Copyright © 2004 by the Johns Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Who Is at Risk of Death in an Earthquake?
1 Department of Social Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
2 Department of Health Policy, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
3 Institute of Health Care and Hospital Administration, National Yang-Ming University, Taipei, Taiwan.
4 Bureau of National Health Insurance, Taipei, Taiwan.
Although, theoretically, the impacts of a disaster are not randomly distributed across health and socioeconomic classes, empirical evidence of this claim is scarce. In a population-based cohort study, the authors identified risk factors for mortality from the September 21, 1999, Taiwan earthquake, which occurred in the middle of the night. Among 297,047 earthquake victims in central Taiwan who experienced partial or complete dwelling damage, 295,437 (noncases) survived the earthquake and 1,610 (cases) died between September 21 and October 31, 1999. Odds ratios were adjusted for both micro-level individual variables and macro-level neighborhood variables. People with mental disorders (odds ratio (OR) = 2.0, 95% confidence interval (CI): 1.1, 3.5), people with moderate physical disabilities (OR = 1.7, 95% CI: 1.2, 2.3), and people who had been hospitalized just prior to the earthquake (OR = 1.4, 95% CI: 1.2, 1.7) were the most vulnerable. The degree of vulnerability increased with decreasing monthly wage (measured in New Taiwanese dollars (NT$)) (NT$20,000
NT$39,999: OR = 1.5, 95% CI: 1.1, 2.1; <NT$20,000: OR = 2.2, 95% CI: 1.6, 3.0). The significant associations of both prequake health status and socioeconomic status with earthquake death suggest that earthquake death did not occur randomly. These results might help to guide allocation of public resources for reducing casualties.
health status; mortality; natural disasters; social class; socioeconomic status
Abbreviations: Abbreviations: CI, confidence interval; ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification; NT$, New Taiwanese dollars; OR, odds ratio; SES, socioeconomic status.
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