Associations between community-level disaster exposure and individual-level changes in disability and risk of death for older Americans

TitleAssociations between community-level disaster exposure and individual-level changes in disability and risk of death for older Americans
Publication TypeJournal Article
Year of Publication2017
AuthorsBrilleman, SL, Wolfe, R, Moreno-Betancur, M, Sales, AE, Langa, KM, Li, Y, Biddison, ELDaugher, Rubinson, L, Iwashyna, TJ
JournalSocial Science & Medicine
Volume173
Pagination118 - 125
Date PublishedJan-01-2017
ISSN Number02779536
KeywordsDisabilities, Emergency preparedness, Health Conditions and Status, Mortality, Older Adults, Risk Factors
Abstract

Disasters occur frequently in the United States (US) and their impact on acute morbidity, mortality and short-term increased health needs has been well described. However, barring mental health, little is known about the medium or longer-term health impacts of disasters. This study sought to determine if there is an association between community-level disaster exposure and individual-level changes in disability and/or the risk of death for older Americans. Using the US Federal Emergency Management Agency's database of disaster declarations, 602 disasters occurred between August 1998 and December 2010 and were characterized by their presence, intensity, duration and type. Repeated measurements of a disability score (based on activities of daily living) and dates of death were observed between January 2000 and November 2010 for 18,102 American individuals aged 50-89 years, who were participating in the national longitudinal Health and Retirement Study. Longitudinal (disability) and time-to-event (death) data were modelled simultaneously using a 'joint modelling' approach. There was no evidence of an association between community-level disaster exposure and individual-level changes in disability or the risk of death. Our results suggest that future research should focus on individual-level disaster exposures, moderate to severe disaster events, or higher-risk groups of individuals.

URLhttp://linkinghub.elsevier.com/retrieve/pii/S0277953616306785http://api.elsevier.com/content/article/PII:S0277953616306785?httpAccept=text/plainhttp://api.elsevier.com/content/article/PII:S0277953616306785?httpAccept=text/xml
DOI10.1016/j.socscimed.2016.12.007
Short TitleSocial Science & Medicine
Citation Key8805
PubMed ID27960126
PubMed Central IDPMC5222547