A large epidemiological study investigating the long-term effects of the catastrophic 1988 Armenian earthquake has found that the more personal and material losses sustained by individuals in that earthquake, the more illness those individuals would report in years to come. The study appeared in the December issue of The American Journal of Epidemiology.
Lead author Haroutune K. Armenian, professor, Epidemiology, School of Public Health, said, "Our findings support the hypothesis that longer-term increased rates of hypertension, heart disease, arthritis and diabetes following an earthquake may be related to the intensity of exposure to disaster-related damage and losses." The authors said their results suggested that persons who sustain such losses in a disaster should be considered at risk for increased long-term illnesses and should be closely monitored afterward.
The researchers studied employees of the Armenian Ministry of Health and their immediate families (a total of 35,043 subjects) who had been living in the earthquake region on the day preceding the earthquake. Also, 705 new employees who had started working at the Ministry of Health after the earthquake were interviewed.
Each Health Ministry employee was interviewed twice during four years of follow-up, to look for any new health problems that had cropped up since the earthquake. Interviewers inquired in detail about each family member's general health, health behaviors, deaths and illnesses such as heart disease, hypertension, diabetes and arthritis before and after the earthquake. All deaths and illnesses directly related to injuries sustained during the earthquake were excluded.
To study the cumulative effect of various types of personal loss resulting from the earthquake, the authors developed a scoring system in which the loss of a family member or the loss of a house each counted as one point, while injuries to family members or the loss of household goods each contributed half a point.
Compared with persons who did not experience any major losses during the earthquake, those people with increasing loss scores of 1, 2 and 3 had significantly greater illness, with their incidences of diabetes, hypertension and arthritis all statistically associated with the degree of damage and loss resulting from the earthquake.
"There was a dose-response type of relationship between loss resulting from the earthquake and morbidity from heart disease," Armenian said, "and these findings for reported heart disease were replicated for hypertension, diabetes and arthritis."
The Dec. 7, 1988, earthquake in the northern part of the Armenian Republic registered 6.9 on the Richter scale. Half a million to 700,000 persons were made homeless, with deaths estimated at 25,000. More than 21,000 residences were destroyed.