Pratiti Rebecca
Internal Medicine, McLaren Health Care Flint, Flint, USA.
Cureus. 2023 Sep 18;15(9):e45500. doi: 10.7759/cureus.45500. eCollection 2023 Sep.
Disasters, whether natural or manmade, disrupt the functioning of communities, significantly impacting people's lives and health. To build community resilience, the Centers for Disease Control and Prevention recommends community preparedness, where multiple stakeholders work together. Disaster Preparedness Science Research (DPSR) similarly encourages the improvement of disaster relief outcomes. This literature review assesses the vulnerability of communities for prioritized intervention, summarizes disaster effects, and suggests the scope for improvement in disaster preparedness (DP). Twenty-one articles were reviewed based on disaster mitigation and economic factors from 90 studies identified through a PubMed search till September 2021. Vulnerable communities with higher hazard risks are identified by vulnerability indices (VI), including the Climate Risk Index, Environmental VI, and Socio-Economic VI. However, VI predicting one disaster may not predict another. Disaster behavioral response involves five phases. Disaster effects include medical, mental, environmental, and economic effects, as well as the unique recovery time from each domain effect. Medical effects include malnutrition, malaria, diarrhea, heat stress, exacerbations of chronic conditions, infectious disease outbreaks, trauma, and death. Mental effects are post-traumatic stress disorders, depression, anxiety, somatic complaints, psychological distress, sleep problems, and suicides. Environmental effects include isolation, migration, injury to family members, life threats, and property damage. Loss of livelihood and property are associated with worse outcomes. Disaster recovery, which is seldom measured and not clearly defined, affects measurement and comparison across settings. A uniform validated VI, including multiple indicators assessing vulnerability to various disasters, is required. Livelihood restoration is integral to mental health recovery in some disaster types. Fund diversification, prioritized to the vulnerable and to each domain effect of disaster in the immediate post-disaster phase, expedites recovery. Later recovery investments focused on helping people rebuild their community enhance psychological outcomes. Promoting job insurance in highly vulnerable labor-based communities with high VI, wherein willing-to-pay is high, could facilitate faster recovery. DPSR should be encouraged.
灾难，无论是自然灾害还是人为灾害，都会扰乱社区的正常运转，对人们的生活和健康产生重大影响。为了增强社区恢复力，疾病控制与预防中心建议开展社区备灾工作，让多个利益相关方共同努力。灾难备灾科学研究（DPSR）同样鼓励改善救灾成果。这篇文献综述评估了社区的脆弱性，以便确定优先干预措施，总结灾难影响，并提出改进灾难备灾（DP）工作的方向。通过在PubMed数据库中检索，截至2021年9月共识别出90项研究，基于减灾和经济因素对其中21篇文章进行了综述。通过脆弱性指数（VI）来识别具有较高灾害风险的脆弱社区，这些指数包括气候风险指数、环境脆弱性指数和社会经济脆弱性指数。然而，预测一种灾难的脆弱性指数可能无法预测另一种灾难。灾难行为反应包括五个阶段。灾难影响包括医疗、心理、环境和经济影响，以及每个领域影响的独特恢复时间。医疗影响包括营养不良、疟疾、腹泻、热应激、慢性病加重、传染病暴发、创伤和死亡。心理影响是创伤后应激障碍、抑郁、焦虑、躯体不适、心理困扰、睡眠问题和自杀。环境影响包括隔离、迁移、家庭成员受伤、生命威胁和财产损失。生计和财产损失与更糟糕的结果相关。灾难恢复很少被衡量且定义不明确，这影响了不同环境下的测量和比较。需要一个统一的经过验证的脆弱性指数，包括多个评估对各种灾难脆弱性的指标。在某些灾难类型中，生计恢复是心理健康恢复不可或缺的一部分。在灾后即刻阶段，优先为弱势群体和灾难的每个领域影响进行资金多元化配置，可加快恢复。后期的恢复投资侧重于帮助人们重建社区，这能改善心理状况。在脆弱性指数高且基于劳动力的高度脆弱社区中推广失业保险，由于人们的支付意愿较高，可能有助于更快恢复。应鼓励开展灾难备灾科学研究。
