Netherlands Institute for Health Services Research, Utrecht
National Institute for Public Health and the Environment, Bilthoven
Institute for Psychotrauma, Zaltbommel
Netherlands Institute for Health Services Research, Utrecht, The Netherlands
Correspondence: Dr A. J. E. Dirkzwager, NIVEL, P.O. Box 1568, 3500 BN Utrecht, The Netherlands. Tel.: +31 30 2729781; fax: +31 30 2729729; email: a.dirkzwager{at}nivel.nl
Funding detailed in Acknowledgements.
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 and18 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 presentedtothe 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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