Research and Evaluations of the Health Aspects of Disasters, Part I: An Overview

Abstract

The ultimate goals of conducting disaster research are to obtain information to: (1) decrease risks that a hazard will produce a disaster; (2) decrease the mortality associated with disasters; (3) decrease the morbidity associated with disasters; and (4) enhance recovery of the affected community. And decrease the risks that a hazard will produce a disaster. Two principal, but inter-related, branches of disaster research are: (1) Epidemiological; and (2) Interventional. Epidemiological research explores the relationships and occurrences that comprise a disaster from a particular event. Interventional research involves evaluations of interventions, whether they are directed at relief, recovery, hazard mitigation, capacity building, or performance. In response to the need for the discipline of Disaster Health to build its science on data that are generalizeable and comparable, a Disaster Logic Model (DLM) and a set of five Frameworks have been developed to structure the information and research of the health aspects of disasters. These Frameworks consist of the: (1) Conceptual; (2) Temporal; (3) Societal; (4) Relief/Recovery; and (5) Risk-Reduction Frameworks. The Frameworks provide a standardized format for studying and comparing the epidemiology of disasters, and with the addition of the DLM, for evaluating the interventions (responses) provided prior to, during, and following a disaster, especially as they relate to the health status of the people affected by, or at-risk for, a disaster. Critical to all five Frameworks is the inclusion of standardized definitions of the terms. The Conceptual Framework describes the progression of a hazard that becomes an event, which causes structural damage, which, in turn, results in compromised, decreased, or losses of function(s) (functional damage) that, in turn, produce needs that lead to an emergency or a disaster. The Framework incorporates a cascade of risks that lead from the presence of a hazard to the development of a disaster. Risk is the likelihood that each of the steps leading from a hazard to a disaster will take place, as well as the probabilities of consequences of each of the elements in the Conceptual Framework. The Temporal Framework describes this chronological progression as phases in order of their appearance in time; some may occur concurrently. In order to study and compare the effects of an event on the complex amalgam that constitutes a community, the essential functions of a community have been deconstructed into 13 Societal Systems that comprise the Societal Framework. These diverse, but inter-related, Societal Systems interface with each other through a 14th System, Coordination and Control. The DLM can be used to identify the effects, costs, outcomes, and impacts of any intervention. Both the Relief/Recovery and Risk-Reduction Frameworks are based on the DLM. The Relief/Recovery Framework provides the structure necessary to systematically evaluate the processes involved in interventions provided during the Relief or Recovery phases of a disaster....

Health among disaster survivors and health professionals after the Haiyan Typhoon: a self-selected Internet-based web survey

“…Selection biases, such as previous health history, level of exposure, or willingness to report health problems, are difficult to control using web-based recruitment strategies [14]. The lack of baseline data is another commonly described issue when describing health impacts and evaluate disaster response interventions [13, 40]. To summarize, generalization from a self-selected Internet sample to the general population and from one disaster to another can be problematic [13].…”

“…So far, there is no agreed-upon consensus about timing for disaster health research [12, 40]. The time for data collection in studies on health and recovery after disasters varies from one month to over 15 years [21].…”

Disaster E-Health Framework for Community Resilience

“…There is therefore an imperative to develop a framework for disaster health that integrates the principles and practice of the contributing domains and combines them holistically to enhance community resilience. Research directed to this goal has begun to appear emphasising mainly practical aspects [21] but also addressing the need for a theoretical foundation and generic principles [22]. As mentioned previously, this framework should recognize the potential of cutting-edge e-health technologies [11] for disaster health.…”

“…The starting point for the roadmap is the definition of an unambiguous terminology accepted and understood by policy makers, managers, community leaders, and members of the public. The lexicon will be based on the UN's Terminology of Disaster Risk Reduction [52] and supplemented or amended by terms invoked in other relevant publications [22], including recent ones that deal with social capital [19,31] and social learning [33] in community resilience, and terms that are commonly used in e-health [33].…”

“…In 2015-2106 Birnbaum et al published a sequence of papers aimed at establishing a definitive conceptual framework for disaster-related health based on the disaster cycle [22,40,[53][54][55][56][57][58][59]. These papers cover an extensive range of topics from hazard classification, through societal structures such as water, sanitation, and medical care, to risk management, risk reduction, and capacity building.…”