Health Consequences Of Disasters Research Articles

Health consequences of disasters: Advancing disaster data science.

Understanding the health effects of disasters is critical for effective preparedness, response, recovery, and mitigation. However, research is negatively impacted by both the limited availability of disaster data and the difficulty of identifying and utilizing disaster-specific and health data sources relevant to disaster research and management. In response to numerous requests from disaster researchers, emergency managers, and operational response organizations, 73 distinct data sources at the intersection of disasters and health were compiled and categorized. These data sources generally cover the entire United States, address both disasters and health, and are available to researchers at little or no cost. Data sources are described and characterized to support improved research and guide evidence-based decision making. Current gaps and potential solutions are presented to improve disaster data collection, utilization, and dissemination.

Patient Healthcare Following a Disaster: Guidelines for Family Doctors

Introduction:Health effects of disasters are mostly consistent across hazard types. Those working in communities affected by disasters have an opportunity to provide surveillance and early management to patients affected by disaster through increased understanding of the epidemiology or health consequences in the days, weeks, months, and years after disasters. Disasters have been called a social determinant of health and population-level changes or social determinants that have been documented post-incident. Environmental and community disruption contribute to health effects. Consequent health effects are evidenced across body systems, affecting both physical and mental health.Aim:To develop guidelines for primary care patient review following a disaster, based on the temporal pattern of disease epidemiology.Methods:A systematic review of the literature was undertaken to examine the epidemiology of health consequences following disasters.Results:Guidelines for Family Doctors based on the literature review were developed to assist preventative care, surveillance, early identification of emerging conditions, and ongoing management of pre-existing disease.Discussion:Healthcare management in disasters focuses on acute healthcare in emergency departments and hospitals. However, healthcare is also being provided in primary healthcare settings during the first days to weeks of the catastrophe, with many health consequences ongoing in the weeks, months, and years after the event.

Nested case-control study of predictors of postpartum depression in a long-term cohort of earthquake survivors, Armenia, 1990-2012

Background Disasters have serious long-term impact on mental health of survivors. Women are especially vulnerable to mental health consequences of disasters, particularly during pregnancy and postpartum periods. This study investigated the predictors of postpartum depression (PD) among survivors of a devastating earthquake, which struck the northern part of Armenia in 1988. Methods We applied a nested case-control survey design to investigate women included in a large-scale cohort study of survivors of 1988 earthquake. The latter started in 1990 and had four …

Armenia 1988 Earthquake and Telemedicine: Lessons Learned and Forgotten

To showcase the observations and lessons learned from the first large-scale international telemedicine program addressing the medical and health consequences of disasters. Almost 24 years ago a major earthquake devastated the northwestern region of Soviet Armenia. The National Aeronautics and Space Administration deployed a telemedicine spacebridge, which operated uninterrupted for 3 months, extending its services to the remote region of Ufa to help the burn victims, mostly children, from a railroad explosion accident. Expert consultations were provided by four major medical center from the United States and several military and civilian medical services of the Soviet Union. Disasters continue to contribute to increased morbidity and mortality with significant economic impacts worldwide. Psychological, physical, and social sequelae persist years after the events. Many pre-existing socioeconomic conditions are aggravated following disasters. Telemedicine is a useful medical and public health technology that continues to be underutilized due to the lack of inclusion in the preparedness planning, training, availability of networks, and connectivity costs. Natural and human-made disasters require both near-term and long-term interventions to reduce morbidity and mortality among the surviving victims. Telemedicine, information technology, and modern portable communication devices should be incorporated in disaster preparedness and recovery training and operations.

Emotional Dimensions of Conducting Research in Disaster Settings: A Note on Social Psychological Considerations

In the wake of Hurricane Katrina, disaster research witnessed a convergence of researchers from the social sciences in disciplinary and multidisciplinary teams. National Science Foundation grants funded significant numbers of teams to address topics related to the event and the emotional responses of its impact. Research on disaster mental health is not a new field of study, and research has demonstrated the devastating psychological and mental health effects of disasters; however, the literature focuses predominantly on assisting victims and survivors, with substantially less literature related to the potential social psychological and emotional impacts related to research conducting intense field studies. This essay discusses the emotional dimensions of conducting disaster research by using classic and contemporary social psychological theories to explore how researchers deal with and/or negotiate the potential role conflict and the emotional dimensions of their fieldwork.

Women and Public Health Emergency Preparedness

Women’s health issues, and women’s studies in general, encompass a broad range of topics, however rigorous studies that examine the roles of, and effects on, women in public health emergencies remains a relatively unexplored area of empirical research. Public Health Emergency Preparedness (PHEP) is itself a relatively new field. Although disasters have existed as long as civilization, and the public health consequences of disasters have been well-documented throughout history, a field devoted to thinking about, preparing for, and mobilizing the resources of multiple communities to mitigate and respond to public health emergencies is a relatively new phenomenon. This new field, not yet a decade old, is still struggling to define itself. In 2007, researchers from RAND undertook an effort to formally define PHEP. Their resulting definition was:

The Public Health Dimension of Disasters—Health Outcome Assessment of Disasters

A broad range of health problems are related to disasters. Insight into these health problems is needed for targeted disaster management. Disaster health outcome assessment can provide insight into the health effects of disasters. During the 15th World Congress on Disaster and Emergency Medicine in Amsterdam (2007), experts in the field of disaster epidemiology discussed important aspects of disaster health outcome assessment, such as: (1) what is meant by disaster health outcome assessment?; (2) why should one conduct a disaster health outcome assessment, and what are the objectives?, and (3) who benefits from the information obtained by a disaster health outcome assessment? A disaster health outcome assessment can be defined as a systematic assessment of the current and potential health problems in a population affected by a disaster. Different methods can be used to examine these health problems such as: (1) rapid assessment of health needs; (2) (longitudinal) epidemiological studies using questionnaires; (3) continuous surveillance of health problems using existing registration systems; (4) assessment of the use and distribution of health services; and (5) research into the etiology of the health effects of disasters. The public health impact of a disaster may not be immediately evident. Disaster health outcome assessment provides insight into the health related consequences of disasters. The information that is obtained by performing a disaster health outcome assessment can be used to initiate and adapt the provision of health care. Besides information for policymakers, disaster health outcome assessments can contribute to the knowledge and evidence base of disaster health outcomes (scientific objective). Finally, disaster health outcome assessment might serve as a signal of recognition of the problems of the survivors. Several stakeholders may benefit from the information obtained from a disaster health outcome assessment. Disaster decision-makers and the public health community benefit from performing a disaster health outcome assessment, since it provides information that is useful for the different aspects of disaster management. Also, by providing information about the nature, prevalence, and course of health problems, (mental) health care workers can anticipate the health needs and requirements in the affected population. It is important to realize that the disaster is not over when the acute care has been provided. Instead, disasters will cause many other health problems and concerns such as infectious diseases and mental health problems. Disaster health outcome assessments provide insight into the public health impact of disasters.

Are physical symptoms among survivors of a disaster presented to the general practitioner? A comparison between self-reports and GP data

BackgroundMost studies examining medically unexplained symptoms (MUS) have been performed in primary or secondary care and have examined symptoms for which patients sought medical attention. Disasters are often described as precipitating factors for MUS. However, health consequences of disasters are typically measured by means of questionnaires, and it is not known whether these self-reported physical symptoms are presented to the GP. It is also not known if the self-reported symptoms are related to a medical disorder or if they remain medically unexplained. In the present study, three research questions were addressed. Firstly, were self-reported symptoms among survivors presented to the GP? Secondly, were the symptoms presented to the GP associated with a high level of functional impairment and distress? Thirdly, what was the GP's clinical judgment of the presented symptoms, i.e. were the symptoms related to a medical diagnosis or could they be labeled MUS?MethodsSurvivors of a man-made disaster (N = 887) completed a questionnaire 3 weeks (T1) and 18 months (T2) post-disaster. This longitudinal health survey was combined with an ongoing surveillance program of health problems registered by GPs.ResultsThe majority of self-reported symptoms was not presented to the GP and survivors were most likely to present persistent symptoms to the GP. For example, survivors with stomachache at both T1 and T2 were more likely to report stomachache to their GP (28%) than survivors with stomachache at only T1 (6%) or only T2 (13%). Presentation of individual symptoms to the GP was not consistently associated with functional impairment and distress. 56 – 91% of symptoms were labeled as MUS after clinical examination.ConclusionThese results indicate that the majority of self-reported symptoms among survivors of a disaster are not presented to the GP and that the decision to consult with a GP for an individual symptom is not dependent on the level of impairment and distress. Also, self-reported physical symptoms such as headache, back pain and shortness of breath are likely to remain medically unexplained after the clinical judgment of a GP.

Disparities in Prolonged Indirect Health Effects of Disasters

Disparities in Prolonged Indirect Health Effects of Disasters

Social context and the health consequences of disasters

Disasters have been and will continue to be relatively common events in the human experience, and they make important contributions to variations in population health. There is a need, therefore, for conceptual models that identify the social and ecological factors influencing post-disaster consequences on population health. This article presents one such conceptual model which links the health consequences of natural, technological, and human-made disasters to a set of nested socioecological factors. Specifically, we attempt to link post-disaster consequences to aspects of the global and local environment and to highlight the roles played by social and ecological factors, including the social infrastructure, cultural beliefs, demography, and underlying historical and geographical circumstances. Examples from existing population-based health and disaster research are used to illustrate and amplify connections drawn from the model. From an applied standpoint, the model suggests that the role of multiple contextual determinants in shaping population health is likely to be complex. Practitioners interested in mitigating the consequences of disasters should pursue strategies that improve the underlying determinants of health, as well as practicable population-based interventions that could be implemented rapidly.

The Oklahoma City Bombing Study and Methodological Issues in Longitudinal Disaster Mental Health Research

SUMMARY Several methodological issues may affect the findings of studies of the mental health effects of disasters over time. These issues include analysis of the course of individual disorders over time that may be lost when they are presented embedded in general summary statistics, consideration of assessment of psychiatric disorders versus symptoms, adherence to established criteria in assigning psychiatric diagnoses, and orientation of mental health issues to the type of disaster exposure of the sample. This report will explore these methodological issues in a review of disaster literature and in data obtained from study of survivors of the Oklahoma City bombing. Clinical implications of the data obtained from the Oklahoma City bombing study of survivors of the direct bomb blast are presented in the context of these methodological concerns.

An Exploratory Study of the Impact of the Year of 9/11 on Older Hispanic Immigrants in New York City

Hispanics are the largest minority in the US and may be at increased risk for the mental health consequences of disasters. Elderly Hispanics are vulnerable in terms of both age and ethnicity and are the fastest growing subpopulation among the aged.We conducted an exploratory, qualitative investigation of the impact of the year of 9/11 on older Hispanic immigrants in New York City. Six focus groups were conducted with a total of 31 elderly Hispanics attending a community senior center day program. Participants reported on their psychological reactions to the traumatic events of 9/11, the crash of Flight 587, and the anthrax scare. Most subjects had recovered from their acute distress reactions to 9/11 and Flight 587 four months post-September 11, but many still experienced a wide range of psychological reactions related to these traumatic events, including anxiety, avoidance, and hypervigilance. To develop relevant interventions for this population, social workers need to learn more about the psychological impact that the events of the year of 9/11 had on older Hispanics. Such interventions are necessary, especially given the continuing preoccupation in the US over the threat of terrorist acts and the possibility of war.

Medical and Public Health Consequences of Natural and Biological Disasters

Better epidemiologic knowledge of the causes of death and types of injuries and illnesses caused by disasters is clearly essential to determine appropriate relief supplies, equipment, and personnel needed to effectively respond to such situations. The overall objective of health disaster managers is to measure and describe as accurately as possible the health effects of disasters and contributing factors to these effects, with the goals of assessing the needs of disaster-affected populations, efficient matching of resources to needs, further prevention of adverse health effects, evaluation of program effectiveness, and for contingency planning. In addition, public health professionals have an important role to play in providing informed advice about the probable health effects that may arise in the future, in establishing priorities for action, and in emphasizing the need for accurate information as the basis for relief decisions. This paper outlines a number of important areas where public health can contribute to making overall disaster management more effective.

The Public Health Consequences of Disasters

The Public Health Consequences of Disasters

The Public Health Consequences of Disasters

To increase our awareness of the significant human losses associated with disasters throughout the world, the United Nations declared the 1990s the International Decade for Natural Disaster Reduction (IDNDR). As part of the response to the United Nations initiative, editor Dr Eric Noji, with 15 other contributors, has developed a major reference text on public health and disasters. The Public Health Consequences of Disasters is a significant update to the 1989 monograph by the Centers for Disease Control and Prevention (CDC) on the same subject. As with the earlier monograph, many of the contributors have had extensive medical and public health experience related to recent disasters in both national and international settings while serving as physician-scientists or public health professionals within the CDC. Following the approach used by Dr Michael Gregg, who served as editor and contributing author of the 1989 CDC monograph and who provides the foreword to this

Disaster epidemiology and disease monitoring.

Better epidemiologic knowledge of the mechanisms of death and of the types of injuries and illnesses caused by disasters is clearly essential to determining the appropriate relief medications, supplies, equipment, and personnel needed to effectively respond to such emergencies. The overall objective of disaster epidemiology is to measure scientifically and describe the health effects of disasters and the factors contributing to these effects. The results of such investigations allow disaster epidemiologists to assess the needs of disaster-affected populations, efficiently match resources to needs, prevent further adverse health effects, evaluate relief effectiveness, and plan for future disasters.

Disaster Epidemiology: Challenges for Public Health Action

Better epidemiologic knowledge of the causes of death and types of injuries and illnesses caused by disasters is clearly essential to determine appropriate relief supplies, equipment and personnel needed to respond effectively to such situations. The overall objective of disaster epidemiology is to scientifically measure and describe the health effects of disasters and contributing factors to these effects, with the goals of assessing the needs of disaster-affected populations, efficient matching of resources to needs, further prevention of adverse health effects, evaluation of program effectiveness, and contingency planning. In addition, the epidemiologist has an important role to play in providing informed advice about the probable health effects which may arise in the future, in establishing priorities for action and in emphasizing the need for accurate information as the basis for relief decisions. This presentation outlines a number of important areas where epidemiologists can contribute to making disaster management more effective.

The World Heath Organization's Disaster Reduction Policies in Africa at the Dawn of 1990's: Steps in the Right Direction?

AbstractThe World Health Organization, Panafrican Centre for Emergency Preparedness and Response (WHO/EPR) was established in 1988, and officially opened in March 1989, as a practical and functional response to the identified need for a regional institution to deal effectively with the health and related consequences of both natural and man-made disasters. The principal objective of the Centre is to aid member countries in the prevention and/or reduction of the adverse health effects of disasters, be they direct or indirect, by strengthening national capacities for disaster preparedness and response. The WHO has reoriented its disaster operations unit to incorporate preparedness activities, particularly within an overall developmental framework which is crucial for reducing losses, both human and material, in the event of a disaster. In keeping with this focus, the Centre has defined its goals and activities: development of national disaster preparedness programs; training of national and international personnel in health emergency preparedness and response; production and dissemination of technical publications on disaster preparedness and management; undertaking risk assessment missions; and executing relevant research projects.