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Research and Evaluations of the Health Aspects of Disasters, Part I: An Overview

Published online by Cambridge University Press:  09 October 2015

Marvin L. Birnbaum ,
Elaine K. Daily ,
Ann P. O’Rourke  and
Alessandro Loretti
Marvin L. Birnbaum*
Affiliation:
Emeritus Professor of Medicine and Physiology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin USA; Emeritus Editor-in-Chief, Prehospital and Disaster Medicine
Elaine K. Daily
Affiliation:
Nursing Section Editor, Prehospital and Disaster Medicine; Executive Secretary, World Association for Disaster and Emergency Medicine, Madison, Wisconsin USA
Ann P. O’Rourke
Affiliation:
Assistant Professor, Division of General Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin USA
Alessandro Loretti
Affiliation:
Retired, World Health Organization; Consultant, World Association for Disaster and Emergency Medicine, Adelaid, South Australia, Australia
*
Correspondence: Marvin L. Birnbaum, MD, PhD Suite 407 610 N. Whitney Way Madison, WI 53705 USA E-mail: mbirnbaum@wadem.org
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Abstract

The ultimate goals of conducting disaster research are to obtain information to: (1) decrease risks that a hazard will produce a disaster; (2) decrease the mortality associated with disasters; (3) decrease the morbidity associated with disasters; and (4) enhance recovery of the affected community. And decrease the risks that a hazard will produce a disaster. Two principal, but inter-related, branches of disaster research are: (1) Epidemiological; and (2) Interventional. Epidemiological research explores the relationships and occurrences that comprise a disaster from a particular event. Interventional research involves evaluations of interventions, whether they are directed at relief, recovery, hazard mitigation, capacity building, or performance. In response to the need for the discipline of Disaster Health to build its science on data that are generalizeable and comparable, a Disaster Logic Model (DLM) and a set of five Frameworks have been developed to structure the information and research of the health aspects of disasters. These Frameworks consist of the: (1) Conceptual; (2) Temporal; (3) Societal; (4) Relief/Recovery; and (5) Risk-Reduction Frameworks. The Frameworks provide a standardized format for studying and comparing the epidemiology of disasters, and with the addition of the DLM, for evaluating the interventions (responses) provided prior to, during, and following a disaster, especially as they relate to the health status of the people affected by, or at-risk for, a disaster. Critical to all five Frameworks is the inclusion of standardized definitions of the terms. The Conceptual Framework describes the progression of a hazard that becomes an event, which causes structural damage, which, in turn, results in compromised, decreased, or losses of function(s) (functional damage) that, in turn, produce needs that lead to an emergency or a disaster. The Framework incorporates a cascade of risks that lead from the presence of a hazard to the development of a disaster. Risk is the likelihood that each of the steps leading from a hazard to a disaster will take place, as well as the probabilities of consequences of each of the elements in the Conceptual Framework. The Temporal Framework describes this chronological progression as phases in order of their appearance in time; some may occur concurrently. In order to study and compare the effects of an event on the complex amalgam that constitutes a community, the essential functions of a community have been deconstructed into 13 Societal Systems that comprise the Societal Framework. These diverse, but inter-related, Societal Systems interface with each other through a 14th System, Coordination and Control. The DLM can be used to identify the effects, costs, outcomes, and impacts of any intervention. Both the Relief/Recovery and Risk-Reduction Frameworks are based on the DLM. The Relief/Recovery Framework provides the structure necessary to systematically evaluate the processes involved in interventions provided during the Relief or Recovery phases of a disaster. The Risk-Reduction Framework details the processes involved in interventions aimed at mitigating the risk that a hazard will produce a destructive event, and/or in capacity building to augment the resilience of a community to the consequences of such an event.

Birnbaum ML, Daily EK, O’Rourke AP, Loretti A. Research and Evaluations of the Health Aspects of Disasters, Part I: An Overview. Prehosp Disaster Med. 2015;30(5):512–522.

Keywords

disasterDisaster Logic Modelframeworksresearchrisk
Type
Special Reports
Information
Prehospital and Disaster Medicine , Volume 30 , Issue 5 , October 2015 , pp. 512 - 522
Copyright
© World Association for Disaster and Emergency Medicine 2015 

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Footnotes

a

Task Force for Quality Control of Disaster Medicine, World Association for Disaster and Emergency Medicine, Nordic Society for Disaster Medicine. Health Disaster Management Guidelines for Evaluation and Research in the Utstein Style. Sundnes KO, Birnbaum ML (eds). Prehosp Disaster Med. 2003;17(Supplement 3).

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