DISASTER EPIDEMIOLOGY

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DISASTER EPIDEMIOLOGY

Epidemiology, as classically defined, is the quantitative study of the distributions and determinants of health-related events in human populations.28 Disaster epidemiology, however, must be viewed in a broader perspective; it links data collection and analysis to an immediate decision-making process.4 Disaster epidemiologists measure and describe the adverse health effects of natural and human-caused disasters and the factors that contribute to those effects, with the overall objective of

DEFINITION OF DISASTER

There are many definitions of disasters. From the standpoint of health care providers, a disaster should be defined on the basis of its consequences on health and health services. A pragmatic definition follows:

A disaster is the result of a vast ecological breakdown in the relation between humans and their environment, a serious and sudden event (or slow, as in a drought) on such a scale that the stricken community needs extraordinary efforts to cope with it, often with outside help or

GENERAL PUBLIC HEALTH EFFECTS OF DISASTERS

Disasters affect a community in numerous ways. Roads, telephone lines, and other transportation and communication links are often destroyed. Public utilities (e.g., water supply and sewage-disposal services) and energy supplies (e.g., gas and electricity) may be disrupted. Substantial numbers of victims may be rendered homeless. Portions of the community's industrial or economic base may be destroyed or damaged.55 Disasters may be considered a public health problem for many reasons:

APPLICATIONS OF EPIDEMIOLOGY IN DISASTERS

During the past 20 years, disaster epidemiology has emerged as an area of special interest. The applications of epidemiologic methods in disaster situations have been reviewed in a number of reports, and periodic updates on the "state of the art" appear every few years.6, 26, 31, 46, 57 The role of epidemiology in disaster situations has included a broad range of activities:

  • Rapid assessment of health needs

  • Surveillance and action-oriented information systems

  • Disease-control strategies for

USE OF EPIDEMIOLOGY AFTER A DISASTER

Generally, epidemiologic studies of natural disasters, including studies of the preimpact and impact phases, are conducted during the postimpact phase. Valuable information gathered during the hours, days, months, and years following a disaster can lead to policies and practices that reduce the risk of loss of death.5 For example, Glass and coworkers14 have emphasized the need for such postdisaster epidemiologic follow-up studies to identify risk factors for death and injury that can then serve

CRITICAL KNOWLEDGE GAPS AND RESEARCH PRIORITIES IN DISASTER EPIDEMIOLOGY

Research relating to disasters is often imprecise in identifying causes associated with increased morbidity and mortality. If epidemiologic approaches to the study of disasters are to be applied effectively, theoretic models must be developed further and research strategies must be refined (e.g., study design and sampling methods). The following are specific steps that epidemiologists can take to help make the results of disaster epidemiology more precise:

  • Develop standardized protocols

SUMMARY

Sound epidemiologic knowledge of the morbidity and mortality caused by disasters is essential when determining what relief supplies, equipment, and personnel are needed to respond effectively in emergency situations. All disasters are unique because each affected region of the world has different social, economic, and baseline health conditions. Some similarities exist, however, among the health effects of different types of disasters, that if recognized, can ensure that the limited health and

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      A disaster may be defined as a natural or manmade event that results in an imbalance between the supply and demand for resources.1

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    Address reprint requests to Eric K. Noji, MD, MPH, FACEP, Mailstop: K01, International Health Program Office, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Atlanta, GA 30341

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    From the International Emergency and Refugee Health Unit, International Health Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia

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