TY - JOUR
T1 - The role of epidemiology in disaster response policy development
AU - Thorpe, Lorna E.
AU - Assari, Shervin
AU - Deppen, Stephen
AU - Glied, Sherry
AU - Lurie, Nicole
AU - Mauer, Matthew P.
AU - Mays, Vickie M.
AU - Trapido, Edward
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Purpose: Disasters expose the general population and responders to a range of potential contaminants and stressors which may harm physical and mental health. This article addresses the role of epidemiology in informing policies after a disaster to mitigate ongoing exposures, provide care and compensation, and improve preparedness for future disasters. Methods: The World Trade Center disaster response is used as a case study. We examine how epidemiologic evidence was used to shape postdisaster policy and identify important gaps in early research. Results: In the wake of World Trade Center attacks, epidemiologic research played a key role in identifying and characterizing affected populations, assessing environmental exposures, quantifying physical and mental health impacts, and producing evidence to ascribe causation. However, most studies suffered from methodological challenges, including delays, selection biases, poor exposure measurement, and nonstandardized outcomes. Gaps included measuring unmet health needs and financing coverage, as well as coordination across longitudinal cohorts of studies for rare conditions with long latency, such as cancer. Conclusions: Epidemiologists can increase their impact on evidence-based policymaking by ensuring core mechanisms are in place before a disaster to mount monitoring of responders and other affected populations, improve early exposure assessment efforts, identify critical gaps in scientific knowledge, and coordinate communication of scientific findings to policymakers and the public.
AB - Purpose: Disasters expose the general population and responders to a range of potential contaminants and stressors which may harm physical and mental health. This article addresses the role of epidemiology in informing policies after a disaster to mitigate ongoing exposures, provide care and compensation, and improve preparedness for future disasters. Methods: The World Trade Center disaster response is used as a case study. We examine how epidemiologic evidence was used to shape postdisaster policy and identify important gaps in early research. Results: In the wake of World Trade Center attacks, epidemiologic research played a key role in identifying and characterizing affected populations, assessing environmental exposures, quantifying physical and mental health impacts, and producing evidence to ascribe causation. However, most studies suffered from methodological challenges, including delays, selection biases, poor exposure measurement, and nonstandardized outcomes. Gaps included measuring unmet health needs and financing coverage, as well as coordination across longitudinal cohorts of studies for rare conditions with long latency, such as cancer. Conclusions: Epidemiologists can increase their impact on evidence-based policymaking by ensuring core mechanisms are in place before a disaster to mount monitoring of responders and other affected populations, improve early exposure assessment efforts, identify critical gaps in scientific knowledge, and coordinate communication of scientific findings to policymakers and the public.
KW - Case study
KW - Disaster epidemiology
KW - Policy
KW - World Trade Center
UR - http://www.scopus.com/inward/record.url?scp=84928212946&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84928212946&partnerID=8YFLogxK
U2 - 10.1016/j.annepidem.2014.05.016
DO - 10.1016/j.annepidem.2014.05.016
M3 - Article
C2 - 25150446
AN - SCOPUS:84928212946
SN - 1047-2797
VL - 25
SP - 377
EP - 386
JO - Annals of Epidemiology
JF - Annals of Epidemiology
IS - 5
ER -