Research Outline: Disaster Epidemiology

Abstract

The amount of people injured or impacted from natural disasters is a major consideration of a disaster’s definition. Hurricane Katrina was a notable example of poor prevention and recovery. Disaster epidemiologists have used events such as the hurricane to implement appropriate public awareness programs and heightened security and response methods. In addition to property damage and death tolls, disaster epidemiologists consider communicable disease prevention along with mental and physical health care resources necessary for overall recovery. 

Research Question:

How does disaster epidemiology develop strategies for preventing acute and chronic health events due to natural disasters? 

Introduction: 

Poor response to natural disasters such as hurricane Katrina was highly criticized at state and national levels. Nevertheless, government officials used their experiences to implement a new protocol for disaster relief. In addition, their research has indicated that along with physical health care, survivors of natural disasters are at risk for mental health issues that continue to plague for years after the emergencies. Therefore, disaster epidemiology considers strategies such as primary, secondary, and tertiary prevention plans in order to alleviate negative effects from natural disasters. 

Outline:

I. The Centre for Research on the Epidemiology of Disasters explained one out of four criteria must be met in order for an event to be categorized as a disaster.

a. Rudenstine and Galea (2012) reported the four criteria included “(1) 10 or more people dead, (2) 100 or more persons affected, (3) declaration of a state of emergency, or (4) call for international assistance” (p. 6). 

b. While an event only needs to meet one criterion, natural disasters often result in extensive property damage and affect large communities at one time. 

i. Hurricane Katrina caused billions of dollars’ worth of damage and took approximately 1,836 lives (Zimmerman, 2012).

c. However, disaster epidemiologists have suggested that hurricane Katrina’s overall damage could have been reduced.  

II. Disaster epidemiology proposes to understand the reasons behind the disaster and to apply appropriate measures after the disaster. 

a. Understanding the causes of natural disasters such as hurricanes, earthquakes, and tornadoes will allow epidemiologists to provide timely evacuation or safety measures (Marshall, 2010, August, no page.). 

III. Likewise, natural disasters affect one’s physical or emotional health, so disaster epidemiologists recognize needs for accessible treatment centers. 

a. Specifically, in the aftermath of a natural disaster, individuals are prone to illness, depression, and post-traumatic syndrome. 

b. In addition, Rudenstine and Galea (2012) have noted that “social relationships have long been known to be associated with health” (p. 1). 

c. Because natural disasters may result in loss of homes and loved ones, survivors and victims may require significant resources that include health care and therapy. 

IV. While public health professionals cannot eliminate natural disasters, they can reduce ill effects with careful planning before disasters strike. 

a. The American Public Health Association (2005) suggests primary prevention plans minimize deaths associated with natural disasters.

b. Primary prevention plans include timely evacuation. 

i. Many New Orleans residents ignored the warnings to evacuate (Zimmerman, 2012). 

V. In addition, the American Public Health Association (2005) has revealed secondary and tertiary prevention will also reduce morbidities. 

a. Secondary prevention seeks to “mitigate the health consequences of a disaster by providing education about injury control during clean-up and recovery periods” (American Public Health Association, 2005, no page.) 

i. Hurricane Katrina’s recovery efforts were criticized because of the lack of resources for some. For example, the elderly and lower socio-economic classes did not have the abilities to evacuate, so they were unprepared and unadvised how to take care of themselves during the disaster and recovery period. 

b. “Tertiary prevention minimizes the effects of disease and disability among those who are already ill by setting up evaluation units where the chronically ill can obtain access to short term” (American Public Health Association, 2005, no page.) health care. 

i. While New Orleans designated specific areas for safe housing, they became overloaded and exacerbated communicable illnesses (American Society of Civil Engineers, 2007). 

VI. The Center of Disease Control (CDC 2013) collects health and needs data in order to “prevent further morbidity and mortality by addressing both immediate and long-term needs, adjusting priorities, allocating resources, and projecting and planning for future needs” (no page.). 

a. As a secondary prevention plan, state health departments use a variety of tools to assess disaster response. 

b. The CDC offers a Community Assessment for Public Health Emergency Response (CASPER) toolkit. (Centers for Disease Control and Prevention, 2012)

c. The CASPER provides a checklist that will monitor deaths, illness, and injuries.

d. The CASPER appraises real-time data and communication, creates procedures and protocols, and documents all response activities from state and national assistance (Centers for Disease Control and Prevention, 2012). 

VII. However, disaster situations are diverse phenomena and standard protocol is not always possible. 

a. The American Public Health Association (2005) has revealed that “Due to time constraints and adverse environmental conditions, use of rigorous epidemiological methods may not be feasible in the post-impact phase. In disaster situations, assessment team members often use "quick and dirty" methods” (no page.).

b. Also, disasters can include elements that do not rely on natural events; however, such emergencies pose natural health risks and require tertiary prevention protocol.  

c. Meewisse, Olff, Kleber, Kitchiner, and Gersons (2011) revealed that “on May 13, 2000, a huge explosion in a central storage facility of a fireworks factory…was situated in the middle of a residential area and severely damaged or destroyed 500 homes…[and] Approximately 4,500 adult residents were directly affected” (p. 406).

d. Even though the explosion was not due to weather conditions, the CDC would consider it as a disaster because of the number of lives lost, mental health and physical health conditions, and extensive damage. 

VIII. Meewisse et al. (2012) emphasized that mental health issues were the most prevalent because they caused survivors to experience PTSD, phobias, and depression.

a. Arnberg and Melin (2013) have revealed that strong support systems in family members and government concern would decrease the number of mental health issues after natural disasters. Thus, secondary and tertiary prevention are vital tools in disaster response. 

IX. Developing surveys based on primary, secondary, and tertiary prevention and recovery methods will allow state agencies to offer communities guidance in precarious situations. 

a. Consequently,  Kessler, Keane, Ursano, Mokdad, and Zaslavsky (2008)proposed that  “disaster surveys will create opportunities to address these practical challenges in the US as well as to expand the conventional role of needs assessment surveys by developing ongoing collaborations with government disaster-preparedness agencies and relief agencies”(p. S7).

b. Public awareness is necessary in regards to practicing safety measures such as evacuating. 

i. A survey should measure times between warnings and evacuations for future planning and implementation (Young -Landesman, 2006).

c. In addition, the public would need to be aware of their access to health care and safe houses.

i. A survey should determine if mental or physical issues pose the greater risks in order to provide proper care. 

Conclusion

Disaster epidemiology develops strategies such as surveys, evacuation plans, recovery methods, and mental and physical health care awareness in order to prevent acute and chronic health events due to natural disasters.

References

American Public Health Association. (2005). Disaster-related surveillance and emergency information systems. Medscape. Retrieved from http://www.medscape.com/viewarticle/513259_3

American Society of Civil Engineers. (2007). The New Orleans hurricane protection system: What went wrong and why? (Rep.). Retrieved August 22, 2013, from http://www.asce.org/uploadedFiles/Publications/ASCE_News/2009/04_April/ERPreport.pdf

Arnberg, F. K., & Melin, L. (2013). Can demographic and exposure characteristics predict levels of social support in survivors from a natural disaster? PloS One, 8(6), 1-7. doi: 10.1371/journal.pone.0065709

Centers for Disease Control and Prevention. (2012). Community assessment for public health emergency response (CASPER) toolkit: Second edition [PDF]. Atlanta: CDC.

Kessler, R. C., Keane, T. M., Ursano, R. J., Mokdad, A., & Zaslavsky, A. M. (2008). Sample and design considerations in post-disaster mental health needs assessment tracking surveys. International Journal Of Methods In Psychiatric Research, 17S6-S20. doi:10.1002/mpr.269

Marshall, P. (2010, August). Disaster preparedness: Is the U.S. ready for another major disaster? Retrieved August 22, 2013, from http://library.cqpress.com/cqresearcher/

Meewisse, M., Olff, M., Kleber, R., Kitchiner, N. J., & Gersons, B. R. (2011). The course of mental health disorders after a disaster: Predictors and comorbidity. Journal of Traumatic Stress, 24(4), 405-413. doi: 10.1002/jts.20663

Rudenstine, S., & Galea, S. (2012). Understanding disasters. In The causes and behavioral consequences of disasters: Models informed by the global experience 1950-2005 (pp. 3-8). New York: Springer. doi: 10.1007/978-1-4614-0317-3

Young -Landesman, L. (2006). Public health management of disasters: The pocket guide [PDF]. Washington, DC: American Public Health Association.

Zimmerman, K. (2012, August 20). Hurricane Katrina: Facts, damage & aftermath. LiveScience.com. Retrieved from http://www.livescience.com/22522-hurricane-katrina-facts.html