Variations in disaster preparedness by mental health, perceived general health, and disability status.
Variations in disaster preparedness by mental health, perceived general health, and disability status.
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DOI：
10.1097/dmp.0b013e318193be89
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发表时间：
2009-03-01
影响因子：
2.7
通讯作者：
Long, Anna
中科院分区：
文献类型：
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作者：
Eisenman, David P;Zhou, Qiong;Long, Anna
目标：慢性医疗和精神疾病以及残疾会增加灾害的脆弱性。国家努力的重点是让残疾人做好准备，研究发现他们的准备程度越来越高，但对患有慢性精神和医学疾病的人却知之甚少。我们研究了健康状况（心理健康、总体健康状况和残疾）与备灾（家庭救灾用品和家庭沟通计划）之间的关系。 方法：2004 年 10 月至 2005 年 1 月，以 6 种语言对洛杉矶县人口进行了随机数字拨号电话调查。单独的多变量回归模拟了备灾的决定因素，调整了社会人口学协变量，然后是社会人口学变量和健康状况变量。 结果：只有 40.7% 的健康状况为一般/差的人拥有灾难物资，而健康状况为优秀的人中有 53.1% 拥有救灾物资（P < 0.001）。只有 34.8% 的健康状况为一般/较差的人有应急计划，而健康状况为优秀的人有 44.8% 有应急计划 (P < 0.01)。只有 29.5% 的患有严重精神疾病的人拥有救灾物资，而没有患有严重精神疾病的人则为 49.2%（P < 0.001）。在调整社会人口统计学协变量后，与那些健康状况良好的人相比，健康状况一般/较差的人仍然不太可能拥有灾难物资（调整后的比值比 [AOR] 0.69，95% 置信区间 [CI] 0.50-0.96），也不太可能制定应急计划（AOR 0.68，95% CI 0.51-0.92）。在调整社会人口统计学协变量后，患有严重精神疾病的人获得灾难物资的可能性仍然较小（AOR 0.67，95% CI 0.48-0.93）。在双变量或多变量分析中，残疾状况与较低的灾难供应率或应急通信计划无关。最后，调整社会人口统计和其他健康变量后，健康状况一般/较差的人制定应急计划的可能性仍然较小（AOR 0.66，95% CI 0.48-0.92），患有严重精神疾病的人拥有灾难物资的可能性仍然较小（AOR 0.67，95% CI 0.47-0.95）。结论：报告一般健康状况一般/较差且可能患有严重精神疾病的人的可能性较小报告家庭灾难 准备和应急通信计划。我们的研究结果可以加深我们对为什么已有健康问题的人遭受灾难的比例更大的理解。公共卫生部门可以考虑与社区合作伙伴和卫生服务提供者合作，以改善慢性病患者和精神病患者的准备情况。
OBJECTIVES: Chronic medical and mental illness and disability increase vulnerability to disasters. National efforts have focused on preparing people with disabilities, and studies find them to be increasingly prepared, but less is known about people with chronic mental and medical illnesses. We examined the relation between health status (mental health, perceived general health, and disability) and disaster preparedness (home disaster supplies and family communication plan).METHODS: A random-digit-dial telephone survey of the Los Angeles County population was conducted October 2004 to January 2005 in 6 languages. Separate multivariate regressions modeled determinants of disaster preparedness, adjusting for sociodemographic covariates then sociodemographic variables and health status variables.RESULTS: Only 40.7% of people who rated their health as fair/poor have disaster supplies compared with 53.1% of those who rate their health as excellent (P < 0.001). Only 34.8% of people who rated their health as fair/poor have an emergency plan compared with 44.8% of those who rate their health as excellent (P < 0.01). Only 29.5% of people who have a serious mental illness have disaster supplies compared with 49.2% of those who do not have a serious mental illness (P < 0.001). People with fair/poor health remained less likely to have disaster supplies (adjusted odds ratio [AOR] 0.69, 95% confidence interval [CI] 0.50-0.96) and less likely to have an emergency plan (AOR 0.68, 95% CI 0.51-0.92) compared with those who rate their health as excellent, after adjusting for the sociodemographic covariates. People with serious mental illness remained less likely to have disaster supplies after adjusting for the sociodemographic covariates (AOR 0.67, 95% CI 0.48-0.93). Disability status was not associated with lower rates of disaster supplies or emergency communication plans in bivariate or multivariate analyses. Finally, adjusting for the sociodemographic and other health variables, people with fair/poor health remained less likely to have an emergency plan (AOR 0.66, 95% CI 0.48-0.92) and people with serious mental illness remained less likely to have disaster supplies (AOR 0.67, 95% CI 0.47-0.95).CONCLUSIONS: People who report fair/poor general health and probable serious mental illness are less likely to report household disaster preparedness and an emergency communication plan. Our results could add to our understanding of why people with preexisting health problems suffer disproportionately from disasters. Public health may consider collaborating with community partners and health services providers to improve preparedness among people with chronic illness and people who are mentally ill.