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Risk factors for psychological and physical health problems after a man-made disaster. Prospective study
Anja J E Dirkzwager1, Linda Grievink, Peter G van der Velden
1Netherlands Institute for Health Services Research, Utrecht, The Netherlands. a.dirkzwager@nivel.nl
Background:
There are few prospective studies on risk factors for health problems after disasters in which actual pre-disaster health data are available.
Aims:
To examine whether survivors' personal characteristics, and pre-disaster psychological problems, and disaster-related variables, are related to their post-disaster health.
Method:
Two studies were combined: a longitudinal survey using the electronic medical records of survivors' general practitioners (GPs), from 1 year before to 1 year after the disaster, and a survey in which questionnaires were filled in by survivors, 3 weeks and 18 months after the disaster. Data from both surveys and the electronic medical records were available for 994 survivors.
Results:
After adjustment for demographic and disaster-related variables, pre-existing psychological problems were significantly associated with post-disaster self-reported health problems and post-disaster problems presented presented to the to the GP. This association was found for both psychological and physical post-disaster problems.
Conclusions:
In trying to prevent long-term health consequences after disaster, early attention to survivors with pre-existing psychological problems, and to those survivors who are forced to relocate or are exposed to many stressors during the disaster, appears appropriate.
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