{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:39:20Z","timestamp":1760150360293,"version":"build-2065373602"},"reference-count":35,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013138","name":"Office for Victims of Crime (OVC) award","doi-asserted-by":"publisher","award":["2017-MU-GX-K144","F32ES34238-01"],"award-info":[{"award-number":["2017-MU-GX-K144","F32ES34238-01"]}],"id":[{"id":"10.13039\/100013138","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIEHS","award":["2017-MU-GX-K144","F32ES34238-01"],"award-info":[{"award-number":["2017-MU-GX-K144","F32ES34238-01"]}]},{"name":"Samuel Belonging Lab at the Samuel Center for Social Connectedness","award":["2017-MU-GX-K144","F32ES34238-01"],"award-info":[{"award-number":["2017-MU-GX-K144","F32ES34238-01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Public works environmental disasters such as the Flint water crisis typically occur in disenfranchised communities with municipal disinvestment and co-occurring risks for poor mental health (poverty, social disconnection). We evaluated the long-term interplay of the crisis and these factors with substance use difficulties five years after the crisis onset. A household probability sample of 1970 adults living in Flint during the crisis was surveyed about their crisis experiences, use of substances since the crisis, and risk\/resilience factors, including prior potentially traumatic event exposure and current social support. Analyses were weighted to produce population-representative estimates. Of the survey respondents, 17.0% reported that substance use since the crisis contributed to problems with their home, work, or social lives, including 11.2% who used despite a doctor\u2019s warnings that it would harm their health, 12.3% who used while working or going to school, and 10.7% who experienced blackouts after heavy use. A total of 61.6% of respondents reported using alcohol since the crisis, 32.4% using cannabis, and 5.2% using heroin, methamphetamine, or non-prescribed prescription opioids. Respondents who believed that exposure to contaminated water harmed their physical health were more likely to use substances to the detriment of their daily lives (RR = 1.32, 95%CI: 1.03\u20131.70), as were respondents with prior potentially traumatic exposure (RR = 2.99, 95%CI: 1.90\u20134.71), low social support (RR = 1.94, 95%CI: 1.41\u20132.66), and PTSD and depression (RR\u2019s of 1.78 and 1.49, respectively, p-values &lt; 0.01). Public works disasters occurring in disenfranchised communities may have complex, long-term associations with substance use difficulties.<\/jats:p>","DOI":"10.3390\/ijerph20237090","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T01:48:45Z","timestamp":1700531325000},"page":"7090","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of Public Works Disasters with Substance Use Difficulties: Evidence from Flint, Michigan, Five Years after the Water Crisis Onset"],"prefix":"10.3390","volume":"20","author":[{"given":"Tuviere","family":"Onookome-Okome","sequence":"first","affiliation":[{"name":"Institute for the Environment, University of North Carolina Chapel Hill, Chapel Hill, NC 27517, USA"},{"name":"Samuel Centre for Social Connectedness, Montr\u00e9al, QC H3A 0G4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angel","family":"Hsu","sequence":"additional","affiliation":[{"name":"Institute for the Environment, University of North Carolina Chapel Hill, Chapel Hill, NC 27517, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dean G.","family":"Kilpatrick","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Moreland","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5713-4913","authenticated-orcid":false,"given":"Aaron","family":"Reuben","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA"},{"name":"Department of Psychology & Neuroscience, Duke University, Durham, NC 27708, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3544","DOI":"10.1038\/s41467-021-23898-z","article-title":"The widespread and unjust drinking water and clean water crisis in the United States","volume":"12","author":"Mueller","year":"2021","journal-title":"Nat. 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