Votre recherche

Plus aucune communauté n’est à l’abri des catastrophes naturelles et technologiques et de plus en plus les intervenants du domaine du social sont appelés à intervenir lors de ces situations. Malheureusement, plusieurs d’entre eux interviennent pendant et après une catastrophe sans avoir reçu une formation de base sur l’intervention en situation de crise macrosociale. Pourtant, ce type d’intervention exige des habiletés de base qui doivent s’acquérir à la fois dans les maisons d’enseignement et lors de formations continues. De plus, en cas de désastre naturels ou technologiques, certains groupes d’individus, dont les personnes âgées, sont plus vulnérables que d’autres parce qu’elles n’ont pas facilement accès aux ressources de la communauté. Par exemple, plusieurs personnes âgées, surtout celles présentant des incapacités physiques ou cognitives et celles à faible revenu n’ont, en général, pas de voitures à leur disponibilité, ce qui peut nuire à leur évacuation lors d’inondations, de tremblements de terre ou d’ouragans. De plus, plusieurs aînés habitent dans de vieux logements moins bien construits pour faire face à des chocs de toutes sortes. Les personnes âgées et particulièrement celles présentant des incapacités physiques ou cognitives, celles à faibles revenus ou sans réseau de soutien social font parties des groupes à risque de subir des blessures, de mourir ou de développer des problèmes de santé post-désastre. Le décès d’un nombre important de personnes âgées pendant l’ouragan Katrina et la vague de chaleur de l’été 2003 en Europe, a malheureusement démontré que plusieurs communautés sont très mal préparées à protéger et secourir, en cas de catastrophe, les aînés et plus particulièrement les personnes âgées vulnérables. De plus, plusieurs études ont fait ressortir qu’à la suite d’un désastre, les personnes âgées reçoivent proportionnellement moins d’aide que les personnes plus jeunes (Fernandez et al 2002), soit parce qu’elles ne sont pas priorisées par les autorités locales ou parce qu’elles-mêmes hésitent à informer leurs proches et les organismes publics ou communautaires de leurs besoins de soutien. Tout individu, quel que soit son âge a un important besoin de soutien social pendant et après un désastre afin d’atténuer les effets du stress et surmonter les obstacles qui se présenteront. On pense par exemple à l’interruption des services essentiels comme l’eau potable ou l’électricité, la lourdeur démocratique, l’endettement, les négociations avec des entrepreneurs quelque peu malhonnêtes, etc. À ce sujet, plusieurs chercheurs considèrent les désastres comme une suite d’événements stressants pouvant occasionner de nombreuses difficultés aux individus (Murphy, 1986). Cette communication permettra de présenter les résultats de nos études effectuées sur les conséquences des désastres sur la santé physique et psychologique des aînés ainsi que sur divers aspects de leur vie (vie personnelle, conjugale, familiale et sociale). En explicitant les sentiments et les difficultés que ces personnes éprouvent lors de catastrophes, les intervenants du domaine du social seront alors mieux outiller pour intervenir auprès de ce groupe cible. Cette communication a donc pour but de présenter les principaux faits saillants et les recommandations de la recension des écrits scientifiques que nous avons dernièrement complété et des faits saillants des diverses études que nous avons réalisées jusqu’à maintenant auprès des personnes âgées à la suite de deux types de désastres : inondation et tempête de verglas. Cette communication a pour but de sensibiliser les participants à l’importance de tenir compte, pour les intervenants du social, des spécificités des aînés lors de l’application des mesures d’urgence et lors de la période de rétablissement des communautés.

Abstract. While disaster studies researchers usually view risk as a function of hazard, exposure, and vulnerability, few studies have systematically examined the relationships among the various physical and socioeconomic determinants underlying disasters, and fewer have done so through seismic risk analysis. In the context of the 1999 Chi-Chi earthquake in Taiwan, this study constructs three statistical models to test different determinants that affect disaster fatality at the village level, including seismic hazard, exposure of population and fragile buildings, and demographic and socioeconomic vulnerability. The Poisson regression model is used to estimate the impact of these factors on fatalities. Research results indicate that although all of the determinants have an impact on seismic fatality, some indicators of vulnerability, such as gender ratio, percentages of young and aged population, income and its standard deviation, are the important determinants deteriorating seismic risk. These findings have strong social implications for policy interventions to mitigate such disasters.

Résumé La modification des habitudes de vie pour adopter des comportements sains repose notamment sur la capacité des individus et des populations à estimer les conséquences à long terme des gestes accomplis aujourd’hui. Cette capacité peut cependant varier d’une personne à l’autre, notamment en raison des perspectives temporelles (PT) adoptées. Les PT réfèrent à la tendance d’une personne ou d’un groupe de personnes à orienter ses décisions en fonction d’une vision tournée vers le passé, le présent ou le futur. Cet article vise à démystifier le concept de PT et à comprendre leur construit, afin d’identifier différentes façons d’en tenir compte dans les interventions en promotion de la santé. L’influence des PT sur la santé est principalement liée à leur capacité d’agir sur la motivation des personnes à adopter et à maintenir certains comportements. Une attention particulière doit être portée aux personnes et aux populations dont les PT sont orientées vers le présent. Elles présenteraient un plus grand risque d’adopter des comportements délétères et seraient susceptibles d’être moins sensibles aux messages qui visent la modification de ces comportements que les personnes qui adoptent une PT orientée vers le futur. En ce qui concerne leur construit, les PT sont le fruit de différentes dynamiques psychologiques et des facteurs individuels (âge, sexe, état de santé) et environnementaux (milieu familial, statut socioéconomique, éducation, culture). Parmi les moyens présentés pour tenir compte des PT dans les interventions en promotion de la santé figurent la mise en valeur des avantages à court terme d’un changement de comportement qui vise des bénéfices à long terme pour la santé, la modulation de l’intensité du soutien à l’empowerment des communautés en fonction des PT adoptées et la permutation d’une PT orientée vers le présent vers une PT orientée vers le futur.

This dissertation explores the psychosocial consequences of climate change and psychosocial adaptation opportunities in High River, Alberta. Influenced by the theoretical approach of Political Ecology, I investigate community impacts and community-based mental health responses in High River following the 2013 Southern Alberta floods. Research methods include: a desktop climate change and health vulnerability and adaptation assessment that includes over 116 data sources; telephone interviews with key informant health and social services leaders (n = 14); four focus group sessions with front-line health and social services workers (n = 14); and, semi-structured interviews (n = 18) with a sample of community-members exposed to the 2013 flood and who self-identify in any one or more ways: female, youth, elderly, non-white, someone living in a low socio-economic status, someone with pre-existing health concerns. A total of 46 participants were recruited in this research. Results of the empirical investigation in High River are showcased in three manuscripts. The first manuscript, informed by critical Political Ecology, is an investigation of sociopolitical conditions that influence health inequities and adaptation opportunities (or lack thereof) in a changing climate in High River. The second is an empirical exploration of the long-term psychosocial consequences of the 2013 flood, relating these

There is increasing evidence that exposure to weather-related hazards like storms and floods adversely affects mental health. However, evidence of treated and untreated mental disorders based on diagnostic criteria for the general population is limited. We analysed the Adult Psychiatric Morbidity Survey, a large probability sample survey of adults in England (n = 7525), that provides the only national data on the prevalence of mental disorders assessed to diagnostic criteria. The most recent survey (2014–2015) asked participants if they had experienced damage to their home (due to wind, rain, snow or flood) in the six months prior to interview, a period that included months of unprecedented population exposure to flooding, particularly in Southern England. One in twenty (4.5%) reported living in a storm- or flood-damaged home in the previous six months. Social advantage (home ownership, higher household income) increased the odds of exposure to storm or flood damage. Exposure predicted having a common mental disorder over and above the effects of other known predictors of poor mental health. With climate change increasing the frequency and severity of storms and flooding, improving community resilience and disaster preparedness is a priority. Evidence on the mental health of exposed populations is key to building this capacity.

Introduction:Public health emergency management involves the timely translation of relevant evidence and effective coordination of diverse actors. In practice, this can be challenging in the absence of a common framework for action among diverse actors.Aim:To apply an Integrated Knowledge Translation (iKT) approach throughout the development of a conceptual framework and performance measurement indicators for public health emergency preparedness (PHEP), to ensure knowledge generated is relevant and useful to the field.Methods:The iKT approach was initiated by identifying a research question based on priorities from the field. The two phases of the study used participatory research methods as well as active engagement with potential end users at key study milestones. The Structured Interview Matrix (SIM) facilitation technique for focus groups and an expert panel using Delphi methodology were used to define the PHEP framework and performance measurement indicators, respectively. An advisory committee was assembled consisting of potential end-users of the research, in senior positions in applied and decision-making roles.Results:iKT was an essential component for this applied public health project, contributing to and enhancing the relevance of the knowledge generated. iKT contributed to the following: broad national engagement and interest in the study, successful recruitment in both phases, and engagement with decision-makers. This multi-dimensional participatory approach successfully generated knowledge that was important to the field demonstrated by relevance to practice and policy in jurisdictions across Canada. Furthermore, the approach fostered building resilience in local and national communities through collaboration.Discussion:The iKT approach was essential to generating knowledge that is relevant and useful to the field, mainly to promote health system preparedness and resilience. Future research to study the implementation of knowledge will be important to continue addressing the knowledge-to-action gap in health emergency management research.

Emergencies and disasters impact population health. Despite the importance of upstream readiness, a persistent challenge for public health practitioners is defining what it means to be prepared. There is a knowledge gap in that existing frameworks lack consideration for complexity relevant to health systems and the emergency context. The objective of this study is to describe the essential elements of a resilient public health system and how the elements interact as a complex adaptive system.

Abstract Objective To examine mental health and community cohesion in women living in Calgary after a natural disaster considering previously collected mental health data. Methods Data from an ongoing longitudinal cohort, the All Our Families study, were used to examine mental health and community cohesion 5 months after a major flood in Calgary, Canada. Participants who had completed a baseline questionnaire before the flood were eligible for inclusion in this study (N=923). Four multivariable logistic regression models were built to examine predictors of post-traumatic stress, depression, anxiety, and community cohesion. Results Elevated anxiety before the flood was associated with 2.49 (95% CI: 1.17, 5.26) increased odds of experiencing high levels of post-traumatic stress, regardless of whether respondents lived in a flood-risk community or not. Women who experienced damage to property, or who provided help to others, were more likely to perceive an increased sense of community cohesion (adjusted ods ratio (AOR): 1.67; 95% CI: 1.09, 2.54 and AOR: 1.68; 95% CI: 1.13, 2.52, respectively). Conclusions Women with underlying mental health conditions may be more vulnerable to the psychological impacts of a natural disaster regardless of their level of exposure. Natural disasters may bring communities together, especially those who were more tangibly impacted. ( Disaster Med Public Health Preparedness . 2018;12:470–477)

This paper investigates the link between development, economic growth, and the economic losses from natural disasters in a general analytical framework, with an illustration on hurricane flood risks in New Orleans. It concludes that, where capital accumulates through increased density of capital at risk in a given area, (i) the probability of disaster occurrence decreases with income; (ii) capital at risk and thus economic losses in case of disaster -- increases faster than economic growth; (iii) increasing risk-taking reinforces economic growth. Economic growth and improved protection transfer risks from frequent low-intensity events to rarer high-impact events. In this context, average annual losses from disasters grow with income, and they grow faster than income at low levels of development and slower than income at high levels of development. These findings are robust to a broad range of modeling choices and parameter values, to the inclusion of risk aversion, and to variations in the decision-making framework (including the introduction of prospect theory's decision weights, biases in risk perception and myopic expectations). They show that risk-taking is both a driver and a consequence of economic development, that risk taking should not be indiscriminately suppressed, and that the world is very likely to experience fewer but more costly disasters in the future.

This review discusses the ways in which countries are affected by natural disasters, depending on their socioeconomic characteristics, their level of development, and their inherent levels of natural disaster risk. We also explore various aspects of ex ante disaster mitigation such as improvements in natural disaster risk information and natural disaster insurance markets, as well as ex post responses to natural disaster in the form of postdisaster aid and long-run growth prospects. By highlighting some of the recent findings in this literature, we synthesize what we know about the economics of natural disasters and identify research areas of interest for future work.

Introduction:In July 2013, a train carrying 72 cars of crude oil derailed in the town of Lac-Mégantic (Eastern Townships, Quebec, Canada). This disaster provoked a major conflagration, explosions, 47 deaths, the destruction of 44 buildings, the evacuation of one-third of the local population, and an unparalleled oil spill. Notwithstanding the environmental impact, many citizens of this town and in surrounding areas have suffered and continue to suffer substantial losses as a direct consequence of this catastrophe.Problem:To tailor public health interventions and to meet the psychosocial needs of the community, the Public Health Department of Eastern Townships has undertaken repeated surveys to monitor health and well-being over time. This study focuses on negative psychosocial outcomes one and two years after the tragedy.Methods:Two cross-sectional surveys (2014 and 2015) were conducted among large random samples of adults in Lac-Mégantic and surrounding areas (2014: n = 811; 2015: n = 800), and elsewhere in the region (2014: n = 7,926; 2015: n = 800). A wide range of psychosocial outcomes was assessed (ie, daily stress, main source of stress, sense of insecurity, psychological distress, excessive drinking, anxiety or mood disorders, psychosocial services use, anxiolytic drug use, gambling habits, and posttraumatic stress symptoms [PSS]). Exposure to the tragedy was assessed using residential location (ie, six-digit postal code) and intensity of exposure (ie, intense, moderate, or low exposure; from nine items capturing human, material, or subjective losses). Relationships between such exposures and adverse psychosocial outcomes were examined using chi-squares and t-tests. Distribution of outcomes was also examined over time.Results:One year after the disaster, an important proportion of participants reported human, material, and subjective losses (64%, 23%, and 54%, respectively), whereas 17% of people experienced intense exposure. Participants from Lac-Mégantic, particularly those intensely exposed, were much more likely to report psychological distress, depressive episode, anxiety disorders, and anxiolytic drug use, relative to less-exposed ones. In 2015, 67% of the Lac-Mégantic participants (76% of intensely exposed) reported moderate to severe PSS. Surprisingly, the use of psychosocial services in Lac-Mégantic declined by 41% from 2014 to 2015.Conclusion:The psychosocial burden in the aftermath of the Lac-Mégantic tragedy is substantial and persistent. Public health organizations responding to large-scaling disasters should monitor long-term psychosocial consequences and advocate for community-based psychosocial support in order to help citizens in their recovery process.

Canada regularly faces environmental public health (EPH) disasters. Given the importance of evidence-based, risk-informed decision-making, we aimed to critically assess the integration of EPH expertise and research into each phase of disaster management. In-depth interviews were conducted with 23 leaders in disaster management from Canada, the United States, the United Kingdom, and Australia, and were complemented by other qualitative methods. Three topics were examined: governance, knowledge creation/translation, and related barriers/needs. Data were analyzed through a four-step content analysis. Six critical success factors emerged from the analysis: blending the best of traditional and modern approaches; fostering community engagement; cultivating relationships; investing in preparedness and recovery; putting knowledge into practice; and ensuring sufficient human and financial resources. Several promising knowledge-to-action strategies were also identified, including mentorship programs, communities of practice, advisory groups, systematized learning, and comprehensive repositories of tools and resources. There is no single roadmap to incorporate EPH expertise and research into disaster management. Our findings suggest that preparation for and management of EPH disaster risks requires effective long-term collaboration between science, policy, and EPH practitioners at all levels in order to facilitate coordinated and timely deployment of multi-sectoral/jurisdictional resources when and where they are most needed.

Emergencies and disasters typically affect entire communities, cause substantial losses and disruption, and result in a significant and persistent mental health burden. There is currently a paucity of evidence on safe and effective individual- and community-level strategies for improving mental health before, during, and after such events. In October 2018, the World Health Organization (WHO) Centre for Health Development (WHO Kobe Centre) convened a meeting bringing together leading Asia Pacific and international disaster research experts. The expert meeting identified key research needs in five major areas, one being “Psychosocial management before, during, and after emergencies and disasters”. Experts for this research area identified critical gaps in observational research (i.e., the monitoring of long-term psychological consequences) and interventional research (i.e., the development and evaluation of individual- and community-level interventions). Three key research issues were identified. First, experts underscored the need for a standardized and psychometrically robust instrument that classified the mental health/psychosocial risk of people within both a clinical and community setting. Then, the need for a standardization of methods for prevention, screening, diagnosis, and treatment for affected people was highlighted. Finally, experts called for a better identification of before, during, and after emergency or disaster assets associated with greater community resilience.

Renforcer la capacité d’intervention et d’adaptation en santé publique nécessite d’améliorer l’efficacité des systèmes d’alerte précoce vis-à-vis des risques climatiques en évolution. Ceci implique des ajustements aux activités en cours, voire de modifier les façons de faire au sein des organisations et entre les organisations en augmentant, notamment, leurs collaborations. L’interdisciplinarité au service de la santé publique est donc de mise.

Objective To assess the association between flooding/repeat flooding and: (1) psychological morbidity (anxiety, depression, post-traumatic stress disorder (PTSD)) and (2) health-related quality of life (HRQoL) at 6 months post-flooding. Design Cross-sectional analysis of data from the English National Study of Flooding and Health. Setting Cumbria, England. Participants Questionnaires were sent to 2500 residential addresses at 6 months post-flooding; 590 people responded. Outcomes Probable depression was assessed using the Patient Health Questionnaire, probable anxiety using the Generalised Anxiety Disorder scale and probable PTSD using the short-form PTSD checklist (PCL-6). HRQoL was assessed using the EQ-5D-5L. Mental health outcomes were analysed using logistic regression; HRQoL dimensions using ordinal regression; and summary index/Visual Analogue Scale scores using linear regression. Results One hundred and nineteen participants had been flooded, over half of whom were experiencing a repeat flooding event (54%; n=64). Mental health outcomes were elevated among flooded compared with unaffected participants (adjusted OR for probable depression: 7.77, 95% CI: 1.51 to 40.13; anxiety: 4.16, 95% CI: 1.18 to 14.70; PTSD: 14.41, 95% CI: 3.91 to 53.13). The prevalence of depression was higher among repeat compared with single flooded participants, but this was not significant after adjustment. There was no difference in levels of anxiety or PTSD. Compared with unaffected participants, those flooded had lower EQ-5D-5L index scores (adjusted coefficient: −0.06, 95% CI: −0.12 to −0.01) and lower self-rated health scores (adjusted coefficient: −6.99, 95% CI: −11.96 to −2.02). There was, however, little difference in HRQoL overall between repeat and single flooded participants. Conclusions Interventions are needed to help minimise the impact of flooding on people’s mental health and HRQoL.

Hurricane Katrina destroyed over 200,000 homes and led to massive economic and physical dislocation. Using a panel of tax return data, we provide one of the first comprehensive analyses of the hurricane's long-term economic impact on its victims. Hurricane Katrina had large and persistent impacts on where people live, but small and surprisingly transitory effects on employment and income. Within just a few years, Katrina victims' incomes actually surpass that of controls from similar unaffected cities. The strong economic performance of Hurricane Katrina victims is particularly remarkable given that the hurricane struck with essentially no warning. (JEL D14, H24, Q53, R23)

Intact Centre on Climate Adaptation, University of Waterloo