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Disaster Epidemiology

The epidemiologic study of disasters is a relatively new area of research and practice in public health settings. The epidemiologic investigation of disaster events focuses on two approaches. The first is the study of the underlying causes of the disaster. This may focus on the event itself or the mortality and morbidity associated with the event. Learning as much as possible about the reasons for disasters is important for developing population-based prevention activities in the future. The second approach is to use epidemiologic methods to investigate mechanisms for alleviating the burden of a disaster once it occurs. The most direct applications of epidemiology in this situation are the establishment of surveillance systems to identify injuries and the possible emergence of communicable and mental health diseases, the deployment of rapid needs assessment to identify and prioritize solutions to existing problems, and analytical studies of risk factors and the natural history of health events.

Defining Disasters

What is a disaster? One of the most difficult concepts in the discipline is to arrive at a definition of a disaster. The answer to this question is shaped by many factors. Historically, in many areas, disasters have been viewed from a fatalistic perspective. Disasters were or are accepted as a feature of life. In the opinion of many individuals, there is little that one can do to prevent a disaster—it is an “act of God.” In recent years, though, there has been a paradigm shift with the perspective in public health and other settings that disasters are something that one should prepare for to mitigate the circumstances arising from a disaster.

The frequency of an event and the level of magnitude of its impact can also influence whether an event is regarded as a disaster or not. Events with a low frequency in occurrence and a high magnitude of impact (in terms of large economic and human losses) are usually declared disasters by government authorities. Events with a high frequency of occurrence and a low magnitude of impact might be regarded as normal or routine events. The determination of what levels are high and what levels are low, though, can be subjective and may vary by culture, prior history with the event, and the ability to respond to the event. Thus, a disaster of similar characteristics might be viewed differently in different settings. Recent efforts have taken place to begin to standardize our view of disasters. The Center for Research on the Epidemiology of Disasters (CRED) in Brussels, Belgium, and other international agencies now typically use the United Nations Department of Humanitarian Affairs definition of disasters as a situation or event that “overwhelms local capacity, necessitating a request to a national or international level for external assistance” (EM-DAT glossary, unpaginated).

Classifying Disasters

Many different types of events can lead to situations that overwhelm local institutions and require external assistance. As one result, crude classification schemes have evolved in the discipline to classify disasters. Most commonly, disasters are classified as either natural disaster events or man-made disaster events. Natural disasters include situations brought about from extreme climatological, geological, or ecological events. Drought, flood, windstorms, extreme temperature, or extreme rain are the most common climate issues that have led to disasters in the past. Earthquakes, tsunamis, and volcanoes are frequency geological-related disasters. Man-made disasters include industrial accidents and acts of terrorism from nuclear, biological, chemical, or explosive materials. Recent episodes of large population displacement related to war have also been identified as a form of a disaster, largely a man-made disaster.

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