Impact of disasters, including pandemics, on cardiometabolic outcomes across the life-course: a systematic review

BMJ Open - Tập 11 Số 5 - Trang e047152 - 2021
Vanessa De Rubeis1, Jinhee Lee1, Muhammad Saqib Anwer1, Yulika Yoshida‐Montezuma1, Alessandra T. Andreacchi1, Erica Stone1, Saman Iftikhar1, J. Morgenstern1, Reid Rebinsky1,2, Sarah Neil-Sztramko1,3, Elizabeth Álvarez4,1, Emma Apatu4,1, Laura N. Anderson4,1
1Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
2Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
3National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, Ontario, Canada
4Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada

Tóm tắt

BackgroundDisasters are events that disrupt the daily functioning of a community or society, and may increase long-term risk of adverse cardiometabolic outcomes, including cardiovascular disease, obesity and diabetes. The objective of this study was to conduct a systematic review to determine the impact of disasters, including pandemics, on cardiometabolic outcomes across the life-course.DesignA systematic search was conducted in May 2020 using two electronic databases, EMBASE and Medline. All studies were screened in duplicate at title and abstract, and full-text level. Studies were eligible for inclusion if they assessed the association between a population-level or community disaster and cardiometabolic outcomes ≥1 month following the disaster. There were no restrictions on age, year of publication, country or population. Data were extracted on study characteristics, exposure (eg, type of disaster, region, year), cardiometabolic outcomes and measures of effect. Study quality was evaluated using the Joanna Briggs Institute critical appraisal tools.ResultsA total of 58 studies were included, with 24 studies reporting the effects of exposure to disaster during pregnancy/childhood and 34 studies reporting the effects of exposure during adulthood. Studies included exposure to natural (n=35; 60%) and human-made (n=23; 40%) disasters, with only three (5%) of these studies evaluating previous pandemics. Most studies reported increased cardiometabolic risk, including increased cardiovascular disease incidence or mortality, diabetes and obesity, but not all. Few studies evaluated the biological mechanisms or high-risk subgroups that may be at a greater risk of negative health outcomes following disasters.ConclusionsThe findings from this study suggest that the burden of disasters extend beyond the known direct harm, and attention is needed on the detrimental indirect long-term effects on cardiometabolic health. Given the current COVID-19 pandemic, these findings may inform public health prevention strategies to mitigate the impact of future cardiometabolic risk.PROSPERO registration numberCRD42020186074.

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BMJ Open

Tập 11 Số 5

e047152

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