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Mortality From Forces of Nature Among Older Adults by Race/Ethnicity and Gender
Abstract
Older adults are especially vulnerable to disasters due to high rates of chronic illness, disability, and social isolation. Limited research examines how gender, race/ethnicity, and forces of nature-defined here as different types of natural hazards, such as storms and earthquakes-intersect to shape older adults' disaster-related mortality risk. We compare mortality rates among older adults (60+ years) in the United States across gender, race/ethnicity, and hazard type using the Centers for Disease Control and Prevention's Wonder database. Our results demonstrate that older adult males have higher mortality rates than females. American Indian/Alaska Native (AI/AN) males have the highest mortality and are particularly impacted by excessive cold. Mortality is also high among Black males, especially due to cataclysmic storms. To address disparities, messaging and programs targeting the dangers of excessive cold should be emphasized for AI/AN older adult males, whereas efforts to reduce harm from cataclysmic storms should target Black older adult males.
... Comprehensive literature details the magnitude of older adults' vulnerability during and after a disaster [40][41][42][43]. For example, in a systematic review and meta-analysis [43], found that older adults exposed to disasters were 2.11 times more likely to experience post-traumatic stress symptoms when compared with younger adults. ...
... For example, in a systematic review and meta-analysis [43], found that older adults exposed to disasters were 2.11 times more likely to experience post-traumatic stress symptoms when compared with younger adults. Older adults' experience and their level of vulnerability may relate to whether they have functional and access needs, given that previous research highlights particular preparation and support needs of those with disabilities during and after a disaster [40,44,45], as well as increased mortality for some subgroups [40]. Johnson et al. (2015) [46] argued that disability or functional capacity, rather than chronological age alone, should be considered for disaster preparation and signal a higher level of support. ...
... For example, in a systematic review and meta-analysis [43], found that older adults exposed to disasters were 2.11 times more likely to experience post-traumatic stress symptoms when compared with younger adults. Older adults' experience and their level of vulnerability may relate to whether they have functional and access needs, given that previous research highlights particular preparation and support needs of those with disabilities during and after a disaster [40,44,45], as well as increased mortality for some subgroups [40]. Johnson et al. (2015) [46] argued that disability or functional capacity, rather than chronological age alone, should be considered for disaster preparation and signal a higher level of support. ...
... On the other hand, NCDs account for 63% of all deaths in India; deaths from CVDs, chronic respiratory diseases, cancers, and other NCDs account for 27%, 11%, 9%, and 13%, respectively (20). Furthermore, elderly persons are more likely to suffer from multiple chronic diseases and illnesses, which can exacerbate during and after the disaster due to interruptions in care, lack of regular check-ups, and physical, social, and emotional distress (21). Due to disaster, they consume low-nutrient foods and contaminated foods, leading to high levels of exposure to disease and deaths from contamination (22). ...
This study analyzes the impact of disasters on the health of older adults in India, using data from LASI Wave-1 (2017-18) with 2,487 participants. Descriptive and multivariate analyses examined the link between health outcomes and disasters in older adults. The research reveals that drought, floods, and earthquakes are prevalent disaster, while traffic accidents and building collapses are significant man-made disasters. Older adults exposed to disasters caused by natural hazards experienced higher rates of psychological trauma, chronic illness, and physical disabilities. Man-made disasters were associated with increased risk of physical disability and chronic illness. Disasters were strongly linked to psychological trauma. This study emphasizes the importance of disaster preparedness and response strategies tailored to the needs of older adults. It calls for policies to improve healthcare access, social support, and disaster resilience, particularly in rural areas. Conducted through personal interviews, this research offers valuable insights for shaping policy and disaster management.
... 3 While individuals in these aforementioned groups may live unique lives from 1 another, the dynamism caused by demographic intersections may affect individual levels of vulnerability. 4 For instance, African Americans experienced higher mortality rates than Whites during and following Hurricane Katrina, but interactions among age, gender, and evacuation status resulted in disproportionate fatalities among African American men over the age of 75. 5,6 Since the onset of the coronavirus pandemic, African American and Latinx older adults have been disproportionately affected, experiencing an excess 8.4% COVID-19 related deaths in proportion to their population distribution. ...
Objective:
Studies have reported that minorities are disproportionately impacted by the COVID-19 pandemic. Few studies have elucidated the lived experiences of African American older adults, and the resiliency displayed in combatting the COVID-19 pandemic and other disasters.
Methods:
This study used 4 recorded focus groups with 26 African American older adults who have spent most of their lives living in Houston, Texas to assess safety, economic, and health concerns related to the pandemic and similarities or differences with other types of disasters that are specific to Houston/ the Gulf Region of Texas, such as Hurricane Harvey.
Results:
Key themes emerged from the thematic analysis: 1) previous disasters provided important coping and preparation skills, although each occurrence was still a major stressor, 2) while telehealth was a significant benefit, regular health maintenance and chronic disease management were not completed during the COVID-19 pandemic, 3) information from the federal and state authorities were inconsistent and spurred fear and anxiety, 4) participants experienced few to no disruptions to their income but were heavily called on to support family members, and 5) participants experienced anxiety and isolation, but many used existing social connections to cope.
Conclusions:
These findings demonstrate how African American older adults navigate disaster response and recovery through experience and community. Providing unambiguous information to older adults could prove useful in preparing for future disaster events and coping with disasters.
... Research has also found that older adults are more likely to be impacted by disasters due to multiple factors, including a higher likelihood of chronic health conditions and sensory, cognitive, and mobility disabilities, as well as limited social and economic support systems [48,49]. Evidence suggests that older adults have higher rates of mortality related to disasters [50], brought into sharp focus in the aftermath of California's 2018 Camp Fire where three-quarters of victims were age 65 years or older [51]. ...
Extreme weather events are expected to increase in frequency and severity due to climate change. However, we lack an understanding of how recent extreme weather events have impacted the U.S. population. We surveyed a representative sample of the U.S. public (n = 1071) in September 2021 about self-reported impacts they experienced from six types of extreme weather events within the past three years. We find that an overwhelming majority (86%) of the U.S. public reported being at least slightly impacted by an extreme weather event, and one-third (34%) reported being either very or extremely impacted by one or more types of extreme weather events. We clustered respondents into four impact groups, representing a composite of self-reported impacts from multiple types of extreme weather events. Respondents in the highest extreme weather impact group are more than 2.5 times as likely to identify as Black or Hispanic and 1.89 times more likely to live in a household with income levels below the Federal poverty level. We also observe reports of higher extreme weather impacts from respondents who are female, do not have a bachelor’s degree and live in a rural area. Our results indicate that extreme weather impacts are being felt by a broad cross-section of the U.S. public, with the highest impacts being disproportionately reported by populations that have previously been found to be more vulnerable to natural disasters and other extreme events.
... Risk of dying associated with higher temperatures and extreme heat events was elevated among Black, Latinx, and Native American individuals compared to Whites in studies across the USA, with even higher risk among non-US citizens. For example, a national study from 1999 to 2017 found that across all ages, American Indians/Native Alaskans and Blacks had higher mortality rates from excessive heat, followed by Latinos, Whites, and Asians/Pacific Islanders [71]. Another national study from 2005 to 2014 found a higher proportion of heatrelated deaths among non-US citizens than US citizens. ...
Purpose of Review
Climate change is causing warming over most parts of the USA and more extreme weather events. The health impacts of these changes are not experienced equally. We synthesize the recent evidence that climatic changes linked to global warming are having a disparate impact on the health of people of color, including children.
Recent Findings
Multiple studies of heat, extreme cold, hurricanes, flooding, and wildfires find evidence that people of color, including Black, Latinx, Native American, Pacific Islander, and Asian communities are at higher risk of climate-related health impacts than Whites, although this is not always the case. Studies of adults have found evidence of racial disparities related to climatic changes with respect to mortality, respiratory and cardiovascular disease, mental health, and heat-related illness. Children are particularly vulnerable to the health impacts of climate change, and infants and children of color have experienced adverse perinatal outcomes, occupational heat stress, and increases in emergency department visits associated with extreme weather.
Summary
The evidence strongly suggests climate change is an environmental injustice that is likely to exacerbate existing racial disparities across a broad range of health outcomes.
Knowledge of excess deaths after tropical cyclones is critical to understanding their impacts, directly relevant to policies on preparedness and mitigation. We applied an ensemble of 16 Bayesian models to 40.7 million U.S. deaths and a comprehensive record of 179 tropical cyclones over 32 years (1988-2019) to estimate short-term all-cause excess deaths. The deadliest tropical cyclone was Hurricane Katrina in 2005, with 1491 [95% credible interval (CrI): 563, 3206] excess deaths (>99% posterior probability of excess deaths), including 719 [95% CrI: 685, 752] in Orleans Parish, LA (>99% probability). Where posterior probabilities of excess deaths were >95%, there were 3112 [95% CrI: 2451, 3699] total post-hurricane force excess deaths and 15,590 [95% CrI: 12,084, 18,835] post-gale to violent storm force deaths; 83.1% of post-hurricane force and 70.0% of post-gale to violent storm force excess deaths occurred more recently (2004-2019); and 6.2% were in least socially vulnerable counties.
Climate change impacts are characterized by their differential treatment of diverse age groups and generations. Although both the old and the young are particularly vulnerable to climate change, it is the younger and unborn generations that will suffer the longest. Consequently, the youth are perceived as leaders of the climate movement. This study developed and evaluated a measure to assess the perceived role of younger people in climate action. The measure consists of three items that assess the perceived role of younger people as positive, and two items that assess their perceived role as a nuisance. The measure demonstrated adequate reliability and validity. The findings highlight the presence of both positive and negative perceptions of younger people in the context of climate change. This information can be used to address generational barriers and facilitate intergenerational solidarity toward a healthy climate.
This chapter focuses on the contributions of sociologists who study the root causes and social consequences of everyday emergencies, disasters, and large-scale catastrophes. It defines key terms and concepts, offers a brief history and overview of the field, and explains why sociologists study disasters. It also describes what research has revealed regarding human and organizational behavior during times of collective upheaval through offering a review of available research regarding three enduring areas of study in disaster—convergence behavior, panic and prosocial behavior, and crime and conflict. This chapter demonstrates how disaster risk is patterned in ways that reflect pre-existing social and economic inequalities. The concluding section focuses on the future of this field of study and offers forward-looking recommendations. Ultimately, this chapter illustrates the power of sociology in revealing social processes and group-based patterns, while also shedding light on the complicated, sometimes contradictory, and ever-expanding body of knowledge that characterizes the sociological study of disaster. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.
Past research clearly demonstrates that gender influences resources, capacities, decision-making processes, and outcomes throughout the disaster lifecycle, as well as the practical management of disaster risk, response, and recovery structures. Now well-established in disaster science, gender analysis has grown in scope and influence over the past decade. This chapter updates the authors’ earlier review, again focusing on English-language peer-reviewed materials relating to natural, technological, and intentional hazards and disasters. The authors reflect on the diverse theories and methods shaping contemporary research, and synthesize key international findings about mortality, health, and well-being; gender-based violence; family and work; and grassroots change. They further highlight three critical lines of inquiry now emerging regarding sexual minorities, masculinities, and climate change in gender and disaster research. The chapter concludes with research recommendations and with strategies for utilizing new knowledge about gendered vulnerability and resilience to reduce risk, minimize losses, and decrease suffering in disasters.
About 80% of older adults have at least one chronic condition that makes them more vulnerable than healthy people during a disaster. These chronic conditions - combined with the physiological, sensory, and cognitive changes experienced as part of aging - result in frail older adults having special needs during emergencies. Planning and coordination among public health and emergency preparedness professionals and professionals who provide services for the aging are essential to meet these special needs. Several tools and strategies already exist to help prepare these professionals to protect and assist older adults during a disaster. These include having professionals from diverse fields work and train in coalitions, ensuring that advocates for older adults participate in community-wide emergency preparedness, and using community mapping data to identify areas where many older adults live.
Objectives
This report presents the findings of an updated study of the validity of race and Hispanic-origin reporting on death certificates in the United States, and its impact on race- and Hispanic origin-specific death rates.
Methods
The latest version of the National Longitudinal Mortality Study (NLMS) was used to evaluate the classification of race and Hispanic origin on death certificates for deaths occurring in 1999–2011 to decedents in NLMS. To evaluate change over time, these results were compared with those of a study based on an earlier version of NLMS that evaluated the quality of race and ethnicity classification on death certificates for 1979–1989 and 1990–1998. NLMS consists of a series of annual Current Population Survey files (1973 and 1978–2011) and a sample of the 1980 decennial census linked to death certificates for 1979–2011. Pooled 2009–2011 vital statistics mortality data and 2010 decennial census population data were used to estimate and compare observed and corrected race- and Hispanic origin-specific death rates.
Results
Race and ethnicity reporting on death certificates continued to be highly accurate for both white and black populations during the 1999–2011 period. Misclassification remained high at 40% for the American Indian or Alaska Native (AIAN) population. It improved, from 5% to 3%, for the Hispanic population, and from 7% to 3% for the Asian or Pacific Islander (API) population. Decedent characteristics such as place of residence and nativity affected the quality of reporting on the death certificate. Effects of misclassification on death rates were large for the AIAN population but not significant for the Hispanic or API populations.
Background:
The study was designed to examine the 30- and 90-day mortality and hospitalization rates among nursing facility (NF) residents in the affected areas of Louisiana and Mississippi following Hurricane Katrina and to assess the rate of significant posthurricane functional decline.
Methods:
A secondary data analysis was conducted using Medicare claims merged with NF resident data from the Minimum Data Set. Thirty- and 90-day mortality and hospitalization rates for long-stay (>90 days) residents residing in 141 at-risk NFs during Hurricane Katrina were compared to rates for residents residing at the same facilities during the same time period in prior nonhurricane years (2003 and 2004). Functional decline was assessed as a 4+ drop in function using a 28-point Minimum Data Set Activities of Daily Living Scale.
Results:
There were statistically significant differences (all P < .0001) in mortality, hospitalization, and functional decline among residents exposed to Hurricane Katrina. At 30 days, the mortality rate was 3.88% among the exposed cohort compared with 2.10% and 2.28% for residents in 2003 and 2004, respectively. The 90-day mortality rate was 9.27% compared with 6.71% and 6.31%, respectively. These mortality differences translated into an additional 148 deaths at 30 days and 230 deaths at 90 days. The 30-day hospitalization rate was 9.87% compared with 7.21% and 7.53%, respectively. The 90-day hospitalization rate was 20.39% compared with 18.61% and 17.82%, respectively. Finally, the rate of significant functional decline among survivors was 6.77% compared with 5.81% in 2003 and 5.10% in 2004.
Conclusions:
NF residents experienced a significant increase in mortality, hospitalization, and functional decline during Hurricane Katrina.
Older adults, aged 65+, are a rapidly growing segment of the world population. To adequately inform all members of the public, hazard researchers and practitioners must be aware of the information processing capabilities and limitations of this increasingly large group. This paper illustrates how documented age-related normative changes in perception, attention, memory, text comprehension, and decision making can affect the processing of hazard information within the context of the Protective Action Decision Model. For the stages of the model that are heavily reliant on the information processing capabilities of the message recipient, current cognitive aging findings are reviewed and potential elder-friendly information design solutions are suggested for general hazard information and warnings.
Disasters disrupt the natural, built, and social environments, affecting communities and the people within them. Disasters
can be triggered by climatic, geophysical, technological, or human-initiated events, or a combination of these. Their impact
on the health of a community can be immediate or delayed, and changes in health status may be attributable to the original
event or result from events subsequent to the disaster. Deaths, injuries, and other health outcomes of a disaster are usually
caused by the destruction of the built infrastructure. In the absence of people living in built communities, disasters do
not occur.
Natural disasters do not affect people equally. In fact, a vulnerability approach to disasters would suggest that inequalities in exposure and sensitivity to risk as well as inequalities in access to resources, capabilities and opportunities systematically disadvantage certain groups of people, rendering them more vulnerable to the impact of natural disasters. In this article we address the specific vulnerability of girls and women with respect to mortality from natural disasters and their aftermath. Biological and physiological differences between the sexes are unlikely to explain large-scale gender differences in mortality rates. Social norms and role behavior provide some further explanation, but what is likely to matter most is the everyday socio-economic status of women. We analyze the effect of disaster strength and its interaction with the socio-economic status of women on the change in the gender gap in life expectancy in a sample of up to 141 countries over the period 1981 to 2002. We find, first, that natural disasters lower the life expectancy of women more than that of men. In other words, natural disasters (and their subsequent impact) on average kill more women than men or kill women at an earlier age than men. Since female life expectancy is generally higher than that of males, for most countries natural disasters narrow the gender gap in life expectancy. Second, the stronger the disaster (as approximated by the number of people killed relative to population size), the stronger this effect on the gender gap in life expectancy. That is, major calamities lead to more severe impacts on female life expectancy (relative to that of males) than smaller disasters. Third, the higher women’s socio-economic status, the weaker this effect on the gender gap in life expectancy. In other words, taken together our results show that it is the socially constructed gender-specific vulnerability of females built into everyday socio-economic patterns that lead to the relatively higher female disaster mortality rates compared to men.
Hurricane Katrina struck the US Gulf Coast on August 29, 2005, causing unprecedented damage to numerous communities in Louisiana and Mississippi. Our objectives were to verify, document, and characterize Katrina-related mortality in Louisiana and help identify strategies to reduce mortality in future disasters.
We assessed Hurricane Katrina mortality data sources received in 2007, including Louisiana and out-of-state death certificates for deaths occurring from August 27 to October 31, 2005, and the Disaster Mortuary Operational Response Team's confirmed victims' database. We calculated age-, race-, and sex-specific mortality rates for Orleans, St Bernard, and Jefferson Parishes, where 95% of Katrina victims resided and conducted stratified analyses by parish of residence to compare differences between observed proportions of victim demographic characteristics and expected values based on 2000 US Census data, using Pearson chi square and Fisher exact tests.
We identified 971 Katrina-related deaths in Louisiana and 15 deaths among Katrina evacuees in other states. Drowning (40%), injury and trauma (25%), and heart conditions (11%) were the major causes of death among Louisiana victims. Forty-nine percent of victims were people 75 years old and older. Fifty-three percent of victims were men; 51% were black; and 42% were white. In Orleans Parish, the mortality rate among blacks was 1.7 to 4 times higher than that among whites for all people 18 years old and older. People 75 years old and older were significantly more likely to be storm victims (P < .0001).
Hurricane Katrina was the deadliest hurricane to strike the US Gulf Coast since 1928. Drowning was the major cause of death and people 75 years old and older were the most affected population cohort. Future disaster preparedness efforts must focus on evacuating and caring for vulnerable populations, including those in hospitals, long-term care facilities, and personal residences. Improving mortality reporting timeliness will enable response teams to provide appropriate interventions to these populations and to prepare and implement preventive measures before the next disaster.
This study assessed mortality associated with the mid-July 1995 heat wave in Chicago.
Analyses focused on heat-related deaths, as designated by the medical examiner, and on the number of excess deaths.
In July 1995, there were 514 heat-related deaths and 696 excess deaths. People 65 years of age or older were overrepresented and Hispanic people underrepresented. During the most intense heat (July 14 through 20), there were 485 heat-related deaths and 739 excess deaths.
The methods used here provide insight into the great impact of the Chicago heat wave on selected populations, but the lack of methodological standards makes comparisons across geographical areas problematic.
To assess heat related mortalities in relation to climate within Europe.
Observational population study. Setting: North Finland, south Finland, Baden-Württemberg, Netherlands, London, north Italy, and Athens.
People aged 65-74. Main outcome measures: Mortalities at temperatures above, below, and within each region's temperature band of minimum mortality.
Mortality was lowest at 14.3-17.3 degrees C in north Finland but at 22.7-25.7 degrees C in Athens. Overall the 3 degrees C minimum mortality temperature bands were significantly higher in regions with higher than lower mean summer temperatures (P=0.027). This was not due to regional differences in wind speeds, humidity, or rain. As a result, regions with hot summers did not have significantly higher annual heat related mortality per million population than cold regions at temperatures above these bands. Mean annual heat related mortalities were 304 (95% confidence interval 126 to 482) in North Finland, 445 (59 to 831) in Athens, and 40 (13 to 68) in London. Cold related mortalities were 2457 (1130 to 3786), 2533 (965 to 4101), and 3129 (2319 to 3939) respectively.
Populations in Europe have adjusted successfully to mean summer temperatures ranging from 13.5 degrees C to 24.1 degrees C, and can be expected to adjust to global warming predicted for the next half century with little sustained increase in heat related mortality. Active measures to accelerate adjustment to hot weather could minimise temporary rises in heat related mortality, and measures to maintain protection against cold in winter could permit substantial reductions in overall mortality as temperatures rise.
Episodes of extremely hot or cold temperatures are associated with increased mortality. Time-series analyses show an association between temperature and mortality across a range of less extreme temperatures. In this paper, the authors describe the temperature-mortality association for 11 large eastern US cities in 1973-1994 by estimating the relative risks of mortality using log-linear regression analysis for time-series data and by exploring city characteristics associated with variations in this temperature-mortality relation. Current and recent days' temperatures were the weather components most strongly predictive of mortality, and mortality risk generally decreased as temperature increased from the coldest days to a certain threshold temperature, which varied by latitude, above which mortality risk increased as temperature increased. The authors also found a strong association of the temperature-mortality relation with latitude, with a greater effect of colder temperatures on mortality risk in more-southern cities and of warmer temperatures in more-northern cities. The percentage of households with air conditioners in the south and heaters in the north, which serve as indicators of socioeconomic status of the city population, also predicted weather-related mortality. The model developed in this analysis is potentially useful for projecting the consequences of climate-change scenarios and offering insights into susceptibility to the adverse effects of weather.
There is growing evidence that older adults exposed to natural disasters are at disproportionate risk for adverse health events such as all-cause mortality, injury, hospital admissions, stroke, displacement, cardiopulmonary distress, stress-related mental health problems, and exacerbation of chronic illnesses. Typically, analyses of the health consequences of natural disasters focus only on the populations impacted for the duration and immediate aftermath of the disaster. With few exceptions, the long-term effects of natural disasters on older adult health have not been examined. This article describes the potential consequences of exposure to natural disasters that contribute to cancer and disruption of cancer care treatment systems for older adults. It is argued that exposures to floods and wildfires in particular present an underestimated threat to the onset and/or progression of cancer and cancer care management in older adults. We propose that these impacts should be examined not only from an emergency preparedness perspective during the event but also from a public health focus that prospectively assesses risks for cancer and other health disparities. Recommendations for comprehensive longitudinal risk assessment and emergency preparedness models that address the full impact of natural disasters on the health and well-being of vulnerable, at risk, older adults are offered.
This study investigated to what extent income status and race/ethnicity in old age interplayed with disaster preparedness. Data came from the 2010 Health and Retirement Study, a nationally representative panel survey of older Americans over 51 years old. Our sample was restricted to respondents who participated in a special survey about disaster preparedness (N=1,711). Disaster preparedness was measured as a score, which includes 13 variables. Race/ethnicity was categorized by White, Black, and Hispanic. Low income was defined as below 300% of the federal poverty line. OLS regression was used to examine the main and interaction effects of race/ethnicity and lower income status on disaster preparedness scores. We found that older adults in lower income status had lower preparedness level than those in higher income (Coef. =-0.318, p<.01). Hispanics tend to be less prepared compared to White and Blacks (Coef. =-0.608, p<.001). Preparedness of Black elders was not significantly different from that of Whites. However, interestingly, Black elders in lower income status were significantly less prepared for disaster than other groups (Coef. =- 0.622, p<.05). This study identified vulnerable subgroups of older adults for disaster preparedness and suggests that preparedness programs should target minority and low income elders.
This chapter provides an overview of morbidity and mortality trends associated with a wide range of disasters, including physical as well as mental health effects, that have been documented within and beyond the U.S. The chapter begins with an introduction to morbidity, mortality, and related concepts within the disciplines of public health and epidemiology. The chapter then provides an overview of social vulnerability to disaster morbidity and mortality, which provides a useful lens for understanding and interpreting patterns. Next, morbidity and mortality findings for each of a variety of hazard types are presented, along with data from specific disaster events. Finally, the chapter considers the case of psychological injury and other mental health effects of disasters, followed by a brief discussion of methodological concerns. Concluding remarks summarize overall trends and patterns in disaster related death and injury, and outline future research needs.
Older adults represent the fastest growing demographic of the United States population. However, the elderly are insufficiently represented in studies examining the mental health impact of natural and man-made disasters. Social, cultural, and economic variables influence disaster-related mental health sequelae with a higher risk for morbidity and mortality among older adults due to physiologic factors, associated cognitive underpinnings, and chronic disease burden. Post-disaster mental health symptoms in elderly include sleep disturbance, irritability, acute stress reactions, depression, generalized anxiety disorder (GAD), substance use, and post-traumatic stress disorder (PTSD).
Objective
This article conceptualized emergency preparedness as a complex, multidimensional construct and empirically examined an array of sociodemographic, motivation, and barrier variables as predictors of levels of emergency preparedness.
Methods
The authors used the 2010 wave of the Health and Retirement Study’s emergency preparedness module to focus on persons 50 years old and older in the United States by use of logistic regression models and reconsidered a previous analysis.
Results
The models demonstrated 3 key findings: (1) a lack of preparedness is widespread across virtually all sociodemographic variables and regions of the country; (2) an authoritative voice, in the role of health care personnel, was a strong predictor of preparedness; and (3) previous experience in helping others in a disaster predisposes individuals to be better prepared. Analyses also suggest the need for caution in creating simple summative indexes and the need for further research into appropriate measures of preparedness.
Conclusion
This population of older persons was generally not well prepared for emergencies, and this lack of preparedness was widespread across social, demographic, and economic groups in the United States. Findings with implications for policy and outreach include the importance of health care providers discussing preparedness and the use of experienced peers for outreach. ( Disaster Med Public Health Preparedness . 2017;page 1 of 10)
Objective
Research on the impact of natural disasters on the mental health of older adults finds both vulnerabilities and resilience. We report on the rates of clinically significant depression among older adults (aged ≥60 years) living in areas affected by Hurricane Sandy in 2012 and the factors associated with mental health need.
Methods
The Sandy Mobilization, Assessment, Referral and Treatment for Mental Health (SMART-MH) program integrates community outreach and needs assessments to identify older adults with mental health and aging service needs. Older adults with significant anxiety or depressive symptoms were offered short-term psychotherapy. Social service referrals were made directly to community agencies. All SMART-MH activities were offered in Spanish, Russian, Mandarin/Cantonese, and English.
Results
Across the full sample, 14% of participants screened positive for depression. Hurricane Sandy stressors predicted increased odds of depression, including storm injury, post-storm crime, and the total count of stressors. Outcomes varied significantly by age group, such that all Sandy-related variables remained significant for younger-old adults (aged 60–74 years), whereas only the loss of access to medical care was significant for older-old adults (aged ≥75 years).
Conclusions
Storm-affected communities show higher rates of depressive symptoms than seen in the general population, with storm stressors affecting mental health needs differentially by age group. ( Disaster Med Public Health Preparedness . 2016;page 1 of 13)
Objective:
This project aimed to describe demographic patterns and circumstances surrounding injury deaths in New York City (NYC) related to Hurricane Sandy.
Methods:
Injury deaths related to Hurricane Sandy were classified by using data from multiple sources: NYC's Office of Vital Statistics death records, Office of Chief Medical Examiner case investigation files, and American Red Cross disaster mortality data. Injury deaths were classified as being related to Hurricane Sandy if they were caused directly by the storm's environmental forces or if they were indirectly caused by an interruption of services, displacement, or other lifestyle disruption.
Results:
We identified 52 injury deaths in NYC related to Hurricane Sandy. Most decedents were male (75%); nearly half were aged 65 years and older (48%). Most (77%) deaths were caused by injuries directly related to Hurricane Sandy. Ninety percent of direct deaths were caused by drowning; most (73%) occurred within 3 days of landfall. Half (50%) of the 12 indirect deaths that occurred up to 30 days after the storm were caused by a fall. Nearly two-thirds (63%) were injured at home. Three-quarters (75%) of fatal injuries occurred in evacuation Zone A.
Conclusions:
Risk communication should focus on older adults, males, and those living in evacuation zones; more evacuation assistance is necessary. NYC's fatal injury profile can inform future coastal storm planning efforts. (Disaster Med Public Health Preparedness. 2016;page 1 of 8).
All regions of the US experience disasters which result in a number of negative public health consequences. Some populations have higher levels of social vulnerability and, thus, are more likely to experience negative impacts of disasters including emotional distress, loss of property, illness, and death. To mitigate the impact of disasters on at-risk populations, emergency managers must be aware of the social vulnerabilities within their community. This paper describes a qualitative study which aimed to understand how emergency managers identify social vulnerabilities, also referred to as at-risk populations, in their populations and barriers and facilitators to current approaches. Findings suggest that although public health tools have been developed to aid emergency managers in identifying at-risk populations, they are not being used consistently. Emergency managers requested more information on the availability of tools as well as guidance on how to increase ability to identify at-risk populations.
Episodes of extremely hot or cold temperatures are associated with increased mortality. Time-series analyses show an association between temperature and mortality across a range of less extreme temperatures. In this paper, the authors describe the temperature-mortality association for 11 large eastern US cities in 1973-1994 by estimating the relative risks of mortality using log-linear regression analysis for time-series data and by exploring city characteristics associated with variations in this temperature-mortality relation. Current and recent days' temperatures were the weather components most strongly predictive of mortality, and mortality risk generally decreased as temperature increased from the coldest days to a certain threshold temperature, which varied by latitude, above which mortality risk increased as temperature increased. The authors also found a strong association of the temperature-mortality relation with latitude, with a greater effect of colder temperatures on mortality risk in more-southern cities and of warmer temperatures in more-northern cities. The percentage of households with air conditioners in the south and heaters in the north, which serve as indicators of socioeconomic status of the city population, also predicted weather-related mortality. The model developed in this analysis is potentially useful for projecting the consequences of climate-change scenarios and offering insights into susceptibility to the adverse effects of weather.
We sought to determine natural disaster preparedness levels among older US adults and assess factors that may adversely affect health and safety during such incidents.
We sampled adults aged 50 years or older (n = 1 304) from the 2010 interview survey of the Health and Retirement Study. The survey gathered data on general demographic characteristics, disability status or functional limitations, and preparedness-related factors and behaviors. We calculated a general disaster preparedness score by using individual indicators to assess overall preparedness.
Participant (n = 1 304) mean age was 70 years (SD = 9.3). Only 34.3% reported participating in an educational program or reading materials about disaster preparation. Nearly 15% reported using electrically powered medical devices that might be at risk in a power outage. The preparedness score indicated that increasing age, physical disability, and lower educational attainment and income were independently and significantly associated with worse overall preparedness.
Despite both greater vulnerability to disasters and continuous growth in the number of older US adults, many of the substantial problems discovered are remediable and require attention in the clinical, public health, and emergency management sectors of society.
This research note examines children's mortality resulting from forces of nature, including heat exposure, cold exposure, storms and flooding, lightning strikes, avalanches, earthquakes, and volcanic eruptions. Data indicate that in the United States, children's risk of death resulting from natural disasters is relatively low. However, differential risks exist depending on the type of hazard agent involved and between youth populations based on age, gender, and race. Specifically, analyses of mortality data show that risk of death by natural disaster among youth cohorts age 0-24 is highest for infants, the most fragile and dependent segment of our population. The death rate for male children is higher than the death rate for female children across all age cohorts. Data on race indicate that African American male children between the ages of 0-4 are most at risk for death by disaster, while white male children between the ages of 5-24 are most at risk. In terms of risk by age by hazard type, infants and very young children age 0-4 are most likely to die of exposure to extreme heat, 5-14 year-olds are most likely to die in cataclysmic storms and flood events, and youth age 15-24 are most likely to die of excessive cold. These findings have important implications for future research and policy decisions associated with protecting children and youth in disasters.
Hurricane Katrina has been interpreted as both a “metaphor” for the racial inequality that characterizes urban America and as a purely “natural” disaster that happened to strike a predominantly Black city. To resolve these conflicting interpretations, the author analyzes data on New Orleans residents who died during Katrina in an effort to provide an empirical look at the groups most directly affected by the hurricane. Contrary to prior reports in the popular press, the author finds that the impact of the storm was felt most acutely by the elderly population in New Orleans and by Blacks, who were much more likely to die than would be expected given their presence in the population. Data on the locations of recovered bodies also show that Katrina took its largest toll in New Orleans’s Black community. These findings confirm the impression that race was deeply implicated in the tragedy of Katrina.
This study evaluated how individuals living on the Gulf Coast perceived hurricane risk after Hurricanes Katrina and Rita. It was hypothesized that hurricane outlook and optimistic bias for hurricane risk would be associated positively with distance from the Katrina-Rita landfall (more optimism at greater distance), controlling for historically based hurricane risk and county population density, demographics, individual hurricane experience, and dispositional optimism. Data were collected in January 2006 through a mail survey sent to 1,375 households in 41 counties on the coast (n = 824, 60% response). The analysis used hierarchal regression to test hypotheses. Hurricane history and population density had no effect on outlook; individuals who were male, older, and with higher household incomes were associated with lower risk perception; individual hurricane experience and personal impacts from Katrina and Rita predicted greater risk perception; greater dispositional optimism predicted more optimistic outlook; distance had a small effect but predicted less optimistic outlook at greater distance (model R(2) = 0.21). The model for optimistic bias had fewer effects: age and community tenure were significant; dispositional optimism had a positive effect on optimistic bias; distance variables were not significant (model R(2) = 0.05). The study shows that an existing measure of hurricane outlook has utility, hurricane outlook appears to be a unique concept from hurricane optimistic bias, and proximity has at most small effects. Future extension of this research will include improved conceptualization and measurement of hurricane risk perception and will bring to focus several concepts involving risk communication.
On Thursday, July 13, 1995, Chicagoans awoke to a blistering day in which the temperature would reach 106 degrees. The heat index, which measures how the temperature actually feels on the body, would hit 126 degrees by the time the day was over. Meteorologists had been warning residents about a two-day heat wave, but these temperatures did not end that soon. When the heat wave broke a week later, city streets had buckled; the records for electrical use were shattered; and power grids had failed, leaving residents without electricity for up to two days. And by July 20, over seven hundred people had perished-more than twice the number that died in the Chicago Fire of 1871, twenty times the number of those struck by Hurricane Andrew in 1992âin the great Chicago heat wave, one of the deadliest in American history. Heat waves in the United States kill more people during a typical year than all other natural disasters combined. Until now, no one could explain either the overwhelming number or the heartbreaking manner of the deaths resulting from the 1995 Chicago heat wave. Meteorologists and medical scientists have been unable to account for the scale of the trauma, and political officials have puzzled over the sources of the city's vulnerability. In Heat Wave, Eric Klinenberg takes us inside the anatomy of the metropolis to conduct what he calls a "social autopsy," examining the social, political, and institutional organs of the city that made this urban disaster so much worse than it ought to have been. Starting with the question of why so many people died at home alone, Klinenberg investigates why some neighborhoods experienced greater mortality than others, how the city government responded to the crisis, and how journalists, scientists, and public officials reported on and explained these events. Through a combination of years of fieldwork, extensive interviews, and archival research, Klinenberg uncovers how a number of surprising and unsettling forms of social breakdownâincluding the literal and social isolation of seniors, the institutional abandonment of poor neighborhoods, and the retrenchment of public assistance programsâcontributed to the high fatality rates. The human catastrophe, he argues, cannot simply be blamed on the failures of any particular individuals or organizations. For when hundreds of people die behind locked doors and sealed windows, out of contact with friends, family, community groups, and public agencies, everyone is implicated in their demise. As Klinenberg demonstrates in this incisive and gripping account of the contemporary urban condition, the widening cracks in the social foundations of American cities that the 1995 Chicago heat wave made visible have by no means subsided as the temperatures returned to normal. The forces that affected Chicago so disastrously remain in play in America's cities, and we ignore them at our peril.
To identify the vulnerabilities of elderly to disasters, and to develop strategies to address these vulnerabilities.
A relevant literature search of journal articles, government training materials, news reports, and materials from senior organizations was conducted.
The vulnerability of the elderly to disasters is related to their impaired physical mobility, diminished sensory awareness, chronic health conditions, and social and economic limitations that prevent adequate preparation for disasters, and hinder their adaptability during disasters. Frail elderly, those with serious physical, cognitive, economic, and psycho-social problems, are at especially high risk.
This segment of the population is growing rapidly. Therefore, it is important that emergency management recognize the frail elderly as a special needs population, and develop targeted strategies that meet their needs. Several management strategies are presented and recommendations for further action are proposed.
Simple preventive measures may help reduce mortality
Increasing evidence shows that atmospheric carbon dioxide levels are rising and are causing global warming.1 Record air temperatures were recorded in Britain during the last month. Accurate estimates of the consequences of these must wait until daily mortality data are available, but press reports indicate that the hot weather caused around 1000 deaths during one week alone in Britain and perhaps 10 000 overall in France, where temperatures were higher.
Mortality in Britain is lowest when the mean daily temperature is 17-18°C. The number of heat related deaths per year, obtained as the number of excess deaths on days hotter than this, has averaged around 800 in recent years.2 Most of those deaths are of people over 70 years of age, and most occur in the first day or two of a period of high temperature.3
Few of these deaths are recognisable clinically as being due to heat.4 5 Heat stress causes loss of salt and water …
Objective. County‐level socioeconomic and demographic data were used to construct an index of social vulnerability to environmental hazards, called the Social Vulnerability Index (SoVI) for the United States based on 1990 data.
Methods. Using a factor analytic approach, 42 variables were reduced to 11 independent factors that accounted for about 76 percent of the variance. These factors were placed in an additive model to compute a summary score—the Social Vulnerability Index.
Results. There are some distinct spatial patterns in the SoVI, with the most vulnerable counties clustered in metropolitan counties in the east, south Texas, and the Mississippi Delta region.
Conclusion. Those factors that contribute to the overall score often are different for each county, underscoring the interactive nature of social vulnerability—some components increase vulnerability; others moderate the effects.
An investigation of United States federal policy attempts to reduce American Indian and Alaska Native disaster vulnerability
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Carter, L. (2016). An investigation of United States federal policy
attempts to reduce American Indian and Alaska Native disaster vulnerability [Unpublished master's thesis]. Department of
Sociology, Colorado State University.
Participation please: Barriers to tribal disaster mitigation planning
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Carter, L., & Peek, L. (2016). Participation please: Barriers to tribal
disaster mitigation planning. Natural Hazards Observer, 40(4).
Natural Hazards Center, University of Colorado Boulder.
https://hazards.colorado.edu/article/participation-please-barriers-to-tribal-mitigation-planning
Centers for Disease Control and Prevention. (2018a). Tribal population. https://www.cdc.gov/tribal/tribes-organizations-health/
tribes/state-population.html
Centers for Disease Control and Prevention. (2018b). Underlying
cause of death, 1999-2017 results. http://wonder.cdc.gov/ucd-icd10.html
Gender and disasters
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Enarson, E., Fothergill, A., & Peek, L. (2018). Gender and disasters.
In H. Rodríguez, W. Donner, & J. E. Trainor (Eds.), Handbook
of disaster research (2nd ed., pp. 205-223). Springer.
Poor, elderly and too frail to escape: Paradise fire killed the most vulnerable residents
- L Newberry
Newberry, L. (2019, February 10). Poor, elderly and too frail to
escape: Paradise fire killed the most vulnerable residents. Los
Angeles Times. https://www.latimes.com/local/lanow/la-meln-camp-fire-seniors-mobile-home-deaths-20190209-story.
html
Peek, L. (2013). Age. In D. S. K. Thomas, B. D. Philips, W. E.
Lovekamp, & A. Fothergill (Eds.), Social vulnerability to
disasters (2nd ed., pp. 167-198). CRC Press.
Economic losses, poverty, and disasters: 1998-2017. Centre for Research on the Epidemiology of Disasters, United Nations Office for Disaster Risk Reductions
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Wallemacq, P., & House, R. (2018). Economic losses, poverty, and
disasters: 1998-2017. Centre for Research on the Epidemiology
of Disasters, United Nations Office for Disaster Risk Reductions.
Closing the gaps: Advancing disaster preparedness, response and recovery for older adults
American Red Cross. (2020). Closing the gaps: Advancing disaster
preparedness, response and recovery for older adults. https://
www.johnahartford.org/dissemination-center/view/reportadvancing-disaster-preparedness-response-and-recovery-forolder-adults