The Imbalance in Medical Demand and Supply for Pediatric Victims in an Earthquake.

OBJECTIVES: We quantified an absolute imbalance of the medical risks and the support needs for children at each disaster-based hospital in Kanagawa immediately following the occurrence of a large earthquake by using the risk resource ratio (RRR) and need for medical resources (NMR). METHODS: The RRR and NMR of 33 disaster-based hospitals were estimated through dividing the estimated number of pediatric victims by the number of critically patients. We calculated the ratio of the NMR of each hospital. RESULTS: The total number of pediatric victims in Kanagawa was estimated at 8,391. The total number of vacant beds for pediatric victims was 352. The median RRR and NMR of the total number of pediatric victims were 27 and 224. The median RRR and NMR of the number of critically ill pediatric patients were 27 and 12. CONCLUSIONS: The absolute imbalance of the RRR and NMR for children in Kanagawa was quantified. This suggests that we might embark on preparedness strategies for children in advance. (Disaster Med Public Health Preparedness. 2018;13:672-676).

Historical Earthquakes and Their Socioeconomic Consequences in China: 1950⁻2017.

Understanding the spatiotemporal pattern of historical earthquake disasters and resultant socioeconomic consequences is essential for designing effective disaster risk reduction measures. Based on historical earthquake disaster records, this study compiles a Chinese earthquake disaster catalog (CH-CAT) that includes records of 722 earthquake disasters that occurred during 1950⁻2017 in the mainland of China. This catalog includes more complete data records than other existing global earthquake databases for China as a whole. Statistical results demonstrate that the number of earthquake disasters and the resultant direct economic losses (DELs) exhibit significant increasing trends (p < 0.01) over the studied 68-year period. Earthquake-induced deaths vary greatly between individual years and exhibit no significant trend. The Qinghai-Tibet seismic zone is the area with the highest frequency of earthquake disasters and the largest accumulated DELs, whereas the North China seismic zone is associated with the highest number of deaths. Among the 722 earthquake disasters, nearly 99.0% of deaths and 95.0% of DELs are attributable to 1.8% and 3.9% of the earthquake disasters, respectively. Approximately 54.2% of recorded earthquake disasters have earthquake magnitude (Ms) values between 5.0 and 5.9, while earthquake disasters with Ms greater than or equal to 7.0 account for 88.5% of DELs and 98.8% of deaths. On average, earthquake-induced DELs and deaths increase nonlinearly with increasing Ms per earthquake. DELs have a positive correlation with deaths and casualties on a logarithmic scale. This study further discusses that during different stages of socioeconomic development, changes in both exposure and vulnerability may be the major factors leading to change differences in earthquake-induced socioeconomic consequences. This study is a beneficial supplement to the global earthquake database and is useful for calibrating global or regional empirical loss models.

Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study.

OBJECTIVES: To examine associations between access to medical care, geological data, and infant and child mortality in the area of North-Eastern Japan that was impacted by the Great East Japan Earthquake and Tsunami (GEJET) in 2011. DESIGN: A population-based ecological study using publicly available data. SETTING: Twenty secondary medical areas (SMAs) in the disaster-affected zones in the north-eastern prefectures of Japan (Iwate, Fukushima and Miyagi). PARTICIPANTS: Children younger than 10 years who died in the 20 SMAs between 2008 and 2014 (n=1 748). Primary and secondary outcome measures: Multiple regression analysis for infant and child mortality rate. The mean values were applied for infant and child mortality rates and other factors before GEJET (2008-2010) and after GEJET (2012-2014). RESULTS: Between 2008 and 2014, the most common cause of death among children younger than 10 years was accidents. The mortality rate per 100 000 persons was 39.1±41.2 before 2011, 226.7±43.4 in 2011 and 31.4±39.1 after 2011. Regression analysis revealed that the mortality rate was positively associated with low age in each period, while the coastal zone was negatively associated with fewer disaster base hospitals in 2011. By contrast, the number of obstetrics and gynaecology centres (ß=-189.9, p=0.02) and public health nurses (ß=-1.7, p=0.01) was negatively associated with mortality rate per person in 2011. CONCLUSIONS: In 2011, the mortality rate among children younger than 10 years was 6.4 times higher than that before and after 2011. Residence in a coastal zone was significantly associated with higher child mortality rates.

Lifestyle factors and social ties associated with the frequency of laughter after the Great East Japan Earthquake: Fukushima Health Management Survey.

PURPOSE: Although mental health problems such as depression after disasters have been reported, positive psychological factors after disasters have not been examined. Recently, the importance of positive affect to our health has been recognised. We therefore investigated the frequency of laughter and its related factors among residents of evacuation zones after the Great East Japan Earthquake of 2011. METHODS: In a cross-sectional study on 52,320 participants aged 20 years and older who were included in the Fukushima Health Management Survey in Japan's fiscal year 2012, associations of the frequency of laughter with changes in lifestyle after the disaster, such as a changed work situation, the number of family members, and the number of address changes, and other sociodemographic, psychological, and lifestyle factors were examined using logistic regression analysis. The frequency of laughter was assessed using a single-item question: "How often do you laugh out loud?" RESULTS: The proportion of those who laugh almost every day was 27.1%. Multivariable models adjusted for sociodemographic, psychological, and lifestyle factors demonstrated that an increase in the number of family members and fewer changes of address were significantly associated with a high frequency of laughter. Mental health, regular exercise, and participation in recreational activities were also associated with a high frequency of laughter. CONCLUSION: Changes in lifestyle factors after the disaster were associated with the frequency of laughter in the evacuation zone. Future longitudinal studies are needed to examine what factors can increase the frequency of laughter.

Health-Related Quality of Life in the Aftermath of the L'Aquila Earthquake in Italy.

OBJECTIVE: A recent article reported a reduction in the suicide rate in the inhabitants of L'Aquila (Italy) in 2009, when on the night of April 6, a devastating earthquake struck the city. The potential implications of the role of resilience in the aftermath of natural disasters, together with the limitations of existing evidence on this topic, suggest a need for more research. We aimed to retrospectively investigate the impact of the L'Aquila earthquake on a standardized self-reported measure of health-related quality of life (HRQoL). METHODS: HRQoL data were collected through 2 separate cross-sectional surveys conducted during 2008 and 2010, before and after the earthquake that occurred in 2009, on 2 random samples of adults living in L'Aquila. RESULTS: The data seemed to suggest no decrease in the inhabitants' HRQoL level after the disaster, which may suggest the role of resilience in supporting survivors' HRQoL. The findings were also consistent with previous observations of a reduction in the suicide rate in the same inhabitants after the earthquake. CONCLUSIONS: After a natural disaster, people likely activate personal resources and protective social factors that result in better subjective outcomes.

A Sex Disparity Among Earthquake Victims.

OBJECTIVE: Understanding who is most vulnerable during an earthquake will help health care responders prepare for future disasters. We analyzed the demography of casualties from the Christchurch earthquake in New Zealand. METHODS: The demography of the total deceased, injured, and hospitalized casualties of the Christchurch earthquake was compared with that of the greater Christchurch population, the Christchurch central business district working population, and patients who presented to the single acute emergency department on the same month and day over the prior 10 years. Sex data were compared to scene of injury, context of injury, clinical characteristics of injury, and injury severity scores. RESULTS: Significantly more females than males were injured or killed in the entire population of casualties (P20% were injured at commercial or service localities (444/2032 males [22%]; 1105/4627 females [24%]). Adults aged between 20 and 69 years (1639/2032 males [81%]; 3717/4627 females [80%]) were most frequently injured. CONCLUSION: Where people were and what they were doing at the time of the earthquake influenced their risk of injury.

The Association Between Medical Treatment of Physical Diseases and Psychological Distress After the Great East Japan Earthquake: The Shichigahama Health Promotion Project.

OBJECTIVE: Physical disease patients are known to experience high levels of psychological distress. This study examined the association between the medical treatment of physical diseases and psychological distress in the coastal area affected by the Great East Japan Earthquake. METHODS: Using cross-sectional data, we studied 3032 individuals aged ≥40 years who lived in Shichigahama, Miyagi, Japan. We examined the associations between 8 medical treatments for physical diseases and psychological distress, defined as Kessler Psychological Distress scale score ≥13 of 24 points. To investigate the associations, we performed multiple logistic regression analyses. RESULTS: There were statistically significant associations between psychological distress and medical treatments for myocardial infarction/angina pectoris (odds ratio [OR]=1.8, 95% confidence interval [CI]=1.0-3.0) and liver disease (OR=3.1, 95% CI=1.0-7.7). The other 4 medical treatments for physical diseases had ORs of 1.3 or higher and were positively associated with psychological distress: cancer, hyperlipidemia, kidney disease, and diabetes mellitus. The degree of damage to homes did not affect the association between most of the medical treatments for physical diseases and psychological distress. CONCLUSIONS: In the disaster area, most of the medical treatments for physical diseases had positive associations with psychological distress, irrespective of the degree of damage to homes.

Performance Assessment of a Communicable Disease Surveillance System in Response to the Twin Earthquakes of East Azerbaijan.

OBJECTIVE: Following the twin earthquakes on August 11, 2012, in the East Azerbaijan province of Iran, the provincial health center set up a surveillance system to monitor communicable diseases. This study aimed to assess the performance of this surveillance system. METHODS: In this quantitative-qualitative study, performance of the communicable diseases surveillance system was assessed by using the updated guidelines of the Centers for Disease Control and Prevention (CDC). Qualitative data were collected through interviews with the surveillance system participants, and quantitative data were obtained from the surveillance system. RESULTS: The surveillance system was useful, simple, representative, timely, and flexible. The data quality, acceptability, and stability of the surveillance system were 65.6%, 10.63%, and 100%, respectively. The sensitivity and positive predictive value were not calculated owing to the absence of a gold standard. CONCLUSIONS: The surveillance system satisfactorily met the goals expected for its setup. The data obtained led to the control of communicable diseases in the affected areas. Required interventions based on the incidence of communicable disease were designed and implemented. The results also reassured health authorities and the public. However, data quality and acceptability should be taken into consideration and reviewed for implementation in future disasters.

Resilience and quality of life among Wenchuan earthquake survivors: the mediating role of social support.

OBJECTIVES: To examine the extent social support mediates resilience and quality of life in Wenchuan earthquake survivors. STUDY DESIGN: Originals. METHODS: Self-report psychological questionnaires, the standard Chinese 12-item Short Form (SF-12v2), the Resilience Scale for Adults (RSA), and the Social Support Rating Scale (SSRS) were used to interview a total of 2080 survivors from 19 counties in the 2008 Wenchuan Earthquake area. A regression analysis was conducted to evaluate the mediating effect of social support on quality of life. RESULTS: Males and individuals with a higher level of education were found to have a better quality of life. The association between resilience and quality of life improved after social support was included, suggesting that at least a part of this association was mediated by the level of social support provided. CONCLUSIONS: This analysis highlighted that the level of resilience and quality of life after an earthquake was associated with the level of social support. This result has clear policy implications, and indicates that more focus needs to be placed on policies that aim for the provision of early mental health intervention and social support to improve the quality of life of earthquake survivors.

The perspective of psychosocial support a decade after Bam earthquake: achievements and challenges.

The 2003 Bam earthquake was one of the most catastrophic disasters to have struck Iran. This article summarizes the short-term and long-term psychological, social, and economic impacts of the Bam earthquake on survivors across a decade since its occurrence. Identification and definition of capability as well as recognizing the nature and extent of personal and social capabilities in a community are priceless in preventing disasters and reducing their consequent destruction.

Características epidemiológicas de los fallecidos durante el terremoto y maremoto de Chile 2010 / Epidemiological profile of deaths after the 2010 earthquake in Chile

Background: On February 27, 2010 a powerful earthquake followed by a tsunami stroke Chile. The study of mortality during this emergency can provide important public health information. Aim: To describe the main characteristics of people who died during the earthquake and the following three months. Material and Methods: Cross sectional analysis of death records databases obtained from Department of Health Statistics and Information of the Ministry of Health and the Coroner office. Results: Until May 25,2010, 505 corpses were completely identified. Seventy two of these corresponded to people aged 80 years or more. The higher age adjusted death rates per 100,000 inhabitants were observed among subjects aged more than 80 years and those aged 70 to 79 years (22.6 and 7.7 respectively). The higher rates of deaths were observed in regions where the earthquake had a higher intensity and coastal regions affected by the tsunami. The causes of death were trauma in 75% of cases and drowning in 25%. There was no association between the Mercalli scale of earthquake intensity and rates of death. Among deceased subjects, there was a concentration of unemployed, under educated and low socioeconomic status subjects. Conclusions: After the earthquake, the higher rates of deaths occurred among older people and in the region of the epicenter of the earthquake. Most deaths were due to trauma.