The Evolution of Well-Being among Older Adults after a Disaster

描述（申请人提供）：自2004年以来，地球仪的6个国家发生了死亡人数达数万人的自然灾害。几乎没有证据表明这些大规模灾害对老年人的健康和福祉产生长期影响。然而，这些后果对老年人具有潜在的破坏性影响，他们的健康通常在下降，对他们来说，失去资产和家庭往往意味着失去未来的经济支持，他们重建生活的时间比年轻人少。该项目将审查2004年印度洋海啸对海啸发生时生活在印度尼西亚亚齐和北苏门答腊沿海地区的老年人的健康和福祉造成的长期后果。印度洋海啸是一场无法预料的大规模自然灾害，由地震引发，该地区600年来没有经历过海啸。它杀死了超过160，000名埃塞俄比亚人。在海啸前人口代表性基线的基础上，我们在5年内每年跟踪和重新采访了近30 000名海啸幸存者。这一延续项目将在海啸发生8年和10年后再次采访老年人及其家人。将对这些独特而丰富的数据进行分析，以调查海啸及其后果对老年人死亡率、心理社会、身体和生物健康指标的长期影响，以及海啸对一系列社会和经济状况指标的长期影响。一些老年人在面对逆境时表现出非凡的韧性。这项研究将确定与提高健康和福祉各领域的复原力有关的社会经济和人口特征。为了深入了解潜在的生物学机制，我们将研究被认为影响健康结果的假设基因-环境相互作用，并研究环境和心理因素如何影响基因表达。基于我们每个研究地点的高分辨率卫星图像的海啸损害的社区水平的措施将提供可能的外源性暴露于海啸的指标。这些措施将辅之以个人对海啸恐怖以及家庭成员和经济资产损失的具体经历。该项目将收集和分析的海啸后果和恢复研究（星星）数据将被置于公共领域，为政策和科学提供极其丰富的资源。

DESCRIPTION (provided by applicant): Since 2004, natural disasters with death tolls in the tens of thousands have struck in 6 countries across the globe. Little evidence exists on the longer-term consequences of these large-scale disasters on the health and well-being of older adults. Yet, the consequences have potentially devastating implications for older adults whose health is typically in decline, for whom loss of assets and family often means loss of future economic support and who have less time to rebuild their lives than their younger counterparts. This project will examine the longer-term consequences of the 2004 Indian Ocean tsunami on the health and well-being of older adults who were living in coastal areas of Aceh and North Sumatra, Indonesia, at the time of the tsunami. The Indian Ocean tsunami was an unanticipated, massive natural disaster spawned by an earthquake in an area that had not experienced a tsunami for 600 years. It killed over 160, 000 Indonesians. Building on a pre-tsunami population-representative baseline, we have tracked and re-interviewed almost 30,000 tsunami survivors annually for 5 years. This continuation project will re-interview older adults and their families 8 and 10 years after the tsunami. These uniquely rich data will be analyzed to investigate the longer-term consequences of the tsunami, and its aftermath, for mortality, psycho-social, physical and biological markers of the health of older adults as well as the longer-term impacts of the tsunami on an array of indicators of social and economic status. Some older adults display remarkable resilience in the face of adversity. The research will identify the socio-economic and demographic characteristics associated with greater resilience in each of the domains of health and well-being. To provide insights into underlying biological mechanisms, we will investigate hypothesized gene-environment interactions that are thought to affect health outcomes and examine how environmental and psychological factors influence gene expression. Community level measures of tsunami damage based on high resolution satellite imagery of each of our study sites will provide indicators of plausibly exogenous exposure to the tsunami. These measures will be complemented with individual-specific experiences of the horror of the tsunami as well as loss of family members and economic assets. The Study of the Tsunami Aftermath and Recovery (STAR) data that will be collected and analyzed in this project will be placed in the public domain to provide an extremely rich resource for policy and science.