title: Prospective study of predictors of poor self-rated health in a 23-year cohort of earthquake survivors in Armenia.
abstract: Long-term prospective studies exploring general health outcomes among disaster survivors are rare. Self-rated health (SRH) - a proven correlate of morbidity and mortality prognosis - was used to investigate predictors of perceived health status among a 23-year cohort of survivors of 1988 Spitak earthquake in Armenia. A geographically-stratified subsample of 725 adults from a larger initial cohort was followed during the period of 1990-2012. A logistic regression model identified predictors of SRH. Adjusted relative risks for the long-term predictors of SRH were calculated. The rate of poor SRH among the survivors was 18.8%, fair 56.5%, and good/excellent 24.7%. In the fitted model, long-term risk factors of poor SRH included baseline body mass index, baseline multi-morbidity, number of experienced stressful life events, and perceived poor living standards during the post-earthquake decade, while participation in sports in the early 1990s was a protective factor. Short-term protective factors included socio-economic status score, social support, employment and dignity, while current household size was a risk factor for poor SRH. No association was found between earthquake exposure severity and SRH after 23 years. However, the identified predictors included a number of modifiable lifestyle, material and psychological factors. Thus, interventions targeting these factors could have a long-lasting impact on disaster victims' health status.
authors.affiliation: School of Public Health, American University of Armenia, 40 Marshal Baghramian Ave., Yerevan 0019, Armenia. Electronic address: ademirch@aua.am.
authors.forename: Anahit
authors.initials: A
authors.lastname: Demirchyan
authors.affiliation: School of Public Health, American University of Armenia, 40 Marshal Baghramian Ave., Yerevan 0019, Armenia.
authors.forename: Varduhi
authors.initials: V
authors.lastname: Petrosyan
authors.affiliation: Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Dr. South, 16-035 Center for Health Sciences, Los Angeles, CA 90095-1772, USA.
authors.forename: Haroutune K
authors.initials: HK
authors.lastname: Armenian
authors.affiliation: School of Public Health, American University of Armenia, 40 Marshal Baghramian Ave., Yerevan 0019, Armenia.
authors.forename: Vahe
authors.initials: V
authors.lastname: Khachadourian
mesh_terms: D001136:Armenia; D059026:Diagnostic Self Evaluation; D055866:Earthquakes; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D017741:Survivors; D013997:Time Factors
keywords: Earthquake; Long-term cohort; Predictor; Self-rated health; Survivor