Does disaster affect immigrant victims more than non-immigrant victims in Dutch general practice: a matched cohort study

Background: In the literature, immigrant victims appear to be more vulnerable to health effects of a disaster than indigenous victims. Most of these studies were performed without pre-disaster measurement and without using a control group. Aim: The objective of the study is to monitor differences between two groups of victims, Turkish immigrants and indigenous Dutch, in utilization and morbidity as presented in general practice after a man-made disaster. Methods: A matched cohort study was performed with pre-disaster (1 year) and post-disaster (4 years) measurements of patients from 30 general practices in Enschede. Turkish victims (N=303) and Dutch victims (N=606), matched on age, gender and socioeconomic status, were included. Main outcome measures were psychological problems and physical symptoms as recorded by the general practitioner, using the International Classification of Primary Care (ICPC). Results: The Turkish victims showed higher utilization than the Dutch victims prior to the disaster. In the 1st post-disaster year, both groups of victims showed an increase in utilization, but the increases did not differ significantly. The Turkish group showed no significantly greater increase than the Dutch group in the five most prevalent clusters of health problems (psychological, respiratory, skin, musculoskeletal, and digestive). Conclusion: The Turkish victims in general practice were as vulnerable as the Dutch victims for the effects on their health of this man-made disaster. Differences between Turkish and native Dutch victims of this man-made disaster can largely be explained by the differences that existed already before the disaster

Does disaster affect immigrant victims more than non-immigrant victims in Dutch general practice: a matched cohort study

International audienc

Changes in the pattern of service utilisation and health problems of women, men and various age groups following a destructive disaster: a matched cohort study with a pre-disaster assessment.

Contains fulltext : 69779.pdf (publisher's version ) (Open Access)OBJECTIVES: Female gender and young age are known risk factors for psychological morbidity after a disaster, but this conclusion is based on studies without a pre-disaster assessment. The aim of this study in family practice was to investigate if these supposed risk factors would still occur in a study design with a pre-disaster measurement. METHODS: A matched cohort study with pre-disaster (one year) and post-disaster (five years) data. Community controls (N = 3164) were matched with affected residents (N = 3164) on gender, age and socioeconomic status. Main outcome measures were utilization rates measured by family practice attendances and psychological, musculoskeletal and digestive health problems as registered by the family practitioner using the International Classification of Primary Care (ICPC). RESULTS: Affected residents of female and male gender and in five age groups all showed increases in utilization rates in the first post-disaster year and in psychological problems when compared to their pre-disaster baseline levels. The increases showed no statistically significant changes, however, between women and men and between all age groups. CONCLUSION: Gender and age did not appear to be disaster-related risk factors in this study in family practice with a pre-disaster base line assessment, a comparison group and using existing registries. Family practitioners should not focus specifically on these risk groups