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Global disasters, both natural and man-made, affect health in many ways, as reviewed in this article in the Global Health series. Natural disasters and armed conflict have marked human existence throughout history and have always caused peaks in mortality and morbidity. But in recent times, the scale and scope of these events have increased markedly. Since 1990, natural disasters have affected about 217 million people every year, 1 and about 300 million people now live amidst violent insecurity around the world. 2 The immediate and longer-term effects of these disruptions on large populations constitute humanitarian crises. In recent decades, public health interventions in the humanitarian response have made gains in the equity and quality of emergency assistance. Natural disasters are broadly classified as . . .

Several mortality estimates for the Darfur conflict have been reported since 2004, but few accounted for conflict dynamics such as changing displacement and causes of deaths. We analyse changes over time for crude and cause-specific mortality rates, and assess the effect of displacement on mortality rates. Retrospective mortality surveys were gathered from an online database. Quasi-Poisson models were used to assess mortality rates with place and period in which the survey was done, and the proportions of displaced people in the samples were the explanatory variables. Predicted mortality rates for five periods were computed and applied to population data taken from the UN's series about Darfur to obtain the number of deaths. 63 of 107 mortality surveys met all criteria for analysis. Our results show significant reductions in mortality rates from early 2004 to the end of 2008, although rates were higher during deployment of fewer humanitarian aid workers. In general, the reduction in rate was more important for violence-related than for diarrhoea-related mortality. Displacement correlated with increased rates of deaths associated with diarrhoea, but also with reduction in violent deaths. We estimated the excess number of deaths to be 298 271 (95% CI 178 258–461 520). Although violence was the main cause of death during 2004, diseases have been the cause of most deaths since 2005, with displaced populations being the most susceptible. Any reduction in humanitarian assistance could lead to worsening mortality rates, as was the case between mid 2006 and mid 2007. US Department of State Bureau of Population, Refugees and Migration, and UK Department for International Development funded the complex emergency database project; and European Commission funded the MICROCON project.

Reliable and complete data held in disaster databases are imperative to inform effective disaster preparedness and mitigation policies. Nonetheless, disaster databases are highly prone to missingness. In this article, we conduct a missing data diagnosis of the widely-cited, global disaster database, the Emergency Events Database (EM-DAT) to identify the extent and potential determinants of missing data within EM-DAT. In addition, through a review of prominent empirical literature, we contextualise how missing data within EM-DAT has been handled previously. A large proportion of missing data was identified for disasters attributed to natural hazards occurring between 1990 and 2020, particularly on the economic losses. The year the disaster occurred, income-classification of the affected country and disaster type were all significant predictors of missingness for key human and economic loss variables. Accordingly, data are unlikely to be missing completely at random. Advanced statistical methods to handle missing data are thus warranted when analysing disaster data to minimise the risk of biasing statistical inferences and to ensure global disaster data can be trusted.

Evidence from recent armed conflicts shows that a long-term approach is needed to support health infrastructure and protect the vulnerable. Evidence from recent armed conflicts shows that a long-term approach is needed to support health infrastructure and protect the vulnerable. Image credit: Annette Etges

Epidemiological studies have indicated that natural disasters have important impacts on ischemic stroke. This study determined the associations between natural disasters and the incidence and prevalence of ischemic stroke at the global level. A 28-year ecological trend study was performed to estimate worldwide changes in the incidence and prevalence of ischemic stroke and their associations with natural disasters by analyzing data from 193 countries. Quantum geographic information system-based visualization and multivariable linear regression were used. Changes in the incidence and prevalence of ischemic stroke, as well as disaster occurrence, varied among the different regions over the past 28 years ( p  < 0.001). Multiple linear regression revealed an independent and positive association between disaster occurrence and the incidence of ischemic stroke in males, females and both sexes combined (standardized coefficients = 0.515, 0.470 and 0.483, p  < 0.001); similar associations were found for the prevalence of ischemic stroke (standardized coefficients = 0.471, 0.417 and 0.438, p  < 0.001). The incidence and prevalence of ischemic stroke changed significantly at the global level and were independently associated with natural disasters. Both males and females show common but different vulnerabilities to natural disasters. This evidence supports policy making and resource allocation for disaster response and disease burden reduction.

Purpose The purpose of this paper is to discuss how, despite increasing data availability from a wide range of sources unlocks unprecedented opportunities for disaster risk reduction, data interoperability remains a challenge due to a number of barriers. As a first step to enhancing data interoperability for disaster risk reduction is to identify major barriers, this paper presents a case study on data interoperability in disaster risk reduction in Europe, linking current barriers to the regional initiative of the European Science and Technology Advisory Group. Design/methodology/approach In support of Priority 2 (“Strengthening disaster risk governance to manage disaster risk”) of the Sendai Framework and SDG17 (“Partnerships for the goals”), this paper presents a case study on barriers to data interoperability in Europe based on a series of reviews, surveys and interviews with National Sendai Focal Points and stakeholders in science and research, governmental agencies, non-governmental organizations and industry. Findings For a number of European countries, there remains a clear imbalance between long-term disaster risk reduction and short-term preparation and the dominant role of emergency relief, response and recovery, pointing to the potential of investments in ex ante measures with better inclusion and exploitation of data. Originality/value Modern society is facing a digital revolution. As highlighted by the International Council of Science and the Committee on Data for Science and Technology, digital technology offers profound opportunities for science to discover unsuspected patterns and relationships in nature and society, on scales from the molecular to the cosmic, from local health systems to global sustainability. It has created the potential for disciplines of science to synergize into a holistic understanding of the complex challenges currently confronting humanity; the Sustainable Development Goals are a direct reflectance of this. Interdisciplinary is obtained with integration of data across relevant disciplines. However, a barrier to realization and exploitation of this potential arises from the incompatible data standards and nomenclatures used in different disciplines. Although the problem has been addressed by several initiatives, the following challenge still remains: to make online data integration a routine.

Despite the intuitive connection between drought and mortality, we still lack a sound quantitative synthesis of evidence drawn from the available data. In this study, we estimate the pooled under-five death rates (U5DR) and assess the effect of drought on child death in Ethiopia. Small-scale mortality surveys were searched from the Complex Emergency Database and then aggregated spatially and temporally with drought exposure data from the Global Drought Monitor and food insecurity data from the Famine Early Warning Systems Network. A Bayesian Poisson meta-analysis was performed on 88 surveys conducted in Ethiopia between 2009 and 2014, consisting of 55,219 under-five children. The pooled U5DR was estimated at 0.323/10,000/day (95% credible interval, CrI: 0.254-0.397), which is below both the emergency and the baseline death rate thresholds of sub-Saharan Africa. We failed to find a plausible association between drought and U5DR. However, minimal food insecure areas showed elevated U5DR compared to stressed food insecure areas. Furthermore, the U5DR increases as the prevalence of acute malnutrition increases. Targeted interventions to improve the underlying causes of child malnutrition are crucial. Further, revising and updating the existing mortality thresholds, both the baseline and the emergency, is recommended.

Tropical cyclones have far-reaching impacts on livelihoods and population health that often persist years after the event 1 – 4 . Characterizing the demographic and socioeconomic profile and the vulnerabilities of exposed populations is essential to assess health and other risks associated with future tropical cyclone events 5 . Estimates of exposure to tropical cyclones are often regional rather than global 6 and do not consider population vulnerabilities 7 . Here we combine spatially resolved annual demographic estimates with tropical cyclone wind fields estimates to construct a global profile of the populations exposed to tropical cyclones between 2002 and 2019. We find that approximately 560 million people are exposed yearly and that the number of people exposed has increased across all cyclone intensities over the study period. The age distribution of those exposed has shifted away from children (less than 5 years old) and towards older people (more than 60 years old) in recent years compared with the early 2000s. Populations exposed to tropical cyclones are more socioeconomically deprived than those unexposed within the same country, and this relationship is more pronounced for people exposed to higher-intensity storms. By characterizing the patterns and vulnerabilities of exposed populations, our results can help identify mitigation strategies and assess the global burden and future risks of tropical cyclones. A global profile of tropical cyclone population exposure for the period 2002–2019 shows a steady increase, with approximately 560 million people exposed yearly and a disproportionate exposure among those with lower socioeconomic status.

The paper explores the degree to which exposure to natural disasters and poor governance (quality of governance) is associated with absolute child poverty in sixty-seven middle- and low-income countries. The data is representative for about 2.8 billion of the world´s population. Institutionalist tend to argue that many of society's ills, including poverty, derive from fragile or inefficient institutions. However, our findings show that although increasing quality of government tends to be associated with less poverty, the negative effects of natural disasters on child poverty are independent of a country´s institutional efficiency. Increasing disaster victims (killed and affected) is associated with higher rates of child poverty. A child´s estimated odds ratio to be in a state of absolute poverty increases by about a factor of 5.7 [95% CI: 1.7 to 18.7] when the average yearly toll of disasters in the child´s country increases by one on a log-10 scale. Better governance correlates with less child poverty, but it does not modify the correlation between child poverty and natural disasters. The results are based on hierarchical regression models that partition the variance into three parts: child, household, and country. The models were cross-sectional and based on observational data from the Demographic Health Survey and the Multiple Indicator Cluster Survey, which were collected at the beginning of the twenty-first millennium. The Sustainable Development Goals are a principle declaration to halt climate change, but they lack a clear plan on how the burden of this change should be shared by the global community. Based on our results, we suggest that the development agencies should take this into account and to articulate more equitable global policies to protect the most vulnerable, specifically children.