Adult Mortality Five Years after a Natural Disaster

Can we mitigate the effect of natural disasters on child health? Evidence from the Indian Ocean tsunami in Indonesia

The 2004 Indian Ocean tsunami was an international natural disaster unlike any seen before, killing 166,561 people in Aceh province, Indonesia. It prompted an unprecedented humanitarian response and was a catalyst in ending almost 30 years of civil conflict in Aceh. Since the tsunami was followed by a multitude of events, we first conduct a systematic review to identify those events in Indonesia. We then use a synthetic control method to estimate the combination of those effects on child mortality indicators in Aceh for the 13 years that followed the disaster using data from 258,918 children born between 1990 and 2017. The results show a significant increase in under-5 mortality only the year after the tsunami and no effect in the medium term. However, younger and older children were affected differently in the medium term. In fact, we show a decrease in child mortality among children aged 1-4 years. In contrast, we observe an increase in mortality among children under-1 in 2009 and 2010. Overall, the resilience of Aceh province points to the importance of coordinated international disaster responses after natural disasters.

Life expectancy, death, and disability in Haiti, 1990-2017: a systematic analysis from the Global Burden of Disease Study 2017

Objective.

To investigate the magnitude and distribution of the main causes of death, disability, and risk factors in Haiti.

Methods.

We conducted an ecological analysis, using data estimated from the Global Burden of Disease Study 2017 for the period 1990-2017, to present life expectancy (LE), healthy life expectancy (HALE) at under 1-year-old, cause-specific deaths, years of life lost (YLLs), years lived with disability (YLDs), disability adjusted life-years (DALYs), and risk factors associated with DALYs.

Results.

LE and HALE increased substantially in Haiti. People may hope to live longer in 2017, but in poor health. The Caribbean countries had significantly lower YLLs rates than Haiti for ischemic heart disease, stroke, lower respiratory infections, and diarrheal diseases. Road injuries were the leading cause of DALYs for people aged 5-14 years. Road injuries and HIV/AIDS were the leading causes of DALYs for men and women aged 15-49 years, respectively. Ischemic heart disease was the main cause of DALYs for people older than 50 years. Maternal and child malnutrition were the leading risk factors for DALYs in both sexes.

Conclusion.

Haiti faces a double burden of disease. Infectious diseases continue to be an issue, while non-communicable diseases have become a significant burden of disease. More attention must also be focused on the increase in worrying public health issues such as road injuries, exposure to forces of nature and HIV/AIDS in specific age groups. To address the burden of disease, sustained actions are needed to promote better health in Haiti and countries with similar challenges.

Effects of a natural disaster on mortality risks over the longer term

Exposure to disasters and other extreme events is rising across the globe but the impact on long-term mortality risks of affected populations is not established. We examine how mortality and individual-specific traumatic exposures at the time of the disaster affect mortality risks of survivors over the next ten years, using data from Aceh, Indonesia collected before and after the 2004 Indian Ocean Tsunami. Across communities, the higher the percentage of individuals killed in the tsunami, the lower the mortality rate for adults over the next decade. However, among older adults post-disaster mortality is elevated for males with poor post-tsunami psychosocial health and for females whose spouse died in the tsunami. Individual-specific tsunami exposures do not affect mortality of younger adults within the 10 year time frame. Whereas positive mortality selection is evident for all adults, scarring is evident only for older adults and is large enough to substantively counteract the reductions in risk from positive mortality selection.