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Brent Burkholder, Paul Spiegel, and Peter Salama  
 
Michael H. N. Golden and Yvonne Grellety We predicted that social heterogeneity would lead to changes in the shape of the distribution curve of acute malnutrition when a population is exposed to famine.  
 
Paul Spiegel, Mani Sheik, Carol Gotway-Crawford, Peter Salama  
 
Taiwan Society of Disaster Medicine Powerpoint Presentation  
 
Academy for Educational Development- Profiles  
 
Pan American Health Organization 4. Morbidity and mortality
Disasters may have an indirect negative influence on health because of the way they alter the environment. The frequency of diseases will not always increase, but flood disasters do present the potential for outbreaks of communicable diseases. According to Western (1982), the risk factors involved in communicable disease outbreaks after disasters are:
1. Alterations in pre-existing morbidity: It is highly unlikely that the disaster will spark outbreaks of diseases that are not endemic to the region, unless such diseases are introduced by emergency relief personnel. The problem lies in the fact that reliable figures on disease frequencies in a given region are generally nonexistent.
2. Ecological changes resulting from the disaster: Droughts, floods, and hurricanes, in particular, will have a noticeable effect on the region's ecology by exerting an impact on the habitats of vectors and on water sources, thereby increasing the risk of vector-transmitted diseases.
3. Population displacements: If affected populations move far, they may come upon diseases against which they are not immunized or may carry a disease or its vector to an area previously free of it. Furthermore, if they move to populated areas, they may overburden the services and facilities of the community sheltering them.
4. Changes in population density: Overcrowding, especially in evacuation camps or centers, will contribute to the possibility of disease outbreak created either by direct or airborne contact.
5. Disorganized public services.
6. Interruption of basic public health services: Water treatment plants may be destroyed or severely damaged and programs, such as malaria control and follow-up of tuberculosis cases, may be interrupted.
 
 
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