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This chapter summarizes the current state of the literature relating to each of the disaster phases across a wide range of variables, including sociocultural factors and environment and community resources. Social networks among racial/ethnic minority cultures can be a significant protective factor against adverse mental health consequences, and the emphasis on social networks among many racial/ethnic minority cultures appears to also influence evacuation efforts. Differences in risk perception between minority and majority populations contribute to differences in disaster exposure. A variety of cultural beliefs appear to affect individuals in pre- and peridisaster phases. Several factors have an impact on marginalized populations' postdisaster mental health outcomes. Environmental and community resources suggest that limited or lack of resources appears to significantly impact disaster-response in marginalized populations. The chapter further discusses the implications for research, disaster-response efforts, and practice.
There are few prospective studies on risk factors for health problems
after disasters in which actual pre-disaster health data are
To examine whether survivors' personal characteristics, and pre-disaster
psychological problems, and disaster-related variables, are related to
their post-disaster health.
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 and 18 months after the disaster.
Data from both surveys and the electronic medical records were available
for 994 survivors.
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 to the GP. This association was found for both psychological
and physical post-disaster problems.
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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