Socioeconomic consequences of the 2004 tsunami: Policy implications for natural disaster management T.T. Su a, ⁎, B.I. Saimy a , A.M. Bulgiba b a Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia b Julius Centre University of Malaya (JCUM), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia abstract article info Available online 8 January 2013 Keywords: Tsunami Consequence of disaster Disaster management Evidence-based health policy Objective. The objective of the study is to assess the socioeconomic status of the households affected by the tsunami of 2004 & to determine the factors associated with the recovery of household economic status. Methods. The study was conducted in tsunami-affected areas in Malaysia in 2010–2011. A total of 193 households were included in the survey. Multivariate logistic regression was performed to determine the factors related to the recovery of households' economic status. Findings. Among 193 households, 37% were in a better condition, 40% were unchanged and 22% had not recovered. It took 2.2 years to get back to pre-disaster economic status. Factors leading to successful house- hold economic recovery were “household resided in Sungai Petani”, “belong to highest income quartile” and “age of household head”. In contrast, “extended family type” and “unemployed household head” reduced the odds of recovery. Households which lost their fishing boats during the tsunami had less chance to recover their previous status. Conclusion. The findings of our study would be useful for policy consideration and planning of post disaster management in order to enhance the recovery of household economic status in the short period. © 2013 Elsevier Inc. All rights reserved. Background Disasters, whether natural or man-made, have been shown to be one of the major public health problems over the past decades (IFRC, 2006). Since the onset of natural disasters occurs swiftly and often without any warning, there is a dramatic impact on the life and health of people which leads to negative socio-economic consequences. A well-organized disaster preparedness plan and effective community participation are crucial to mitigate the impacts of a natural disaster (Limpakarnjanarat et al., 2007; Srivastava, 2009). Outbreak of infectious diseases, exacerbation of chronic diseases and malnutrition are well known consequences of a disaster (Miller and Arquilla, 2008; Ndongosieme et al., 2007; Rossi et al., 2006; Rossi et al., 2008). The importance of early and appropriate psychological support for victims of a disaster was explored in some studies in order to prevent immediate psychological distress and long term mental health problems (Ibrahim and Hameed, 2006; Mahoney et al., 2006). Experiences in India demonstrated that widespread damage to societies and economies, deaths and illness interact in a dynamic of increasing social vulnerability and poverty post-disaster (Srivastava, 2009). However, there is very little scientific evidence on long term socio- economic consequences of affected communities and how the commu- nities cope with the situation in order to sustain the households' economic condition in the post-disaster period. The objective of the study was to assess the socioeconomic status of the households affected by the tsunami in 2004 & to determine the factors associated with the recovery of household economic status. Methods The study, approved by the Medical Ethics Committee, University of Malaya Medical Centre (Ref. 739.20/19th August 2009) used a combination of both qualitative and quantitative methods. Study area The tsunami's devastating effect in Malaysia in 2004 was concentrated on the northern coastal areas with at least 82 people confirmed to have died. Our study was conducted in these affected areas of Sungai Petani (Kuala Muda) and Penang (Tanjung Bungah and Pulau Betong). The first phase (qualitative study) The main aim of the qualitative study was to develop a questionnaire for the household survey. The in-depth interviews were conducted on 33 participants who were victims of the tsunami selected using the snowball technique in purposeful sampling. The interview guideline which covered social, economic and health effects of the respective families was developed. Two trained inter- viewers and one of the researchers conducted the in-depth interviews in Malay, the local language, and recorded with permission from the participants. Preventive Medicine 57 (2013) S74–S76 ⁎ Corresponding author. Fax: +60 379674975. E-mail addresses: tintinsu03@yahoo.com, tstin@ummc.edu.my (T.T. Su). 0091-7435/$ – see front matter © 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.ypmed.2012.12.024 Contents lists available at SciVerse ScienceDirect Preventive Medicine journal homepage: www.elsevier.com/locate/ypmed