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Long-Term Impact of Disasters on the Public Health System: A Multi-Case Analysis
Open AccessArticle

Increased Medical Visits and Mortality among Adults with Cardiovascular Diseases in Severely Affected Areas after Typhoon Morakot

1
Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan
2
School of Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
3
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
4
Department of Urban Planning, National Cheng Kung University, Tainan 70101, Taiwan
5
Department of Paediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan
6
School of Medicine for International Students, I-Shou University, Kaohsiung 82445, Taiwan
7
Division of Geriatrics & Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 70403, Taiwan
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(18), 6531; https://doi.org/10.3390/ijerph17186531
Received: 19 June 2020 / Revised: 1 September 2020 / Accepted: 2 September 2020 / Published: 8 September 2020
Natural disasters have negative health impacts on chronic diseases in affected populations. Severely affected areas are usually rural areas with limited basic infrastructure and a population have that has limited access to optimal healthcare after a disaster. Patients with cardiovascular diseases are required to maintain quality care, especially after disasters. A population-based case-control study enrolled adults from the National Health Insurance Registry who had ischemic heart disease and cerebrovascular disease histories and lived in the area affected by Typhoon Morakot in 2009. Monthly medical visits for acute cerebrovascular and ischemic heart diseases markedly increased at approximately 1–2 months after the typhoon. Survival analysis during the two years following the typhoon indicated a significant increase in mortality in adults with an acute ischemic heart disease history who lived in the severely affected area. Mortality hazard analysis showed that among affected adults with previous cerebrovascular diseases and acute ischemic heart diseases, patients with diabetes (adjusted hazard ratio [HR]: 1.3–1.7), Chronic Kidney Disease (CKD) (adjusted HR: 2.0–2.7), chronic obstructive pulmonary diseases (COPD) and asthma (adjusted HR: 1.7–2.1), liver cirrhosis (adjusted HR: 2.3–3.3) and neoplasms (adjusted HR: 1.1–2.1) had significantly increased mortality rates. Consequently, high-quality and accessible primary healthcare plans should be made available to maintain and support affected populations after disasters. View Full-Text
Keywords: disaster; typhoon; flood; elderly; cardiovascular diseases; cerebrovascular diseases disaster; typhoon; flood; elderly; cardiovascular diseases; cerebrovascular diseases
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MDPI and ACS Style

Shih, H.-I.; Chao, T.-Y.; Huang, Y.-T.; Tu, Y.-F.; Sung, T.-C.; Wang, J.-D.; Chang, C.-M. Increased Medical Visits and Mortality among Adults with Cardiovascular Diseases in Severely Affected Areas after Typhoon Morakot. Int. J. Environ. Res. Public Health 2020, 17, 6531.

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