Table of Contents

Volume 1, Issue 1

  January/February/March 2013

  Pages 1 - 62

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EDITORIAL

Open Access Article

Welcome to Disaster Health

James M. Shultz and Yuval Neria
Page 1
http://dx.doi.org/10.4161/dish.24414
PDF




EDITOR'S PREVIEW

Open Access Article

In this issue of Disaster Health

James M. Shultz and Yuval Neria
Pages 2 - 3
http://dx.doi.org/10.4161/dish.24412
PDF




COMMENTARY

Open Access Article

Trauma signature analysis: State of the art and evolving future directions

James M. Shultz and Yuval Neria
Pages 4 - 8
http://dx.doi.org/10.4161/dish.24011
Abstract | Full Text | PDF

Trauma signature (TSIG) analysis is an evidence-based method that examines the interrelationship between population exposure to a disaster, extreme event, or complex emergency, and the inter-related physical and psychological consequences for the purpose of providing timely, actionable guidance for effective mental health and psychosocial support that is organically tailored and targeted to the defining features of the event.

A series of TSIG case studies has been published since 2011 and TSIG analyses of recent disasters are in process. Disaster Health intends to expedite and feature novel TSIG research focusing on late-breaking disaster events.

At the current stage of development, expert consensus is sought for refining the TSIG methodology using a Delphi process. The overarching goal is to create a fully operational system to provide timely guidance for adapting disaster behavioral health support to the salient psychological risk factors in each disaster.




SHORT ARTICLE

Open Access Article

A mental health training program for community members following a natural disaster

Darryl Wade, Tracey Varker, Sally Coates, Therese Fitzpatrick, Clare Shann and Mark Creamer
Pages 9 - 12
http://dx.doi.org/10.4161/dish.22658
Abstract | Full Text | PDF

This study reports data on a disaster mental health training program to enhance the capacity of lay people from disaster-affected communities, to provide assistance to others following a bushfire disaster. Local facilitators conducted training sessions which were actively promoted within communities. Participants were asked to complete an anonymous pre- and post-training survey to obtain data on the impact and quality of the training program. Responses from 462 (80%) of 577 people who attended 39 sessions showed substantial and significant increases in key competencies including confidence in their abilities to detect difficulties coping in others and to provide assistance. The quality of the program and materials were rated highly. The findings of the evaluation provide support for the program as a beneficial, acceptable and feasible community-level intervention following disaster.




RESEARCH PAPERS

Open Access Article

Addressing the gap between public health emergency planning and incident response: Lessons learned from the 2009 H1N1 outbreak in San Diego County

Ariela M. Freedman, Michele Mindlin, Christopher Morley, Meghan Griffin, Wilma Wooten and Kathleen Miner
Pages 13 - 20
http://dx.doi.org/10.4161/dish.21580
Abstract | Full Text | PDF

Objectives: Since 9/11, Incident Command System (ICS) and Emergency Operations Center (EOC) are relatively new concepts to public health, which typically operates using less hierarchical and more collaborative approaches to organizing staff. This paper describes the 2009 H1N1 influenza outbreak in San Diego County to explore the use of ICS and EOC in public health emergency response.
Methods: This study was conducted using critical case study methodology consisting of document review and 18 key-informant interviews with individuals who played key roles in planning and response. Thematic analysis was used to analyze data.
Results: Several broad elements emerged as key to ensuring effective and efficient public health response: 1) developing a plan for emergency response; 2) establishing the framework for an ICS; 3) creating the infrastructure to support response; 4) supporting a workforce trained on emergency response roles, responsibilities, and equipment; and 5) conducting regular preparedness exercises.
Conclusions: This research demonstrates the value of investments made and that effective emergency preparedness requires sustained efforts to maintain personnel and material resources. By having the infrastructure and experience based on ICS and EOC, the public health system had the capability to surge-up: to expand its day-to-day operation in a systematic and prolonged manner. None of these critical actions are possible without sustained funding for the public health infrastructure. Ultimately, this case study illustrates the importance of public health as a key leader in emergency response.

Open Access Article

Reducing the risk of public health emergencies for the world’s largest mass gathering: 2010 World Exposition, Shanghai China

Xiaodong Sun, Mark Keim, Yongchao He, Mollie Mahany and Zheng'an Yuan
Pages 21 - 29
http://dx.doi.org/10.4161/dish.22537
Abstract | Full Text | PDF

Mass Gatherings and Public Health

 

Mass gatherings are highly visible events with the potential for serious health and political consequences if not managed carefully and effectively.^1-4 Mass gatherings have been reported to have significant impact upon public health systems throughout the world.^5-10 International mass gathering events, such as those associated with the Olympic Games, often carry high political significance and have a historical risk for terrorist attacks.² Mass gatherings ranging from the subnational level to international the level have also been associated with outbreaks and subsequent spread of communicable diseases. These events have included outbreaks of foodborne shigellosis occurring at an outdoor music festival in the United States.^5,6 The annual Hajj pilgrimage in Saudi Arabia has been plagued by public health threats such as fires, stampedes and an outbreak of meningitis.^7,9 Influenza outbreaks were also reported during the 2008 World Youth Day mass gathering in Australia.¹⁰ Local, provincial and national public health and medical agencies are frequently involved before, during and after a major event. Therefore, disaster risk reduction is a key element for the effective management of mass gatherings.

Disaster Risk Reduction

Throughout the world, the overall approach to emergencies and disasters has recently shifted from post-impact activities (i.e., ad hoc relief and reconstruction) to a more systematic and comprehensive process of risk management.¹¹ Disaster risk management includes pre-impact disaster risk reduction (i.e., prevention, preparedness and mitigation) as well as post-impact response and recovery).¹² While planners may not always have the ability to prevent health hazards from occurring at mass gathering events, the health sector can play an important role in preventing the public health impact of such hazards. This manuscript describes a comprehensive approach for disaster risk reduction as implemented by those entities responsible for health security associated with the 2010 Shanghai World Exposition (Shanghai Expo).

Open Access Article

Mitigating flood exposure: Reducing disaster risk and trauma signature

James M. Shultz, Andrew McLean, Holly B. Herberman Mash, Alexa Rosen, Fiona Kelly, Helena M. Solo-Gabriele, Georgia A. Youngs, Jr., Jessica Jensen, Oscar Bernal and Yuval Neria
Pages 30 - 44
http://dx.doi.org/10.4161/dish.23076
Abstract | Full Text | PDF

Introduction. In 2011, following heavy winter snowfall, two cities bordering two rivers in North Dakota, USA faced major flood threats. Flooding was foreseeable and predictable although the extent of risk was uncertain. One community, Fargo, situated in a shallow river basin, successfully mitigated and prevented flooding. For the other community, Minot, located in a deep river valley, prevention was not possible and downtown businesses and one-quarter of the homes were inundated, in the city’s worst flood on record. We aimed at contrasting the respective hazards, vulnerabilities, stressors, psychological risk factors, psychosocial consequences, and disaster risk reduction strategies under conditions where flood prevention was, and was not, possible.
Methods. We applied the “trauma signature analysis” (TSIG) approach to compare the hazard profiles, identify salient disaster stressors, document the key components of disaster risk reduction response, and examine indicators of community resilience.
Results. Two demographically-comparable communities, Fargo and Minot, faced challenging river flood threats and exhibited effective coordination across community sectors. We examined the implementation of disaster risk reduction strategies in situations where coordinated citizen action was able to prevent disaster impact (hazard avoidance) compared to the more common scenario when unpreventable disaster strikes, causing destruction, harm, and distress. Across a range of indicators, it is clear that successful mitigation diminishes both physical and psychological impact, thereby reducing the trauma signature of the event.
Conclusion. In contrast to experience of historic flooding in Minot, the city of Fargo succeeded in reducing the trauma signature by way of reducing risk through mitigation.

Open Access Article

Post disaster resilience: Racially different correlates of depression symptoms among hurricane Katrina-Rita volunteers

Ethel G. Nicdao, La Tonya Noel, Amy L. Ai, Carol Plummer and Sara Groff
Pages 45 - 53
http://dx.doi.org/10.4161/dish.23077
Abstract | Full Text | PDF

The present analyses examined the differential risks of and protective factors against depressive symptoms of African American and Non-Hispanic White American student volunteers, respectively after Hurricanes Katrina and Rita (H-KR). A total sample of 554 student volunteers were recruited from mental health professional programs at five universities located in the Deep South, namely areas severely impacted by H-KR during fall semester 2005. The response rate was 91% (n = 505). African American respondents (n = 299) and Non-Hispanic White Americans (n = 206) completed the survey questionnaires. Respondents retrospectively provided information on peritraumatic emotional reactions and previous trauma that were recalled by H-KR and H-KR stressors. African American respondents reported higher levels of depressive symptoms (65.2%) than their Non-Hispanic White counterparts (34.8%). Hierarchical regression analyses revealed that disaster related stressors affected African Americans (p < 0.001), but not Non-Hispanic Whites. However, African Americans who experienced peritraumatic positive emotions had lower depression levels. Lower rates of recollection of prior traumas during H-KR were reported by African American respondents, whereas previous trauma recollections predicted symptoms among Non-Hispanic White Americans (p < 0.05). Exhibiting more optimism had lower depression levels among Non-Hispanic White Americans. Peritraumatic negative emotion was the only shared risk for depressive symptoms of both groups. Findings underscore racially different levels of depressive symptoms that may contribute to varying degrees of resilience among student volunteers. Future research and practice may address these racial differences by understanding the risk factors for depressive symptoms to develop appropriate interventions for racial groups, and cultivating the protective factors that contribute to resilience from traumatic experiences.

Open Access Article

An innovative approach to capability-based emergency operations planning

Mark E. Keim
Pages 54 - 62
http://dx.doi.org/10.4161/dish.23480
Abstract | Full Text | PDF

This paper describes the innovative use information technology for assisting disaster planners with an easily-accessible method for writing and improving evidence-based emergency operations plans.

 

This process is used to identify all key objectives of the emergency response according to capabilities of the institution, community or society. The approach then uses a standardized, objective-based format, along with a consensus-based method for drafting capability-based operational-level plans. This information is then integrated within a relational database to allow for ease of access and enhanced functionality to search, sort and filter and emergency operations plan according to user need and technological capacity.

This integrated approach is offered as an effective option for integrating best practices of planning with the efficiency, scalability and flexibility of modern information and communication technology.