Long-Term Impact of Disasters on the Public Health System: A Multi-Case Analysis

Abstract

As past events have shown, disasters can have a tremendous impact on the affected population’s health. However, research regarding the long-term impact on a systems level perspective is still scarce. In this multi-case study, we analyzed and compared the long-term impacts on the public health system of five disasters which took place in Europe: avalanche (Austria), terror attack (Spain), airplane crash (Luxembourg), cable-car tunnel fire (Austria), and a flood in Central Europe. We used a mixed-methods approach consisting of a document analysis and interviews with key stakeholders, to examine the various long-term impacts each of the disasters had on health-system performance, as well as on security and health protection. The results show manifold changes undertaken in the fields of psychosocial support, infrastructure, and contingency and preparedness planning. The holistic approach of this study shows the importance of analyzing long-term impacts from the perspective of the type (e.g., disasters associated with natural hazards) and characteristic (e.g., duration and extent) of a disaster, as well as the regional context where a disaster took place. However, the identified recurring themes demonstrate the opportunity of learning from case studies in order to customize the lessons and apply them to the own-disaster-management setting.

Comparative risk assessment of non-communicable diseases by evacuation scenario– a retrospective study in the 7 years following the Fukushima Daiichi nuclear power plant accident

“…There has been repeated emphasis that it is important to continue follow-up studies in order to understand the health status of evacuees, to prevent, detect, and treat diseases at an early stage, and to maintain and improve the health of residents in the future [18][19][20][21]. The Sendai Framework for Disaster Risk Reduction 2015-2030 (the 2015 United Nations landmark agreements for disaster risk reduction) also points out the importance of post-disaster follow-up in its Priority 4 ('Enhancing disaster preparedness for effective response and to "Build Back Better" in recovery, rehabilitation and reconstruction').…”

Metrics and indicators used to assess health system resilience in response to shocks to health systems in high income countries—A systematic review

“…Important impact metrics related to alternative modes of delivery (telemedicine or deploying medical staff to evacuation centres) [ 45 , 62 , 80 ], and the closure and gradual reopening of services [ 62 ]. These latter two points were also important metrics for conflict and disaster management studies [ 42 , 70 , 81 , 82 ], as was coordination and cooperation of the wider emergency response community [ 39 , 81 , 83 ].…”

Long-Term Mental Health Support after Natural Hazard Events: A Report from an Online Survey among Experts in Japan

“…Recent international literature and guidelines emphasize the distinction between mental health activities in the acute- and long-term recovery phase after a natural hazard event, but in practice there is poor consensus regarding the definition of “long-term”, as the psychological effects of the disasters were considered likely to persist for months to even years [ 4 , 23 ]. Indeed, a literature review by Lorenzoni et al (2020) found that studies assessing the long-term impact of disasters on the public health system as a whole usually failed to provide a rigorous discussion, definition, or rationale for the definition of “long-term” [ 24 ]. Thus, we did not request for information on the time period itself but information on the quantitative definition of “long-term”, however, a similar discrepancy was reproduced (Category A).…”