Pre-Earthquake Burden of Illness and Post-Earthquake Health and Preparedness in Veterans

Der-Martirosian C, Riopelle D, Naranjo D, Yano EM, Rubenstein LV, Dobalian A. Prehosp Disaster Med. 2014 Jun;29(3):223-9. doi: 10.1017/S1049023X14000272. Epub 2014 Apr 10.

BACKGROUND: During an earthquake, vulnerable populations, especially those with chronic conditions, are more susceptible to adverse, event-induced exacerbation of chronic conditions such as limited access to food and water, extreme weather temperatures, and injury. These circumstances merit special attention when health care facilities and organizations prepare for and respond to disasters.

METHODS: This study explores the relationship between pre-earthquake burden of illness and post-earthquake health-related and preparedness factors in the US. Data from a cohort of male veterans who were receiving care at the Sepulveda Veterans Affairs Medical Center (VAMC) in Los Angeles, California USA during the 1994 Northridge earthquake were analyzed.

RESULTS: Veterans with one or more chronic conditions were more likely to report pain lasting two or more days, severe mental/emotional stress for more than two weeks, broken/lost medical equipment, having difficulty refilling prescriptions, and being unable to get medical help following the quake compared to veterans without chronic conditions. In terms of personal emergency preparedness, however, there was no association between burden of illness and having enough food or water for at least 24 hours after the earthquake.

CONCLUSION: The relationship that exists between health care providers, including both individual providers and organizations like the US Department of Veterans Affairs (VA), and their vulnerable, chronically-ill patients affords providers the unique opportunity to deliver critical assistance that could make this vulnerable population better prepared to meet their post disaster health-related needs. This can be accomplished through education about preparedness and the provision of easier access to medical supplies. Disaster plans for those who are burdened with chronic conditions should meet their social needs in addition to their psychological and physical needs.

Keywords: Preparedness, post-earthquake, burden of illness, U.S. Military Veterans