Combs D L, Parrish R G, McNabb S J, Davis J H
National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atalanta, GA 30341-3724, USA.
Int J Epidemiol. 1996 Jun;25(3):537-44. doi: 10.1093/ije/25.3.537.
Information about circumstances leading to disaster-related deaths helps emergency response coordinators and other public health officials respond to the needs of disaster victims and develop policies for reducing the mortality and morbidity of future disasters. In this paper, we describe the decedent population, circumstances of death, and population-based mortality rates related to Hurricane Andrew, and propose recommendations for evaluating and reducing the public health impact of natural disasters.
To ascertain the number and circumstances of deaths attributed to Hurricane Andrew in Florida and Louisiana, we contacted medical examiners in 11 Florida counties and coroners in 36 Louisiana parishes.
In Florida medical examiners attributed 44 deaths to the hurricane. The mortality rate for directly-related deaths was 4.4 per 1 000 000 population and that for indirectly-related deaths was 8.5 per 1 000 000 population. In Louisiana, coroners attributed 11 resident deaths to the hurricane. Mortality rates were 0.6 per 1000 000 population for deaths directly related to the storm and 2.8 for deaths indirectly related to the storm. Six additional deaths occurred among non-residents who drowned in international waters in the Gulf of Mexico. In both Florida and Louisiana, mortality rates generally increased with age and were higher among whites and males.
In addition to encouraging people to follow existing recommendations, we recommend emphasizing safe driving practices during evacuation and clean-up, equipping shelters with basic medical needs for the population served, and modifying zoning and housing legislation. We also recommend developing and using a standard definition for disaster-related deaths, and using population-based statistics to describe the public health effectiveness of policies intended to reduce disaster-related mortality.
有关导致灾害相关死亡的情况的信息有助于应急响应协调员和其他公共卫生官员满足灾难受害者的需求,并制定政策以降低未来灾害的死亡率和发病率。在本文中,我们描述了与安德鲁飓风相关的死亡人口、死亡情况以及基于人群的死亡率,并提出了评估和减少自然灾害对公共卫生影响的建议。
为确定佛罗里达州和路易斯安那州归因于安德鲁飓风的死亡人数和情况,我们联系了佛罗里达州11个县的法医和路易斯安那州36个教区的验尸官。
在佛罗里达州,法医将44例死亡归因于飓风。直接相关死亡的死亡率为每100万人口4.4例,间接相关死亡的死亡率为每100万人口8.5例。在路易斯安那州,验尸官将11例居民死亡归因于飓风。与风暴直接相关的死亡死亡率为每100万人口0.6例,与风暴间接相关的死亡死亡率为每100万人口2.8例。另外有6名非居民在墨西哥湾国际水域溺水死亡。在佛罗里达州和路易斯安那州,死亡率一般都随年龄增长而上升,白人和男性的死亡率更高。
除了鼓励人们遵循现有建议外,我们建议强调疏散和清理期间的安全驾驶做法,为避难所配备所服务人群的基本医疗需求,并修改分区和住房立法。我们还建议制定并使用灾害相关死亡的标准定义,并使用基于人群的统计数据来描述旨在降低灾害相关死亡率的政策的公共卫生效果。