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Social context and the health consequences of disasters.

Disasters have been and will continue to be relatively common events in the human experience, and they make important contributions to variations in population health. There is a need, therefore, for conceptual models that identify the social and ecological factors influencing post-disaster consequences on population health. This article presents one such conceptual model which links the health consequences of natural, technological, and human-made disasters to a set of nested socioecological factors. Specifically, we attempt to link post-disaster consequences to aspects of the global and local environment and to highlight the roles played by social and ecological factors, including the social infrastructure, cultural beliefs, demography, and underlying historical and geographical circumstances. Examples from existing population-based health and disaster research are used to illustrate and amplify connections drawn from the model. From an applied standpoint, the model suggests that the role of multiple contextual determinants in shaping population health is likely to be complex. Practitioners interested in mitigating the consequences of disasters should pursue strategies that improve the underlying determinants of health, as well as practicable population-based interventions that could be implemented rapidly.