Impacts of Disaster-Induced Death and Destruction on Health and Mortality Over the Longer Term

Wednesday, 26-04-2023Elizabeth Frankenberg, Nicholas Ingwersen, Rene Iwo, Cecep Sumantri & Duncan Thomas


Extreme events causing death and property destruction are on the rise across the globe. We document the long-term consequences for population health of exposure to an extreme event, the 2004 Indian Ocean earthquake and tsunami, which killed an estimated quarter of a million people worldwide. Using data from an extremely rich population-representative longitudinal survey, the Study of the Tsunami Aftermath and Recovery (STAR), we explore how this major natural disaster affected survival and psychosocial health of adults in the 15 years after the tsunami. Leveraging the unanticipated nature of the tsunami, contrasts between those who were directly affected by the disaster and those who were not can plausibly be interpreted as causal. We also investigate the impacts of specific exposures and stressors. Results for mortality and post-traumatic stress reactivity establish that a large-scale natural disaster exerts enduring impacts on health and well-being. In communities that were directly affected by the tsunami, survivors are positively selected with respect to characteristics associated with longevity. For some, this advantage dissipates over time as the deleterious effects of their experiences during the tsunami and in its aftermath emerge over the long term, both in terms of subsequent survival rates and psychosocial health.

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