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A national study of health care service utilization and substance use after the 2010 Chilean earthquake
Dana Rose Garfin1, Vanessa Juth, Roxane Cohen Silver
1Dr. Garfin, Dr. Juth, and Dr. Silver are with the Department of Psychology and Social Behavior, University of California, Irvine. Dr. Ugalde, Mr. Linn, and Dr. Inostroza are with the Instituto de Salud Pública, Universidad Andrés Bello, Santiago, Chile. Send correspondence to Dr. Silver (e-mail: rsilver@uci.edu ).
Objective:
A national epidemiological survey in Chile assessed adaptive (health care utilization) and maladaptive (substance use) postearthquake behaviors.
Methods:
Three months after the 8.8-magnitude 2010 Bio-Bio earthquake, face-to-face interviews were conducted with a representative sample of 2,108 adults. Logistic regression analyses examined predictors of health care service utilization and substance use.
Results:
Few participants utilized available government- and community-based psychosocial resources (16.6%). A minority reported increased substance use (13.2%). Lower self-efficacy was correlated with increased health care utilization (odds ratio [OR]=.92, 95% confidence interval [CI]=.88-.96) and use of tranquilizers, illicit and psychotropic drugs, and alcohol (OR=.95, CI=.91-.99); this pattern was not limited to residents of areas with the heaviest impacts.
Conclusions:
Self-efficacy beliefs elucidate variability in survivors' behaviors postdisaster and may provide an avenue to encourage salubrious responses. Postdisaster interventions should broadly target the population; those less heavily affected may need, and be as likely to use, available resources.
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