- The Black Summer Australian bushfires of 2019/2020 were closely followed by the COVID-19 pandemic in 2020, threatening Australian communities in many ways within a short time frame.
- People with disabilities, such as MS, can be more greatly impacted by disasters and crises than the general population.
- To build resilience for future crises, it is essential to understand the impact of crises on people with MS, so that measures can be taken to support them, and recommendations can be made to avoid negative consequences on long term health outcomes.
During the Black Summer Australian bushfires of 2019/2020, an estimated 1.8 million people were evacuated, and 11 million Australians were affected by bushfire smoke, placing a major strain on the healthcare system. Shortly thereafter, the COVID-19 pandemic resulted in unprecedented changes worldwide, restricting movement and social contact as well as impacting on psychological health, access to healthcare and treatment regimes. Although the community measures in Australia were very successful in controlling the COVID-19 pandemic, the wider impact of these restrictions on people living with MS is not yet known.
Investigating health behaviours in people with MS
In a study funded by the Melbourne Disability Institute, researchers Dr Claudia Marck (a Fellowship funding recipient from MS Research Australia) and Dr Yvonne Learmonth, together with their research teams, have explored the impact of these back-to-back crises on the health behaviours of people with MS. They investigated behaviours such as physical activity, unhealthy eating habits, sleeping patterns, alcohol consumption, medication adherence and smoking. This research aimed to understand what needs to be done in the future to help people with MS through difficult times, whilst minimising negative health outcomes. The researchers conducted an online survey of 113 people with MS, with 39 respondents being affected by the bushfires and 84 respondents affected by the COVID-19 pandemic. The survey aimed to assess the health behaviours of the survey respondents during these crises. A smaller group of these participants were also interviewed by the researchers for a more in-depth exploration of the effects of the crises, along with healthcare providers, MS advocates and carers.
What did the researchers find out?
The analysis of the surveys indicated that the impact of the bushfires was predominately from the smoke. This affected participation in physical activity and exercise outdoors, as well as causing fear about the adverse health effects of the smoke. Some participants were also impacted by the added stress coping with the disaster unfolding around them.
Interestingly, for those affected by the pandemic, 27.5% of participants reported improved health behaviours. This included more time available to be physically active due to lack of commuting. Some of these participants reported they wanted to be as fit as possible in case of infection with COVID-19 and to improve MS symptoms. This concept is known as ‘pre-habilitation’ and has also been noted in the general population. However, 53.8% of participants reported a decrease in physical activity, while 43.6% of people reported an increase in unhealthy eating. There was also a 35.4% increase in alcohol consumption and a 40.5% reduction in normal sleeping patterns. For those reporting these negative impacts on their health behaviours, the consequences to their short-term health included reduced fitness and mobility, weight gain, and mood changes. Some participants were also concerned about the long-term consequences of changes in their health behaviours for their ongoing physical and mental health.
How can we improve health behaviours for people with MS?
We know that many people with MS are already struggling to meet the current exercise guidelines and the Australian dietary guidelines. Therefore people with MS are missing out on many potential benefits from these modifiable lifestyle behaviours.
The recent bushfire crisis and pandemic have added further challenges to healthy behaviours with greater physical inactivity, unhealthy eating and increased alcohol consumption among Australians with MS. Although these are in line with findings in the general population, it is arguably of higher importance in people with MS, who may need additional support to maintain positive health. The researchers are advocating for MS healthcare professionals and people with MS to be aware of this tendency during times of adversity and to actively promote the uptake of more healthy behaviours such as maintaining physical activity, healthy eating and sleeping patterns, and adhering to recommended alcohol consumption guidelines. This will ensure the best quality of life in the future for people living with MS.