected by 315 natural disasters, which 

took 11,804 lives and affected 68.5 million people, causing $132 billion in economic damages (Centre 

for Research on the Epidemiology of Disasters, 2019). From 2014 through 2018, there were 528 U.S. 

disaster declarations, averaging 106 per year (Federal Emergency Management Agency [FEMA], n.d.). 

Also, more than half of the U.S. population is female (U.S. Census Bureau, 2019). It is imperative to 

understand women’s experiences of disasters in support of disaster behavioral health planning and 

preparedness, response, and recovery, and an overall healthier nation.

This issue of the Supplemental Research Bulletin is based on literature and scientific publications 

found through the National Center for Biotechnology Information and U.S. National Library of Medicine 

(PubMed), as well as Google Scholar. All research cited in this issue was published in English, and most 

was conducted in the United States (with a few exceptions where investigations in other countries proved 

useful). We limited our review to studies involving participants identified as 18 years or older at the time of 

the study and female, or as women.

PREPAREDNESS

Research suggests that women are less likely than men to be prepared for disasters—though they may 

also have greater awareness of hazards in their area. Through a national survey of U.S. preparedness, 

FEMA found that men were more likely than women to report that they had been prepared for a disaster 

for at least 1 year, whereas women were more likely to be aware of hazards (42 percent of women versus 

39 percent of men) (FEMA, 2018).

Another investigation examined personal preparedness among 439 Centers for Disease Control and 

Prevention (CDC) staff living in and around Atlanta, Georgia, and found that women were less likely to 

report household emergency preparedness than men (Thomas, Leander-Griffith, Harp, & Cioffi, 2015). 

Similarly, a study analyzed emergency preparedness data for 96,137 adults in 10 states and found that 
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women were less likely than men to report two of the three preparedness behaviors assessed: household 

preparedness (having a 3-day supply of water and food, battery-powered radio, and flashlight) and having 

a 3-day supply of medication (Ekenga & Ziyu, 2019). They were not less likely than men to have an 

emergency evacuation plan. A study that examined preparedness for natural disasters among adults ages 

50 years and older found differences in preparedness based on age, physical disability, education, and 

income—but not on sex or gender (Al-rousan, Rubenstein, & Wallace, 2014).

EFFECTS OF DISASTER ON WOMEN

Post-disaster Distress

In a study of women affected by the Deepwater Horizon Oil Spill (2010), researchers collected data in 

two waves—approximately 2–4 years after the disaster, and then again approximately 4–6 years after 

the disaster (Rung et al., 2019). Substantial proportions of women in the study had depressive symptoms 

(28 percent in wave 1, and 36 percent in wave 2) and probable mental distress (13 percent with probable 

serious mental distress in waves 1 and 2, and 20 percent with probable moderate mental distress in wave 

1 and 16 percent in wave 2) (Rung et al., 2019).

Another team of researchers surveyed New York City-area primary care patients after the World Trade 

Center attacks of September 11, 2001, and found that women were more likely than men to express 

increased worry about their families’ safety, their own safety, and about staying in the United States (study 

participants were primarily Hispanic immigrants, with about 20 percent born in the United States). The 

differences in worry for women and men remained significant even after adjustment for sociodemographic 

variables (Weissman et al., 2005).

Posttraumatic Stress Disorder (PTSD)

Women seem to be more likely than men to develop disaster-related PTSD. In a study of directly exposed 

survivors of two bombings—one of the U.S. embassy in Nairobi, Kenya (1998), and the other of the 

Murrah Federal Building in Oklahoma City (1995)—researchers found that women were more likely than 

men to develop post-disaster bombing-related PTSD (North et al., 2005). About 34 percent of men and 49 

percent of the women in the Nairobi sample had bombing-related PTSD; about 22 percent of men and 40 

percent of women in the Oklahoma City sample had bombing-related PTSD. Another study reviewed data 

from directly exposed survivors of 10 disasters and found female gender to be positively associated with 

disaster-related PTSD (among several other predictors, including younger age, less education, and predisaster psychopathology) (North, Oliver, & Pandya, 2012).

Some research also suggests that PTSD after disasters linked to any trauma (including the disaster, 

but also other past traumatic events) may be more common among women than men—although such 

differences may disappear after adjustment for potentially confounding factors. In the study of survivors 

of Nairobi and Oklahoma City bombings, women were more likely than men to have PTSD associated 

with any event (including the bombings, but not limited to them) (North et al., 2005). In the study of New 

York City primary care patients exposed to the World Trade Center attacks (2001), researchers found 

that rates of PTSD were significantly higher in women in their sample, but differences between men and 

women fell below the level of statistical significance after adjustment for race/ethnicity, marital status, and 

education (Weissman et al., 2005). In a review of disaster behavioral health research, Goldmann and 
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Galea report that PTSD and other psychological outcomes after disasters are generally worse for women 

than for men and that this disparity aligns with the greater prevalence of mood and anxiety disorders 

among women and substance use disorders among men in general populations (Kessler et al., 1994; as 

cited in Goldmann & Galea, 2014).

Major Depression

Women seem to be more likely to experience major depression after disasters than are men. In the 

study done with bombing survivors in Nairobi and Oklahoma City, women in both locations were more 

likely than men to have major depression after the disaster, including depression beginning before the 

bombings and depression that started after the bombings. The difference was more pronounced among 

the Oklahoma survivors, for whom post-disaster major depression was more than twice as common 

among women as men (North et al., 2005). In another study of survivors of the September 11, 2001, 

attacks, researchers found that post-disaster new major depressive disorder (MDD) episodes were 

significantly more prevalent in women than in men (in 33 percent of women and 18 percent of men) 

(North et al., 2015). These researchers also found a significant difference based on gender in relation to 

lifetime prevalence of pre-disaster MDD, which they found in 37 percent of women and 24 percent of men 

(North et al., 2015). Among the New York City primary care patients affected by the 2001 World Trade 

Center attacks, the rate of MDD was also significantly higher among women in their sample, even after 

adjustment for race/ethnicity, marital status, and education (Weissman et al., 2005).

Substance Use Disorders

Women seem to be less likely to have alcohol use disorder than men after disasters—as well as outside 

of the context of disaster. In the study of bombing survivors in Nairobi and Oklahoma City, researchers 

reported lower prevalence of alcohol use disorder among women than men in both locations—both before 

and after the disasters (North et al., 2005). In another review of data from 10 natural and human-caused 

disasters, researchers found that women were significantly less likely to have pre-disaster and postdisaster alcohol misuse/dependence (11 percent of women versus 29 percent of men) (North et al., 2011).

Research has arrived at similar findings in relation to substance use disorders. The researchers who 

surveyed New York City primary care patients after September 11, 2001, found that the rate of alcohol or 

drug use disorder was significantly higher among men than women (Weissman et al., 2005). In research 

on Hurricane Katrina (2005) survivors in New Orleans, Louisiana, researchers found that men were more 

likely than women to be hospitalized for substance use disorders before and after the disaster (Moise 

& Ruiz, 2016). In their review of disaster behavioral health research, Goldmann and Galea report that 

substance use disorders after disasters are generally more prevalent among men than women (van der 

Velden & Kleber, 2009; as cited in Goldmann & Galea, 2014). As noted earlier, they point out that this 

disparity aligns with the greater prevalence of substance use disorders among men in general populations 

around the world (Kessler et al., 1994; as cited in Goldmann & Galea, 2014). In a later review, North 

reports that research has found post-disaster prevalence of substance use disorders among men to be 

significantly higher than among women (Norris et al., 2002; North et al., 2013; North et al., 2011) (North, 

2016).
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Posttraumatic Growth

Researchers have identified a phenomenon called posttraumatic growth (PTG) in trauma survivors. 

PTG is “a positive psychological change as a result of cognitive processing after a traumatic event . . 

. includ[ing] greater appreciation of life, improved interpersonal relationships, a greater attunement to 

spiritual matters, a heightened sense of new possibilities, and increased personal strength” (Tedeschi & 

Calhoun, 1996; as cited in Schneider et al., 2019).

A study of survivors of Hurricane Sandy (2012) suggests that women may not be more or less likely to 

experience PTG because of their sex or gender. In the study, researchers found PTG to be associated 

with ethnicity (not being white, for example) and other variables (such as greater exposure to Hurricane 

Sandy)—but not with female sex or gender (Schneider et al., 2019).

Research has shed light on factors that may be associated with PTG in women. In a study of 334 lowincome mothers who survived Hurricane Katrina, participants with probable PTSD after the disaster 

reported significantly greater PTG (Lowe, Manove, & Rhodes, 2013). Participants with a stronger sense 

of purpose before the disaster experienced significantly higher PTG after the disaster. Participants with 

a stronger sense of purpose after the disaster were significantly more likely to have higher PTG—but not 

higher levels of PTSD symptoms (Lowe et al., 2013).

In a related, smaller study of low-income Black mothers whose homes were damaged or destroyed in 

Hurricane Katrina, researchers combined in-depth interviews and assessment with the Posttraumatic 

Growth Inventory (PTGI) and found that 26 out of 32 participants, or 81 percent, reported experiencing 

PTG in the 5 domains of the PTGI (greater appreciation of life, improved relationships, increased 

spirituality, new possibilities, and personal strength) (Manove et al., 2019). In particular, participants noted 

the new possibilities that the hurricane had created for them and their families (Manove et al., 2019).

Another research team assessed PTG and resilience in 222 pregnant and 292 postpartum women who 

had survived Hurricane Katrina (Harville, Xiong, Buekens, Pridjian, & Elkind-Hirsch, 2010). Based on 

a definition of PTG related to benefits perceived of the hurricane, they found that 75–90 percent of the 

women had experienced PTG. Experiencing damage due to the storm was associated with PTG, while 

experiencing illness/injury or danger was not. Black women in the study were more likely than women of 

other races to experience PTG (Harville et al., 2010).

Pregnant Women

Challenging disaster experiences and related stress experienced by women during pregnancy may have 

effects on perinatal maternal depression, which, along with being a problem in itself, can affect child 

mental health, cognitive development, and physical health (Goodman et al., 2011; Grace et al., 2003; 

Gump et al., 2009; as cited in Brock et al., 2015).

EFFECTS ON PREGNANT WOMEN

A study involving perinatal women who were pregnant during eastern Iowa floods in 2008 found that 

greater severity of flood exposure was associated with greater depression throughout the perinatal 

period, as well as lower levels of well-being (Brock et al., 2015). They also determined that distress the 

women experienced around the time of the flooding was responsible for elevated symptoms of depression 

throughout the study period—though the same mediating relationship was not found between distress 
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and maternal well-being. They found that on average, women’s symptoms of depression decreased at a 

significant rate over the times at which data were collected (Brock et al., 2015).

Disaster-related stress experienced by women during pregnancy may affect pregnancy outcomes 

and complications. In a study of approximately 150 women in New Orleans and Baton Rouge who 

were pregnant during or immediately after Hurricane Katrina, those who reported hurricane stress 

had significantly higher rates of labor induction (Oni, Harville, Xiong, & Buekens, 2015). Those who 

reported situations in their lives to be stressful were significantly more likely to have pregnancy-induced 

hypertension and gestational diabetes (Oni et al., 2015).

Coping styles that pregnant women use to manage disaster stress may reduce the likelihood of 

pregnancy complications. In the same study of pregnant women affected by Katrina, researchers found 

that coping styles of planning, acceptance, humor, instrumental support, and venting were associated 

with significant reduction in complications (Oni et al., 2015). Women who used a denial coping style had 

higher rates of gestational diabetes (Oni et al., 2015).

EFFECTS ON OFFSPRING

Disaster-related stress experienced by women during pregnancy may affect physical health in offspring. 

In another report on research on women who were pregnant during flooding in eastern Iowa, authors write 

that women who reported greater prenatal maternal stress (PNMS) were more likely to have children with 

greater body mass indexes (BMIs) at 30 months (Kroska et al., 2017). Another research team found that 

women who were pregnant during a 1998 Quebec ice storm or who became pregnant shortly after and 

who experienced objective hardship linked to the disaster were more likely to have offspring with higher 

BMIs and central adiposity (greater waist circumference relative to height) at several ages assessed (Liu, 

Dancause, Elgbeili, Laplante, & King, 2016).

Social support for pregnant women may have a protective effect in relation to disaster stress and child 

physical health outcomes. In the study of pregnant Iowa flood survivors and their children, high levels of 

social support, in terms of satisfaction with social support or size of social support network, buffered the 

effects of PNMS on child BMI at 30 months (Kroska et al., 2017).

Other aspects of the experience of a disaster during pregnancy may have effects on the physical health 

of children. In a study of women who were pregnant during the North Dakota Red River floods (2009), 

women who lived closer to the flood site were significantly more likely to have offspring of lower birth 

weight than women who lived farther away—but this relationship only held for women who were earlier in 

pregnancy at the time of the flood crest (Hilmert, Kvasnicka-Gates, Teoh, Bresin, & Fiebiger, 2016).

One study also found effects of disaster-related stress during pregnancy on child mental health outcomes. 

The study included 94 mother-child dyads with women who were pregnant during the 2008 Iowa floods 

and involved an assessment of stress reactivity in the 21⁄2-year-old children (Yong Ping et al., 2015). 

Investigators found that PNMS was positively correlated with one measure of stress reactivity in toddlers, 

as was timing of the disaster in gestation—the later in pregnancy the flooding occurred, the greater one 

measure of stress reactivity in toddlers. Subjective PNMS was significantly associated with two measures 

of stress reactivity in 21⁄2-year-old girls only (Yong Ping et al., 2015).
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Older Adult Women

One study found that older women in a sample of about 1,600 people ages 65 years and older who 

survived Hurricane Sandy (2012) were significantly more likely to experience distress and fear linked 

to the disaster than older men (Sands, Xie, Pruchno, Heid, & Hong, 2018). Some research seems to 

suggest that older women may not be more likely than older men to develop PTSD after disaster. In 

a study involving 206 adults ages 60 years and older living in an area struck by Hurricane Ike (2008), 

researchers found three trajectories of disaster-related PTSD symptoms: resistant (low or no symptoms), 

chronic (chronically elevated, clinically significant symptoms), and delayed (delayed-onset, clinically 

significant symptoms). The only difference related to sex or gender that they found is that women were 

more likely to be in the resistant or chronic than delayed dysfunction groups (Pietrzak, Van Ness, Fried, 

Galea, & Norris, 2013).

One study suggests that older adult women may be more vulnerable than older adult men to post-disaster 

depression. Among 1,130 older adult survivors (ages 60 years and older) of 2004 hurricanes in Florida, 

those with more depressive symptoms were more likely to be female than male (Acierno, Ruggiero, 

Kilpatrick, Resnick, & Galea, 2006).

Violence Against Women

Violence against women may increase after disasters. In a study of GBV among 420 women displaced 

by Hurricane Katrina, researchers found that the crude rate of new cases of GBV among women more 

than tripled in the year after the hurricane (from 4.6 per 100,000 per day to 16.3 per 100,000 per day) 

and did not return to baseline in the following year (when the crude rate was 10.1 per 100,000 per day) 

(Anastario, Shehab, & Lawry, 2009). The main type of GBV causing the increase was intimate partner 

violence (Anastario et al., 2009).

In another study, researchers interviewed 66 women ages 18 to 49 years who were living in FEMA trailer 

parks in Louisiana to which they had been evacuated after Hurricane Katrina (Picardo, Burton, Naponick, 

& Katrina Reproductive Assessment Team, 2010). Nearly one-fourth of the women (23 percent) reported 

being hit or verbally threatened since the hurricane. Of that group, about two-thirds reported new or 

increased abuse since the disaster. Four women (about 6 percent) had experienced sexual abuse (been 

forced to have sex) since the hurricane. Those women were significantly less likely to be the head of their 

household than women reporting no sexual abuse since the hurricane (Picardo et al., 2010).

INTIMATE PARTNER VIOLENCE (IPV)

After disasters, women may be more vulnerable than men to IPV involving physical abuse. In a 

study involving 445 married or cohabiting adult survivors of Hurricane Katrina, researchers assessed 

participants for physical and psychological IPV, stressful life events associated with the hurricane, PTSD, 

and depression (Schumacher et al., 2010). They found a significant increase in the percentage of women 

experiencing psychological victimization after the hurricane (from 33.6 to 45.2 percent). They found a 98 

percent increase in the prevalence of physical victimization among women after the hurricane. Men also 

reported an increase in psychological victimization (from 36.7 to 43.1 percent), but, unlike women, no 

change in physical victimization (Schumacher et al., 2010).

Post-disaster IPV and GBV may be associated with heightened risk for some mental illnesses in disaster 

survivors who are women. In the study of GBV among women displaced by Katrina, researchers found 
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a significant association of GBV and poor mental health outcomes such as depression (Anastario et 

al., 2009). Also, in the study of IPV among married or cohabiting hurricane survivors, researchers found 

that both psychological and physical IPV heightened risk for Katrina-related PTSD and that physical IPV 

raised the risk of post-disaster depression (Schumacher et al., 2010).

RISK AND PROTECTIVE FACTORS

The research reviewed for this Supplemental Research Bulletin did not include extensive information 

about risk and protective factors associated with sex and gender. In this section, we present the insights 

that did appear in studies we reviewed.

Risk Factors for Lack of Preparedness

The study examining household preparedness data for approximately 96,100 adults found that women 

who were divorced, widowed, or separated and living in a household with children were less likely to 

report household preparedness than other women (Ekenga & Ziyu, 2019).

Post-disaster Distress, PTSD, and Depression: Risk and Protective Factors

In the study of women affected by the Deepwater Horizon oil spill (2010), at the first point at which they 

collected data, researchers assessed self-reported exposure, including economic exposure (income loss, 

degree of economic influence on the respondent relative to others, and the oil spill’s effects on household 

finances) and physical exposure (Rung et al., 2019). After adjusting for sociodemographic variables, 

they found that women with higher levels of both types of exposure also experienced higher levels of 

depressive symptoms and mental distress to a significant extent at both times at which they collected 

data (Rung et al., 2019). In another study of women who survived Deepwater Horizon, women with the 

most severe symptoms of depression had lower levels of education and income, higher prevalence of 

unemployment, and the lowest levels of perceived social support—suggesting that less education and 

income, unemployment, and low perceived social support may all be risk factors for depression after 

disaster in women (Gaston et al., 2016). In another report drawing from the same data, social support 

and cognitive social capital (related to sense of community and informal social control) were protective 

in relation to depression (Rung et al., 2017). Another team of researchers analyzed data from 386 lowincome, predominantly Black single mothers who survived Hurricanes Katrina and Rita (2005) and 

found that post-disaster optimism and sense of purpose was protective against psychological distress 

(Chan, Rhodes, & Pérez, 2012). Researchers who studied 102 mothers of young children who survived 

Hurricanes Katrina and Gustav (2008) found that those with high levels of social support after Katrina had 

better mental health after Gustav (Harville et al., 2011).

Being married may be a risk factor for post-disaster depression for women, whereas among men it may 

be a protective factor (Norris et al., 2002, as cited in Goldmann & Galea, 2014). On the other hand, 

the researchers who surveyed New York City primary care patients after the attacks of September 11 

found that the significantly higher rate of PTSD for women in their sample disappeared after adjustment 

for marital status, while the difference between rates in men and women of MDD remained even after 

adjustment (Weissman et al., 2005). The researchers write that “these results suggest that marital 

status—which may be a reflection of social supports—could play a role in protecting women against 

PTSD but less of a role in protecting women against MDD” (Weissman et al., 2005, p. 7).
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Risk and Protective Factors for Pregnant Women

Please refer to the section about pregnant women for full discussion of factors associated with negative 

and positive outcomes for pregnant women affected by disasters and their children.

Risk Factors for Violence Against Women and IPV

In the post-Katrina study of IPV among 445 married or cohabiting adult survivors, researchers found that 

the strongest predictor of post-Katrina IPV was pre-Katrina IPV, for both men and women. They also 

found that if women had experienced multiple stressors linked to Katrina, they were at increased risk of 

post-disaster physical IPV (Schumacher et al., 2010). Another team of researchers surveyed 123 women 

who had survived Hurricane Katrina 6 months after they had given birth and found associations between 

hurricane damage to home or property and post-disaster aggression and violence as part of IPV (Harville 

et al., 2011).

APPROACHES TO SUPPORT WOMEN AND ADDRESS IDENTIFIED NEEDS

In this section, we examine approaches to support women before, during, and after disasters. We 

anticipated finding research and other literature about interventions designed specifically for women, but 

we did not find any such research related to women in the United States. This lack of woman-specific 

interventions may reflect greater equality between women and men in the United States, less attention 

to women as a special population within the United States, or the greater tendency of women to seek out 

mental health support after disaster.

Pregnant Women

The Committee on Health Care for Underserved Women of the American College of Obstetricians and 

Gynecologists (ACOG) recommends several steps that obstetrician-gynecologists can take to support 

emergency preparedness for women (2010). These include encouraging patients to develop a disaster 

evacuation plan, collaborating with public health officials to identify facilities that can provide prenatal and 

obstetric services during a disaster, and promoting prompt attention to mental health needs (2010).

The researchers who studied women who were pregnant during the 2008 Iowa floods note that their 

study has implications for interventions to prevent and treat perinatal depression (Brock et al., 2015). 

Specifically, they note that their study highlights peritraumatic distress as key in the relationship between 

disaster exposure and depression, and they note that interventions could include psycho-education about 

traumatic stress, coping skills training, and guidance on accessing resources such as social support. They 

also note that the Peritraumatic Distress Inventory, which they used in their study, can be used to identify 

disaster-affected women at risk for perinatal depression, so that care and follow-up can be provided to 

those with the greatest distress, and individuals with moderate distress can be monitored (Guardia et al., 

2013; as cited in Brock et al., 2015).

Women at Risk of Experiencing GBV or IPV

The ACOG Committee on Health Care for Underserved Women also recommends measures in shelters 

to help prevent violence against women (2010). These include establishment of rule of law, safety, and 

order in disaster shelters, as well as ensuring availability of services to survivors of sexual assault, such 

as emergency contraception and sexual assault examiners (2010).
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The researchers who studied women displaced by Hurricane Katrina point to the importance of several 

steps after disasters, including providing information about safe havens for women experiencing abuse at 

the same time as food, clothing, and other supplies are distributed (Picardo et al., 2010). They also write 

that relief workers should be aware of abuse as a potential issue and have service providers to whom 

they can refer women if needed (Picardo et al., 2010).

CONCLUSION

More than half of the U.S. population is female, and so it is imperative to ensure understanding of how 

women experience disaster and inclusion of women in disaster planning and preparedness, response, 

and recovery. Research suggests that women may be less prepared at an individual and household level 

for disasters than are men. Studies have found women to be likely to experience distress after disasters, 

sometimes more so than men. A great deal of research has shown women to be more likely to develop 

disaster-related PTSD and MDD after disasters, which researchers have observed seems to echo the 

increased lifetime prevalence of these disorders in women relative to men. Women seem to be less 

likely after disasters to have substance use disorders than men are. After disasters, women may also 

experience PTG.

Disaster effects on pregnant women include depression and lower levels of well-being, though research 

also suggests the ability to recover quickly in relation to depression. Effects associated with maternal 

stress during pregnancy include higher rates of labor induction, pregnancy-induced hypertension, and 

gestational diabetes. Several maternal coping styles seem to be protective. PNMS has also been found 

to be associated with negative physical and mental health outcomes in children. Some research suggests 

that older adult women may not be as vulnerable to adverse post-disaster mental health outcomes as 

younger women, though findings are mixed.

Violence against women may increase after disasters, sometimes to a dramatic degree. IPV also may 

increase. Both IPV and GBV have been found to be associated with increased risk for some mental 

illnesses in women disaster survivors.

Specific types and intensities of disaster exposure seem to be associated with heightened risk of some 

mental illnesses in women. Being married may be a protective factor for women in relation to postdisaster PTSD. In addition to pre-disaster IPV, disaster-related stressors and certain types of disaster 

damages have been associated with heightened risk of post-disaster IPV for women.

Assessment of peritraumatic distress may help identify pregnant women at risk of post-disaster 

depression, and steps can be taken to follow up with women at greatest risk and to monitor those at an 

intermediate level of risk. Relief workers should provide disaster survivors with information about safe 

havens for women experiencing GBV and have service providers to whom they can refer women 

if needed.

The Substance Abuse and Mental Health Services Administration (SAMHSA) is not responsible for the 

information provided by any of the webpages, materials, or organizations referenced in this communication. 

Although the Supplemental Research Bulletin includes valuable information and links, SAMHSA does not 

necessarily endorse any specific products or services provided by public or private organizations unless 

expressly stated. In addition, SAMHSA does not necessarily endorse the views expressed by such sites or 

organizations nor does SAMHSA warrant the validity of any information or its fitness for any particular purpose.
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