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Mahapatra P, Sahoo KC, Pati S. A longitudinal qualitative study on physician experience in managing multimorbidity across the COVID-19 pandemic in Odisha, India. Sci Rep 2024; 14:12866. [PMID: 38834635 DOI: 10.1038/s41598-024-60473-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 04/23/2024] [Indexed: 06/06/2024] Open
Abstract
While many studies have documented adverse impact of multiple chronic conditions or multimorbidity on COVID-19 outcomes in patients, there is scarcity of report on how physicians managed these patients. We investigated the experiences and challenges of clinicians in managing patients with multimorbidity throughout the COVID-19 pandemic in Odisha state, India. To understand the factors influencing illness management and the adaptive responses of physicians alongside the evolving pandemic, we followed a longitudinal qualitative study design. Twenty-three physicians comprising general practitioners, specialists, and intensivists, were telephonically interviewed in-depth. Saldana's longitudinal qualitative data analysis method was employed for data analysis. COVID-19 pandemic initially diverted the attention of health systems, resulting in reduced care. With time, the physicians overcame fear, anxiety, and feelings of vulnerability to COVID-19 and started prioritising patients with multimorbidity for treatment and vaccination. All physicians recommended teleconsultation and digital health records to benefit chronic illness care during future public health crises. The findings underscore the transformative potential of physician resilience and adaptation during the COVID-19 pandemic, emphasizing the importance of prioritizing patients with multimorbidity, incorporating teleconsultation, and implementing digital health records in healthcare systems to enhance chronic illness care and preparedness for future public health crises.
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Affiliation(s)
- Pranab Mahapatra
- Department of Psychiatry, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Krushna Chandra Sahoo
- Department of Health Research, Health Technology Assessment in India (HTAIn), Ministry of Health and Family Welfare, New Delhi, 110001, India
| | - Sanghamitra Pati
- ICMR-Regional Medical Research Centre Bhubaneswar, Chandrasekharpur, Bhubaneswar, Odisha, 751023, India.
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Wu Y, Gasevic D, Wen B, Yang Z, Yu P, Zhou G, Zhang Y, Song J, Liu H, Li S, Guo Y. Floods and cause-specific mortality in the UK: a nested case-control study. BMC Med 2024; 22:188. [PMID: 38715068 PMCID: PMC11077877 DOI: 10.1186/s12916-024-03412-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Floods are the most frequent weather-related disaster, causing significant health impacts worldwide. Limited studies have examined the long-term consequences of flooding exposure. METHODS Flood data were retrieved from the Dartmouth Flood Observatory and linked with health data from 499,487 UK Biobank participants. To calculate the annual cumulative flooding exposure, we multiplied the duration and severity of each flood event and then summed these values for each year. We conducted a nested case-control analysis to evaluate the long-term effect of flooding exposure on all-cause and cause-specific mortality. Each case was matched with eight controls. Flooding exposure was modelled using a distributed lag non-linear model to capture its nonlinear and lagged effects. RESULTS The risk of all-cause mortality increased by 6.7% (odds ratio (OR): 1.067, 95% confidence interval (CI): 1.063-1.071) for every unit increase in flood index after confounders had been controlled for. The mortality risk from neurological and mental diseases was negligible in the current year, but strongest in the lag years 3 and 4. By contrast, the risk of mortality from suicide was the strongest in the current year (OR: 1.018, 95% CI: 1.008-1.028), and attenuated to lag year 5. Participants with higher levels of education and household income had a higher estimated risk of death from most causes whereas the risk of suicide-related mortality was higher among participants who were obese, had lower household income, engaged in less physical activity, were non-moderate alcohol consumers, and those living in more deprived areas. CONCLUSIONS Long-term exposure to floods is associated with an increased risk of mortality. The health consequences of flooding exposure would vary across different periods after the event, with different profiles of vulnerable populations identified for different causes of death. These findings contribute to a better understanding of the long-term impacts of flooding exposure.
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Affiliation(s)
- Yao Wu
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Bo Wen
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Zhengyu Yang
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Guowei Zhou
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Yan Zhang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Jiangning Song
- Department of Biochemistry and Molecular Biology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC, 3800, Australia
| | - Hong Liu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Shanshan Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Yuming Guo
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
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Moslehi S, Shirazi FB. Challenges of providing health services to patients with cardiovascular diseases during disasters in Iran: A qualitative study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:25. [PMID: 37034868 PMCID: PMC10079189 DOI: 10.4103/jehp.jehp_548_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/25/2022] [Indexed: 06/19/2023]
Abstract
BACKGROUND Cardiovascular diseases are the most common causes of death in the world. Because of the rate of emergencies and disasters in the country, this study was conducted to investigate the challenges of providing health services to cardiovascular patients in emergencies and disasters in Iran. MATERIALS AND METHODS This conventional content analysis study was conducted in 2020. Subjects were selected from among 16 Iranian experts) epidemiologists, cardiologists, PhD in Disaster Health, and PhD in Nursing (using purposeful and snowball sampling methods. Data were collected using semi-structured interviews and were analyzed by the content analysis. RESULTS The results were obtained after analyzing the data in the pre-emergency phase (lack of training on medication and nutrition, lack of training vulnerable groups, lack of databases of cardiovascular patients, and lack of identification of patients before disasters), the emergency response phase (lack of sleep and rest patterns, lack of health forces, lack of blood pressure control, lack of proper nutrition, increased medication needs, and lack of mental health interventions), and the post-emergency phase (lack of planning, lack of management of patients' mental problems). CONCLUSION Developing strategies for planning, training, providing resources, and mental health during the three phases of the emergency management cycle for specific groups such as cardiovascular patients together with empowering these patients in the event of disasters is one of the key strategies which can be used after curbed emergencies and disasters to reduce the rate of mortality.
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Affiliation(s)
- Shandiz Moslehi
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Barghi Shirazi
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Ghazanchaei E, Allahbakhshi K, Khorasani-Zavareh D, Aghazadeh-Attari J, Mohebbi I. Challenges in Providing Care for Patients with Chronic Diseases during Disasters: A Qualitative Study with Focus on Diabetes and Chronic Respiratory Diseases in Iran. TANAFFOS 2023; 22:83-101. [PMID: 37920319 PMCID: PMC10618573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 09/09/2022] [Indexed: 11/04/2023]
Abstract
Background Non-communicable diseases are of the major health challenges and the leading cause of death in Iran and at the global level. Moreover, Iran is a disaster-prone country and considering the exacerbation of diabetes and chronic respiratory diseases in natural disasters, its healthcare system is facing challenges. This study was designed to explore challenges in providing healthcare services to patients with diabetes and chronic respiratory diseases during disasters in Iran. Materials and Methods The conventional content analysis is used in this qualitative study. Participants included 46 patients with diabetes and chronic respiratory diseases, and 36 of stakeholders were experienced and had theoretical knowledge. Participants' selection started by means of purposive sampling and continued to the point of data saturation. Data collection was carried out employing semi-structured interviews. Data analysis was performed using Graneheim and Lundman method. Results Based on participants' experiences, four major challenges in providing care to patients with diabetes and chronic respiratory diseases during natural disasters include integrated management (with three subcategories: control and supervision, patient data management, volunteer management), physical, psychosocial health (with three subcategories: psychological impacts, exacerbation of signs and symptoms, special patient characteristics), health literacy and the behavior (with three subcategories: risk perception, values and beliefs, education and awareness) and barriers to healthcare delivery (with three subcategories: facilities and human resources, financial and living problems and insurances, accessibilities and geographic access). Conclusion Developing countermeasures against medical monitoring system shutdown in order to detect medical needs and problems faced by chronic disease patients including those with diabetes and chronic obstructive pulmonary disease (COPD), is essential in preparedness for future disasters. Developing effective solutions may result in improved preparedness and better planning of diabetic and COPD patients for disasters, and potentially promote health outcomes during and after disasters.
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Affiliation(s)
- Elham Ghazanchaei
- Social Determinants of Health Research Center Urmia University of Medical Sciences, Urmia, Iran
| | - Kiyoumars Allahbakhshi
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Davoud Khorasani-Zavareh
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Health in Emergencies and Disasters, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Javad Aghazadeh-Attari
- Social Determinants of Health Research Center Urmia University of Medical Sciences, Urmia, Iran
| | - Iraj Mohebbi
- Social Determinants of Health Research Center Urmia University of Medical Sciences, Urmia, Iran
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Shinan-Altman S, Hamama-Raz Y. Factors Associated with Pro-Environmental Behaviors in Israel: A Comparison between Participants with and without a Chronic Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13123. [PMID: 36293714 PMCID: PMC9603240 DOI: 10.3390/ijerph192013123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
This study examined differences regarding climate change pro-environmental behaviors (PEBs), comparing between individuals with chronic diseases and those without. A cross-sectional survey was conducted among 402 adults, of whom 25% had a chronic disease. Participants completed measures for PEBs, climate change exposure (i.e., exposure to its effects), climate change risk appraisal, environmental self-efficacy, collective efficacy, and sociodemographic variables. Results revealed a significant difference between participants with and without chronic diseases in climate change risk appraisal. Having a chronic disease was associated with higher climate change risk appraisal (β = 0.16, p < 0.001), which in turn was associated with higher collective efficacy (β = 0.29, p < 0.001). The latter was associated with more PEBs (β = 0.10, p = 0.049). Furthermore, higher climate change exposure was associated with higher climate change risk appraisal (β = 0.49, p < 0.001), which in turn was associated with collective efficacy (β = 0.29, p < 0.001). The latter was associated with more PEBs (β = 0.10, p = 0.049). In addition, higher climate change exposure was directly associated with both self-efficacy (β = 0.33, p < 0.001) and collective efficacy (β = 0.10, p = 0.049), which in turn were associated with more PEBs (β = 0.28, p < 0.001 and β = 0.10, p = 0.049, respectively). This study highlights the need to provide efficacy-enhancing information in climate change messaging for PEBs in general. A threat component in environment-relevant messages for people with chronic diseases, specifically, should also be adopted.
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Schmid B, Ansbro É, Raju E, Willis R, Shabila N, Perel P. Models of care for non-communicable diseases for displaced populations in Iraq: a scoping review. Confl Health 2022; 16:40. [PMID: 35841046 PMCID: PMC9283558 DOI: 10.1186/s13031-022-00474-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/08/2022] [Indexed: 11/25/2022] Open
Abstract
Non-communicable diseases (NCDs) are the leading cause of death and disability globally. Their importance in humanitarian settings is increasingly recognised, but evidence about how best to address NCDs in these setting is limited. This scoping review aimed to explore models of NCD care for displaced populations in Iraq, in order to build evidence to design context adapted models of care. A search of key databases (Medline, Embase, Scopus, EconLit, Global Health, Web of Science, and the Iraqi Academic Scientific Journals) was conducted and complemented with grey literature and snowballing searches. Documents were included if they referred to models of NCD care for displaced populations. We synthesised the data using a conceptual model of care framework. The findings were reported according to the PRISMA guidelines for scoping reviews. We identified 4036 documents of which 22 were eligible for inclusion. Only six documents were peer-reviewed studies with most being internal reports, commentaries, or press releases. Of the 14 documents that reported on their methods, most applied quantitative approaches (n = 7), followed by mixed-methods (n = 5) and qualitative approaches (n = 2). Only one document reported on outcome data and none applied longitudinal study designs. Documents generally described individual framework dimensions, mostly centring around medicines, facility-based services, and selected access dimensions. Most dimensions had few or no references. The most common model for displaced populations in Iraq was primary-level centred care that complemented or supported existing—mostly tertiary—public health system structures. Additionally, private facilities played an important role and were frequently accessed by displaced populations in most settings. Quality of care, particularly patient-perceived quality, emerged as a critical factor for designing context-adapted models of NCD care. This review also identified a strong regionality of NCD care, particularly in terms of access rates and barriers. We concluded that there is a scarcity of evidence on the effectiveness of models of NCD care for displaced populations in Iraq, calling for capacity building initiatives focused on implementation research and evaluation.
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Affiliation(s)
- Benjamin Schmid
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK. .,Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Éimhín Ansbro
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK.,Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Emmanuel Raju
- Global Health Section and Copenhagen Centre for Disaster Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Unit for Environmental Sciences and Management, African Centre for Disaster Studies, North-West University, Potchefstroom, South Africa
| | - Ruth Willis
- Research Fellow in Social Science, Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Nazar Shabila
- Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq
| | - Pablo Perel
- Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK.,Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Abstract
PURPOSE OF REVIEW Tropical cyclones impact human health, sometimes catastrophically. Epidemiological research characterizes these health impacts and uncovers pathways between storm hazards and health, helping to mitigate the health impacts of future storms. These studies, however, require researchers to identify people and areas exposed to tropical cyclones, which is often challenging. Here we review approaches, tools, and data products that can be useful in this exposure assessment. RECENT FINDINGS Epidemiological studies have used various operational measures to characterize exposure to tropical cyclones, including measures of physical hazards (e.g., wind, rain, flooding), measures related to human impacts (e.g., damage, stressors from the storm), and proxy measures of distance from the storm's central track. The choice of metric depends on the research question asked by the study, but there are numerous resources available that can help in capturing any of these metrics of exposure. Each has strengths and weaknesses that may influence their utility for a specific study. Here we have highlighted key tools and data products that can be useful for exposure assessment for tropical cyclone epidemiology. These results can guide epidemiologists as they design studies to explore how tropical cyclones influence human health.
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Deadly Flood and Landslides amid COVID-19 Crisis: A Public Health Concern for the World’s Largest Refugee Camp in Bangladesh. Prehosp Disaster Med 2022; 37:292-293. [PMID: 35057877 PMCID: PMC8814474 DOI: 10.1017/s1049023x22000164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Environmental Stressors Suffered by Women with Gynecological Cancers in the Aftermath of Hurricanes Irma and María in Puerto Rico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111183. [PMID: 34769708 PMCID: PMC8583450 DOI: 10.3390/ijerph182111183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/04/2021] [Accepted: 10/14/2021] [Indexed: 12/23/2022]
Abstract
Background: Hurricanes are the immediate ways that people experience climate impacts in the Caribbean. These events affect socio-ecological systems and lead to major disruptions in the healthcare system, having effects on health outcomes. In September 2017, Puerto Rico (PR) and the United States Virgin Islands (USVI) experienced one of the most catastrophic hurricane seasons in recent history (Hurricane Irma was a Category 5 and Hurricane María was a Category 4 when they hit PR). Objective: This study examines environmental stressors experienced by women with gynecologic (GYN) cancers from PR and USVI who received oncologic cancer care in PR, in the aftermath of the hurricanes. Methods: A descriptive qualitative study design was used to obtain rich information for understanding the context, barriers, knowledge, perspectives, risks, vulnerabilities, and attitudes associated to these hurricanes. We performed focus groups among GYN cancer patients (n = 24) and key-informant interviews (n = 21) among health-care providers and administrators. Interviews were conducted from December 2018–April 2019. Results: Environmental health stressors such as lack of water, heat and uncomfortable temperatures, air pollution (air quality), noise pollution, mosquitos, and rats ranked in the top concerns among cancer patients and key-informants. Conclusions: These findings are relevant to cancer patients, decision-makers, and health providers facing extreme events and disasters in the Caribbean. Identifying environmental secondary stressors and the most relevant cascading effects is useful for decision-makers so that they may address and mitigate the effects of hurricanes on public health and cancer care.
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Weinberger KR, Kulick ER, Boehme AK, Sun S, Dominici F, Wellenius GA. Association Between Hurricane Sandy and Emergency Department Visits in New York City by Age and Cause. Am J Epidemiol 2021; 190:2138-2147. [PMID: 33910231 DOI: 10.1093/aje/kwab127] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 11/12/2022] Open
Abstract
The magnitude, timing, and etiology of morbidity associated with tropical cyclones remains incompletely quantified. We examined the relative change in cause-specific emergency department (ED) visits among residents of New York City during and after Hurricane Sandy, a tropical cyclone that affected the northeastern United States in October 2012. We used quasi-Poisson constrained distributed lag models to compare the number of ED visits on and after Hurricane Sandy with all other days, 2005-2014, adjusting for temporal trends. Among residents aged ≥65 years, Hurricane Sandy was associated with a higher rate of ED visits due to injuries and poisoning (relative risk (RR) = 1.19, 95% confidence interval (CI): 1.10, 1.28), respiratory disease (RR = 1.35, 95% CI: 1.21, 1.49), cardiovascular disease (RR = 1.10, 95% CI: 1.02, 1.19), renal disease (RR = 1.44, 95% CI: 1.22, 1.72), and skin and soft tissue infections (RR = 1.20, 95% CI: 1.03, 1.39) in the first week following the storm. Among adults aged 18-64 years, Hurricane Sandy was associated with a higher rate of ED visits for renal disease (RR = 2.15, 95% CI: 1.79, 2.59). Among those aged 0-17 years, the storm was associated with lower rates of ED visits for up to 3 weeks. These results suggest that tropical cyclones might result in increased health-care utilization due to a wide range of causes, particularly among older adults.
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Weinberger KR, Kulick ER, Boehme AK, Sun S, Dominici F, Wellenius GA. Association Between Hurricane Sandy and Emergency Department Visits in New York City by Age and Cause. Am J Epidemiol 2021. [PMID: 33910231 DOI: 10.1093/aje/kwab127/6257048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Abstract
The magnitude, timing, and etiology of morbidity associated with tropical cyclones remains incompletely quantified. We examined the relative change in cause-specific emergency department (ED) visits among residents of New York City during and after Hurricane Sandy, a tropical cyclone that affected the northeastern United States in October 2012. We used quasi-Poisson constrained distributed lag models to compare the number of ED visits on and after Hurricane Sandy with all other days, 2005-2014, adjusting for temporal trends. Among residents aged ≥65 years, Hurricane Sandy was associated with a higher rate of ED visits due to injuries and poisoning (relative risk (RR) = 1.19, 95% confidence interval (CI): 1.10, 1.28), respiratory disease (RR = 1.35, 95% CI: 1.21, 1.49), cardiovascular disease (RR = 1.10, 95% CI: 1.02, 1.19), renal disease (RR = 1.44, 95% CI: 1.22, 1.72), and skin and soft tissue infections (RR = 1.20, 95% CI: 1.03, 1.39) in the first week following the storm. Among adults aged 18-64 years, Hurricane Sandy was associated with a higher rate of ED visits for renal disease (RR = 2.15, 95% CI: 1.79, 2.59). Among those aged 0-17 years, the storm was associated with lower rates of ED visits for up to 3 weeks. These results suggest that tropical cyclones might result in increased health-care utilization due to a wide range of causes, particularly among older adults.
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Safer Hospital Infrastructure Assessments for Socio-Natural Disaster - A Scoping Review. Prehosp Disaster Med 2021; 36:627-635. [PMID: 34284848 DOI: 10.1017/s1049023x21000650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The aim of this review was to explore hospital socio-natural disaster resilience by identifying: studies assessing structural and non-structural aspects of building resilience; components required to maintain a safe and functional health facility; and if the checklists used were comprehensive and easily performed. METHODS A review systemic approach using PRISMA was taken to search the literature. The search focused on articles that discuss hospital disaster resilience. This includes assessments and checklists for facility structural and non-structural components. RESULTS This review identified 22 articles describing hospital assessments using checklists containing structural and non-structural elements of resilience. These studies identified assessments undertaken in ten countries, with eight occurring across Iran. A total of seven differing checklists were identified as containing aspects of structural or non-structural aspects of building resilience. The World Health Organization (WHO) has authored three checklists and four others were developed independently.The structural resilience domain includes building integrity, building materials, design standards, and previous event damages as important elements to determine resilience. Within the internal safety and resilience domains, 11 differing elements were identified as important to non-structural or internal infrastructure resilience. These included the safety of power, water, telecommunication, medical gas supply, and medical equipment resupply systems.Independent evaluation methods were reported in the majority of articles, with a small number highlighting the benefits of both self-evaluation and independent review processes. Implementation of training programs to evaluators was mentioned in three papers with the assessor's knowledge and understanding of all checklist elements being highlighted as important to the validity of the evaluation. CONCLUSION The review identified the assessment of hospital resilience as important for management to determine areas of vulnerability within the hospital's infrastructure and to inform improvement strategies. Assessment criteria must be comprehensive, highlighting structural and non-structural aspects of facility infrastructure. These assessments are best done as a multi-disciplinary collective of experts, involving hospital employees in the journey. This collaborative approach provides a key educational tool for developing disaster capacity, engaging ownership of the process, and the resulting improvements.The on-going development of health facility and wider health system resilience must remain a key strategic focus of national governments and health authorities. The development of standardized procedures and guidelines must be embedded into daily practice.
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Ghazanchaei E, Khorasani-Zavareh D, Aghazadeh-Attari J, Mohebbi I. Identifying and Describing Impact of Disasters on Non-Communicable Diseases: A Systematic Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:1143-1155. [PMID: 34540735 PMCID: PMC8410956 DOI: 10.18502/ijph.v50i6.6413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 10/21/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patients with non-communicable diseases are vulnerable to disasters. This is a systematic review describing the impact of disasters on non-communicable diseases. METHODS A systematic review was conducted using PRISMA standards. Relevant articles published from 1997 to 2019 collected by searching the Scopus, PubMed, Science Direct, databases. We specifically examined reports describing NCDs and including the key words "non-communicable disease and Disasters". NCDs included cardiovascular, respiratory, diabetes, cancer and mental health diseases. RESULTS Of the 663 studies identified, only 48 articles met all the eligibility criteria. Most studies have shown the impact of all natural disasters on non-communicable diseases (39.8% n=19). The largest study was the effect of earthquakes on non-communicable diseases (29.2% n=14). For the NCDs targeted by this research, most of the included studies were a combination of four diseases: cardiovascular disease, respiratory disease, diabetes and cancer (44% n=21). Followed by cardiovascular disease (14.6% n=7), chronic respiratory disease (12.5% n=6), diabetes and cancer (6.2% n=3) and mental health (12.5% n=6). CONCLUSION The incidence of disasters affects the management of treatment and care for patients with NCDs. Specific measures include a multi-part approach to ensuring that patients with non-communicable diseases have access to life-saving services during and after disasters. The approach of the health system should be expanded from traditional approaches to disasters and requires comprehensive planning of health care by policy makers and health professionals to develop effective strategies to enable patients to access medical, therapeutic and diagnostic services in natural disasters.
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Affiliation(s)
- Elham Ghazanchaei
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Davoud Khorasani-Zavareh
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Workplace Health Promotion Research Center, Department of Health in Emergencies and Disasters, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Javad Aghazadeh-Attari
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Iraj Mohebbi
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
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Babaie J, Pashaei Asl Y, Naghipour B, Faridaalaee G. Cardiovascular Diseases in Natural Disasters; a Systematic Review. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2021; 9:e36. [PMID: 34027431 PMCID: PMC8126350 DOI: 10.22037/aaem.v9i1.1208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: As a result of destruction and lack of access to vital infrastructures and mental stress, disasters intensify cardiovascular diseases (CVDs) and hence management of CVDs becomes more challenging. The aim of this study is investigating incidence and prevalence of CVDs, morbidity and mortality of CVDs, treatment and management of CVDs at the time of natural disasters. Methods: In the present systematic review, the articles published in English language until 28. 11. 2020, which studied CVDs in natural disasters were included. The inclusion criteria were CVDs such as myocardial infarction (MI), acute coronary syndrome (ACS), hypertension (HTN), pulmonary edema, and heart failure (HF) in natural disasters such as earthquake, flood, storm, hurricane, cyclone, typhoon, and tornado. Result: The search led to accessing 4426 non-duplicate records. Finally, the data of 104 articles were included in quality appraisal. We managed to find 4, 21 and 79 full text articles, which considered cardiovascular diseases at the time of flood, storm, and earthquake, respectively. Conclusion: Prevalence of CVD increases after disasters. Lack of access to medication or lack of medication adjustment, losing home blood pressure monitor as a result of destruction and physical and mental stress after disasters are of the most significant challenges of controlling and managing CVDs. By means of quick establishment of health clinics, quick access to appropriate diagnosis and treatment, providing and access to medication, self-management, and self-care incentives along with appropriate medication and non-medication measures to control stress, we can better manage and control cardiovascular diseases, particularly hypertension.
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Affiliation(s)
- Javad Babaie
- Department of Health Policy& Management, Tabriz University of Medical Sciences, Tabriz, Iran.,Tabriz Health Services Management Research Center,Tabriz University of Medical Sciences, Tabriz, Iran.,Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yousef Pashaei Asl
- Department of Health Policy& Management, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Health Services Management, School of Health Management and information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Bahman Naghipour
- Department of Anaesthesiology and Intensive Care, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Gholamreza Faridaalaee
- Emergency Medicine Research Team, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Emergency Medicine, Maragheh University of Medical Sciences, Maragheh, Iran.,Disaster Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
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15
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Guo Y, Wu Y, Wen B, Huang W, Ju K, Gao Y, Li S. Floods in China, COVID-19, and climate change. Lancet Planet Health 2020; 4:e443-e444. [PMID: 32860740 PMCID: PMC7449653 DOI: 10.1016/s2542-5196(20)30203-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/13/2020] [Accepted: 08/14/2020] [Indexed: 05/18/2023]
Affiliation(s)
- Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Yao Wu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Bo Wen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Wenzhong Huang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ke Ju
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Yuan Gao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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16
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Schiller JH, Averbuch SD, Berg CD. Why Oncologists Should Care About Climate Change. JCO Oncol Pract 2020; 16:775-778. [PMID: 32915709 DOI: 10.1200/op.20.00609] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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17
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De Guzman R, Malik M. Global Cancer Burden and Natural Disasters: A Focus on Asia's Vulnerability, Resilience Building, and Impact on Cancer Care. J Glob Oncol 2019; 5:1-8. [PMID: 30978152 PMCID: PMC6528740 DOI: 10.1200/jgo.19.00037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2019] [Indexed: 12/24/2022] Open
Abstract
The world has been witnessing more frequent and greater intensity weather-related disasters. Natural disasters hit every continent in the world. Asia has borne the brunt in terms of frequency and the total numbers of people affected. This is mainly because of Asia's increasing population and its large and varied landmass, with multiple river basins, mountains, flood plains, and active seismic and volcanic zones. The Union for International Cancer Control New Global Cancer Date: GLOBOCAN 2018 has estimated the global cancer burden to have risen to 18.1 million new cases and 9.6 million deaths. Asia constitutes roughly 60% of the world's population. The region contributes nearly one half of new cancer cases and more than one half of cancer deaths worldwide. This increase in the regional burden of cancer is largely a result of socioeconomic growth and the increasing size and aging of the population. In addition to the increasing cancer cases, the string of natural disasters will cause heavy damage and a great human toll in Asia. Medical care for disaster-affected populations is focused traditionally on the management of immediate trauma and acute infections. For people with noncommunicable diseases, this presents a significant risk. Patients with cancer are especially susceptible to the disruptions that natural disasters can cause. Their special needs are largely neglected. There is a need to refocus and expand disaster risk reduction strategies and resources to include patients with noncommunicable diseases such as cancer, because these conditions are generating the bulk of disability, ill health, and premature death around the globe. Having the world's biggest burden of cancer, Asia will definitely be facing these challenges.
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Affiliation(s)
| | - Monica Malik
- Nizam's Institute of Medical Sciences, Hyderabad, India
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18
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Bukvic A, Gohlke J, Borate A, Suggs J. Aging in Flood-Prone Coastal Areas: Discerning the Health and Well-Being Risk for Older Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122900. [PMID: 30567352 PMCID: PMC6313428 DOI: 10.3390/ijerph15122900] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/06/2018] [Accepted: 12/10/2018] [Indexed: 01/15/2023]
Abstract
Coastal communities are increasingly exposed to more intense and frequent hurricanes, accelerated sea-level rise, and prolonged tidal inundation, yet they are often a preferred retirement destination for older adults vulnerable to flooding and extreme weather events. The unique physical and psychosocial challenges of older population age 65 and over may affect their level of preparedness, capacity to cope with, and ability to respond and recover from a hazard event. Despite the clear vulnerabilities of older residents living in high-risk areas when compared to younger coastal populations, there is a lack of empirical research on the integrated flood risks to this population group in the coastal context. This paper provides a holistic assessment of this emerging problem along the U.S. East Coast by measuring the exposure of older population to sea level rise and storm surge in coastal counties. It further evaluates how age-related vulnerabilities differ between rural and urban settings using the case study approach and geospatial and statistical analysis the paper also conducts a review of scientific literature to identify gaps in the current understanding of health and well-being risks to aging populations in coastal communities. The results show that older populations are unevenly distributed along the U.S. East Coast with some states and counties having significantly higher percent of residents age 65 and older living along the shoreline. Many places with larger older populations have other attributes that further shape the vulnerability of this age group such as older housing stock, disabilities, and lower income and that often differ between rural and urban settings. Lastly, our study found that vast majority of research on aging in high-risk coastal locations has been conducted in relation to major disasters and almost none on the recurrent nuisance flooding that is already affecting many coastal communities.
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Affiliation(s)
- Anamaria Bukvic
- Department of Geography, Virginia Tech, Blacksburg, VA 24061, USA.
| | - Julia Gohlke
- Department of Population Health Sciences, Virginia Tech, Blacksburg, VA 24061, USA.
| | - Aishwarya Borate
- Urban Affairs and Planning, Virginia Tec h, Blacksburg, VA 24061, USA.
| | - Jessica Suggs
- Department of Statistics, Virginia Tech, Blacksburg, VA 24061, USA.
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19
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Springgate BF, Arevian AC, Wennerstrom A, Johnson AJ, Eisenman DP, Sugarman OK, Haywood CG, Trapido EJ, Sherbourne CD, Everett A, McCreary M, Meyers D, Kataoka S, Tang L, Sato J, Wells KB. Community Resilience Learning Collaborative and Research Network (C-LEARN): Study Protocol with Participatory Planning for a Randomized, Comparative Effectiveness Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1683. [PMID: 30720791 PMCID: PMC6121437 DOI: 10.3390/ijerph15081683] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 08/04/2018] [Indexed: 11/16/2022]
Abstract
This manuscript presents the protocol and participatory planning process for implementing the Community Resilience Learning Collaborative and Research Network (C-LEARN) study. C-LEARN is designed to determine how to build a service program and individual client capacity to improve mental health-related quality of life among individuals at risk for depression, with exposure to social risk factors or concerns about environmental hazards in areas of Southern Louisiana at risk for events such as hurricanes and storms. The study uses a Community Partnered Participatory Research (CPPR) framework to incorporate community priorities into study design and implementation. The first phase of C-LEARN is assessment of community priorities, assets, and opportunities for building resilience through key informant interviews and community agency outreach. Findings from this phase will inform the implementation of a two-level (program-level and individual client level) randomized study in up to four South Louisiana communities. Within communities, health and social-community service programs will be randomized to Community Engagement and Planning (CEP) for multi-sector coalition support or Technical Assistance (TA) for individual program support to implement evidence-based and community-prioritized intervention toolkits, including an expanded version of depression collaborative care and resources (referrals, manuals) to address social risk factors such as financial or housing instability and for a community resilience approach to disaster preparedness and response. Within each arm, the study will randomize individual adult clients to one of two mobile applications that provide informational resources on services for depression, social risk factors, and disaster response or also provide psychoeducation on Cognitive Behavioral Therapy to enhance coping with stress and mood. Planned data collection includes baseline, six-month and brief monthly surveys for clients, and baseline and 12-month surveys for administrators and staff.
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Affiliation(s)
- Benjamin F Springgate
- LSU Health Sciences Center, New Orleans School of Medicine, New Orleans, LA 70112, USA.
- LSU Health Sciences Center, New Orleans School of Public Health, New Orleans, LA 70112, USA.
| | - Armen C Arevian
- UCLA Semel Institute for Neuroscience and Human Behavior, Research Center for Health Services and Society, Los Angeles, CA 90024, USA.
| | | | - Arthur J Johnson
- Center for Sustainable Engagement and Development, New Orleans, LA 70117, USA.
| | - David P Eisenman
- David Geffen School of Medicine at UCLA and UCLA Center for Public Health and Disasters, Los Angeles, CA 90095, USA.
| | - Olivia K Sugarman
- LSU Health Sciences Center, New Orleans School of Medicine, New Orleans, LA 70112, USA.
- LSU Health Sciences Center, New Orleans School of Public Health, New Orleans, LA 70112, USA.
| | | | - Edward J Trapido
- LSU Health Sciences Center, New Orleans School of Public Health, New Orleans, LA 70112, USA.
| | | | - Ashley Everett
- LSU Health Sciences Center, New Orleans School of Medicine, New Orleans, LA 70112, USA.
| | - Michael McCreary
- UCLA Semel Institute for Neuroscience and Human Behavior, Research Center for Health Services and Society, Los Angeles, CA 90024, USA.
| | - Diana Meyers
- St. Anna's Episcopal Church, New Orleans, LA 70116, USA.
| | - Sheryl Kataoka
- UCLA Semel Institute for Neuroscience and Human Behavior, Research Center for Health Services and Society, Los Angeles, CA 90024, USA.
| | - Lingqi Tang
- UCLA Semel Institute for Neuroscience and Human Behavior, Research Center for Health Services and Society, Los Angeles, CA 90024, USA.
| | - Jennifer Sato
- LSU Health Sciences Center, New Orleans School of Medicine, New Orleans, LA 70112, USA.
| | - Kenneth B Wells
- UCLA Semel Institute for Neuroscience and Human Behavior, Research Center for Health Services and Society, Los Angeles, CA 90024, USA.
- The RAND Corporation, Santa Monica, CA 90401, USA.
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20
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Ruskin J, Rasul R, Schneider S, Bevilacqua K, Taioli E, Schwartz RM. Lack of access to medical care during Hurricane Sandy and mental health symptoms. Prev Med Rep 2018; 10:363-369. [PMID: 29868393 PMCID: PMC5984240 DOI: 10.1016/j.pmedr.2018.04.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/26/2018] [Accepted: 04/21/2018] [Indexed: 11/17/2022] Open
Abstract
Destruction caused by natural disasters compromises medical providers' and hospitals' abilities to administer care. Hurricane Sandy was particularly devastating, resulting in massive disruptions of medical care in the region. This study aimed to determine whether a lack of access to medical care during Hurricane Sandy was associated with posttraumatic stress disorder (PTSD) symptoms and other mental health/substance abuse outcomes. A secondary aim was to examine whether having a chronic illness moderates those associations. Self-reported medical access and mental health symptomatology were obtained from New York City and Long Island residents (n = 1669) following Hurricane Sandy under the Leaders in Gathering Hope Together project (10/23/2013–2/25/2015) and Project Restoration (6/5/2014–8/9/2016). Multivariable logistic regressions were utilized to determine the relationship between lack of access to medical care and mental health outcomes. Of the 1669 participants, 994 (59.57%) were female, 866 (51.89%) were white, and the mean age was 46.22 (SD = 19.2) years old. Those without access to medical care had significantly higher odds of showing symptoms of PTSD (AOR = 2.71, CI = [1.77–4.16]), as well as depression (AOR = 1.94, CI = [1.29–2.92]) and anxiety (AOR = 1.61, CI = [1.08–2.39]) compared to those with access. Lack of access to care was associated with a 2.12 point increase in perceived stress scale score (SE = 0.63). The interaction between having a chronic illness and lack of access to medical care was not significantly associated with any outcomes. The findings emphasize the importance of making medical care more accessible to patients, both chronically and acutely ill, during natural disasters to benefit their physical as well as their mental health. Individuals without access to medical care had asignificantly higher odds of showing symptoms of mental health difficulties. Chronic illness did not moderate the relationship between a lack of access to care and mental health outcomes. Access to medical care during natural disasters may benefit the mental health of survivors with and without chronic illness.</span>
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Affiliation(s)
- Julia Ruskin
- Department of Occupational Medicine Epidemiology and Prevention, Northwell Health, Great Neck, NY, United States
- Feinstein Institute for Medical Research, Manhasset, NY, United States
- Joint Center for Trauma, Disaster Health and Resilience at Mount Sinai, Stony Brook University, and Northwell Health, United States
| | - Rehana Rasul
- Department of Occupational Medicine Epidemiology and Prevention, Northwell Health, Great Neck, NY, United States
- Feinstein Institute for Medical Research, Manhasset, NY, United States
- Joint Center for Trauma, Disaster Health and Resilience at Mount Sinai, Stony Brook University, and Northwell Health, United States
- Biostatistics Unit, Feinstein Institute for Medical Research
- Department of Occupational Medicine Epidemiology and Prevention, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Samantha Schneider
- Department of Occupational Medicine Epidemiology and Prevention, Northwell Health, Great Neck, NY, United States
- Feinstein Institute for Medical Research, Manhasset, NY, United States
- Joint Center for Trauma, Disaster Health and Resilience at Mount Sinai, Stony Brook University, and Northwell Health, United States
| | - Kristin Bevilacqua
- Department of Occupational Medicine Epidemiology and Prevention, Northwell Health, Great Neck, NY, United States
- Feinstein Institute for Medical Research, Manhasset, NY, United States
- Joint Center for Trauma, Disaster Health and Resilience at Mount Sinai, Stony Brook University, and Northwell Health, United States
| | - Emanuela Taioli
- Joint Center for Trauma, Disaster Health and Resilience at Mount Sinai, Stony Brook University, and Northwell Health, United States
- Department of Population Health Science and Policy and Institute of Translational Epidemiology, The Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Rebecca M. Schwartz
- Department of Occupational Medicine Epidemiology and Prevention, Northwell Health, Great Neck, NY, United States
- Feinstein Institute for Medical Research, Manhasset, NY, United States
- Joint Center for Trauma, Disaster Health and Resilience at Mount Sinai, Stony Brook University, and Northwell Health, United States
- Biostatistics Unit, Feinstein Institute for Medical Research
- Department of Occupational Medicine Epidemiology and Prevention, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
- Department of Population Health Science and Policy and Institute of Translational Epidemiology, The Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Corresponding author at: Department of Occupational Medicine, Epidemiology and Prevention (OMEP), Northwell Health Physician Partners, Hofstra Northwell School of Medicine, 175 Community Drive 2nd floor, Great Neck, NY 11021, United States.
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21
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Brown LA, Fernandez CA, Kohn R, Saldivia S, Vicente B. Pre-disaster PTSD as a moderator of the relationship between natural disaster and suicidal ideation over time. J Affect Disord 2018; 230:7-14. [PMID: 29355729 PMCID: PMC6576262 DOI: 10.1016/j.jad.2017.12.096] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 11/23/2017] [Accepted: 12/31/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Natural disasters are associated with a variety of negative health consequences, including enhanced suicide risk. Factors that moderate the relationship between disaster exposure and enhanced suicide risk are unknown. The aim of the current study was to determine whether pre-disaster PTSD moderates the association between change over time in thoughts of death, suicidal ideation (SI), suicide plans, and suicide attempts (SA) from pre- to post-disaster. METHODS Participants (n = 2832) were recruited from Chile as part of the larger PREDICT study and completed a measure of lifetime PTSD and panic disorder at baseline and a lifetime death/suicide measure at baseline in 2003 and again 6, 12, and 24 months later (i.e. "pre-disaster"). One year following a major earthquake and tsunami in 2010 (i.e., "post-disaster"), participants completed another death/suicide measure. RESULTS Both those with and without pre-disaster PTSD experienced significant increases in SI from pre- to post-disaster. However, pre-disaster PTSD was associated with significantly accelerated increases in thoughts of death and SI from pre-to post-disaster. At nearly all time-points, pre-disaster PTSD was associated with higher thoughts of death and SI, suicide planning, and SA. In contrast, panic disorder did not moderate the association between time and changes in SI. LIMITATIONS There was a long time-gap between pre-disaster and post-disaster, with limited data about what occurred during this time. CONCLUSION Pre-disaster PTSD is an important predictor of increased SI following a natural disaster, and groups with pre-disaster PTSD should be prioritized for receipt of mental health resources following a natural disaster.
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Affiliation(s)
- Lily A Brown
- University of Pennsylvania, Department of Psychiatry, United States
| | - Cristina A Fernandez
- Harvard University, T.H. Chan School of Public Health, United States; Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, United States
| | - Robert Kohn
- Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, United States
| | - Sandra Saldivia
- Departamento de Psiquiatría y Salud Mental, Universidad de Concepción, Concepción, Chile
| | - Benjamin Vicente
- Departamento de Psiquiatría y Salud Mental, Universidad de Concepción, Concepción, Chile.
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22
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Paterson DL, Wright H, Harris PNA. Health Risks of Flood Disasters. Clin Infect Dis 2018; 67:1450-1454. [DOI: 10.1093/cid/ciy227] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/20/2018] [Indexed: 12/31/2022] Open
Affiliation(s)
- David L Paterson
- Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Hugh Wright
- Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Patrick N A Harris
- Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
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23
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Sasaki Y, Aida J, Tsuji T, Miyaguni Y, Tani Y, Koyama S, Matsuyama Y, Sato Y, Tsuboya T, Nagamine Y, Kameda Y, Saito T, Kakimoto K, Kondo K, Kawachi I. Does Type of Residential Housing Matter for Depressive Symptoms in the Aftermath of a Disaster? Insights From the Great East Japan Earthquake and Tsunami. Am J Epidemiol 2018; 187:455-464. [PMID: 28992035 PMCID: PMC5860436 DOI: 10.1093/aje/kwx274] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 07/06/2017] [Indexed: 12/19/2022] Open
Abstract
The 2011 Great East Japan Earthquake and Tsunami resulted in widespread property destruction and over 250,000 displaced residents. We sought to examine whether the type of housing arrangement available to the affected victims was associated with a differential incidence of depressive symptoms. In this prospective cohort study, which comprised participants aged ≥65 years from Iwanuma as a part of the Japan Gerontological Evaluation Study, we had information about the residents' mental health both before the disaster in 2010 and 2.5 years afterward. The Geriatric Depression Scale was used. Type of accommodation after the disaster was divided into 5 categories: no move, prefabricated housing (temporary housing), existing private accommodations (temporary apartment), newly established housing, and other. Poisson regression analysis was adopted, with and without multiple imputation. Among the 2,242 participants, 16.2% reported depressive symptoms at follow-up. The adjusted rate ratio for depressive symptoms among persons moving into prefabricated housing, compared with those who did not, was 2.07 (95% confidence interval: 1.45, 2.94). Moving into existing private accommodations or other types of accommodations was not associated with depression. The relationship between living environment and long-term mental health should be considered for disaster recovery planning.
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Affiliation(s)
- Yuri Sasaki
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Correspondence to Dr. Yuri Sasaki, Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan (e-mail: )
| | - Jun Aida
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Miyagi, Japan
| | - Taishi Tsuji
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Yasuhiro Miyaguni
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Shihoko Koyama
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Miyagi, Japan
- Department of Community Medical Supports, Tohoku Medical Megabank Organization, Miyagi, Japan
| | - Yusuke Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Yukihiro Sato
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Miyagi, Japan
| | - Toru Tsuboya
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Miyagi, Japan
| | - Yuiko Nagamine
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Yoshihito Kameda
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Tami Saito
- Department of Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Kazuhiro Kakimoto
- Kansai International Airport Quarantine Station, Ministry of Health, Labour and Welfare, Osaka, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts
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24
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Suneja A, Gakh M, Rutkow L. Burden and Management of Noncommunicable Diseases After Earthquakes and Tsunamis. Health Secur 2018; 16:30-47. [PMID: 29355393 DOI: 10.1089/hs.2017.0059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This integrative review examines extant literature assessing the burden and management of noncommunicable diseases 6 months or more after earthquakes and tsunamis. We conducted an integrative review to identify and characterize the strength of published studies about noncommunicable disease-specific outcomes and interventions at least 6 months after an earthquake and/or tsunami. We included disasters that occurred from 2004 to 2016. We focused primarily on the World Health Organization noncommunicable disease designations to define chronic disease, but we also included chronic renal disease, risk factors for noncommunicable diseases, and other chronic diseases or symptoms. After removing duplicates, our search yielded 6,188 articles. Twenty-five articles met our inclusion criteria, some discussing multiple noncommunicable diseases. Results demonstrate that existing medical conditions may worsen and subsequently improve, new diseases may develop, and risk factors, such as weight and cholesterol levels, may increase for several years after an earthquake and/or tsunami. We make 3 recommendations for practitioners and researchers: (1) plan for noncommunicable disease management further into the recovery period of disaster; (2) increase research on the burden of noncommunicable diseases, the treatment modalities employed, resulting population-level outcomes in the postdisaster setting, and existing models to improve stakeholder coordination and action regarding noncommunicable diseases after disasters; and (3) coordinate with preexisting provision networks, especially primary care.
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25
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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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Mishra SR, Khanal V, Kallestrup P. Cancer in the aftermath of Nepal's earthquakes. Lancet Oncol 2016; 17:705-706. [DOI: 10.1016/s1470-2045(16)00164-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 03/05/2016] [Indexed: 11/25/2022]
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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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