Who Is at Risk of Death in an Earthquake?

Abstract

Although, theoretically, the impacts of a disaster are not randomly distributed across health and socioeconomic classes, empirical evidence of this claim is scarce. In a population-based cohort study, the authors identified risk factors for mortality from the September 21, 1999, Taiwan earthquake, which occurred in the middle of the night. Among 297,047 earthquake victims in central Taiwan who experienced partial or complete dwelling damage, 295,437 (noncases) survived the earthquake and 1,610 (cases) died between September 21 and October 31, 1999. Odds ratios were adjusted for both micro-level individual variables and macro-level neighborhood variables. People with mental disorders (odds ratio (OR) = 2.0, 95% confidence interval (CI): 1.1, 3.5), people with moderate physical disabilities (OR = 1.7, 95% CI: 1.2, 2.3), and people who had been hospitalized just prior to the earthquake (OR = 1.4, 95% CI: 1.2, 1.7) were the most vulnerable. The degree of vulnerability increased with decreasing monthly wage (measured in New Taiwanese dollars (NT$)) (NT$20,000 approximately NT$39,999: OR = 1.5, 95% CI: 1.1, 2.1; <NT$20,000: OR = 2.2, 95% CI: 1.6, 3.0). The significant associations of both prequake health status and socioeconomic status with earthquake death suggest that earthquake death did not occur randomly. These results might help to guide allocation of public resources for reducing casualties.

Integrating epidemiological and engineering approaches in the assessment of human casualties in earthquakes

“…The Japanese study (Osaki and Minowa 2001) found an odds ratio of 1.9 (95 % CI 1.0, 3.4), and similarly, the study from Taiwan (Chou et al 2004) found an odds ratio of 1.7 (95 % CI 1.2, 2.3).…”

“…Studies from Haiti (Kolbe et al 2010) and Taiwan (Chou et al 2004) found children to be at higher risk of death, and both reported similar odds ratios of 5.8 (95 % CI 4, 8.3) and 5.5 (95 % CI 4.4, 6.8), respectively.…”

“…Among the four studies that found women at higher risk of injury and death, two from the USA (Shoaf et al 1998;Peek-Asa et al 2003) had the highest odds ratios (OR) for increased risk of injury of 1.64 (95 % CI N/A) and 2.4 (95 % CI 1.2, 5.1), respectively. Studies from Taiwan and Peru found women to be at higher risk of injury (Doocy et al 2009) and death (Chou et al 2004), but with smaller odds ratios: OR 1.2 (95 % CI 1.1, 1.3) and OR 1.6 (95 % CI 1.0, 2.7), respectively. The USA and Taiwan had conflicting findings, with studies in both regions reporting increased risk of females and no significant differences related to gender regarding the same earthquake events.…”

“…Figure 1 demonstrates that most deadly earthquakes occur in developing countries rather than in developed countries, but even when an earthquake strikes a well-developed country such as the USA, there is evidence that lowincome households were more affected than high-income households (Fothergill and Peek 2004). However, studies from Taiwan (Chou et al 2004) and Peru (Doocy et al 2009) used analytical methods to measure the role of socioeconomic status as a risk factor for earthquake-related injury and death. The Taiwanese study found that the degree of vulnerability to earthquake-related death increased with decreasing monthly wage (OR 2.2, 95 % CI 1.6, 3.0).…”

“…These criteria used to screen all abstracts included. Thirteen studies met these criteria and were included in this section (Shoaf et al 1998;Mahue-Giangreco et al 2001;(Liang et al 2001;Peek-Asa et al 2003;Chou et al 2004;Doocy et al 2009Doocy et al , 2013Ellidokuz et al 2005;Dong et al 2012;Kolbe et al 2010;Osaki and Minowa 2001;Roces et al 1992;Armenian et al 1992). The steps of the literature review are described in Fig.…”