Health Impacts of Disasters and Social Indicators: An Ecological Study

Abstract The objective of this study is to investigate the correlation between certain social indicators and the mortality and morbidity in disasters recorded in the EM-DAT database within countries in the last decade. The correlation between the mortality and morbidity in disasters recorded in the EM-DAT database between March 1, 2014-2024 and the most recent data on Human Development Index (HDI), Gender Inequality Index (GII), Gini Coefficient (GC), Government Health Expenditure as a share of GDP (GHE/GDP) and Corruption Perception Index (CPI) were analyzed. During the period of the study, disasters from a total of 207 countries/regions were recorded in the database. The median (IQR) values of countries in disasters were found to be 35.1 (67.5) for death per million and 76.3 (783.0) for injury per million. The most frequent types of disasters, the most frequent cause of mortality and the most frequent cause of injury in each country were found to be floods, extreme temperatures, and epidemics, respectively. While there was no significant difference between the social indicators analyzed and the total number of deaths, there was a negative correlation between the number of injuries and the HDI, CPI, GHE/GDP values of the countries, and a positive correlation between the GC and GII values (for all tests, Spearman correlation test, p < 0.001). The correlation coefficient was interpreted as ‘weak’ in all other pairwise analyses except for the GHE/GDP value (moderate). Countries with social indicators closer to the positive threshold have been found to have less injuries in disasters. The possible reason for the insignificant correlation with the mortality is thought to be the difficulties in detecting mortality, especially in ‘extreme temperatures’, and the fact that it is mostly recorded in countries where social indicators are relatively more advanced. More research is needed to investigate the relationality between social indicators and disaster harms. Key messages • Disasters are critical mediators between social determinants and health. Addressing and reducing inequalities should remain on the public health agenda to prevent disasters and protect health. • Analysis of disasters shows that ‘extreme temperatures’, which cause the most deaths in some countries, are barely detected in developing countries. Disaster recording systems need to be strengthened.