Although blacks are more likely than whites to experience posttraumatic stress disorder (PTSD) after a natural disaster, the reasons for this disparity are unclear. This study explores whether race is associated with PTSD after adjusting for differences in preexisting vulnerabilities, exposure to stressors, and loss of social support due to Hurricane Katrina using a representative sample of 279 black and white adult current and past smokers who were present when Hurricane Katrina struck, and identified it as the most traumatic event in their lifetime. Multiple logistic regression models evaluated whether differential vulnerability (pre-hurricane physical and mental health functioning, and education level), differential exposure to hurricane-related stressors, and loss of social support deterioration reduced the association of race with PTSD. Blacks were more likely than whites to screen positive for PTSD (49 vs. 39 %, respectively, p = 0.030). Although blacks reported greater pre-hurricane vulnerability (worse mental health functioning and lower educational attainment) and hurricane-related stressor exposure and had less social support after the hurricane, only pre-hurricane mental health functioning attenuated the association of race with screening positive for PTSD. Thus, racial differences in pre-hurricane functioning, particularly poorer mental health, may partially explain racial disparities in PTSD after natural disasters, such as Hurricane Katrina. Future studies should examine these associations prospectively using representative cohorts of black and whites and include measures of residential segregation and discrimination, which may further our understanding of racial disparities in PTSD after a natural disaster.
Keywords: Exposure; Hurricane Katrina; PTSD; Racial disparity; Social support; Vulnerability.