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Risk factors for psychological and physical health problems after a man-made disaster

Prospective study

Netherlands Institute for Health Services Research, Utrecht

Linda Grievink, PhD

National Institute for Public Health and the Environment, Bilthoven

Peter G. Van der Velden, PhD

Institute for Psychotrauma, Zaltbommel

C. Joris Yzermans, PhD

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

Declaration of interest None.

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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