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papers

Disaster-related injuries in the period of recovery: the effect of prolonged displacement on risk of injury in older adults

Published: October 1, 2009
Category: Papers
Authors: Burke TA, Curriero F, Lieberman R, Uscher-Pines L, Vernick JS
Country: United States
Language: null
Type: Population Health
Settings: Academic, Government

JTrauma 67:834-840.

Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

BACKGROUND: Hurricane Katrina, which struck the Gulf Coast of the United States in August 2005, initially displaced over a million people from their primary place of residence. Displaced older adults subsequently faced challenges, such as new or inferior living conditions, which could increase vulnerability to serious or life-threatening injuries such as hip fracture. The aim of this study was to determine whether Katrina victims who were displaced for a prolonged period of time were more likely to experience injuries than nondisplaced victims.

METHODS: We tracked injury outcomes including fractures, sprains or strains, and lacerations in a cohort of 25,019 older adults (age >or= 65 years) enrolled in a Medicare-Advantage Plan, for 1 year after Katrina. We used medical claims to obtain injury outcomes and analyzed propensity-score adjusted predictors of injury, including displacement status at 12 months.

RESULTS: In our sample, 7,030 (28%) older adults were displaced at 12-month post-Katrina. Displaced victims had 1.53 (95% CI: 1.10-2.13) greater odds of sustaining a hip fracture in the year after the storm and 1.24 (95% CI: 1.07-1.44) greater odds of sustaining other fractures after adjusting for other risk factors. There was no significant association between displacement status at 12 months and sprains or strains or lacerations.

CONCLUSIONS: Prolonged displacement is associated with increased risk of fracture in older adults. Emergency planners should screen temporary housing for injury hazards, and clinicians should regard displaced older adults as a vulnerable population in need of interventions such as risk communication messaging.

PMID: 19820593

Age,Predictive Risk Modeling,Resource Use,Medical Conditions,United States,Aged,80 and over,Cohort Studies,Gender,Fractures,Bone/epidemiology,Health Services Research,Hip Fractures/epidemiology,Lacerations/epidemiology,Logistic Models,Medicare/statistics & numerical data,New Orleans/epidemiology,Risk Assessment,Southeastern United States/epidemiology,Sprains and Strains/epidemiology,Time Factors,Urban Population/statistics & numerical data

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