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Bukvic A, Borate A. Building Flood Resilience Among Older Adults Living in Miami-Dade County, Florida. Disaster Med Public Health Prep 2023; 17:e465. [PMID: 37519236 DOI: 10.1017/dmp.2023.133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
OBJECTIVE This paper explores compounding challenges for older coastal populations due to accelerated sea level rise at the nexus of physical hazard exposure and place-based socioeconomic and health considerations. METHODS This study applies geospatial analysis to assess the spatial distribution of older adults (age 65+) and their socioeconomic characteristics in Miami-Dade County in Florida. Next, it uses logistic regression to evaluate the socioeconomic determinants of block groups with 20% or more of residents age 65 and older at 3 feet of sea level rise compared to the other block groups in Miami-Dade. RESULTS The results show that this study area has an older population clustered in flood-prone locations along the shoreline. The block groups with more than 20% of older adults and sea level rise risk have higher homeownership and vacancy rates, a higher percentage of homes constructed before 1980, and more older individuals who live alone. CONCLUSION This study identifies place-based compounding factors undermining the ability of older residents to adequately cope with accelerated sea level rise flooding in coastal urban locations. Namely, owning an older home in a declining neighborhood and living alone can trap older individuals in place and increase their flood risk.
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Affiliation(s)
- Anamaria Bukvic
- Department of Geography, Center for Coastal Studies, Virginia Tech, Blacksburg, VA, USA
| | - Aishwarya Borate
- Department of Urban Planning and Public Policy, University of California-Irvine, Irvine, CA, USA
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McCarthy S, Friedman S. Disaster Preparedness and Housing Tenure: How Do Subsidized Renters Fare? HOUSING POLICY DEBATE 2023; 33:1100-1123. [PMID: 38323075 PMCID: PMC10846867 DOI: 10.1080/10511482.2023.2224309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 02/08/2024]
Abstract
Homeowners are significantly more prepared for disasters than renters. However, disaster preparedness among subsidized renters is an understudied topic despite their increased vulnerability to negative disaster outcomes. Previous research shows that one in three subsidized units is at risk for exposure to disasters, relative to one in four unsubsidized rental units, and one in seven owner-occupied units. Subsidized housing residents often fall into many vulnerable statuses that would make them less prepared than renters and owners. Using 2017 American Housing Survey data, we examine differences in household disaster preparedness by housing tenure, with and without controls for such factors. Logistic regression analyses indicate that subsidized renters are significantly less prepared than unsubsidized renters, and both renter types are significantly less prepared than homeowners, controlling for demographic and neighborhood characteristics. The policy implications of this research are considered as they relate to the location and management of subsidized housing in an era of climate change.
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Ayalon L, Roy S. The role of chronological age in climate change attitudes, feelings, and behavioral intentions: The case of null results. PLoS One 2023; 18:e0286901. [PMID: 37342993 DOI: 10.1371/journal.pone.0286901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/25/2023] [Indexed: 06/23/2023] Open
Abstract
Past research has stressed the role of age and generation in climate change discourse, worries, and willingness to act. Therefore, the present paper aimed to examine the role of chronological age (as an arbitrary factor, which represents ageism) in lay people's climate change-related attitudes, feelings, and behavioral intentions. Two experiments in different countries, Australia and Israel, were conducted for this purpose. The first study examined the impact of the age of the speaker, who provides information about the climate crisis and the second examined the impact of the age of the group being blamed for the situation. Outcome variables included perceived responsibility and motivation for the current climate situation in study 1 and perceived climate change-related attitudes, feelings, and behavioral intentions in study 2. In study 1 (n = 250, Australia), the age of the speaker, a climate activist, varied randomly to test the hypothesis that a younger activist would be more influential and increase motivation and responsibility to act compared to an older activist. In study 2 (n = 179, Israel), the age (young vs. old) of the group identified as being responsible for the climate crisis varied randomly, to test the hypothesis that people would be more willing to identify older people as being responsible for the current climate situation, and this would impact climate change-related attitudes, feelings, and behavioral intentions. Both studies resulted in null effects. Additionally, there was no interaction between the age of the respondent and the age of the source of the message or the age group being blamed by the message. The present study has failed to show that strategies that emphasize intergenerational conflict and ageism impact people's attitudes, feelings, and behavioral intentions towards the current climate situation. This possibly can serve as an instigator for strategies that emphasize intergenerational solidarity, rather than conflict, as a guiding principle in future campaigns that advocate climate change adaptation and mitigation measures.
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Affiliation(s)
- Liat Ayalon
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel
| | - Senjooti Roy
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel
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Musfike Meraz M, Riad Hossain M, Sultana R, Esraz-Ul-Zannat M. Flood prediction and vulnerability assessment at the south-western region of Bangladesh. ENVIRONMENTAL MONITORING AND ASSESSMENT 2023; 195:794. [PMID: 37264142 DOI: 10.1007/s10661-023-11418-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 05/22/2023] [Indexed: 06/03/2023]
Abstract
Flood is a frequent experience for the people living in Bangladesh, especially in the south-western region. But due to its complexity and multidisciplinary nature, flood management remains a very difficult task. This research focused on finding the most vulnerable areas to flooding for each polder within the Khulna and Satkhira districts since those areas can be identified as one of the most vulnerable areas to flooding. Water level data from fourteen stations of seven rivers (Sibsa, Rupsa-Pasur, Kobadak, Bhadra, Kobadak, Ichamati (Western Border), Betna-Kholpetua, and Satkhira Khal) were analyzed to calculate water levels for 2, 5, 10, 25, and 100-year return period applying normal distribution, extreme value type-I (EV-I), and log person type-III (LP-III) distribution methods. The EV-I distribution method was showing the best fit. The study revealed that station SW243 (Rupsa-Pasur River) in the Dacope region has the most extreme water level, station SW259 (Sibsa River) has the second-highest water level, and station SW254.5 (Satkhira Khal) in Satkhira Sadar has the third-highest water level for the return period of 100 years. A flood inundation map was prepared using the EV-I method's 10-year return period value. The Analytic Hierarchy Process (AHP) was used to demonstrate the polders' vulnerability depending on several factors. Overall, polder15 (Ghubra, Satkhira) is the most vulnerable polder, while polder 33 and polder 32 respectively are the second and third most vulnerable polders for flooding, both located in the Dacope region.
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Affiliation(s)
- Md Musfike Meraz
- Environmental Science Discipline, Life Science School, Khulna University, Khulna, 9208, Bangladesh
| | - Md Riad Hossain
- Institute of Disaster Management, Khulna University of Engineering & Technology, Khulna, 9203, Bangladesh.
| | - Rabeya Sultana
- Environmental Science Discipline, Life Science School, Khulna University, Khulna, 9208, Bangladesh
| | - Md Esraz-Ul-Zannat
- Department of Urban and Regional Planning, Khulna University of Engineering & Technology, Khulna, 9203, Bangladesh
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Andrade EL, Cordova A, Schagen CRV, Jula M, Rodriguez-Diaz CE, Rivera MI, Santos-Burgoa C. The impact of Hurricane Maria on individuals living with non-communicable disease in Puerto Rico: the experience of 10 communities. BMC Public Health 2022; 22:2083. [PMCID: PMC9664670 DOI: 10.1186/s12889-022-14552-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/04/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Coinciding with the rising non-communicable disease (NCD) prevalence worldwide is the increasing frequency and severity of natural hazards. Protecting populations with NCDs against natural hazards is ever more pressing given their increased risk of morbidity and mortality in disaster contexts. This investigation examined Hurricane Maria’s impacts across ten lower SES municipalities in Puerto Rico with varying community characteristics and hurricane impacts to understand experiences of supporting individuals with NCD management in the six-month period following the hurricane.
Methods
We conducted 40 qualitative interviews with mayors, first responders, faith leaders, community leaders, and municipal employees from 10 municipalities in Puerto Rico. Using QSR NVivo software, we deductively and inductively coded interview transcripts and undertook thematic analysis to characterize community-level hurricane impact and consequences for NCD management, and to identify convergent and divergent themes.
Results
Damages to infrastructure, including healthcare facilities and roadways, complicated the provision of timely health care for NCDs, patient transport, and pharmaceutical/medical supply chain continuity. Lengthy power outages at both healthcare facilities and private residences were barriers to healthcare service delivery, use of medical equipment, and storage of prescription medications with refrigeration, and led to a widespread mental health crisis. Cascading failures such as fuel shortages further compounded these challenges. The consequences of these impacts included the reported exacerbation of health conditions and loss of life among NCD patients.
Conclusions
Study findings identify contributors to morbidity and mortality among individuals with NCDs following Hurricane Maria. With the growing frequency of catastrophic disasters from natural hazards, the experiences of communities that endured these impacts offer important lessons regarding policies and practices to better support community disaster resilience and address the evolving preparedness needs of NCD patients.
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Lee S, First JM. Mental Health Impacts of Tornadoes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13747. [PMID: 36360627 PMCID: PMC9655757 DOI: 10.3390/ijerph192113747] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/08/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
Tornadoes are one of the most prevalent natural hazards in the United States, yet they have been underrepresented in the disaster mental health comprehensive literature. In the current study, we systematically reviewed available scientific evidence within published research journals on tornadoes and mental health from 1994 to 2021. The electronic search strategy identified 384 potentially relevant articles. Of the 384 articles, 29 articles met the inclusion criteria, representing 27,534 participants. Four broad areas were identified: (i) Mental health impacts of tornadoes; (ii) Risk factors; (iii) Protective factors; and (iv) Mental health interventions. Overall, results showed adverse mental health symptoms (e.g., post-traumatic stress disorder, depression, anxiety) in both adult and pediatric populations. A number of risk factors were found to contribute to negative mental health, including demographics, tornado exposure, post-tornado stressors, and prior exposure to trauma. Protective factors found to contribute to positive outcomes included having access to physical, social, and psychological resources. Together, these findings can serve as an important resource for future mental health services in communities experiencing tornadoes.
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Prieto Rodríguez MÁ, March Cerdá JC, Martín Barato A, Escudero Carretero M, López Doblas M, Luque Martín N. [Consequences of the COVID-19 lockdown in patients with chronic diseases in Andalusia]. GACETA SANITARIA 2022; 36:139-145. [PMID: 33342601 PMCID: PMC7680018 DOI: 10.1016/j.gaceta.2020.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To understand the consequences of the COVID-19 pandemic lockdown on the self-care of people living with chronic diseases and on their self-perceived health, and to identify factors that may influence the management of their disease in emergency situations. METHOD A qualitative study conducted in 2020 (March and April) in Andalusia (Spain) during the COVID-19 pandemic lockdown, through virtual focus groups, using the Zoom telematics tool. Three virtual focus groups were conducted, including 34 patients from Andalusia with different chronic conditions such as arthritis, diabetes, cardiovascular disease, inflammatory bowel disease, breast cancer and fibromyalgia. RESULTS People with chronic diseases reported effects of the lockdown in relation to their emotional experience, their coping resources, the information they received, the difficulties to manage self-care, and the contact or access to health services. They also suggested some lessons learned for the future. The need for more and better information, patient training, involving patient associations, and improving telematics access to health services are the main areas for improvement to minimize the impact of future quarantines on the self-care and the health of people with chronic diseases. CONCLUSIONS Besides the risk of contracting COVID-19, the difficulties encountered by people with chronic diseases during the lockdown include interferences in the self-care and the health care received. Health crisis situations demand more information, training for patients and improvements in the health services accessibility for patients with chronic conditions.
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Affiliation(s)
- M Ángeles Prieto Rodríguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Escuela Andaluza de Salud Pública, Granada, España; Instituto de Investigación Biosanitaria de Granada, Granada, España
| | - Joan Carles March Cerdá
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Escuela Andaluza de Salud Pública, Granada, España; Instituto de Investigación Biosanitaria de Granada, Granada, España
| | - Amelia Martín Barato
- Escuela Andaluza de Salud Pública, Granada, España; Instituto de Investigación Biosanitaria de Granada, Granada, España
| | - María Escudero Carretero
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Escuela Andaluza de Salud Pública, Granada, España; Instituto de Investigación Biosanitaria de Granada, Granada, España
| | - Manuela López Doblas
- Escuela Andaluza de Salud Pública, Granada, España; Instituto de Investigación Biosanitaria de Granada, Granada, España.
| | - Nuria Luque Martín
- Escuela Andaluza de Salud Pública, Granada, España; Instituto de Investigación Biosanitaria de Granada, Granada, España
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Establishing the Status of Patients With Non-Communicable Diseases in Disaster: A Systematic Review. Disaster Med Public Health Prep 2021; 16:783-790. [PMID: 33583461 DOI: 10.1017/dmp.2020.364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE People with NCDs are particularly vulnerable to disasters. This research systematically reviewed reports describing studies on the status of patients with NCDs before, during and after disasters. METHOD Relevant articles published from 1997 to 2019 were collected by searching the Scopus, PubMed, and Science Direct databases. We specifically examined reports describing NCDs and including the key words 'Non-Communicable Disease and Disasters.' NCDs include cardiovascular, respiratory, diabetes and cancer diseases. RESULTS The review identified 42 relevant articles. Most of the included studies were found to have described the conditions of patients with NCDs after disasters - 14 (13.3%), during disasters - 11 (26.2%), before disasters - 6 (14.3%), within all stages of disasters: before, during and after - 6 (14.3%), only during and after disasters - 4 (9.5%), and includes before and during disasters - 1 (2.4%). CONCLUSION NCDs pose major health issues in disasters. Development of strong counter measures against the interruption of treatment, as well as surveillance systems to ascertain medical needs for NCDs are necessary as preparation for future disasters.
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Wang Y, Hao F, Liu Y. Pro-Environmental Behavior in an Aging World: Evidence from 31 Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041748. [PMID: 33670167 PMCID: PMC7916887 DOI: 10.3390/ijerph18041748] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 12/04/2022]
Abstract
Population change and environmental degradation have become two of the most pressing issues for sustainable development in the contemporary world, while the effect of population aging on pro-environmental behavior remains controversial. In this paper, we examine the effects of individual and population aging on pro-environmental behavior through multilevel analyses of cross-national data from 31 countries. Hierarchical linear models with random intercepts are employed to analyze the data. The findings reveal a positive relationship between aging and pro-environmental behavior. At the individual level, older people are more likely to participate in environmental behavior (b = 0.052, p < 0.001), and at the national level, living in a country with a greater share of older persons encourages individuals to behave sustainably (b = 0.023, p < 0.01). We also found that the elderly are more environmentally active in an aging society. The findings imply that the longevity of human beings may offer opportunities for the improvement of the natural environment.
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Affiliation(s)
- Yan Wang
- Department of Sociology, Zhou Enlai School of Government, Computational Social Science Lab, Nankai University, Tianjin 300353, China;
| | - Feng Hao
- Department of Sociology, University of South Florida, Tampa, FL 33620, USA;
| | - Yunxia Liu
- Zhou Enlai School of Government, Nankai University, Tianjin 300353, China
- Correspondence:
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Walkling B, Haworth BT. Flood risk perceptions and coping capacities among the retired population, with implications for risk communication: A study of residents in a north Wales coastal town, UK. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2020; 51:101793. [PMID: 32834976 PMCID: PMC7413120 DOI: 10.1016/j.ijdrr.2020.101793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/09/2020] [Accepted: 07/29/2020] [Indexed: 06/11/2023]
Abstract
Flood risk communication strategies have been ineffective for older adults as they have failed to accommodate diversity, viewing retired populations as homogenous. There have been calls from academics and NGOs to develop more detailed understandings of older adults' risk experiences to inform disaster risk reduction (DRR) and communication approaches. We conducted in-depth interviews with twelve members of the retired population, of which the majority happened to be members of a local church, in a flood risk area of north Wales, UK, in 2018 to ascertain risk perceptions, coping capacities, and risk communication preferences to inform more age-centred approaches. Results present retired population are a diverse group with varying perceptions and capacities. While personal risk perceptions were low overall, coping capacities varied and were primarily social in nature, which can be sustained despite mobility or other limitations typical of older age. Participants expressed preference for traditional/interpersonal risk communication methods, such as telephone calls or home visits. A key recommendation from this study is that risk communication and DRR practices should adopt people-centric approaches that are co-produced and respect the differentiated vulnerabilities, capacities and needs of at-risk populations. This study and its findings are important is providing a more nuanced picture of the vulnerabilities and capacities of the particularly at-risk population of older adults. We must ensure that future DRR research, policies and practices focus on all experiences of at-risk populations, not only the dominant narratives or extremes of groups, to capture differences within groups' abilities to support more effective community DRR.
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Affiliation(s)
- Ben Walkling
- Humanitarian and Conflict Response Institute, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Billy Tusker Haworth
- Humanitarian and Conflict Response Institute, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
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Cheruvu MS, Bhachu DS, Mulrain J, Resool S, Cool P, Ford DJ, Singh RA. Effect of COVID-19 on a rural orthopaedic hip fracture service. Bone Jt Open 2020; 1:500-507. [PMID: 33215145 PMCID: PMC7659701 DOI: 10.1302/2633-1462.18.bjo-2020-0082.r1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AIMS Our rural orthopaedic service has undergone service restructure during the COVID-19 pandemic in order to sustain hip fracture care. All adult trauma care has been centralised to the Royal Shrewsbury Hospital for assessment and medical input, before transferring those requiring operative intervention to the Robert Jones and Agnes Hunt Orthopaedic Hospital. We aim to review the impact of COVID-19 on hip fracture workload and service changes upon management of hip fractures. METHODS We reviewed our prospectively maintained trust database and National Hip Fracture Database records for the months of March and April between the years 2016 and 2020. Our assessment included fracture pattern (intrascapular vs extracapsular hip fracture), treatment intervention, length of stay and mortality. RESULTS We treated 288 patients during March and April between 2016 and 2020, with a breakdown of 55, 58, 53, 68, and 54 from 2016 to 2020 respectively. Fracture pattern distribution in the pre-COVID-19 years of 2016 to 2019 was 58% intracapsular and 42% extracapsular. In 2020 (COVID-19 period) the fracture patterns were 65% intracapsular and 35% extracapsular. Our mean length of stay was 13.1 days (SD 8.2) between 2016 to 2019, and 5.0 days (6.3) days in 2020 (p < 0.001). Between 2016 and 2019 we had three deaths in hip fracture patients, and one death in 2020. Hemiarthroplasty and dynamic hip screw fixation have been the mainstay of operative intervention across the five years and this has continued in the COVID-19 period. We have experienced a rise in conservatively managed patients; ten in 2020 compared to 14 over the previous four years. CONCLUSION There has not been a reduction in the number of hip fractures during COVID-19 period compared to the same time period over previous years. In our experience, there has been an increase in conservative treatment and decreased length of stay during the COVID -19 period.Cite this article: Bone Joint Open 2020;1-8:500-507.
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Affiliation(s)
- Manikandar Srinivas Cheruvu
- Shrewsbury & Telford Hospitals NHS Trust, Shrewsbury, United Kingdom
- Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry, United Kingdom
| | - Davinder Singh Bhachu
- Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry, United Kingdom
| | - Jill Mulrain
- Shrewsbury & Telford Hospitals NHS Trust, Shrewsbury, United Kingdom
- Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry, United Kingdom
| | - Shko Resool
- Shrewsbury & Telford Hospitals NHS Trust, Shrewsbury, United Kingdom
| | - Paul Cool
- Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry, United Kingdom
| | - David James Ford
- Shrewsbury & Telford Hospitals NHS Trust, Shrewsbury, United Kingdom
- Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry, United Kingdom
| | - Rohit Amol Singh
- Shrewsbury & Telford Hospitals NHS Trust, Shrewsbury, United Kingdom
- Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry, United Kingdom
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Determining Key Influences on Patient Ability to Successfully Manage Noncommunicable Disease After Natural Disaster. Prehosp Disaster Med 2019; 34:241-250. [PMID: 31079592 DOI: 10.1017/s1049023x1900431x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Natural disasters often damage or destroy the protective public health service infrastructure (PHI) required to maintain the health and well-being of people with noncommunicable diseases (NCDs). This interruption increases the risk of an acute exacerbation or complication, potentially leading to a worse long-term prognosis or even death. Disaster-related exacerbations of NCDs will continue, if not increase, due to an increasing prevalence and sustained rise in the frequency and intensity of disasters, along with rapid unsustainable urbanization in flood plains and storm-prone coastal zones. Despite this, the focus of disaster and health systems preparedness and response remains on communicable diseases, even when the actual risk of disease outbreaks post-disaster is low, particularly in developed countries. There is now an urgent need to expand preparedness and response beyond communicable diseases to include people with NCDs.Hypothesis/Problem:The developing evidence-base describing the risk of disaster-related exacerbation of NCDs does not incorporate the perspectives, concerns, and challenges of people actually living with the conditions. To help address this gap, this research explored the key influences on patient ability to successfully manage their NCD after a natural disaster. METHODS A survey of people with NCDs in Queensland, Australia collected data on demographics, disease, disaster experience, and primary concern post-disaster. Descriptive statistics and chi-square tests with a Bonferroni-adjustment were used to analyze data. RESULTS There were 118 responses to the survey. Key influences on the ability to self-manage post-disaster were access to medication, medical services, water, treatment and care, power, and food. Managing disease-specific symptoms associated with cardiovascular disease, diabetes, mental health, and respiratory diseases were primary concerns following a disaster. Stress and anxiety, loss of sleep, weakness or fatigue, and shortness of breath were common concerns for all patients with NCDs. Those dependent on care from others were most worried about shortness of breath and slow healing sores. Accessing medication and medical services were priorities for all patients post-disaster. CONCLUSION The key influences on successful self-management post-disaster for people with NCDs must be reflected in disaster plans and strategies. Achieving this will reduce exacerbations or complications of disease and decrease demand for emergency health care post-disaster.
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Phibbs S, Kenney C, Rivera-Munoz G, Huggins TJ, Severinsen C, Curtis B. The Inverse Response Law: Theory and Relevance to the Aftermath of Disasters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E916. [PMID: 29734692 PMCID: PMC5981955 DOI: 10.3390/ijerph15050916] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 04/19/2018] [Accepted: 04/27/2018] [Indexed: 11/17/2022]
Abstract
The Inverse Care Law is principally concerned with the effect of market forces on health care which create inequities in access to health services through privileging individuals who possess the forms of social capital that are valued within health care settings. The fields of disaster risk reduction need to consider the ways in which inequities, driven by economic and social policy as well as institutional decision-making, create vulnerabilities prior to a disaster, which are then magnified post disaster through entrenched structural differences in access to resources. Drawing on key principles within the Inverse Care Law, the Inverse Response Law refers to the idea that people in lower socio-economic groups are more likely to be impacted and to experience disparities in service provision during the disaster response and recovery phase. In a market model of recovery, vulnerable groups struggle to compete for necessary services creating inequities in adaptive capacity as well as in social and wellbeing outcomes over time. Both the Inverse Care Law and the Inverse Response Law focus on the structural organisation of services at a macro level. In this article, the Inverse Care Law is outlined, its application to medical treatment following disasters considered and an explanation of the Inverse Response Law provided. Case studies from recent disasters, in London, New Zealand, Puerto Rico and Mexico City are examined in order to illustrate themes at work relating to the Inverse Response Law.
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Affiliation(s)
- Suzanne Phibbs
- School of Health Sciences, Massey University, Palmerston North 4442, New Zealand.
| | - Christine Kenney
- Joint Centre for Disaster Research, Massey University, Wellington 6140, New Zealand.
| | - Graciela Rivera-Munoz
- Department of Public Health, Otago School of Medicine, Wellington 6021, New Zealand.
| | - Thomas J Huggins
- Joint Centre for Disaster Research, Massey University, Wellington 6140, New Zealand.
| | - Christina Severinsen
- School of Health Sciences, Massey University, Palmerston North 4442, New Zealand.
| | - Bruce Curtis
- Department of Sociology, University of Auckland, Auckland 1010, New Zealand.
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Social Determinants of Health, Disaster Vulnerability, Severe and Morbid Obesity in Adults: Triple Jeopardy? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017. [PMCID: PMC5750871 DOI: 10.3390/ijerph14121452] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Severe and morbid obesity are associated with highly elevated risks of adverse health outcomes and the prevalence of severe obesity is increasing globally. To date, disaster literature has not considered severe and morbid obesity as a specific vulnerability, despite reports of people being left behind during disasters because of their body size, shape or weight. The complex causes of obesity are associated with the social determinants of health and one’s potential vulnerability to disasters. The absence of appropriate considerations may lead to people being exposed to disproportionate and potentially avoidable risk. The intersection of the social determinants of health, disaster vulnerability, severe and morbid obesity is explored. Previously identified vulnerable groups are also represented in severe and morbid obesity data. This poses the prospect for ‘triple jeopardy’ compounding the social determinants of health, disaster vulnerability and considerations with and for people with morbid obesity. When working to reduce disaster risk for vulnerable groups, the author proposes specific consideration is required to ensure ‘all-of-society engagement and partnership’ in an inclusive, accessible and non-discriminatory manner, to ensure no one is left behind.
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Heid AR, Pruchno R, Cartwright FP, Wilson-Genderson M. Exposure to Hurricane Sandy, neighborhood collective efficacy, and post-traumatic stress symptoms in older adults. Aging Ment Health 2017; 21:742-750. [PMID: 26911314 DOI: 10.1080/13607863.2016.1154016] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Older adults exposed to natural disasters are at risk for negative psychological outcomes such as post-traumatic stress disorder (PTSD). Neighborhood social capital can act as a resource that supports individual-level coping with stressors. This study explores the ability of perceived neighborhood collective efficacy, a form of social capital, to moderate the association between exposure to Hurricane Sandy and PTSD symptoms in older adults. METHOD Data from 2205 older individuals aged 54-80 residing in New Jersey who self-reported exposure to Hurricane Sandy in October of 2012 were identified and extracted from the ORANJ BOWL™ research panel. Participants completed baseline assessments of demographic and individual-level characteristics in 2006-2008 and follow-up assessments about storm exposure, perceived neighborhood collective efficacy (social cohesion and social control), and PTSD symptoms 8-33 months following the storm. Zero-inflated Poisson regression models were tested to examine the association between exposure, neighborhood collective efficacy, and PTSD symptoms. RESULTS After accounting for known demographic and individual-level covariates, greater storm exposure was linked to higher levels of PTSD symptoms. Social cohesion, but not social control, was linked to lower reports of PTSD symptoms and moderated the association between exposure and PTSD. The impact of storm exposure on PTSD symptoms was less for individuals reporting higher levels of social cohesion. CONCLUSION Mental health service providers and disaster preparedness and response teams should consider the larger social network of individuals served. Building social connections in older adults' neighborhoods that promote cohesion can reduce the negative psychological impact of a disaster.
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Affiliation(s)
- Allison R Heid
- a Department of Geriatrics, New Jersey Institute for Successful Aging , Rowan University School of Osteopathic Medicine , Stratford , NJ , USA
| | - Rachel Pruchno
- a Department of Geriatrics, New Jersey Institute for Successful Aging , Rowan University School of Osteopathic Medicine , Stratford , NJ , USA
| | - Francine P Cartwright
- a Department of Geriatrics, New Jersey Institute for Successful Aging , Rowan University School of Osteopathic Medicine , Stratford , NJ , USA
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Wilson-Genderson M, Pruchno R, Heid AR. Modeling Successful Aging Over Time in the Context of a Disaster. J Gerontol B Psychol Sci Soc Sci 2017; 72:328-339. [PMID: 27998894 DOI: 10.1093/geronb/gbw127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 09/14/2016] [Indexed: 11/14/2022] Open
Abstract
Objective Positing that successful aging (SA) has independent, yet related components that are both objective and subjective, we examine how the indicators of SA change over time and how exposure to a disaster affects the developmental course of SA. Method Data were gathered from 5,688 people aged 50-74 years living in New Jersey who participated in baseline telephone interviews between 2006 and 2008 and then were reassessed up to four times over the following 9 years. Multilevel mixed effects models were used to examine change in objective and subjective SA over time and to evaluate the impact of Hurricane Sandy on SA. Results Over the 9-year period, controlling for age, gender, education, and income, average levels of both subjective SA and objective SA declined. People exposed to Hurricane Sandy experienced sharper declines in subjective SA and indicators of objective SA (pain and functional ability) than people not exposed. Discussion Findings have important implications for expanding our conceptualization of SA, clarifying the measures used to understand SA, and the importance of accounting for the effects of disasters on SA.
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Affiliation(s)
| | - Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford
| | - Allison R Heid
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford
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Caring for Older Adults in Disasters: A Special Collection of Papers for a Special Population. Disaster Med Public Health Prep 2017; 11:26-27. [DOI: 10.1017/dmp.2017.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Ryan BJ, Franklin RC, Burkle FM, Aitken P, Smith E, Watt K, Leggat P. Reducing Disaster Exacerbated Non-Communicable Diseases Through Public Health Infrastructure Resilience: Perspectives of Australian Disaster Service Providers. PLOS CURRENTS 2016; 8:ecurrents.dis.d142f36b6f5eeca806d95266b20fed1f. [PMID: 28239511 PMCID: PMC5308209 DOI: 10.1371/currents.dis.d142f36b6f5eeca806d95266b20fed1f] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The exposure of people and infrastructure to flood and storm related disasters across the world is increasing faster than vulnerability is decreasing. For people with non-communicable diseases this presents a significant risk as traditionally the focus of disaster management systems has been on immediate trauma and communicable diseases. This focus must now be expanded to include the management of non-communicable diseases because these conditions are generating the bulk of ill health, disability and premature death around the globe. When public health service infrastructure is destroyed or damaged access to treatment and care is severely jeopardised, resulting in an increased risk of non-communicable disease exacerbation or even death. This research proposes disaster responders, coordinators and government officials are vital assets to mitigate and eventually prevent these problems from being exacerbated during a disaster. This is due to their role in supporting the public health service infrastructure required to maximise treatment and care for people with non-communicable diseases. By focusing on the disaster cycle as a template, and on mitigation and prevention phases in particular, these actions and activities performed by disaster service responders will lead to overall improved preparedness, response, recovery and rehabilitation phases. METHODS Data were collected via 32 interviews and one focus group (eight participants) between March 2014 and August 2015 (total of 40 participants). The research was conducted in the State of Queensland, Australia, with disaster service providers. The analysis included the phases of: organizing data; data description; data classification; and interpretation. RESULTS The research found a relationship between the impact of a disaster on public health service infrastructure, and increased health risks for people with non-communicable diseases. Mitigation strategies were described for all phases of the disaster cycle impacting public health service infrastructure. Specific measures include: increasing the use of telemedicine; preplanning with medical suppliers; effective town planning; health professionals visiting evacuation centers; evacuation centers having power for medical equipment; hubs for treatment and care after a disaster; evacuation of high risk people prior to disaster; mapping people at risk by non-communicable disease; and a mechanism for sharing information between agencies. A common theme from the participants was that having accurate and easily accessible data on people with non-communicable diseases would allow disaster service providers to adequately prepare for and respond to a disaster. CONCLUSIONS Disaster service providers can play a vital role in reducing the risk of disaster exacerbated non-communicable diseases through public health service infrastructure resilience. They are often employed in communities where disasters occur and are therefore best-placed to lead implementation of the mitigation strategies identified in this research. To sustainably implement the mitigation strategies they will need to become integrated into effective performance and monitoring of the disaster response and health sector during non-disaster periods. For this to occur, the strategies should be integrated into business and strategic plans. Achieving this will help implement the Sendia Framework for Disaster Risk Reduction 2015-2030 and, most importantly, help protect the health of people with non-communicable diseases before, during and after a disaster.
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Affiliation(s)
- Benjamin J Ryan
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Richard C Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Frederick M Burkle
- Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts, USA
| | - Peter Aitken
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia; School of Public Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Erin Smith
- School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Kerrianne Watt
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Peter Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia; Faculty of Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Delivering Flexible Education and Training to Health Professionals: Caring for Older Adults in Disasters. Disaster Med Public Health Prep 2016; 10:633-7. [PMID: 27109606 DOI: 10.1017/dmp.2016.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The National Center for Disaster Medicine and Public Health (NCDMPH), in collaboration with over 20 subject matter experts, created a competency-based curriculum titled Caring for Older Adults in Disasters: A Curriculum for Health Professionals. Educators and trainers of health professionals are the target audience for this curriculum. The curriculum was designed to provide breadth of content yet flexibility for trainers to tailor lessons, or select particular lessons, for the needs of their learners and organizations. The curriculum covers conditions present in the older adult population that may affect their disaster preparedness, response, and recovery; issues related to specific types of disasters; considerations for the care of older adults throughout the disaster cycle; topics related to specific settings in which older adults receive care; and ethical and legal considerations. An excerpt of the final capstone lesson is included. These capstone activities can be used in conjunction with the curriculum or as part of stand-alone preparedness training. This article describes the development process, elements of each lesson, the content covered, and options for use of the curriculum in education and training for health professionals. The curriculum is freely available online at the NCDMPH website at http://ncdmph.usuhs.edu (Disaster Med Public Health Preparedness. 2016;10:633-637).
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Lee DC, Gupta VK, Carr BG, Malik S, Ferguson B, Wall SP, Smith SW, Goldfrank LR. Acute post-disaster medical needs of patients with diabetes: emergency department use in New York City by diabetic adults after Hurricane Sandy. BMJ Open Diabetes Res Care 2016; 4:e000248. [PMID: 27547418 PMCID: PMC4964212 DOI: 10.1136/bmjdrc-2016-000248] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 06/13/2016] [Accepted: 07/01/2016] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To evaluate the acute impact of disasters on diabetic patients, we performed a geospatial analysis of emergency department (ED) use by New York City diabetic adults in the week after Hurricane Sandy. RESEARCH DESIGN AND METHODS Using an all-payer claims database, we retrospectively analyzed the demographics, insurance status, and medical comorbidities of post-disaster ED patients with diabetes who lived in the most geographically vulnerable areas. We compared the patterns of ED use among diabetic adults in the first week after Hurricane Sandy's landfall to utilization before the disaster in 2012. RESULTS In the highest level evacuation zone in New York City, postdisaster increases in ED visits for a primary or secondary diagnosis of diabetes were attributable to a significantly higher proportion of Medicare patients. Emergency visits for a primary diagnosis of diabetes had an increased frequency of certain comorbidities, including hypertension, recent procedure, and chronic skin ulcers. Patients with a history of diabetes visited EDs in increased numbers after Hurricane Sandy for a primary diagnosis of myocardial infarction, prescription refills, drug dependence, dialysis, among other conditions. CONCLUSIONS We found that diabetic adults aged 65 years and older are especially at risk for requiring postdisaster emergency care compared to other vulnerable populations. Our findings also suggest that there is a need to support diabetic adults particularly in the week after a disaster by ensuring access to medications, aftercare for patients who had a recent procedure, and optimize their cardiovascular health to reduce the risk of heart attacks.
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Affiliation(s)
- David C Lee
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Vibha K Gupta
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
| | - Brendan G Carr
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- Department of Health & Human Services, Emergency Care Coordination Center, Office of the Assistant Secretary for Preparedness & Response, Washington, DC, USA
| | - Sidrah Malik
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
| | - Brandy Ferguson
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
| | - Stephen P Wall
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
| | - Silas W Smith
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
| | - Lewis R Goldfrank
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
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Ryan B, Franklin RC, Burkle FM, Aitken P, Smith E, Watt K, Leggat P. Identifying and Describing the Impact of Cyclone, Storm and Flood Related Disasters on Treatment Management, Care and Exacerbations of Non-communicable Diseases and the Implications for Public Health. PLOS CURRENTS 2015; 7:ecurrents.dis.62e9286d152de04799644dcca47d9288. [PMID: 26468423 PMCID: PMC4593706 DOI: 10.1371/currents.dis.62e9286d152de04799644dcca47d9288] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Over the last quarter of a century the frequency of natural disasters and the burden of non-communicable diseases (NCD) across the globe have been increasing. For individuals susceptible to, or chronically experiencing, NCDs this has become a significant risk. Disasters jeopardize access to essential treatment, care, equipment, water and food, which can result in an exacerbation of existing conditions or even preventable death. Consequently, there is a need to expand the public health focus of disaster management to include NCDs. To provide a platform for this to occur, this article presents the results from a systematic review that identifies and describes the impact of cyclone, flood and storm related disasters on those susceptible to, or experiencing, NCDs. The NCDs researched were: cardiovascular diseases; cancers; chronic respiratory diseases; and diabetes. METHODS Four electronic publication databases were searched with a date limit of 31 December 2014. The data was analyzed through an aggregation of individual papers to create an overall data description. The data was then grouped by disease to describe the impact of a disaster on treatment management, exacerbation, and health care of people with NCDs. The PRISMA checklist was used to guide presentation of the research. RESULTS The review identified 48 relevant articles. All studies represented developed country data. Disasters interrupt treatment management and overall care for people with NCDs, which results in an increased risk of exacerbation of their illness or even death. The interruption may be caused by a range of factors, such as damaged transport routes, reduced health services, loss of power and evacuations. The health impact varied according to the NCD. For people with chronic respiratory diseases, a disaster increases the risk of acute exacerbation. Meanwhile, for people with cancer, cardiovascular diseases and diabetes there is an increased risk of their illness exacerbating, which can result in death. CONCLUSION Cyclone, flood and storm related disasters impact on treatment management and care for people with NCDs. Possible consequences include exacerbation of illness, complications or even death. There is now a need to expand traditional disaster approaches by public health to incorporate NCDs. This must be guided by the major NCDs identified by the World Health Organization and implemented in-line with the Sendai Framework for Disaster Risk Reduction: 2015-2030. This includes understanding all the factors that influence both direct and indirect (preventable) morbidity and mortality related to NCDs during and after disasters. Once achieved, disaster planners and public health professionals will be in a position to develop and implement effective mitigation strategies.
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Affiliation(s)
- Benjamin Ryan
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Australia; Cairns and Hinterland Hospital and Health Service, Australia
| | - Richard C Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Frederick M Burkle
- Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts; The Woodrow Wilson International Center for Scholars, Washington, DC, USA
| | - Peter Aitken
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Australia; School of Public Health, Queensland University of Technology, Australia
| | - Erin Smith
- School of Medical Sciences, Edith Cowan University; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Kerrianne Watt
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Australia; World Safety Organization Collaborating Centre for Injury Prevention and Safety Promotion
| | - Peter Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia; Faculty of Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Veenema TG, Rains AB, Casey-Lockyer M, Springer J, Kowal M. Quality of healthcare services provided in disaster shelters: An integrative literature review. Int Emerg Nurs 2015; 23:225-31. [PMID: 25731879 DOI: 10.1016/j.ienj.2015.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 01/21/2015] [Accepted: 01/22/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Globally, shelters are a resource to promote critical health and safety in disasters, particularly for vulnerable populations (e.g., children, elderly, chronically ill). This study examines the nature and quality of healthcare services rendered in disaster and emergency shelters. OBJECTIVES To determine based upon systematic and accurate measurement the scope and quality of health care services rendered in disaster shelters and to describe the health outcomes experienced by shelter residents. METHODS An integrative review of English-language literature pertaining to the assessment, evaluation, and systematic measurement of healthcare quality and client outcomes in disaster and emergency shelters was undertaken. Articles were identified using a structured search strategy of six databases and indexing services (PubMed, CINAHL, EMBase, Scopus, Web of Science, and Google Scholar). RESULTS Limited literature exists pertaining specifically to metrics for quality of health care in acute disaster and emergency shelters, and the literature that does exist is predominately U.S. based. Analysis of the existing evidence suggests that nurse staffing levels and staff preparedness, access to medications/medication management, infection control, referrals, communication, and mental health may be important concepts related to quality of disaster health care services. CONCLUSIONS A small number of population-based and smaller, ad hoc outcomes-based evaluation efforts exist; however the existing literature regarding systematic outcomes-based quality assessment of disaster sheltering healthcare services is notably sparse.
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Affiliation(s)
- Tener Goodwin Veenema
- Johns Hopkins School of Nursing, Johns Hopkins Bloomberg School of Public Health, Center for Refugee and Disaster Response, Baltimore, MD 21205, USA.
| | - Adam B Rains
- Information Technology, Tener Consulting Group, LLC, Rochester, NY, USA
| | | | | | - Mary Kowal
- Johns Hopkins School of Nursing, Baltimore, MD, USA
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Jenkins JL, Levy M, Rutkow L, Spira A. Variables associated with effects on morbidity in older adults following disasters. PLOS CURRENTS 2014; 6. [PMID: 25685623 PMCID: PMC4322087 DOI: 10.1371/currents.dis.0fe970aa16d51cde6a962b7a732e494a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Older adults are vulnerable to disproportionately higher morbidity following disasters. Reasons for this vulnerability are multifaceted and vary by disaster type as well as patient comorbidities. Efforts to mitigate this increased morbidity require identification of at-risk older adults who can be targeted for intervention. METHODS A PubMed search was performed using the search terms "geriatric, disaster" and "morbidity, disaster" to identify published articles that reported variables associated with increased morbidity of older adults during and after disasters. A review of article titles and abstracts was then conducted to identify those articles that contained evidence-based variables that render older adults vulnerable to poor health outcomes during disasters. RESULTS A total of 233 studies was initially identified. After applying exclusion criteria, nine studies were chosen for the comprehensive review. Based on the synthesis of the literature, factors were identified that were repeatedly associated with morbidity and mortality among older adults during and shortly after disasters. CONCLUSION Older adults, especially those with multiple co-morbidities, are at risk of increased morbidity after disasters and catastrophic events. Factors such as the need for prescription medications, low social support, visual and hearing impairment, impaired mobility, and poor economic status are associated with an increased risk of morbidity.
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Affiliation(s)
- J Lee Jenkins
- Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matthew Levy
- Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lainie Rutkow
- Health Policy and Management, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Adam Spira
- Department of Mental Health, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Disparate Health Implications Stemming From the Propensity of Elderly and Medically Fragile Populations to Shelter in Place During Severe Storm Events. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2013; 19 Suppl 2:S55-62. [DOI: 10.1097/phh.0b013e318297226a] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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