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Pre-earthquake Burden of Illness and Postearthquake Health and Preparedness in Veterans
- Claudia Der-Martirosian, Deborah Riopelle, Diana Naranjo, Elizabeth M. Yano, Lisa V. Rubenstein, Aram Dobalian
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- Journal:
- Prehospital and Disaster Medicine / Volume 29 / Issue 3 / June 2014
- Published online by Cambridge University Press:
- 10 April 2014, pp. 223-229
- Print publication:
- June 2014
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- Article
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Background
During an earthquake, vulnerable populations, especially those with chronic conditions, are more susceptible to adverse, event-induced exacerbation of chronic conditions such as limited access to food and water, extreme weather temperatures, and injury. These circumstances merit special attention when health care facilities and organizations prepare for and respond to disasters.
MethodsThis study explores the relationship between pre-earthquake burden of illness and postearthquake health-related and preparedness factors in the US. Data from a cohort of male veterans who were receiving care at the Sepulveda Veterans Affairs Medical Center (VAMC) in Los Angeles, California USA during the 1994 Northridge earthquake were analyzed.
ResultsVeterans with one or more chronic conditions were more likely to report pain lasting two or more days, severe mental/emotional stress for more than two weeks, broken/lost medical equipment, having difficulty refilling prescriptions, and being unable to get medical help following the quake compared to veterans without chronic conditions. In terms of personal emergency preparedness, however, there was no association between burden of illness and having enough food or water for at least 24 hours after the earthquake.
ConclusionThe relationship that exists between health care providers, including both individual providers and organizations like the US Department of Veterans Affairs (VA), and their vulnerable, chronically-ill patients affords providers the unique opportunity to deliver critical assistance that could make this vulnerable population better prepared to meet their postdisaster health-related needs. This can be accomplished through education about preparedness and the provision of easier access to medical supplies. Disaster plans for those who are burdened with chronic conditions should meet their social needs in addition to their psychological and physical needs.
. ,Der-Martirosian C ,Riopelle D ,Naranjo D ,Yano E ,Rubenstein L .Dobalian A Pre-earthquake Burden of Illness and Postearthquake Health and Preparedness in Veterans . Prehosp Disaster Med.2014 ;29 (3 ):1 -7
Impact of the Northridge Earthquake on the Mental Health of Veterans: Results From a Panel Study
- Aram Dobalian, Judith A. Stein, Kevin C. Heslin, Deborah Riopelle, Brinda Venkatesh, Andrew B. Lanto, Barbara Simon, Elizabeth M. Yano, Lisa V. Rubenstein
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 5 / Issue S2 / September 2011
- Published online by Cambridge University Press:
- 08 April 2013, pp. S220-S226
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Objective: The 1994 earthquake that struck Northridge, California, led to the closure of the Veterans Health Administration Medical Center at Sepulveda. This article examines the earthquake's impact on the mental health of an existing cohort of veterans who had previously used the Sepulveda Veterans Health Administration Medical Center.
Methods: From 1 to 3 months after the disaster, trained interviewers made repeated attempts to contact participants by telephone to administer a repeated measures follow-up design survey based on a survey that had been done preearthquake. Postearthquake data were obtained on 1144 of 1800 (64%) male veterans for whom there were previous data. We tested a predictive latent variable path model of the relations between sociodemographic characteristics, predisaster physical and emotional health measures, and postdisaster emotional health and perceived earthquake impact.
Results: Perceived earthquake impact was predicted by predisaster emotional distress, functional limitations, and number of health conditions. Postdisaster emotional distress was predicted by preexisting emotional distress and earthquake impact. The regression coefficient from earthquake impact to postearthquake emotional distress was larger than that of the stability coefficient from preearthquake emotional distress. Postearthquake emotional distress also was affected indirectly by preearthquake emotional distress, health conditions, younger age, and lower socioeconomic status.
Conclusions: The postdisaster emotional health of veterans who experienced greater earthquake impact would have likely benefited from postdisaster intervention, regardless of their predisaster emotional health. Younger veterans and veterans with generally poor physical and emotional health were more vulnerable to greater postearthquake emotional distress. Veterans of lower socioeconomic status were disproportionately likely to experience more effects of the disaster because they had more predisaster emotional distress, more functional limitations, and a greater number of health conditions. Because many veterans use non–Department of Veterans Affairs (VA) health care providers for at least some of their health needs, future disaster planning for both VA and non-VA providers should incorporate interventions targeted at these groups.
(Disaster Med Public Health Preparedness. 2011;5:S220-S226)