Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-19T16:53:49.872Z Has data issue: false hasContentIssue false
  • English
  • Français

Pre-earthquake Burden of Illness and Postearthquake Health and Preparedness in Veterans

Published online by Cambridge University Press:  10 April 2014

Claudia Der-Martirosian ,
Deborah Riopelle ,
Diana Naranjo ,
Elizabeth M. Yano ,
Lisa V. Rubenstein  and
Aram Dobalian
Claudia Der-Martirosian*
Affiliation:
Veterans Emergency Management Evaluation Center (VEMEC), Department of Veterans Affairs, North Hills, California USA
Deborah Riopelle
Affiliation:
Veterans Emergency Management Evaluation Center (VEMEC), Department of Veterans Affairs, North Hills, California USA
Diana Naranjo
Affiliation:
Veterans Emergency Management Evaluation Center (VEMEC), Department of Veterans Affairs, North Hills, California USA
Elizabeth M. Yano
Affiliation:
VA Greater Los Angeles Health Services Research and Development (HSR&D) Center of Excellence for the Study of Healthcare Provider Behavior, Sepulveda, California USA
Lisa V. Rubenstein
Affiliation:
VA Greater Los Angeles Health Services Research and Development (HSR&D) Center of Excellence for the Study of Healthcare Provider Behavior, Sepulveda, California USA
Aram Dobalian
Affiliation:
Veterans Emergency Management Evaluation Center (VEMEC), Department of Veterans Affairs, North Hills, California USA Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California USA UCLA School of Nursing, Los Angeles, California USA
*
Correspondence: Claudia Der-Martirosian, PhD Veterans Emergency Management Evaluation Center (VEMEC) 16111 Plummer St., MS-152 North Hills, CA 91343 USA E-mail Claudia.Der-Martirosian@va.gov
Get access Rights & Permissions [Opens in a new window]

Abstract

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.

Methods

This 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.

Results

Veterans 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.

Conclusion

The 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-MartirosianC , RiopelleD , NaranjoD , YanoE , RubensteinL , DobalianA . Pre-earthquake Burden of Illness and Postearthquake Health and Preparedness in Veterans. Prehosp Disaster Med. 2014;29(3):1-7.

Keywords

burden of illnesspostearthquake preparednessveteransvulnerable populations
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 29 , Issue 3 , June 2014 , pp. 223 - 229
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Davis, JR, Wilson, S, Brock-Martin, A, et al. The impact of disasters on populations with health and health care disparities. Disaster Med Public Health Prep. 2010;4(1):30-38.Google Scholar
2. Phifer, JF. Psychological distress and somatic symptoms after natural disaster: differential vulnerability among older adults. Psychol Aging. 1990;5(3):412-420.Google Scholar
3. Dobalian, A, Tsao, JCI, Putzer, GJ, Menendez, SM. Improving rural community preparedness for the chronic health consequences of bioterrorism and other public health emergencies. J Public Health Manag Pract. 2007;13(5):476-480.CrossRefGoogle ScholarPubMed
4. Jhung, MA, Shehab, N, Rohr-Allegrini, C, et al. Chronic disease and disasters: medication demands of Hurricane Katrina Evacuees. Am J Prev Med. 2007;33(3):207-210.Google Scholar
5. Ford, ES, Mokdad, AH, Link, MW, et al. Chronic disease in health emergencies: in the eye of the hurricane. Prev Chronic Dis. 2006;3(2): http://www.cdc.gov/pcd/issues/2006/apr/05_0235.htm. Accessed October 10, 2012.Google Scholar
6. Fernandez, LS, Bayard, D, Lin, CC, et al. Frail elderly as disaster victims: emergency management strategies. Prehosp Disaster Med. 2002;17(2):67-74.Google Scholar
7. Aldrich, N, Benson, WF. Disaster preparedness and the chronic disease needs of vulnerable older adults. Prev Chronic Dis. 2008;5(1): http://www.cdc.gov/pcd//issues/2008/jan/07_0135.htm. Accessed October 10, 2012.Google Scholar
8. Mack, D, Brantley, KM, Bell, KG. Mitigating the health effects of disasters for medically underserved populations: electronic health records, tele-medicine, research, screening, and surveillance. J Health Care Poor Underserved. 2007;18(2):432-442.CrossRefGoogle Scholar
9. Straker, H, Finister, S. Not business as usual. J Health Care Poor Underserved. 2007;18(2):241-246.CrossRefGoogle ScholarPubMed
10. Kleinpeter, MA. Public health preparedness for diverse populations and communities. J Natl Med Assoc. 2007;99(4):447-448.Google Scholar
11. Mokdad, AH, Mensah, GA, Posner, SF, et al. When chronic conditions become acute: prevention and control of chronic disease and adverse health outcomes during natural disaster. Prev Chronic Dis. 2005;2:http://www.cdc.gov/pcd/issues/2005/nov/05_0201.htm. Accessed October 10, 2012.Google Scholar
12. Bailey, MA, Glover, R, Huang, Y. Epidemiologic assessment of the impact of four hurricanes – Florida, 2004. MMWR Morb Mortal Wkly Rep. 2005;54(28):693-697.Google Scholar
13. Morrow, BH. Identifying and mapping community vulnerability. Disasters. 1999;23(1):1-18.Google Scholar
14. Koepsell, T, Reiber, G, Simmons, KW. Behavioral risk factors and use of preventive services among veterans in Washington state. Prev Med. 2002;35(6):557-562.Google Scholar
15. VA Health Services Research & Development Service. Meeting the Challenges of Veterans with Chronic Illnesses. http://www.hsrd.research.va.gov/publications/internal/forum11_05.pdf. Published 2005. Accessed October 12, 2012.Google Scholar
16. Yu, W, Ravelo, A, Wagner, TH, et al. Prevalence and costs of chronic conditions in the VA health care system. Med Care Res Rev. 2003;60(3):146S-167S.Google Scholar
17. Agha, Z, Lofgren, RP, Van Ruiswyk, JV, Layde, PM. Are patients at Veterans Affairs Medical Centers sicker? A comparative analysis of health status and medical resource use. Arch Intern Med. 2000;160(21):3252-3257.Google Scholar
18. Peek-Asa, C, Kraus, JF, Bourque, LB, et al. Fatal and hospitalized injuries resulting from the 1994 Northridge earthquake. Int J Epidemiol. 1998;27:459-465.Google Scholar
19. Eguchi, RT, Goltz, JD, Taylor, CE, et al. Direct economic losses in the Northridge earthquake: a three-year post-event perspective. Earthquake Spectra. 1998;14(2):245-264.Google Scholar
20. Norris, FH, Friedman, MJ, Watson, PJ. 60,000 disaster victims speak: Part II. Summary and implications of the disaster mental health research. Psychiatry. 2002;65(3):240-260.Google Scholar
21. Knight, BG, Gatz, M, Heller, K, Bengtsoon, VL. Age and emotional response to the Northridge earthquake: a longitudinal analysis. Psychol Aging. 2000;15(4):627-634.Google Scholar
22. McMillen, JC, North, CS, Smith, EM. What parts of PTSD are normal: intrusion, avoidance, or arousal? Data from the Northridge, California, earthquake. J Trauma Stress. 2000;13(1):57-75.Google Scholar
23. Siegel, JM, Shoaf, KI, Bourque, LB. Feedback from the field: the Mississippi Scale for PTSD in post-earthquake communities. Int J Mass Emerg Disasters. 2000;18(2):339-346.Google Scholar
24. Ullman, J, Newbomb, M. I felt the earth move: a prospective study of the 1994 Northridge earthquake. In: Cohen P, Slomkowski C, Robins L eds, Historical and Geographical Influences on Psychopathology. Mahwah, NJ, USA: Lawrence Erlbaum Associates, Inc.; 1999:217-246.Google Scholar
25. Mahue-Giangreco, M, Mak, W, Seligson, H, Bourque, LB. Risk factors associated with moderate and serious injuries attributable to the 1994 Northridge earthquake, Los Angeles, California. Ann Epidemiol. 2001;11(5):347-357.Google Scholar
26. Dobalian, A, Stein, JA, Heslin, KC, et al. Impact of the Northridge earthquake on the mental health of veterans: results from a panel study. Disaster Med Public Health Prep. 2011;5(Suppl 2):S220-S226.Google Scholar
27. Heslin, KC, Stein, JA, Dobalian, A, et al. Alcohol problems as a risk factor for post-disaster depressed mood among U.S. veterans. Psychol Addict Behav. 2013;27(1):207-213.Google Scholar
28. Chavez, CW, Binder, B. A hospital as a victim and responder: the Sepulveda VA Medical Center and the Northridge earthquake. Journal Emerg Med. 1996;14(4):445-454.Google Scholar
29. Lee, ML, Yano, EM, Wang, M, et al. What patient population does visit-based sampling in primary care settings represent? Med Care. 2002;40(2):761-770.Google Scholar
30. Jette, AM, Davies, AR, Cleary, PD, et al. The Functional Status Questionnaire: reliability and validity when used in primary care. J Gen Intern Med. 1986;1(3):143-149.Google Scholar
31. Ware, JE, Gandek, B. The SF-36 Health Survey: development and use in mental health research and the IQOLA Project. Inter J Ment Health. 1994;23(2):49-73.Google Scholar
32. Bartels, SA, VanRooyen, MJ. Medical complications associated with earthquakes. Lancet. 2012;379(9817):748-757.Google Scholar
33. Claver, M, Dobalian, A, Fickel, JJ, et al. Comprehensive care for vulnerable elderly veterans during disasters. Arch Gerontol Geriatr. 2013;56:205-213.Google Scholar
34. US Department of Veterans Affairs, VHA Support Service Center (VSSC)—intranet website. Greater Los Angeles Healthcare System, 691A4 Sepulveda. http:/vssc.med.va.gov/. Accessed July 26, 2013.Google Scholar