Predictors of quality of life in disaster victims: A multilevel analysis of individual, community, and policy factors

Disasters have profound and long-lasting impacts on survivors' quality of life (QoL), which is shaped not only by individual vulnerabilities but also by the surrounding community and policy environments. This study examines the influence of multidimensional factors—personal, social, and institutional—on the QoL of disaster victims in South Korea, with a focus on community social capital and the moderating effect of post-traumatic stress disorder (PTSD). Analyzing data from individuals affected by 2017 disasters across 17 local governments, this study employed a hierarchical linear model (HLM) to assess both individual-level (social participation, social support, community resilience, sociodemographic characteristics) and community-level (disaster relief policies) influences. The results show that higher levels of social participation, social support, and perceived community resilience are associated with better QoL. Among policy-level variables, the disaster management fund and temporary housing services positively affected QoL. However, disaster restoration support demonstrated a significant interaction with PTSD levels: while QoL increased with greater restoration support among individuals without significant PTSD symptoms, it decreased for those with PTSD symptoms. These findings suggest that enhancing disaster victims' QoL requires a multidimensional approach that integrates structural assistance, psychological recovery, and community resilience. Moreover, the moderating effect of PTSD supports Hobfoll's Conservation of Resources theory, indicating that psychological intervention should be prioritized, as external resources may have limited impact without sufficient psychological capacity for recovery.