Work

Long-term physical and mental health effects of unresolved disaster-related bereavement: evidence from an 8-year propensity score–matched cohort study

Year: 2026

Type: article

Abstract: Background: Evidence on the long-term mental and physical health effects of disaster-related bereavement remains limited.Objective: To compare long-term healthcare utilisation and disease incidence among individuals bereaved in the Sewol ferry disaster with matched controls.Method: This retrospective cohort study used Korean National Health Insurance data to match 388 bereaved individuals with 1,552 controls. Healthcare utilisation and disease incidence were examined over three years pre-disaster and eight years post-disaster using difference-in-differences and Cox proportional hazards models.Results: Psychiatric outpatient utilisation among the bereaved increased from 10% pre-disaster to 38% in year 1, stabilised around 20%, and rose again to 38% in year 8, whereas controls showed a gradual increase to 22%. Difference-in-differences analyses demonstrated significantly higher psychiatric outpatient visits in the bereaved group, with excess visits of 2.87 (95% CI 1.52–4.22) in years 1–3, 1.86 (0.51–3.21) in years 4–6, and 1.56 (0.21–2.91) in years 7–8. Psychiatric admissions also increased significantly across post-disaster periods. Physical outpatient visits showed delayed excess increases in years 4–6 and 7–8. Cox models indicated elevated risks for infectious, benign neoplastic, endocrine, mental, neurological, digestive, dermatological, and musculoskeletal disorders, as well as abnormal findings and injury.Conclusions: Eight years after the disaster, bereaved individuals continued to exhibit persistent mental health problems and greater physical healthcare utilisation. These findings highlight the need for long-term, integrated support addressing both mental and physical health beyond the immediate aftermath of disasters.

Source: European Journal of Psychotraumatology

DOI: 10.1080/20008066.2026.2635919