1. Disaster Epidemiology
Michael J. Cima, MPH PhD Candidate West Virginia University Department of Epidemiology
Thomas C. Hulsey, MSPH, Sc.D, F.A.C.E. Professor and Chairman Department of Epidemiology West Virginia University

2. Background Information

3. Presentation Objectives
Briefly define epidemiology and introduce epidemiological methods.
Explain applications of epidemiology in disaster settings.
Discuss disaster epidemiology in the context of the April 2016 earthquake.

4. What is Epidemiology?
Study of distribution and determinants of health-related outcomes in populations.
Literally translated (Greek): “study of that which befalls people”
‘epi’ = on, upon, or befall; ‘demos’ = the people; ‘logos’ = the study of.

5. Epidemiological Methods
Descriptive epidemiology:
Characterization of the distribution of health-related states or events
Analytic epidemiology:
Finding and quantifying associations, testing hypotheses, and defining etiology.

6. Activities in Epidemiology
Epidemiologists are involved in a wide range of activities…
Researchers
Practitioners
Communicators
“Experts”
Etc.
How is epidemiologic information used?

7. Epidemiology and Disasters
*Natural (hydrometeorlogical, geological, or biological)
Manmade (unintentional or deliberate)
All disasters carry substantial public health risk!
Responding to immediate and secondary effects

8. Epidemiology and Disasters
Epidemiological methods provide timely and actionable information before, during and after disasters.
Broadly:
Overview of damage, cost, community needs, morbidity, mortality, possible interventions, efficacy of interventions, etc.

9. Epidemiology and Disasters
Disaster Epidemiology vs. Disaster Response

10. Disaster Management Cycle

11. Rapid Needs Assessments
Emergency response requires immediate information.
Ex) Community Assessment for Public Health Emergency Response (CASPER)
Quick
Relatively simple methodology
Dissemination of health and safety messages
2014 Elk River Chemical Spill (West Virginia)

12. Health Surveillance

13. Tracking
Systems that collect data on exposure/health effects in people.
i.e. who might have been exposed, where, when…
Mid- to long-term outcomes
Not always easy!

14. Epidemiological Studies
Employing descriptive and analytical methods
Can occur in all phases of Disaster Management Cycle
Provide information to be used immediately
Provide information to be used in the future

15. Registries Tracking  Registries
Repository for detailed patient information
Not all disaster-related health outcomes occur immediately!
Follow-up time can be years
Many challenges…

16. April 2016 Earthquake

17. Disaster Epidemiology in Earthquakes
Response phase
What information do we need immediately?
Rehabilitation phase
What are the long-term problems?
How did we do?
Preparedness phase
What can we do to make sure we are ready?

18. References
Malilay J, et al. The role of applied epidemiology methods in the disaster management cycle. American Journal of Public Health. 2014: 104(11).
Kapur GB, Smith JP. Emergency Public Health. 1st Edition. Jones & Bartlett Learning
Updated Guidelines for Evaluating Public Health Surveillance Systems. MMWR. 2001: 50(RR13); 1-35.
Merrill RM. Introduction to Epidemiology. 7th edition. Jones & Bartlett Learning.
Lee LM, et al. Principles & Practice of Public Health Surveillance. 3rd edition. Oxford University Press.