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Response of the Elderly to Disaster: An Age-Stratified Analysis
Abstract
This article analyzes the effects of chronological age of disaster victims on their responses to stress effects of natural disasters. Previous research is reviewed and major findings of that research are noted. Findings regarding disaster losses, physical impacts, aid utilization patterns, kinship relations, relative deprivation, social-psychological impacts, neglect of elderly disaster victims, and differential recovery rates by age are retested on new data. Data described herein were gathered using survey techniques in two disaster stricken communities in Texas. Elderly victims' responses to the tornadoes are compared to a nonelderly (under sixty years of age) group to assess differences. Findings of previous research were, in many instances, supported although certain divergences between the current findings and preceding findings are noted, particularly in rates of recovery.
... 3(p11) When disaster strikes, older individuals are among the most vulnerable and are more likely to be injured and to perish. 4,5 This difference is less a function of age but more related to changes associated with aging, including declining economic resources and physical and mental health functioning, and, potentially, less social network support. 6 Economic resources are necessary to prepare for and respond to a disaster (for review, see Fotherfill and ...
... 9 For example, Bolin and Klenow found that the elderly had more difficulty getting post-disaster loans and more difficulty making up a discrepancy between financial losses and what was covered by insurance than did their younger counterparts. 5 Thus, nearly twice as many elderly respondents as nonelderly respondents reported a drop in their standard of living after a disaster. ...
... 16 During recovery, social networks are conduits for resources including childcare, 17 emotional support, 18 and rebuilding and repair assistance, among many others. 5,16,19,20 Disaster research shows how network size affects the outcomes for disaster victims. Network size describes the number of persons with whom an individual has a specific type of relationship. ...
Objective:
Elderly individuals are considered at elevated risk of disaster impacts owing to increased health concerns, reduced mobility, and fixed economic resources. Social capital can counteract these vulnerabilities by increasing the likelihood of hearing disaster warnings, providing social ties to assist with preparation and evacuation, and providing access to financial or nonfinancial resources. I aimed to analyze the relationship between age and perceptions of disaster-related social capital.
Methods:
I used mailed surveys and in-person interviews with a sample of residents from 2 Florida counties to study perceptions of social capital available for disaster.
Results:
The results showed that age has a negative effect on perceptions of social capital resources available during a disaster. The elderly reported fewer social ties overall and much fewer social ties that could provide financial assistance, if necessary, during a disaster.
Conclusions:
These results indicate that social capital may not counteract the social vulnerabilities of elderly persons to disaster impacts. (Disaster Med Public Health Preparedness. 2016;page 1 of 8).
... and those under the age of 65 revealed that younger respondents experienced greater emotional burden as a result of the flood, which was reflected in the fact that 42% felt that they would never fully recover from the disaster, compared with 29% of the older age group. Bolin andKlenow (1982-1983) similarly found that elderly victims exhibited a lower incidence of emotional and family problems than did younger victims. Logue (1985-1986) also found that older adults reported lower anxiety and physical stress than did younger victims following Hurricane Agnes. ...
... and those under the age of 65 revealed that younger respondents experienced greater emotional burden as a result of the flood, which was reflected in the fact that 42% felt that they would never fully recover from the disaster, compared with 29% of the older age group. Bolin andKlenow (1982-1983) similarly found that elderly victims exhibited a lower incidence of emotional and family problems than did younger victims. Logue (1985-1986) also found that older adults reported lower anxiety and physical stress than did younger victims following Hurricane Agnes. ...
At 12, 18, and 24 months after Hurricane Hugo, 831 adults were interviewed regarding their disaster-related stressors and present psychological state. The study’s purposes were to assess whether age influenced one’s vulnerability to postdisaster stress and to evaluate four different perspectives on disaster recovery that have been previously used to explain age differences. Regression analyses demonstrated that disaster exposure had substantial and pervasive psychological effects. The analyses also revealed a curvilinear interaction between disaster exposure and age. Younger people exhibited the most distress in the absence of disaster, but middle-aged people did so in its presence. Differential exposure, resources, and inoculation all failed to explain these differences; however, the burden perspective had considerable explanatory power.
... Beyond the disaster victims' age, studies have emphasized that elderly residents face socio-economic changes related to age, as their vulnerability comes more from socioeconomic changes than age 7 . Due to their limited sources of income, older people are less likely to engage in preparation activities such as purchasing disaster equipment or insurance that may be critical to their survival and recovery 2,5 . In many cases, elderly survivors have not qualified for loans due to their lack of employment and fail to receive proper information about government aid programs, slowing their economic recovery 5 . ...
... Due to their limited sources of income, older people are less likely to engage in preparation activities such as purchasing disaster equipment or insurance that may be critical to their survival and recovery 2,5 . In many cases, elderly survivors have not qualified for loans due to their lack of employment and fail to receive proper information about government aid programs, slowing their economic recovery 5 . Psychologically, many older individuals are hesitant to apply for aid due to their fear of stigma or other unfounded concerns about receiving assistance 21 . ...
Evidence shows that communal resources, cohesion, and social infrastructure can mitigate shocks and enhance resilience. However, we know less about how specific social capital building interventions facilitate recovery in post-disaster environments. Using a survey of over 1000 residents of Ofunato, Japan after the 2011 Tohoku earthquake and tsunami, this study demonstrates that the individuals who actively participated in a community center—created for and led by neighborhood elders—reported higher levels of family and neighborhood recovery than similar individuals who did not participate. Results from ordinal logistic regression analyses, propensity score matching (PSM) and coarsened exact matching (CEM) show arguably stronger causal links between bottom-up, microlocal programs to boost connections in post-disaster areas and post-disaster outcomes. Community-based programs that strengthen social ties even among elderly residents can measurably improve their recoveries.
... Some like Schroeder-Butterfill and Marianti 58 have suggested that environmental factors have little relevance to individual well-being, while other studies emphasize the complexity of environmental influences. 59 In a study by Bolin et al, 60 findings regarding disaster losses, physical impacts, aid utilization patterns, kinship relations, relative deprivation, social-psychological impacts, neglect of elderly disaster victims, and differential recovery rates by age were retested on new data. Findings of previous research were, in many instances supported, although certain divergences between the current findings and previous findings were noted, particularly in rates of recovery. ...
... Findings of previous research were, in many instances supported, although certain divergences between the current findings and previous findings were noted, particularly in rates of recovery. 60 This study found that a detailed plan to overcome existing limitations of disaster management is very necessary. The complete and correct information collected from different groups of people is needed for appropriate management in earthquake situations, because different groups of people have unique needs. ...
Objective
The elderly are especially susceptible to death and injury in disasters. This study aimed to identify indexes of caring for elderly people in an earthquake according to the Iranian experience.
Methods
This qualitative study was conducted during 2014–2016 by use of the content analysis technique. Data were collected through individual deep interviews with the elderly and people with experience providing services to the elderly during earthquakes in an urban area of Iran. The data were analyzed by use of the Graneheim and Lundman method.
Results
Seven categories emerged: vulnerability of elderly people, physiological indexes, psychological indexes, economic indexes, religious and spiritual indexes, health indexes, and security indexes. There were 3 uncategorized issues: “There is no specific protocol for the elderly,” “The need to design plans based on age care,” and “Aid organizations.”
Conclusions
Implementing a comprehensive plan would not only save lives but decrease suffering and enable effective use of available resources. Due to the crucial role of the prehospital care system in disasters, there is a need for further investigation based on the results of this study to develop strategies for improving the system. ( Disaster Med Public Health Preparedness . 2018;page 1 of 9)
... Presently, subclinical depression, or minor depression, is common among community-dwelling elderly adults, although there is a wide range of reported prevalence rates depending on sample characteristics and measurement methods used. 6 Daily functioning is related to mental health among elderly adults, 7,8 and in some longitudinal research, depressive status predicts further functional decline among community-dwelling elderly adults. 9,10 Functional assessment, which is now incorporated in the Japanese national elderly care program, 11 could be an avenue for assessing further needs related to psychological health among elderly adults. ...
... In general, it is well known that elderly people, even under normal conditions, are more likely to be in a depressive state than younger people, which often causes a decline in the activities of daily living (ADL) or independent living skills. [8][9][10] Both cross-sectional and longitudinal studies have revealed the association between low functional independence and psychiatric disorders. A cross-sectional study demonstrated that the prevalence of depression was significantly higher in individuals who were dependent for ADL or instrumental ADL compared with those who were not. ...
This study aimed to explore the relationship between psychological distress and degree of functional independence among elderly adults following the Great East Japan Earthquake. Participants were 20 282 adults aged 65 and older who lived in the Great East Japan Earthquake evacuation zone specified by the government on March 31, 2011. This study is a part of a detailed survey on mental health and lifestyle, the Fukushima Health Management Survey, which was conducted in 2012. Psychological distress was assessed using the Kessler 6 scale. Functional independence in different daily activities was assessed by asking participants whether they could independently perform activities: eating, dressing, toileting, and shopping. According to the multiple logistic regression analysis, psychological distress was significantly associated with independence in all models: without adjustment (Model 1), adjusting for demographic characteristics (Model 2), and adjusting for demographic characteristics and disaster-related factors (Model 3), with an adjusted odds ratio of 2.32 (95% confidence interval = 1.97-2.73). High psychological distress was associated with low functional independence, after controlling for demographic characteristics and disaster-related factors. Thus, using psychological distress as the dependent variable, we examined the relationship between low functional independence and psychological distress among elderly adults who were evacuated.
... As the fi eld of disaster research continues to develop, paying greater attention to individual risk and protective factors will help to elucidate the eff ects of disaster on aging populations. Understanding capacities of resilience in this population -evidenced by lower reported levels of distress (Acierno, Ruggiero, Kilpatrick, Resnick, & Galea, 2006 ;Bolin & Klenow, 1982-1983Th ompson et al., 1993 ), and the mediating role of preexisting mental and physical health in elderly populations -will infl uence prevention eff orts and enable disaster responders to target those with greater risk . ...
... As the fi eld of disaster research continues to develop, paying greater attention to individual risk and protective factors will help to elucidate the eff ects of disaster on aging populations. Understanding capacities of resilience in this population -evidenced by lower reported levels of distress (Acierno, Ruggiero, Kilpatrick, Resnick, & Galea, 2006 ;Bolin & Klenow, 1982-1983Th ompson et al., 1993 ), and the mediating role of preexisting mental and physical health in elderly populations -will infl uence prevention eff orts and enable disaster responders to target those with greater risk . ...
INTRODUCTION Disasters affect many lives and reshape environments for years to come. This chapter aims to provide closing remarks about the evidence provided in this book, on what is known and not known about the impact of disasters on mental and physical health, the differential risk of certain populations and communities, and the determinants of vulnerability and resilience. We also look at lessons learned to date about intervention strategies that mitigate the mental health consequences of these events. Finally, we provide clear recommendations about critical gaps in knowledge and ways to address them going forward. EXPOSURE The mental health impact of disasters is strongly related to the scope of the disaster itself. In this book, Norris and Wind (Chapter 3) systematically review a host of factors that typically comprise exposure in disasters and categorize them into three groups: (1) traumatic stressors, such as loss of life, threats to life, injury, witnessing and horror; (2) loss of property, finances, or other resources, which may often follow floods, hurricanes, and fire; and (3) ongoing adversities, from lack of housing, displacement, and relocation to chronic stress. These potentially are involved in the development and persistence of mental and physical health outcomes, as well as in resilience and recovery processes (see Part Two and Three). Importantly, a large body of research has documented the effects of indirect exposure to disasters, challenging previous definitions of exposure and leading to scientific debate about the accuracy of such findings and their meaning.
... Within the disaster social sciences, older adults are often described as being among the most vulnerable populations in disaster contexts (Bolin and Klenow 1983;Ngo 2001Ngo , 2012Kim and Zakour 2017;Meyer 2017;Lee et al. 2022). Indeed, much of the current research focuses on the increased vulnerability of older adults in disasters (Phifer 1990;Cherry et al. 2010;Tuohy and Stephens 2011;Campbell 2019). ...
Older adults in disaster contexts are often thought of as a passive, vulnerable population that lacks agency and capacities to cope in the aftermath. However, it can be argued that older adults may have underrecognized strengths that can be utilized pre-, peri-, and post-disaster. One of these strengths is older adults’ unique social capital that stems from long-standing connections with other members of their respective communities. Using data from in-depth, semistructured interviews with farmers in British Columbia 3–11 months after the 2021 floods, this research explored the experiences of older adult farmers’ recovery. The farmers discussed how they leveraged their social capital to aid in their recovery efforts from the flood event. By using their bonding social capital, older adult farmers transformed their existing, deep-rooted connections into post-disaster assistance. This, in turn, generated the idea of the therapeutic community, helping community members cope in the aftermath. This research indicated the need to further examine how older adults in disaster settings can be viewed as assets with community knowledge and skills as opposed to solely as a vulnerable population.
... 15 Bolin and Klenow found that the elderly had more difficulty obtaining post-disaster loans and bridging the financial gap between losses and insurance coverage compared to their younger counterparts. 16 Thus, nearly twice as many elderly respondents as nonelderly respondents reported a drop in their standard of living after a natural disaster. Social capital describes the resources available through social Networks. ...
Natural disasters (ND) do not affect all individuals and communities equally and that some are more susceptible to harm than others. The elderly population faces unique vulnerabilities during natural disasters and needs special attention. ND can disrupt access to healthcare services, medication and medical equipment. ND preparedness policies often concentrate on immediate response and relief efforts.
Policies should also address the long-term recovery and rebuilding phase, including mental health support for older adults dealing with trauma. Coordinated efforts among different agencies, healthcare providers, community organizations, and local governments are essential for comprehensive ND response.
The lack of effective interagency collaboration can hinder the success of these policies.
... For instance, older people may have experienced and coped with more tragedies, contributing to mental health issues. After a disaster, people are more likely to experience PTSD, physical injuries, and difficulty getting reconstruction financing [76,77]. Many older adults live alone and have fewer social contacts, worsening these age-related risks [78]. ...
Disasters can pose several threats to our psychological health and create short-term and long-term psychological discomfort, resulting in a considerable burden on the mental health of im-pacted individuals and communities. We have explored women's mental health problems due to the floods. A total of 393 women who resided in Ajmiriganj and Dharmapasha Upazila of Bangladesh during the 2022 flash flood were surveyed. We have applied the DASS-21 tool to assess the mental health status of these women. In addition, we have examined the variables associated with mental health issues. Descriptive statistics and multiple linear regression were done. About 67%, 65%, and 37% of women experienced severe or extremely severe depression, anxiety , and stress, respectively. In addition, 89%, 88%, and 58% of women reported severe or extremely severe depression, anxiety, and stress from experiencing family violence during a flood. Depression was associated with age, education, housing type, social satisfaction, a place's safety rating, flood-related injury or disease, family loss, family violence, and property damage from the 2022 flash flood. Except for education and the present place's flood safety rating, all depression-associated variables were also associated with anxiety. Stress was linked to all anxiety-associated variables. Older women, women living in inadequate infrastructure, least satisfied, unsafe rated of their places against flood, injured or diseased during the flood, lost family members, suffered family violence and property destruction due to flood reported mental health problems. Disaster risk mitigation and psychological intervention can mitigate mental health effects. This study can inform disaster management policies and public health worldwide.
... After disaster has struck, it is noteworthy that older adults tend to be slower in their economic recovery across a variety of hazard types (Bolin & Klenow, 1983). Previous research that investigated the utilization of post-tornado disaster assistance indicates that older adults are less likely than others to seek assistance (Bell, Kara, & Batterson, 1978). ...
... However, there is currently no agreement on the optimum quantitative methodology for assessing social vulnerability. For example, poverty (Fothergill and Peek 2004;Long 2007) [4,5] , race and ethnicity (Fothergill et al. 1999; Peacock et al. 2000) [6,7] , gender (Enarson and Morrow 1998;Enarson et al. 2006) [8,9] , and age (Enarson and Morrow 1998; Enarson et al. 2006) [8,9] all influence vulnerability ( Smith et al. 2009) [10,11,12,13,14,15] . Without all or most of these characteristics, an assessment of vulnerability is likely to be insufficient; consequently, this measure must be a composite measure or index (Adger et al. 2004;Gall 2007; Barnett et al. 2008) [16,32,17] . ...
Social vulnerability indices are a way of gathering information on people who may be impacted by disasters such as river bank erosion. The development and validation of a social vulnerability map of population characteristics towards bank erosion covering Manikchak blocks in Malda district in West Bengal, India, is the goal of this project. This map is based on a composite index of three key indices of social vulnerability in Diara blocks: fragility, socioeconomic conditions, and geographic location. A factor analysis of selected demographic variables derived from the District Statistical Handbook was used to identify these indicators. As a result, depending on a reputable data source, these indicators can be updated annually. An impartial second data set is used to confirm the susceptibility patterns discovered by factor analysis. The second data set's interpretation suggests that a real extreme river bank erosion event reveals vulnerability and that the patterns of the presumed vulnerability match the observations of a real occurrence. It includes a survey of erosion-affected Manikchak families. It is shown that the theoretically assumed signs of susceptibility are right and that the indicators are valid using logistic regression. It has been demonstrated that particular social groups, such as the elderly, the financially disadvantaged, and city dwellers, are at increased risk.
... On the other hand, when external technical assistance is no longer available to communities (or donor fatigue sets in), they can continue to use the tools they have learned through participation to sustain the development of their communities [23]. Furthermore, demographic characteristics, such as age [24], language [25], race [23], education [26], and disability [27], have been shown to have an impact on the involvement of communities in the disaster recovery process. ...
Build Back Better (BBB) is a strategy published as part of the Sendai Framework which has been widely adopted to achieve long-term, effective and sustainable disaster recovery. Assessment of disaster recovery is crucial for improving understanding of the difficulties and insufficiencies experienced during the reconstruction process and to better support disaster risk reduction policies and investment. However, with the focus being on optimizing the economic and physical environment, citizens’ preferences remain unexamined in existing literature. Therefore, this study aims to create a sustainable recovery framework which takes into account the needs of citizens. Based on systems theory, the proposed framework evaluates the sustainable recovery level of families and communities from three dimensions, namely: Element, Structure, and Function. The Best Worst Method (BWM) was used, involving two rounds of interviews with 11 experts, to determine evaluation indexes for each dimension. The Element dimension consists of five sustainable livelihood capitals. The Structure dimension includes community social capital, leadership, and social governance. The Function dimension includes disaster preparedness, disaster response, immediate recovery, and disaster learning. The proposed framework was used to investigate the degree of sustainable recovery in four towns in Wenchuan County, Mainland China. Through interviews and large-scale surveys, the internal mechanisms that influence the level of sustainable recovery in different communities were identified. Practical recommendations are provided to improve disaster recovery management in developing regions. The proposed framework can assist in the development of recovery standards and evaluations at different levels in China and other parts of the world.
... Auch fragen bspw. ältere Menschen im Nachgang von Katastrophen seltener Hilfe an, [57,58] z. B. aus Angst vor Stigmatisierung [59] oder weil sie Schwierigkeiten bei der Beantragung haben. ...
... One of the most significant contributions of sociology to the study of disasters is the concept of vulnerability and the many insightful studies that have highlighted the differential impact of disasters, both rapid and gradual based on class, race and ethnicity [31], geographic location and the built environment [32,33], disability [34][35][36] and various demographic categories, particularly gender [37] and age [7,38]. There is a sense in which the concept of vulnerability contributes to our argument that the temporal and spatial aspects of disaster should be broadened because vulnerability is often a product of long-term social processes that preceded disaster, are exacerbated by it and continue to be present when the acute phase or phases of the disaster have passed. ...
Throughout much of its history, the sociological study of human communities in the disaster has been based on events that occur rapidly, are limited in geographic scope, and their management understood as phased stages of response, recovery, mitigation and preparedness. More recent literature has questioned these concepts, arguing that gradual-onset phenomena like droughts, famines and epidemics merit consideration as disasters and that their exclusion has negative consequences for the communities impacted, public policy in terms of urgency and visibility and for the discipline itself as the analytical tools of sociological research are not brought to bear on these events. We agree that gradual-onset disasters merit greater attention from social scientists and in this paper have addressed the two most significant ongoing disasters that are gradual in onset, global in scope and have caused profound impacts on lives, livelihoods, communities and the governments that must cope with their effects. These disasters are the coronavirus pandemic and global climate change both, of which include dimensions that challenge the prevailing definition of disaster. We begin with an examination of the foundational work in the sociological study of a disaster that established a conceptual framework based solely on rapidly occurring disasters. Our focus is on several components of the existing framework for defining and studying disasters, which we term “borders.” These borders are temporal, spatial, phasing and positioning, which, in our view, must be reexamined, and to some degree expanded or redefined to accommodate the full range of disasters to which our globalized world is vulnerable. To do so will expand or redefine these borders to incorporate and promote an understanding of significant risks associated with disaster agents that are gradual and potentially catastrophic, global in scope and require international cooperation to manage.
... The age of the household head is also considered as a determining factor of recovery in previous studies [3,15,16]. While some studies found it to be an insignificant factor in predicting recovery [3,16], few seem to indicate that recovery is tougher for people of higher age groups [15,64]. Thus, the present study also investigates the influence of age on perception of recovery. ...
Coastal fishing communities are highly susceptible to disasters resulting from oceanic extreme weather events. However, there have been limited studies on understanding recovery exclusively in these communities. This study provides an assessment of the drivers of recovery in coastal fishing communities of Odisha - who were impacted by cyclone Phailin in 2013 - based on data collected through a household survey. The study recognises that recovery may be measured for different aspects and hence investigates the factors driving - levels of perception of overall recovery, and physical levels of recovery in income and housing-separately. Further, the factors linked to perception of overall recovery at three different time points after the cyclone are examined. The results show that economic capital, such as formal credits, high-value assets and aid, is extremely important for recovery. However, the influence of aid becomes significant a year after the disaster. The decision to move to safer places during the cyclone and having concrete/pucca housing can also influence recovery. Trust and cooperation with local government, an indicator of linking social capital, is positively driving recovery. However, the study contradicts the literature by indicating that ‘trust and cooperation with people outside the village’ is negatively linked to recovery. This highlights the fact that fishing communities are marginalised groups with poor bridging social networks. This empirical study contributes to the limited literature by examining drivers of recovery in three different aspects and providing a temporal understanding, and has implications for disaster risk management in poor and vulnerable communities.
... Geographic data can be essential in mapping neighborhoods where older adults are at a higher risk for falls or have less access to a grocery store. Hotspot analyses showing areas with high concentrations of older adults, particularly those living alone or with a health challenge, could also enhance emergency preparedness planning, which is critical because older adults often experience higher rates of injury and death and lower rates of economic recovery following major natural disasters (Bolin, & Klenow, 1983). The Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response developed the emPOWER Initiative through a partnership with the Centers for Medicare and Medicaid Services. ...
Background and Objectives
The public health system in America—at all levels—has relatively few specialized initiatives that prioritize the health and well-being of older adults. And when public health does address the needs of older adults, it is often as an afterthought. In consultation with leaders in public health, health care, and aging, an innovative Framework for an Age-Friendly Public Health System (Framework) was developed outlining roles that public health could fulfill, in collaboration with aging services, to address the challenges and opportunities of an aging society.
Research Design and Methods
With leadership from Trust for America’s Health and The John A. Hartford Foundation, the Florida Departments of Health and Elder Affairs are piloting the implementation of this Framework within Florida’s county health departments and at the state level. The county health departments are expanding data collection efforts to identify older adult needs, creating new alliances with aging sector partners, coordinating with other agencies and community organizations to implement evidence-based programs and policies that address priority needs, and aligning efforts with the age-friendly communities and age-friendly health systems movements.
Results, and Discussion and Implications
The county health departments in Florida participating in the pilot are leveraging the Framework to expand public health practice, programs, and policies that address health services and health behaviors, social, and economic factors and environmental conditions that allow older adults to age in place and live healthier and more productive lives. The model being piloted in Florida can be tailored to meet the unique needs of each community and their older adult population.
... Research pertaining to natural disasters such as hurricanes, floods, and wildfires has evolved over the past several decades. However, it was not until the 1980s that research began reporting findings for older adults (Bolin & Klenow, 1982, 1988. Studies on the health hazards of natural disasters tend to focus on one specific type of disaster (e.g., wildfires) or the consequences from a specific event (e.g., flooding following Hurricane Harvey). ...
There is growing evidence that older adults exposed to natural disasters are at disproportionate risk for adverse health events such as all-cause mortality, injury, hospital admissions, stroke, displacement, cardiopulmonary distress, stress-related mental health problems, and exacerbation of chronic illnesses. Typically, analyses of the health consequences of natural disasters focus only on the populations impacted for the duration and immediate aftermath of the disaster. With few exceptions, the long-term effects of natural disasters on older adult health have not been examined. This article describes the potential consequences of exposure to natural disasters that contribute to cancer and disruption of cancer care treatment systems for older adults. It is argued that exposures to floods and wildfires in particular present an underestimated threat to the onset and/or progression of cancer and cancer care management in older adults. We propose that these impacts should be examined not only from an emergency preparedness perspective during the event but also from a public health focus that prospectively assesses risks for cancer and other health disparities. Recommendations for comprehensive longitudinal risk assessment and emergency preparedness models that address the full impact of natural disasters on the health and well-being of vulnerable, at risk, older adults are offered.
... The one consistent finding between Nakahara and Ichikawa (2013) and Nishikiori et al. (2006), who addressed mortality in Sri Lanka from the great Indonesia earthquake and tsunami of 2004, was higher death rates among the elderly. Studies of other rapid-onset natural disasters including earthquakes (Tanida 1996), tornados (Carter et al. 1989;Bolin and Klenow 1983;Kilijanek and Drabek 1979), hurricanes (Brunkard et al. 2008;Dyer et al. 2008) and cyclones (Chowdhury et al. 1993) consistently demonstrated a pattern of vulnerability for those of advanced age. ...
This paper examines the concept of tsunami tendenko from the disciplinary perspective of sociology. Tendenko as a tsunami evacuation strategy advocates a rapid individual response to an imminent tsunami threat by moving quickly to safety, disregarding others, even one's own family members. The concept developed within a mature disaster subculture along the eastern coast of Japan as a grassroots response to large repeated tsunamigenic earthquakes in which entire families perished. High death tolls in tsunami events were attributed to the desire of families to reunite before evacuating, thus losing precious seconds and minutes during which they could have fled individually, saving their lives. Following the Great East Japan Earthquake of March 11, 2011, tendenko once again became a topic of interest in the news media and among academic researchers and government officials. In this critique of the concept of tendenko, two basic assumptions are examined: that tendenko is facilitated by the human tendency to act individually rather than collectively in a crisis situation, and that practicing tsunami tendenko will save lives. The study draws upon both basic sociological knowledge of human behavior and the extensive disaster research literature to challenge the first assumption and upon demographic research in Japan to question the second assumption.
... 29 Studies indicate that injury and flood-related death rates are higher among elderly people compared with other age groups. 30 However, elderly people pay equal or greater attention to warnings. 31 The Obrenovac flood was a 'flash flood', which involves a sudden onset and sudden downpour. ...
Objectives:
To propose a simple and effective tool for decision-making regarding general evacuation during a rapid river flood.
Study design:
Virtual testing of a tool in a real event.
Method:
A four-component tool was applied to build an alternative scenario of the catastrophic river flood in Obrenovac, Serbia, on May 2014. The components of this tool are: (1) the amount of precipitation above the 95th percentile of all previous measurements; (2) upstream river discharge above the 95th percentile of all previous measurements; (3) upstream river level above the 95th percentile of all previous measurements; and (4) worsening of the hydrometeorological situation in the following 48 h.
Results:
In the early morning of 16 May 2014, a rapid river wave flooded 80% of the Obrenovac territory. There were 13 deaths due to drowning. Application of the study tool shows that these lives could have been saved, as the score to recommend general evacuation was reached 1 day before the flooding. The application of this tool to two previous great floods in Serbia shows that the score to recommend general evacuation was reached either 1 day before or on the onset of flash flooding.
Conclusions:
Due to its simplicity, this tool is universally applicable to facilitate decision-making regarding general evacuation during a rapid river flood, and it should be further tested in future similar catastrophes.
... After disaster has struck, it is noteworthy that older adults tend to be slower in their economic recovery across a variety of hazard types (Bolin and Klenow 1983). Previous research that investigated the utilization of post-tornado disaster assistance indicates that older adults are less likely than others to seek assistance (Bell, Kara, and Batterson 1978). ...
... In major disasters, particularly when they result in widespread damage and disruption, the community's capacity to cope is diminished. As people focus their energies and attention on reconstruction tasks, survivors often report decreased participation in social activities with relatives, friends, neighbours and community organizations (Bolin and Klenow, 1983). This often constitutes a loss of important day-to-day opportunities to convey and preserve a sense of support and connectedness and it causes many people to experience feelings of being alone and isolated in their problems (Kaniasty and Norris, 1993). ...
Problem statement: Climate change and its associated manifestations have only recently emerged as significant threats to health faced by Canadians. The emergence of these threats has meant that Canadians are faced with increasing health-related concerns that are more frequent, more severe and occurring in communities where they have not been previously experienced. The compounding effects of change in weather patterns in communities that are heavily dependent on natural conditions for their agronomical performance could be quite severe on the mental health of farmers and other rural dwellers. Approach: Existing literature was identified for their critical review through a comprehensive serach by using web-based publications, data-base and other archival sources. Specific relevant studies were then analysed with directions for addressing the emerging psychosocial problems. An emphasis was given to the shifting nature of treament from hospital-based supports to community-based social supports. Results: In perspective of recent developments in Canada, the study offers a critical assessment of psychosocial aspects of climate change-induced extreme environmental events. In recent decades, community-based approaches and other micro-level social action interventions have gained acceptance by the concerned institutions. However, institutional supports to enhance commuity level capacity are still meager. As to identify appropriate tools, lessons for improving present systems can be drawn from the Community Emergency Response Volunteer (CERV) programs. Such tools can enhance psychosocial coping abilities through strengthening social support and enhancing the community coping capacity. Conclusion: Psychosocial effects of climate change-induced stress should be addressed from the perspective of 'model of prevention' rathern than the prevailing 'model of treatment'. Instituional changes are required to enhance the required social ties and community capacity to mitigate and cope with the psychosocial stress that disasters cause.
Incorporating social systems and phenomena into virtual community resilience testbeds is uncommon but becoming increasingly important. Social vulnerability indices are a convenient way to account for differential experiences and starting conditions of the population in resilience assessments. This paper proposes a scalable index, termed Social Vulnerability Score (SVS), to serve the purpose of testbed development. The SVS overcomes two important limitations of existing indices: it is constructed using an approach that does not decrease in validity with changing spatial resolution, and it only needs to be calculated for the geographic area of interest, instead of for the entire county thereby significantly reducing computational effort for testbed developers and users. The proposed SVS aggregates the ratio of a set of demographics from U.S. Census datasets at the desired location against their national average values. The resulting scores are mapped into five levels, called zones, ranging from very low vulnerability (zone 1) to very high (zone 5). The validity of the SVS was investigated through a regression analysis of flood outcomes in Lumberton, North Carolina caused by Hurricane Matthew in 2016. The resulting correlations between the SVS zones and post-disaster outcomes of household dislocation and home repair times match the social vulnerability theory. The paper concludes with a discussion of the advantages and limitations of using the SVS.
Cross-sectional studies have found older adults to have lower levels of emotional distress after natural disasters. The maturation hypothesis suggests that older adults are less reactive to stress events, whereas the inoculation hypothesis argues that prior experience with disaster is protective. One hundred and sixty-six adults aged 30 to 102 were interviewed regarding the 1994 Northridge earthquake. Longitudinal data were available on depressed mood before and after the earthquake. The maturation hypothesis was generally not supported. The young–old were least depressed; however, this age difference was present prior to the earthquake. The old–old showed lowest levels of earthquake-specific rumination, but age did not buffer the relationship between damage exposure and rumination. The inoculation hypothesis was supported for depressed mood. Prior earthquake experience was related to lower postearthquake depression scores.
In a panel study, more than 200 older adults were interviewed before and after a severe flood in southeastern Kentucky in 1984. The issue in this study was whether older adult flood victims were differentially vulnerable to increases in psychological and physical symptoms on the basis of their age, sex, marital status, occupational status, education level, and preflood symptom levels. Flood exposure was related to increases in depressive, anxiety, and somatic symptoms at 18 months postflood. Within this older adult sample, men, those with lower occupational status, and persons aged 55–64 were at significantly greater risk for increases in psychological symptoms. Sociodemographic status did not moderate the impact of flood exposure on physical health. Implications for crisis-intervention services to older adult disaster victims are discussed.
Au cours des derniers mois, partout dans le monde, y compris au Québec, des événements catastrophiques, comme des inondations, des accidents ferroviaires, des incendies dans des résidences pour aînés ont malheureusement affecté bon nombre de personnes âgées de 65 ans ou plus. Certaines de ces personnes ont subi de graves blessures, d’autres ont eu peur de mourir et malheureusement plusieurs d’entre elles ont été incapables de se déplacer rapidement pour faire face aux dangers, trouvant ainsi la mort dans des conditions atroces. Le but de cet article est de présenter les faits saillants d’une recension des écrits scientifiques portant sur les facteurs qui fragilisent les personnes âgées en cas de désastre et ceux qui les protègent pendant et après une catastrophe. À ce sujet, les études consultées ont généralement permis de constater qu’en cas de désastre, les personnes âgées de 65 ans ou plus sont plus à risque que les adultes plus jeunes de mourir, de subir des blessures, de ne pas recevoir suffisamment d’aide et de soutien des autorités publiques ou des organismes non gouvernementales (ONG) et de développer des problèmes de santé post-désastre. Il sera aussi possible de constater que trois points de vue différents s’affrontent lorsque l’on parle de la question des conséquences des désastres sur la santé des personnes âgées. C’est ainsi que certains chercheurs estiment que les aînés représentent une population particulièrement à risque de développer des problèmes de santé physique ou psychologique à la suite de leur exposition à un événement traumatisant, tandis que d’autres considèrent, par contre, que les aînés, et particulièrement ceux âgés de plus de 65 ans, s’en sortent mieux que les adultes plus jeunes. Certaines autres études ont, pour leur part, démontré que les personnes âgées ne sont pas plus affectées que les victimes plus jeunes et que la vulnérabilité et la résilience des victimes d’un désastre ne sont pas des éléments nécessairement reliés à l’âge. Cet article permettra aussi de présenter certaines données de recherches qualitatives et quantitatives réalisées au Québec portant sur les effets à moyen et à long terme des sinistres sur la santé physique et psychologique des personnes âgées. Dans ces diverses études portant sur les impacts d’une grave inondation et d’une tempête de verglas sur la santé des aînés et sur leur processus de rétablissement, Maltais et ses collaborateurs ont ainsi pu identifier les principales difficultés que vivent ces personnes pendant et après leur exposition à ce type de désastre ainsi que les répercussions de ce genre d’événement sur leur santé et leurs conditions de vie.
The goal of this research was to model the relationship between stress and natural disasters, with a view to explaining levels of stress among women. Following flooding in Iowa, in 1993, two in-depth questionnaire surveys were administered, one to residents in high flood exposure areas, and another to the general population as a control. Results indicated that gender plays a significant role in interpreting stress responses to natural hazards, with women consistently exhibiting greater stress than men. However, it was evident that a complex web of factors influenced stress levels including marital status, structure of the family unit, age, socio-economic status, health, levels of social involvement, and degree of hazard experience. These findings suggest that more research should focus on determining structural constraints that exacerbate stress levels for women.
This article investigates the utility of a social capital approach for explaining household awareness of what to do in a disaster in the context of long-term threats. Using data from a household survey in Dominica, it assesses how the concepts and measures for two variants of social capita—relational and community—can be used to explain three separate awareness outcomes. Results demonstrate the relevance of both relational and community social capital tools for disaster research. Each type of social capital was found to be significantly related to a different awareness outcome. Further, although there was no evidence of a different effect of relational social capital across outcomes, there were significant differences between the effects of community social capital on awareness of protective measures, knowledge of what to take to a shelter, and familiarity with disaster committee responsibilities.
College students occupy a socially constructed transitional space between childhood and traditional adulthood that may generate unique risks for them during disasters. Yet, few disaster research studies focus specifically on college students. Using data derived from in-depth, qualitative interviews six to eight months following the 2016 Louisiana Flood, this paper explores college students’ perspectives on how the flood affected their educational experience. The students described attendance issues, course schedule changes, grade fluctuations, and changes in motivation. These impacts were often indirectly related to the flood, and varied based on the amount of damage that they or their families experienced, as well as secondary effects including emotional stress, living arrangements, socioeconomic status, and connection with family during recovery. This research exposes the need for further studies on how disasters within college students’ families may reverberate through the students’ educational experiences and potentially affect their life trajectories.
Purpose
Social vulnerability in the context of disaster management refers to the sociodemographic characteristics of a population and the physical, social, economic, and environmental factors that increase their susceptibility to adverse disaster outcomes and capacity to anticipate, cope with, resist, and recover from disaster events. Because disasters do not impact people equally, researchers, public health practitioners, and emergency managers need training to meet the complex needs of vulnerable populations.
Design/methodology/approach
To address gaps in current education, the CONVERGE initiative, headquartered at the Natural Hazards Center at the University of Colorado Boulder, developed the Social Vulnerability and Disasters Training Module. This free online course draws on decades of research to examine the factors that influence social vulnerability to disasters. Examples of studies and evidence-based programs are included to illuminate common methods for studying social vulnerability and ways that research can guide practice. To evaluate the module, all trainees completed a pre- and post-training questionnaire.
Findings
Between July 2019 and September 2021, 1,089 people completed the module. Wilcoxon signed rank tests demonstrated a significant perceived increase in self-rated knowledge, skills, and attitudes (KSA). Students, members of historically underrepresented populations, and those new to or less experienced in the field, had the greatest perceived increase.
Practical implications
This training module can help participants understand the specific needs of socially vulnerable populations to help reduce human suffering from disasters.
Originality/value
This article describes a novel web-based training and offers evaluation data showing how it can help educate a broad hazards and disaster workforce on an important topic for disaster management.
Disasters of any type are often associated with poor psychological health in community-residing adults who experience them. Social support is one factor that has been found to impact the outcome of psychological health in a positive way. In conducting a literature review of the effect of social support provided after a disaster on post-disaster psychological health of community-residing adults, varying types and sources of social support are seen as well as different statuses of disaster survivors. There are also differences in survivors’ attitudes and comfortableness in seeking and providing social support. Using data collected after the 2007 and 2014 northern San Diego County, California, wildfires, this chapter explores various types and sources of social support for a sample of 313 adults ranging in age from 18 to 94 years. Findings indicated that received social support differed among different disaster survivor groups with primary disaster survivors receiving more social support than other disaster survivor groups. Secondary disaster survivors were more comfortable seeking social support and received more social support than non-victims. Feeling comfortable providing social support was associated with providing social support. Implications of these findings for organizations developing programs to facilitate the recovery of disaster survivors are discussed.
Rapid epidemiological assessment (REA) has evolved over the past 30 years into an essential tool of disaster management. Small area survey and sampling methods are the major application. While REA is protocol driven, needs assessment of displaced populations remains highly non-standardized. The United Nations and other international organizations continue to call for the development of standardized instruments for post-disaster needs assessment. This study examines REA protocols from leading agencies in humanitarian health assistance across an evaluation criteria of best-practice attributes. Analysis of inconsistencies and deficits leads to the derivation of a Minimum Essential Data Set (MEDS) proposed for use by relief agencies in post-disaster REA of health status in displaced populations. This data set lends itself to initial assessment, ongoing monitoring, and evaluation of relief efforts. It is expected that the task of rapid epidemiological assessment, and more generally, the professional practice of post-disaster health coordination, will be enhanced by development, acceptance, and use of standardized Minimum Essential Data Sets (MEDS).
En 2013, à Lac-Mégantic (Québec, Canada), un déraillement de train a entrainé d’importantes pertes humaines et matérielles. Cet article dresse le portrait psychosocial de jeunes âgés de 10 à 13 ans et documente les impacts de cette catastrophe sur divers aspects de leur vie. Cette étude a été réalisée auprès de 144 élèves du troisième cycle du primaire (5e et 6e années) par l’intermédiaire d’un questionnaire autoadministré en classe dans deux écoles situées à Lac-Mégantic et dans deux autres situées dans des municipalités à proximité. Cette étude a été réalisée à la suite d’une demande formulée par les organismes du milieu constatant le peu d’informations disponibles sur l’état de santé des jeunes de la communauté de Lac-Mégantic exposés au déraillement du train. Elle démontre que, 3 ans et demi après la tragédie, l’exposition à cette catastrophe technologique a des conséquences sur l’état de santé psychologique des enfants, notamment la présence de manifestations de stress post-traumatique et un faible niveau d’estime de soi. Des proportions plus élevées de jeunes exposés que de non exposés considèrent aussi que des problèmes de stress, d’anxiété ou de comportements ont perturbé leur vie familiale et scolaire. Cet article démontre l’importance d’apporter une attention particulière aux enfants pendant et après leur exposition à une catastrophe technologique afin de limiter les effets néfastes d’un tel évènement sur leur santé à court et à plus long terme. Il s’agit d’une contribution originale étant donné que la majorité des études portant sur les conséquences des catastrophes technologiques abordent le vécu des adultes demeurant aux États-Unis ou en Europe. De plus, les études permettant de documenter les conséquences des désastres sur la santé des jeunes ont surtout été réalisées à la suite de catastrophes naturelles dans d’autres pays que le Canada.
Mots-clés :
catastrophe technologique, enfants, santé psychologique, stress post-traumatique, résilience
In 2007 the legislature in British Columbia, Canada passed legislation making mediation mandatory in contested guardianship applications in court. Older adults often are the defendants in these matters, and, therefore will be required to participate in mediation under this statute. Some adults required to participate may also be victims of abuse. However, very little research exists on mediation in situations of elder abuse. This article fills that gap. In this article the author examines existing research on elder mediation and abuse, draws parallels to research on mediation in other abuse situations, gives examples from existing programs, and analyzes the impact of the new legislation on older adults. Additionally, the author makes recommendations for further research and next steps.
Previous research has identified a number of physical, socioeconomic, and demographic factors related to tornado casualty rates. There remain gaps in our understanding of community-level vulnerabilities to tornadoes. Here a framework is provided for systematically identifying the most unusually devastating tornadoes, defined as those where the observed number of casualties far exceeds the predicted number. Results show that unusually devastating tornadoes occur anywhere tornadoes occur in the United States, but rural areas across the Southeast appear to be most frequented. Seven examples of unusually devastating tornadoes affecting six communities are examined in more detail. In addition, results highlight that cities and towns affected by unusually devastating tornadoes have their own socioeconomic and demographic profiles. Identifying geographic clusters of unusually devastating tornadoes builds a foundation to address community-level causes of destruction that supports ethnographic and qualitative—in addition to quantitative—studies of place-based vulnerability. Key Words: statistics, tornado, vulnerability.
As a group, renters experience a broader range of housing problems than do owners, and disasters worsen these problems. Yet to date, housing tenure has been relatively understudied compared to other vulnerability characteristics. This review addresses the differences in housing needs faced by renters and owners during and after a disaster. It examines variation between renters and owners, recent studies of a disaster’s impacts on each group by disaster phase, and disaster-related housing policies and programs. This research explores significant questions related to the housing needs of renters in times of disaster, yielding important insights for policy makers and local planners.
The current trend in offering universal health care based on open distributed health care network which will provide health care to elderly, socially and economically weak population, and physically challenged patients has lead to rapid digitization of health care data, and wireless medium for data communication. Although it has many advantages and has immense potential to improve health care availability, it has created many challenges in maintaining health care services, in particular in offering security and privacy of the most vulnerable members of society who are the elderly. In this paper we identify the current status of elderly care, their vulnerabilities, and challenges faced to offer them health care in total privacy and dignity.
On May 22, 2011, a devastating tornado hit Joplin, Missouri, virtually destroying one of the two hospitals subsequently causing the medical system to be overwhelmed. This chapter presents first-hand accounts and summarizes lessons learned from six providers who were involved in tornado recovery efforts from this natural disaster. In addition, we discuss the unique implications of tornados for the elderly.
The inclusion of a chapter on psychosocial response to environment change among the elderly in this volume is a tribute to three decades of theoretical and applied research contributions in the areas of environmental psychology and social gerontology. Although initially challenged to provide explanations for eye opening, but somewhat misleading, early findings such as those suggesting that placement of elderly in institutions could dramatically shorten their lifespan (Carmargo & Preston, 1945; Josephy, 1949; Lieberman, 1961), the field has subsequently been marked by the development of theoretical models and methodological strategies to account for the impact of a variety of environmental changes on the physical and emotional well-being of the elderly.
Natural disaster destroys people’s calm daily life, and makes survivors change their perspective about the relationship between man and environment (Raphael, 1988). When one is forcibly moved from one place to another because of a natural disaster, refugees have to face many problems in adjusting to their new surroundings. The environmental transition of relocation to restoration housing is conceptualized as consisting of two major elements which are essential for understanding environment-behavior transactions (Miura, 1995).
This paper presents an analysis of recovery from natural disaster of black and white disaster victims. The data were gathered in Paris, Texas following a tornado in that town in April, 1982 which destroyed or damaged over 1500 houses and apartments. A sample of 219 black victims and 212 white victims were interviewed seven months after the disaster, with information being gathered on some 178 items pertaining to their losses, aid received, psychosocial impacts and recovery. Discriminant function analysis is used to select sets of independent variables that predict recovery levels for black and white victims along two dimensions of recovery, emotional and economic recovery. Differences in determinants of recovery between the two groups of victims involved variations in losses, psychosocial impacts, aid utilization and social support, but not demographic or socioeconomic factors.
The pathogenic effects of traumatic events have been consistently documented over a large range of populations and occurrences (Wilson & Raphael, 1993). At the same time, considerable variability in human response to trauma has been documented (e.g., Solomon, Mikulincer, & Waysman, 1991). Although many survivors are able to put the trauma behind them and resume their lives, others are detrimentally affected. They may suffer a deterioration of health and social functioning, along with a large variety of psychological disturbances, including anxiety, depression, somatization (Solomon, 1993), and posttraumatic stress disorder (PTSD), which is the most common and conspicuous psychological sequela of trauma (American Psychiatric Association, 1994).
INTRODUCTION There is a large body of empirical evidence illustrating that disasters can have considerable mental health effects for a significant proportion of survivors, ranging from temporary stress reactions to more persistent and severe psychopathology (Norris, Friedman, & Watson, 2002). Although there is still some ongoing debate regarding risk and protective factors for mental health vulnerability in the face of disasters, some evidence suggests that those at greater risk are children, women, people of low socioeconomic status, individuals with physical and mental disabilities, ethnic minorities, first responders, the uninsured, residents of rural areas, and subgroups of older adults (Johnson et al., 2006; Johnson & Langlieb, 2005; Mokdad et al., 2005; Norris et al., 2002). Advances in public health, biomedicine, and socioeconomic and living conditions have all contributed to making older adults one of the fastest growing segments of the population in the United States and other industrialized countries (He, Sengupta, Velkoff, & DeBarros, 2005). Among those 65 years of age and older, women far outnumber men, and there is increasing heterogeneity in race and ethnicity (He et al., 2005). Since female gender and ethnic minority status are two potential risk factors for vulnerability in the event of a disaster, this may compound concern for those among the older adult population. There are numerous views regarding why older adults are or are not expected to be differentially vulnerable to the effects of disasters.
Social capital and social networks are considered as the most dependable resources in the aftermath of natural disasters. Based on the data from a rapid needs assessment survey after the May 12 earthquake in Sichuan, China, this chapter describes the role of social networks in the search and rescue of victims and providing information and support and maintaining the mental health of the affected population. The theoretical and policy implications are also discussed.
It is almost impossible to listen to a news broadcast or to pick up a newspaper without learning of yet another catastrophic event. As modern society becomes increasingly technologically based, it can be anticipated that the frequency of disasters will grow, and the types of disasters that occur will change. Disaster events of ages past were primarily natural occurrences, such as floods, volcanic eruptions, and tornadoes. Recent science has provided us with new potential disaster agents, such as nuclear power plants, jumbo jets, and toxic substances. For an excellent historic overview, the reader is directed to a comprehensive discussion in (1986).
The issue of planning for evacuations of nursing homes and related health care facilities concerns both emergency planners and disaster researchers who cite the lack of empirical data on the problems of special populations during emergency evacuations. Although most evacuations of such facilities are carried out successfully, the effectiveness of an evacuation (as measured by time to evacuate) is limited by certain constraints. This study examines selected organizational characteristics of nursing homes and related health care facilities which experienced either a partial or complete evacuation of their facilities. Among the factors affecting facility evacuations are resources, the type and number of clientele, and community characteristics such as population density. Although the issues are related to general evacuation concerns, the findings suggest that individuals within specialized populations are unlike other victims of disaster with particular needs that require different management strategies to expedite an evacuation efficiently.
This study examines the perceived disruptive influence of a natural disaster on the individual, primary relational, and neighborhood
ties of community residents. The data reveal significant differences in disruption and recovery potential by age. Younger
victims experienced more change in the interpersonal spheres of family, friends, and neighbors. In addition, anxiety and physical
stress levels of the young exceeded those of the aged, regardless of damage sustained. Results suggest the coping potential
of the aged to surpass that of their younger counterparts.
A 3-year study of the impact of the 1972 flood in the Wilkes Barre, PA area on the elderly revealed that anticipated adverse long-term effects on elderly flood victims were not realized. The community steady state was restored within 100 days and was virtually complete within 1 year. Area Agencies on Aging are seen as having their greatest potential in assisting in producing hard services, quality control, and in undertaking early planning. AAAs do not appear to have coordinating powers in disaster services to the elderly.
Survey data obtained from a sample of elderly flood victims of Hurricane Agnes, one year after impact, indicate their perceived need for 'hard' services such as housing, increased income, and transportation. In general, this sample believed that agency response was effective. Implications for normal circumstances center on the stigma that seems to hold for service proffered by Public Assistance and mental health agencies. Another finding suggests the need for greater emphasis on supportive services that extend life space beyond the home environment.