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Kuru Alici N, Kalanlar B. Challenges and Coping Strategies of Older Adults in the Aftermath of Kahramanmaraş Earthquake in Türkiye: A Qualitative Research. J Appl Gerontol 2024; 43:1580-1589. [PMID: 38536771 DOI: 10.1177/07334648241241299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2024] Open
Abstract
The aim of this study was to explore the post-earthquake experiences, difficulties, and coping strategies of older adults who experienced the Kahramanmaraş earthquakes that occurred in Türkiye in 2023. This research was designed as a qualitative descriptive study. The study was conducted with 21 (13 female and 8 male) older adults and the mean age of the participants was 70.2 (in the range of 65-85). In line with the data obtained from the participants, "Fulfilling Basic Needs of Older Adults, Emotional Turmoil in Later Life, Healthcare Disparities in Aging, Adaptive Response of Older Adults" themes and sub-themes related to the theme were formed. Both physical and socio-emotional challenges, as well as coping strategies and support systems that older adults face in the aftermath of earthquakes, demonstrate unique characteristics for this demographic group. Therefore, it is recommended to plan programs by considering these differences while planning intervention programs before, during, and after the disaster.
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Affiliation(s)
- Nilgun Kuru Alici
- Department of Public Health Nursing, Hacettepe University Faculty of Nursing, Ankara, Turkey
| | - Bilge Kalanlar
- Department of Public Health Nursing, Hacettepe University Faculty of Nursing, Ankara, Turkey
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Chiba I, Nakaya N, Kogure M, Hatanaka R, Nakaya K, Tokioka S, Nakamura T, Nagaie S, Fuse N, Obara T, Kotozaki Y, Tanno K, Kuriyama S, Hozawa A. Associations between housing and psychological damage by earthquake and modifiable risk factors for dementia in general older adults: Tohoku Medical Megabank community-based cohort study. Geriatr Gerontol Int 2024; 24:509-516. [PMID: 38700081 DOI: 10.1111/ggi.14867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/07/2024] [Accepted: 03/22/2024] [Indexed: 05/05/2024]
Abstract
AIM To evaluate the association between housing and psychological damage caused by the Great East Japan Earthquake (GEJE) and modifiable risk factors (MRFs) of dementia for general population of older adults. METHODS This cross-sectional study enrolled 29 039 community-dwelling older adults (mean age 69.1 ± 2.9 years, 55.5% women). We evaluated disaster-related damage (by complete or not complete housing damage) and psychological damage (by post-traumatic stress reaction [PTSR]) after the GEJE using a self-report questionnaire. MRFs encompassed the presence of depression, social isolation, physical inactivity, smoking, and diabetes. We examined the association between disaster-related damage and MRFs using ordinary least squares and modified Poisson regression models adjusted for sociodemographic and health status variables. RESULTS Complete housing damage and PTSR were identified in 2704 (10.0%) and 855 (3.2%) individuals, respectively. The number of MRFs was significantly larger for the individuals with complete housing damage (β = 0.23; 95% confidence interval [CI]: 0.19-0.27) and PTSR (β = 0.60; 95% CI: 0.53-0.67). Prevalence ratios (PRs) for depression and physical inactivity were higher in individuals with complete housing damage. The PRs for all domains of the MRFs were significantly higher in individuals with PTSR. CONCLUSIONS Housing and psychological damage caused by the GEJE were associated with an increased risk factor of dementia. To attenuate the risk of dementia, especially among older victims who have experienced housing and psychological damage after a disaster, multidimensional support across various aspects of MRFs is required. Geriatr Gerontol Int 2024; 24: 509-516.
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Affiliation(s)
- Ippei Chiba
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Mana Kogure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Rieko Hatanaka
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Kumi Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Sayuri Tokioka
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Faculty of Data Science, Kyoto Women's University, Kyoto, Japan
| | - Satoshi Nagaie
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Nobuo Fuse
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Yuka Kotozaki
- Division of Clinical Research and Epidemiology, Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Morioka, Japan
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Kozo Tanno
- Division of Clinical Research and Epidemiology, Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Morioka, Japan
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Atsushi Hozawa
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
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Okuzono SS, Slopen N, Shiba K, Yazawa A, Kondo K, Kawachi I. Do Adverse Childhood Experiences Modify the Association Between Disaster-Related Trauma and Cognitive Disability? Am J Epidemiol 2024; 193:36-46. [PMID: 37442811 PMCID: PMC10773476 DOI: 10.1093/aje/kwad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/17/2023] [Accepted: 07/07/2023] [Indexed: 07/15/2023] Open
Abstract
Identifying subpopulations that are particularly vulnerable to long-term adverse health consequences of disaster-related trauma is needed. We examined whether adverse childhood experiences (ACEs) potentiate the association between disaster-related trauma and subsequent cognitive disability among older adult disaster survivors. Data were from a prospective cohort study of older adults who survived the 2011 Great East Japan Earthquake. The baseline survey pre-dated the disaster by 7 months. We included participants who completed follow-up surveys (2013 and 2016) and did not have a cognitive disability before the disaster (n = 602). Disaster-related traumas (i.e., home loss, loss of friends or pets) and ACEs were retrospectively assessed in 2013. Cognitive disability levels in 2016 were objectively assessed. After adjusting for pre-disaster characteristics using a machine learning-based estimation approach, home loss (0.19, 95% confidence interval (CI): 0.09, 0.28) was, on average, associated with greater cognitive disability. Among individuals with ACEs, home loss was associated with even higher cognitive disability levels (0.64, 95% CI: 0.24, 1.03). Losses of friends (0.18, 95% CI: 0.05, 0.32) and pets (0.13, 95% CI: 0.02, 0.25) were associated with higher cognitive disability levels only among those with ACEs. Our findings suggest that individuals with a history of ACEs may be particularly vulnerable to adverse health consequences related to disasters.
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Affiliation(s)
- Sakurako S Okuzono
- Correspondence to Sakurako S. Okuzono, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 (e-mail: )
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Gümüşsoy S, Keskin G, Öztürk R. Evaluation of the relationship between the fear of COVID-19 and mental status of female employees during the COVID-19 pandemic. Work 2024; 78:591-600. [PMID: 38457167 DOI: 10.3233/wor-230306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND The stress due to the COVID-19 pandemic has influenced the physical, mental, and social well-being of humans worldwide. OBJECTIVE To evaluate the relationship between the fear of COVID-19 and mental state of female employees during the COVID-19 pandemic. METHODS A cross-sectional study was conducted involving 726 participants. Data was collected using the Personal Information Form, fear of COVID-19 scale, and brief symptom inventory. RESULTS The fear experienced by women during the social isolation and quarantine period was associated with depression, anxiety, somatization, obsessive-compulsive disorder, interpersonal sensitivity, hostility, phobic anxiety and paranoid experiences. CONCLUSION Women, young people, the elderly and single individuals were most likely affected psychologically during the pandemic. Thus, interventions and psychological evaluations are recommended at an early stage to minimize this effect. Such interventions must be implemented considering the strategic planning and coordination of risk groups.
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Affiliation(s)
- Süreyya Gümüşsoy
- Atatürk Health Care Vocational School, Ege University, Izmir, Turkey
| | - Gülseren Keskin
- Atatürk Health Care Vocational School, Ege University, Izmir, Turkey
| | - Ruşen Öztürk
- Department of Women's Health and Diseases Nursing, Faculty of Nursing, Ege University, Izmir, Turkey
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Vahabi S, Lak A, Panahi N. Driving the determinants of older people's mental health in the context of urban resilience: a scoping review. BMC Geriatr 2023; 23:711. [PMID: 37919669 PMCID: PMC10623797 DOI: 10.1186/s12877-023-04387-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/05/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Population aging is a pervasive phenomenon occurring rapidly worldwide, while sustainable development goals are considered the mental health among older adults. METHODS To investigate the factors affecting mental health, we conducted a scoping review of the 47 papers published between 2015 and 2022 to explore various dimensions affecting older adults' mental health. RESULTS Our finding mirrors four dimensions of creating healthy and sustainable environments for older adults: person, place, processes, and resilience-related health in the living environment. The person dimension includes individual characteristics, attitudes and behaviors, and health status. The place dimension is divided into five categories: land use, access, physical form, public open spaces, and housing, while the process consists of the social, cultural, and economic environments. Resilience-related health dimension emphasizes the impact of natural and man-made disasters on older people's mental health. DISCUSSION These findings can provide policymakers insights into developing community-based environmental intervention strategies to promote mental health among older adults and support healthy and active aging.
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Affiliation(s)
- Sajad Vahabi
- Department of Urban Planning, Faculty of Arts, Tarbiat Modares University, Tehran, Iran
| | - Azadeh Lak
- Department of Urban Planning, Faculty of Arts, Shahid Beheshti University, Tehran, Iran.
| | - Niloofar Panahi
- Department of Urban Planning, Faculty of Arts, Tarbiat Modares University, Tehran, Iran
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Kino S, Aida J, Kondo K, Kawachi I. Do disasters exacerbate socioeconomic inequalities in health among older people? INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 98:104071. [PMID: 37982017 PMCID: PMC10655846 DOI: 10.1016/j.ijdrr.2023.104071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Disasters can exacerbate socioeconomic health disparities because of differential exposure (e.g., socioeconomically disadvantaged groups are more likely to be exposed to disaster-related trauma) and differential vulnerability (disadvantaged groups are more likely to suffer health consequences of exposure to trauma). We sought to test whether health disparities among older adults widened in the area which was directly affected by the 2011 Great East Japan Earthquake & Tsunami compared to areas which largely escaped tsunami damage. We used data from a cohort of community-dwelling older adults who were directly affected by the 2011 disaster (the Iwanuma Study) and municipalities that were not directly affected (the JAGES parent cohort excluding Iwanuma city). The Iwanuma Study gathered pre-disaster information from participants in 2010 (seven months before the disaster) as well as post-disaster information in 2013, 2016 and 2019 (2.5, 5.5 and 8.5 years after the disaster). Our outcomes were depressive symptoms (GDS) and instrumental activities of daily living (IADL). We examined the pre- versus post-disaster trends in socioeconomic health disparities using the slope index and relative index of inequality. We then conducted a difference-in-difference analysis comparing the pre/post disaster change in health disparities in the "exposed" city (Iwanuma) compared to "control" cities. We found clear pre-disaster socioeconomic inequalities in both GDS and IADL in both the exposed and control cities. However, the magnitude of these inequalities did not change after the disaster on either the absolute or relative scales. The 2011 disaster in northeastern Japan did not exacerbate pre-existing patterns of health inequalities in the older population.
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Affiliation(s)
- Shiho Kino
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Chiba University, Center for Preventive Medical Sciences, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
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Kotozaki Y, Tanno K, Otsuka K, Sasaki R, Sasaki M. Longitudinal changes in depressive symptoms associated with social isolation after the Great East Japan Earthquake in Iwate Prefecture: findings from the TMM CommCohort study. BMC Public Health 2023; 23:1154. [PMID: 37337230 PMCID: PMC10280825 DOI: 10.1186/s12889-023-16082-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 06/08/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Whether past disaster experiences affect the association between changes in social isolation and depressive symptoms is largely unknown. This study examined the association between changes in social isolation and depressive symptoms among survivors who experienced earthquake damage in the aftermath of the Great East Japan Earthquake (GEJE). METHODS We analyzed longitudinal data from 10,314 participants who responded to self-report questionnaires on the Lubben Social Network Scale-6 (LSNS-6) and the Center for Epidemiological Studies-Depressive Scale (CES-D) in both the baseline survey (FY2013 to FY2015) and follow-up survey (FY2017 to FY2019) after the GEJE. According to changes in the presence of social isolation (< 12 of LSNS-6) at two time points, participants were categorized into four groups: "not socially isolated," "improved socially isolated," "newly socially isolated," and "continuously socially isolated." At the follow-up survey, a CES-D score of ≥ 16 indicates the presence of depressive symptoms. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were estimated using the logistic regression analysis to examine the influence of the change in social isolation over four years on depressive symptoms. RESULTS Participants who were newly socially isolated had a significantly higher prevalence of depressive symptoms than those who were not socially isolated (AOR = 1.89, 95% CI = 1.61 - 2.23). In addition, AORs were highest for those who were continuously socially isolated and had experienced house damage (AOR = 2.17, 95% CI = 1.73 - 2.72) and those who were newly socially isolated and had not experienced the death of family members due to the GEJE (AOR = 1.88, 95%CI = 1.60 - 2.22). CONCLUSION Our longitudinal findings suggest that being newly or continuously socially isolated is associated with a risk of depressive symptoms, not only among those who had experienced house damage or the death of a family member, but also those who had not, in the disaster-affected area. Our study underlines the clinical importance of social isolation after a large-scale natural disaster and draws attention to the need for appropriate prevention measures.
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Affiliation(s)
- Yuka Kotozaki
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Iwate, Japan.
| | - Kozo Tanno
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Iwate, Japan
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Kotaro Otsuka
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Iwate, Japan
- Department of Neuropsychiatry, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Ryohei Sasaki
- Division of Physical Education, Department of Human Sciences, Iwate Medical University Center for Liberal Arts and Sciences, Iwate, Japan
| | - Makoto Sasaki
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Iwate, Japan
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Iwate, Japan
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Han C. Seismic activity and development of mood disorders: Findings from the 2016 Kyungju earthquake. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 867:161328. [PMID: 36603645 DOI: 10.1016/j.scitotenv.2022.161328] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/25/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND An earthquake with a moment magnitude of 5.8 occurred in Kyungju on 12 September 2016. Although the earthquake was the largest seismic activity in Korean history, there were no direct casualties from the event. This study evaluated whether a moderate-level earthquake is related to acute development of mood disorders in earthquake-exposed residents. MATERIAL AND METHODS The healthcare information of residents (n = 865,263) living in Kyungju and control cities (Gimpo, Jeonju, Gimhae, and Pohang) over a 10-year period (from 2010 to 2019) was gathered from the national health insurance database. Difference-in-difference analysis was used to compare the daily incidence of mood disorders (manic episode; bipolar affective disorder; depressive episode; recurrent depressive disorder) 20 weeks before (reference: -20 to -11 weeks, period 1: -10 to -1 weeks) and after (period 2: 0-9 weeks, period 3: 10-19 weeks) the earthquake. Subregional analyses based on the distance to the epicenter and stratification analyses by sex, age, and income were conducted. RESULTS The weekly average incidence rate (/100,000 persons) of mood disorders in Kyungju residents increased from 27.0 (-20 to -11 weeks) and 28.3 (-10 to -1 weeks) persons before the earthquake, to 38.1 persons (0 to 9 weeks) after the earthquake. A significant increase in the risk of developing mood disorders was observed in Kyungju residents during the 0 to 9 weeks after the earthquake when compared to the control cities [relative risk (95 % confidence intervals): vs. Gimpo, 1.40 (1.05, 1.88); vs. Jeonju, 1.45 (1.14, 1.84); vs. Gimhae, 1.48 (1.14, 1.93)]. The increase was more prominent in women, low-income individuals, and those living closer to the epicenter. CONCLUSION Moderate-level earthquakes without direct casualties may cause mood disorders in residents living in affected areas. Mental health aid programs should be provided to earthquake victims even if the earthquake has caused limited life and property loss.
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Affiliation(s)
- Changwoo Han
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea; KDI School of Public Policy and Management, Sejong, Republic of Korea.
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Sawada Y, Ashida T, Iwasaki K. Heterogenous effects of the Great East Japan earthquake on prosociality of people depending on their age. Sci Rep 2023; 13:3211. [PMID: 36828903 PMCID: PMC9950706 DOI: 10.1038/s41598-023-29536-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 02/06/2023] [Indexed: 02/26/2023] Open
Abstract
This study investigates the instability of prosociality in the real world by looking at the age-specific non-linear relationship between disaster exposure and prosocial behavior. We employed unique microdata from two communities in Japan that were hit by the Great East Japan Earthquake and Tsunami disaster in 2011. Exploiting exogenous variations in disaster exposure, we find age-specific heterogeneous effects of disaster exposure on prosocial behavior captured by the behavior of sending New Year's cards as well as attitudinal survey questions. Among the older groups, disaster damages undermine prosociality, whereas the younger groups show reinforced prosocial behaviors. These findings can be explained consistently by combining two possible determinants of prosocial behavior: pure or impure altruism and self-enforcements in repeated interactions at workplaces. Age information can help disentangle these two elements at least partially.
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Affiliation(s)
- Yasuyuki Sawada
- Faculty of Economics, University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
| | - Toyo Ashida
- grid.412160.00000 0001 2347 9884Hitotsubashi Institute for Advanced Study (HIAS), Hitotsubashi University, 2-1 Naka, Kunitachi, Tokyo 186-8601 Japan
| | - Keiko Iwasaki
- NLI Research Institute, 4-1-7 Kudankita, Chiyoda-Ku, Tokyo, 102-0073 Japan
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Shiba K, Daoud A, Hikichi H, Yazawa A, Aida J, Kondo K, Kawachi I. Uncovering Heterogeneous Associations Between Disaster-Related Trauma and Subsequent Functional Limitations: A Machine-Learning Approach. Am J Epidemiol 2023; 192:217-229. [PMID: 36255224 PMCID: PMC10308508 DOI: 10.1093/aje/kwac187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 08/31/2022] [Accepted: 10/13/2022] [Indexed: 02/07/2023] Open
Abstract
This study examined heterogeneity in the association between disaster-related home loss and functional limitations of older adults, and identified characteristics of vulnerable subpopulations. Data were from a prospective cohort study of Japanese older survivors of the 2011 Japan Earthquake. Complete home loss was objectively assessed. Outcomes in 2013 (n = 3,350) and 2016 (n = 2,664) included certified physical disability levels, self-reported activities of daily living, and instrumental activities of daily living. We estimated population average associations between home loss and functional limitations via targeted maximum likelihood estimation with SuperLearning and its heterogeneity via the generalized random forest algorithm. We adjusted for 55 characteristics of survivors from the baseline survey conducted 7 months before the disaster. While home loss was consistently associated with increased functional limitations on average, there was evidence of effect heterogeneity for all outcomes. Comparing the most and least vulnerable groups, the most vulnerable group tended to be older, not married, living alone, and not working, with preexisting health problems before the disaster. Individuals who were less educated but had higher income also appeared vulnerable for some outcomes. Our inductive approach for effect heterogeneity using machine learning algorithm uncovered large and complex heterogeneity in postdisaster functional limitations among Japanese older survivors.
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Affiliation(s)
- Koichiro Shiba
- Correspondence to Dr. Koichiro Shiba, Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118 (e-mail )
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Kim Y, Lee E. The Suicidal Ideation of Disaster Victims: A Nationwide Cross-Sectional Study. Psychol Res Behav Manag 2023; 16:905-914. [PMID: 36974039 PMCID: PMC10039656 DOI: 10.2147/prbm.s405667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/09/2023] [Indexed: 03/29/2023] Open
Abstract
Purpose Various natural and human made disasters occur worldwide. This study aimed to identify the factors affecting suicidal ideation in victims of disasters such as typhoons, heavy rainfall, fires, and earthquakes. Methods Data were obtained from a long-term survey on life changes among disaster victims conducted in 2019 by the National Disaster Management Research Institute. The study included 2234 victims of natural and social disasters occurring in Korea between 2012 and 2018. Suicidal ideation was assessed using the Korean version of the Composite International Diagnostic Interview developed by the World Health Organization. The participants' demographic characteristics, disaster-related characteristics, physical characteristics, psychological characteristics, and social characteristics were analyzed as the influencing factors. The data were analyzed using the chi-square test, t-test, and logistic regression. Results Of the 2234 subjects in this study, 32 were disaster victims who had experienced suicidal ideation, accounting for 1.4%. The results showed that the factors affecting suicidal ideation included disaster-related injury/disease, depression, and social support. The odds ratio of suicidal ideation was higher when there was injury/disease (OR=1.89, 95% CI=0.07-0.48), with higher depression levels (OR=1.31, 95% CI=1.18-1.47) and with lower social support (OR=0.94, 95% CI=0.90-0.99). Conclusion This study identifies the significant influencing factors of suicidal ideation in disaster victims, which were as follows: disaster-related injury or disease, depression, and social support. Our study's findings would contribute to screening high-risk groups of suicidal ideation and developing effective support, interventions, and suicide prevention programs for disaster victims. Furthermore, to prevent suicide and promote the healthy recovery of disaster victims, mental health care services aimed at suicide prevention should be reinforced and the victims should be provided with psychological support and treatment without financial burden.
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Affiliation(s)
- Yujeong Kim
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, Republic of Korea
- Correspondence: Yujeong Kim, College of Nursing, Kyungpook National University, 680 Gukchabosangro, Jung-Gu, Daegu, 41944, Republic of Korea, Tel +82-10-6311-5383, Fax +82-53-421-2758, Email
| | - Eunmi Lee
- Department of Nursing, Hoseo University, Asan, Republic of Korea
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Milić J. Aging and Neuropsychiatric Disease: A General Overview of Prevalence and Trends. Physiology (Bethesda) 2022. [DOI: 10.5772/intechopen.103102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The increasing trend of life-expectancy is becoming a significant demographic, societal and economic challenge. Currently, global number of people above sixty years of age is 900 million, while United Nations expect this number to rise to over 1.4 billion in 2030 and over 2.5 billion by 2050. Concordant to this trend, numerous physiological changes are associated with aging and brain-related ones are associated with neuropsychiatric diseases. The main goal of this chapter is to identify the most important neuropsychiatric diseases to assess in older patients to help to promote health and prevent diseases and complications associated with chronic illness, as these changes are progressive and require important psychological and setting-related social adjustments. Findings identify several health-aspects highly present in elderly: stroke, white matter lesions, dementia rise with age, changes in levels of neurotransmitters and hormones, depression as well as the bereavement following loss of the loved one, and the most common neurodegenerative disease—Alzheimer’s disease and Parkinson’s. In conclusion, studying the aging process should include all developmental, circumstantial, and individual aspects of aging. This offers opportunities to improve the health of elderly by using a wide range of skills and knowledge. Thus, further studies are necessary to elucidate what can be done do to improve the aging process and health of elderly in the future.
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Demirchyan A, Khachadourian V, Armenian HK, Goenjian AK. The course, trajectories and predictors of depression 23 years after the 1988 Spitak earthquake in Armenia: A prospective cohort study. Psychiatry Res 2022; 313:114640. [PMID: 35598565 DOI: 10.1016/j.psychres.2022.114640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/04/2022] [Accepted: 05/14/2022] [Indexed: 11/19/2022]
Abstract
There is a scarcity of long-term studies of depression after natural disasters. This prospective epidemiologic study evaluated the course of depression and factors associated with it among survivors 23-years post-earthquake. A geographically stratified subsample of 725 adults exposed to the Spitak earthquake was assessed for depression using DSM-III-R criteria in 1991 and 2012. Additionally, an adapted CES-D-16 scale was used to assess depressive symptoms in 2012. A fitted multi-nominal logistic regression model identified predictors of different trajectories of depression. For the whole group, the rate of clinical depression dropped from 51.5% in 1991 to 31.7% in 2012. Earthquake intensity and experiencing strong fear at baseline were strongly associated with chronic (depressed at both assessments, 18.1%) and recovered (depressed only in 1991, 33.5%) depression trajectories compared with the healthy group, with odds ratios (OR) over 4.0 and 3.0, respectively. Predictors distinguishing chronic depression included earthquake-related nuclear-family deaths (OR=3.79), chronic illnesses at baseline (OR=1.24), and social support (OR=0.91). Predictors of the late-onset trajectory (depressed only in 2012, 13.5% of the cohort) included post-earthquake trauma (OR=1.42), socioeconomic status (OR=0.45), and social support (OR=0.86). The factors associated with the different trajectories of depression provide guidance for planning more effective mental health interventions after disasters.
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Affiliation(s)
- Anahit Demirchyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia.
| | - Vahe Khachadourian
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Haroutune K Armenian
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Armen K Goenjian
- UCLA/Duke University National Center for Child Traumatic Stress, Department of Psychiatry and Biobehavioral Sciences, UCLA, CA, USA; Collaborative Neuroscience Network, CA, USA
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Shiba K, Hikichi H, Okuzono SS, VanderWeele TJ, Arcaya M, Daoud A, Cowden RG, Yazawa A, Zhu DT, Aida J, Kondo K, Kawachi I. Long-Term Associations between Disaster-Related Home Loss and Health and Well-Being of Older Survivors: Nine Years after the 2011 Great East Japan Earthquake and Tsunami. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:77001. [PMID: 35776697 PMCID: PMC9249145 DOI: 10.1289/ehp10903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/26/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Little research has examined associations between disaster-related home loss and multiple domains of health and well-being, with extended long-term follow-up and comprehensive adjustment for pre-disaster characteristics of survivors. OBJECTIVES We examined the longitudinal associations between disaster-induced home loss and 34 indicators of health and well-being, assessed ∼ 9 y post-disaster. METHODS We used data from a preexisting cohort study of Japanese older adults in an area directly impacted by the 2011 Japan Earthquake (n = 3,350 and n = 2,028 , depending on the outcomes). The study was initiated in 2010, and disaster-related home loss status was measured in 2013 retrospectively. The 34 outcomes were assessed in 2020 and covered dimensions of physical health, mental health, health behaviors/sleep, social well-being, cognitive social capital, subjective well-being, and prosocial/altruistic behaviors. We estimated the associations between disaster-related home loss and the outcomes, using targeted maximum likelihood estimation and SuperLearner. We adjusted for pre-disaster characteristics from the wave conducted 7 months before the disaster (i.e., 2010), including prior outcome values that were available. RESULTS After Bonferroni correction for multiple testing, we found that home loss (vs. no home loss) was associated with increased posttraumatic stress symptoms (standardized difference = 0.50 ; 95% CI: 0.35, 0.65), increased daily sleepiness (0.38; 95% CI: 0.21, 0.54), lower trust in the community (- 0.36 ; 95% CI: - 0.53 , - 0.18 ), lower community attachment (- 0.60 ; 95% CI: - 0.75 , - 0.45 ), and lower prosociality (- 0.39 ; 95% CI: - 0.55 , - 0.24 ). We found modest evidence for the associations with increased depressive symptoms, increased hopelessness, more chronic conditions, higher body mass index, lower perceived mutual help in the community, and decreased happiness. There was little evidence for associations with the remaining 23 outcomes. DISCUSSION Home loss due to a disaster may have long-lasting adverse impacts on the cognitive social capital, mental health, and prosociality of older adult survivors. https://doi.org/10.1289/EHP10903.
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Affiliation(s)
- Koichiro Shiba
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts, USA
| | - Hiroyuki Hikichi
- Division of Public Health, Kitasato University School of Medicine, Kanagawa, Japan
| | - Sakurako S. Okuzono
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Tyler J. VanderWeele
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Mariana Arcaya
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Adel Daoud
- Institute for Analytical Sociology, Linköping University, Linköping, Sweden
- Division of Data Science and Artificial Intelligence, Department of Computer Science and Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Richard G. Cowden
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts, USA
| | - Aki Yazawa
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - David T. Zhu
- Faculty of Science, Western University, London, Ontario, Canada
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsunori Kondo
- Department of Gerontological Evaluation, National Center for Geriatrics and Gerontology, Aichi, Japan
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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15
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Harada K, Sugisawa H, Sugihara Y, Yanagisawa S, Shimmei M. Big Five Personality Traits, Social Networks, and Depression Among Older Adults in Japan: A Multiple Mediation Analysis. Int J Aging Hum Dev 2022; 97:111-128. [PMID: 35733353 DOI: 10.1177/00914150221109893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examines the mediating effect of social network size on depression among older adults in Japan in association with the Big Five personality traits: extraversion, agreeableness, conscientiousness, neuroticism, and openness. Cross-sectional data were obtained from 739 older adults (Mean age = 75.13, SD = 6.86) residing in Tokyo. Multiple mediation analyses estimated total, indirect, and direct effects between personality and depression. Extraversion was associated with the number of kin and friend networks and agreeableness with the number of kin networks. Moreover, these social networks partially mediated the effects of extraversion and agreeableness on depression. The findings show that personality traits such as extraversion and agreeableness are associated with social network size, which contributes to better mental health in old age.
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Affiliation(s)
- Ken Harada
- 91710Jissen Women's University, Tokyo, Japan
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16
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Shiba K, Daoud A, Kino S, Nishi D, Kondo K, Kawachi I. Uncovering heterogeneous associations of disaster-related traumatic experiences with subsequent mental health problems: A machine learning approach. Psychiatry Clin Neurosci 2022; 76:97-105. [PMID: 34936171 PMCID: PMC9102396 DOI: 10.1111/pcn.13322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 11/16/2021] [Accepted: 12/14/2021] [Indexed: 11/29/2022]
Abstract
AIM Understanding the differential mental health effects of traumatic experiences is important to identify particularly vulnerable subpopulations. We examined the heterogeneous associations between disaster-related traumatic experiences and postdisaster mental health, using a novel machine learning-based causal inference approach. METHODS Data were from a prospective cohort study of Japanese older adults in an area severely affected by the 2011 Great East Japan Earthquake. The baseline survey was conducted 7 months before the disaster and the 2 follow-up surveys were conducted 2.5 and 5.5 years after (n = 1150 to n = 1644 depending on the exposure-outcome combinations). As disaster-related traumatic experiences, we assessed complete home loss and loss of loved ones. Using the generalized random forest algorithm, we estimated conditional average treatment effects (CATEs) of the disaster damages on postdisaster mental health outcomes to examine the heterogeneous associations by 51 predisaster characteristics of the individuals. RESULTS We found that, even when there was no population average association between disaster-related trauma and subsequent mental health outcomes, some subgroups experienced severe impacts. We also identified and compared characteristics of the most and least vulnerable groups (ie, top versus bottom deciles of the estimated CATEs). While there were some unique patterns specific to each exposure-outcome combination, the most vulnerable group tended to be from lower socioeconomic backgrounds with preexisting depressive symptoms for many exposure-outcome combinations. CONCLUSIONS We found considerable heterogeneity in the association between disaster-related traumatic experiences and subsequent mental health problems.
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Affiliation(s)
- Koichiro Shiba
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Adel Daoud
- Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Institute for Analytical Sociology, Linköping University, Norrköping, Sweden
- The Division of Data Science and Artificial Intelligence, The Department of Computer Science and Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Shiho Kino
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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17
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Yao Y, Lu Y, Guan Q, Wang R. Can parkland mitigate mental health burden imposed by the COVID-19? A national study in China. URBAN FORESTRY & URBAN GREENING 2022; 67:127451. [PMID: 34955700 PMCID: PMC8684091 DOI: 10.1016/j.ufug.2021.127451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/22/2021] [Accepted: 12/17/2021] [Indexed: 05/11/2023]
Abstract
The worldwide coronavirus disease 2019 (COVID-19) pandemic has seriously affected not only physical health but also mental wellbeing (i.e mental stress and suicide intention) of numerous urban inhabitants across the globe. While many studies have elucidated urban parkland enhances and mental wellbeing of urban residents, the potential for parkland to mitigate mental health burden imposed by the COVID-19 has received no attention. This nationwide study systematically explored the association between parkland, the COVID-19 pandemic situation and mental wellbeing from 296 cities in China. The study innovatively used big data from Baidu Search Engine to assess city-level mental wellbeing, thereby enabling comparisons among cities. The results show that the provision of parkland is positively associated with mental wellbeing during the COVID-19 epidemic. For COVID-19-related indicators, the geographical distance to Wuhan city, work resumption rate, and travel intensity within the city are also positively associated with mental wellbeing, while the number of COVID-19 infections and the proportion of migrants from Hubei Province for each city are negatively associated with mental wellbeing. Last, the most important finding is that parkland reduces the negative effect of COVID-19 on mental wellbeing during the COVID-19 epidemic. To achieve the goal of promoting mental wellbeing through urban planning and design during the future pandemics, policymakers and planners are advised to provide more well-maintained and accessible parkland and encourage residents to use them with proper precautions.
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Affiliation(s)
- Yao Yao
- School of Geography and Information Engineering, China University of Geosciences, Wuhan, 430078, Hubei Province, China
- National Engineering Research Center of GIS, China University of Geosciences, Wuhan, 430078, Hubei Province, China
- Department of Data Technology and Products, Alibaba Group, Hangzhou, 311121, Zhejiang Province, China
| | - Yi Lu
- Department of Architecture and Civil Engineering, City University of Hong Kong, Hong Kong, China
- City University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Qingfeng Guan
- School of Geography and Information Engineering, China University of Geosciences, Wuhan, 430078, Hubei Province, China
- National Engineering Research Center of GIS, China University of Geosciences, Wuhan, 430078, Hubei Province, China
| | - Ruoyu Wang
- Institute of Geography, School of GeoSciences, University of Edinburgh, Edinburgh, UK
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18
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Shiba K, Daoud A, Hikichi H, Yazawa A, Aida J, Kondo K, Kawachi I. Heterogeneity in cognitive disability after a major disaster: A natural experiment study. SCIENCE ADVANCES 2021; 7:eabj2610. [PMID: 34586850 PMCID: PMC8480922 DOI: 10.1126/sciadv.abj2610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Cognitive disability following traumatic experiences of disaster has been documented; however, little is known about heterogeneity in the association across individuals. In this natural experiment study of approximately 3000 Japanese older adults in an area directly affected by the 2011 Great East Japan Earthquake, the baseline survey was established 7 months before the 2011 earthquake. To inductively identify heterogeneity in postdisaster cognitive disability by predisaster characteristics, we applied a machine learning–based causal inference approach—generalized random forest. We identified strong evidence for heterogeneity in the association between home loss and cognitive disability objectively assessed 2.5 and 5.5 years after the 2011 earthquake. The subgroups with the strongest disaster-dementia associations tended to be from low socioeconomic backgrounds and have predisaster health problems. The study demonstrated that some subpopulations are particularly prone to experience cognitive disability after disasters, which could be overlooked in studies assessing population average associations only.
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Affiliation(s)
- Koichiro Shiba
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Corresponding author.
| | - Adel Daoud
- Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Institute for Analytical Sociology, Linköping University, Norrköping, Sweden
- The Division of Data Science and Artificial Intelligence, the Department of Computer Science and Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Hiroyuki Hikichi
- Division of Public Health, Kitasato University School of Medicine, Kanagawa, Japan
| | - Aki Yazawa
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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19
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Shiba K, Kawahara T, Aida J, Kondo K, Kondo N, James P, Arcaya M, Kawachi I. Causal Inference in Studying the Long-Term Health Effects of Disasters: Challenges and Potential Solutions. Am J Epidemiol 2021; 190:1867-1881. [PMID: 33728430 DOI: 10.1093/aje/kwab064] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 03/05/2021] [Accepted: 03/11/2021] [Indexed: 12/17/2022] Open
Abstract
Two frequently encountered but underrecognized challenges for causal inference in studying the long-term health effects of disasters among survivors include 1) time-varying effects of disasters on a time-to-event outcome and 2) selection bias due to selective attrition. In this paper, we review approaches for overcoming these challenges and demonstrate application of the approaches to a real-world longitudinal data set of older adults who were directly affected by the 2011 Great East Japan Earthquake and Tsunami (n = 4,857). To illustrate the problem of time-varying effects of disasters, we examined the association between degree of damage due to the tsunami and all-cause mortality. We compared results from Cox regression analysis assuming proportional hazards with those derived using adjusted parametric survival curves allowing for time-varying hazard ratios. To illustrate the problem of selection bias, we examined the association between proximity to the coast (a proxy for housing damage from the tsunami) and depressive symptoms. We corrected for selection bias due to attrition in the 2 postdisaster follow-up surveys (conducted in 2013 and 2016) using multivariable adjustment, inverse probability of censoring weighting, and survivor average causal effect estimation. Our results demonstrate that analytical approaches which ignore time-varying effects on mortality and selection bias due to selective attrition may underestimate the long-term health effects of disasters.
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20
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Coastal exposure and residents' mental health in the affected areas by the 2011 Great East Japan Earthquake and Tsunami. Sci Rep 2021; 11:16751. [PMID: 34408202 PMCID: PMC8373874 DOI: 10.1038/s41598-021-96168-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 08/05/2021] [Indexed: 11/08/2022] Open
Abstract
No previous study has ever explored the association between coastal exposure and the mental health of residents in a post-disaster context. Therefore, we aimed to confirm whether there was an association between sea visibility and coastal proximity and the mental health of coastal residents a devastating tsunami. We targeted 15 coastal municipalities located in the Miyagi Prefecture, and obtained data from a community-based cohort study. The baseline survey was initiated 2 years after the 2011 Great East Japan Earthquake and Tsunami and the secondary survey was initiated 6 years after the disaster. We applied multilevel mixed-effects models to the longitudinal data. Our outcome measure was the Kessler Psychological Distress Scale (K6) score. We assessed the data collected from 2,327 respondents on both surveys as of April 2018 for this ongoing cohort study. We found that neither sea visibility nor coastal proximity was significantly associated with the recovery of mental health after the disaster. However, we found a distinctive trend of mental health recovery in people who lived alone with a sea view, indicating that visibility of the sea had a negative effect on their mental health immediately after the GEJET, but that the negative effect was subsequently eliminated.
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21
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Minagawa Y, Saito Y. Disasters and the Disablement Process framework: an analysis of the great east Japan earthquake and tsunami of 2011. DISASTERS 2021; 45:647-663. [PMID: 32762069 DOI: 10.1111/disa.12456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study used the Disablement Process framework to examine how exposure to the great east Japan earthquake and tsunami on 11 March 2011 was related to elders' experiences of disability-that is, 'a gap between personal capability and environmental demand' (Verbrugge and Jette, 1994, p. 1). Data were derived from two waves (2009 and 2013) of the Nihon University Japanese Longitudinal Study of Aging, involving a representative sample of citizens aged 65 or more. Logistic regression was employed to model how the disaster was associated with the prevalence and incidence of disability. A significant relationship was documented between the two. Those impacted by the event exhibited greater odds of reporting a disability in 2013 and developing one between 2009 and 2013. Disasters destroy social infrastructure and disrupt daily life, widening the lacuna between the environment and personal resources. Given the increasing number of disasters, more policy attention should be directed to reducing their adverse consequences for health.
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Affiliation(s)
- Yuka Minagawa
- Associate Professor, Faculty of Liberal Arts, Sophia University, Japan
| | - Yasuhiko Saito
- Professor, College of Economics, Nihon University, Japan
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22
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Pruchno R, Wilson-Genderson M, Heid AR, Cartwright FP. Effects of peri-traumatic stress experienced during Hurricane Sandy on functional limitation trajectories for older men and women. Soc Sci Med 2021; 281:114097. [PMID: 34120083 PMCID: PMC8276253 DOI: 10.1016/j.socscimed.2021.114097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/13/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND METHODS Although the short-term effects of disasters on the physical health of mid-life and older people have been documented, little is understood about the long-term effects that disasters have on the physical health of these people. Based on the environmental docility hypothesis and research regarding gender effects on functional limitations and disaster, our analyses examined the effects of peri-traumatic stress experienced during Hurricane Sandy using longitudinal data from 5688 people aged 50 and older collected over six waves (2006-2019). RESULTS We found that functional limitations follow three trajectories, with people in each group having a significant linear increase over time and all but the highest functioning people also having a significant quadratic effect, indicating that the linear increase peaked post-Hurricane and then slowed in later waves. CONCLUSION Consistent with the environmental docility hypothesis, peri-traumatic stress had its greatest impact on people with more functional limitations before the hurricane. Men experiencing peri-traumatic stress during Hurricane Sandy were more likely to experience an increase in functional limitations than women. These findings, which identify people most likely to experience long-term health effects following a disaster, can be used to inform health policies before, during, and after disaster strikes.
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Affiliation(s)
- Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA.
| | | | | | - Francine P Cartwright
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA.
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Dejonckheere E, Houben M, Schat E, Ceulemans E, Kuppens P. The Short-Term Psychological Impact of the COVID-19 Pandemic in Psychiatric Patients: Evidence for Differential Emotion and Symptom Trajectories in Belgium. Psychol Belg 2021; 61:163-172. [PMID: 34221438 PMCID: PMC8231474 DOI: 10.5334/pb.1028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 05/31/2021] [Indexed: 11/20/2022] Open
Abstract
The spread of COVID-19 and the implementation of various containment strategies across the world have seriously disrupted people's everyday life, and it is especially uncertain what the psychological impact of this pandemic will be for vulnerable individuals, such as psychiatric (ex-)patients. Governments fear that this virus outbreak may prelude a major mental health crisis, and psychiatrists launch critical calls to flatten an upcoming mental ill-health surge. Here, we aim to add nuance to the idea that we are heading towards a mental health pandemic and that psychiatric populations will unavoidably (re)develop psychopathology. Despite being subjected to the same challenges posed by COVID-19, we argue that people with a history of psychiatric illness will psychologically deal with this adversity in different ways. To showcase the short-term differential impact of COVID-19 on patients' mental health, we present the day-to-day emotion and symptom trajectories of different psychiatric patients that took part in an experience sampling study before, during, and after the start of the first wave of the COVID-19 pandemic in March 2020 and associated lockdown measures in Belgium. Piecewise regression models show that not all patients' psychological well-being is affected to a similar degree. As such, we argue that emphasizing human resilience, also among the more vulnerable in society, may be opportune in these unsettling times.
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Affiliation(s)
| | - Marlies Houben
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Leuven, 3000, Belgium
- Mind-Body Research and Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Kapucijnenvoer 7, Leuven, 3000, Belgium
| | - Evelien Schat
- KU Leuven - Faculty of Psychology and Educational Sciences, Belgium
| | - Eva Ceulemans
- KU Leuven - Faculty of Psychology and Educational Sciences, Belgium
| | - Peter Kuppens
- KU Leuven - Faculty of Psychology and Educational Sciences, Belgium
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Kotozaki Y, Tanno K, Sakata K, Takusari E, Otsuka K, Tomita H, Sasaki R, Takanashi N, Mikami T, Hozawa A, Nakaya N, Tsuchiya N, Nakamura T, Narita A, Taki Y, Shimizu A, Hitomi J, Satoh M, Sasaki M. Association between the social isolation and depressive symptoms after the great East Japan earthquake: findings from the baseline survey of the TMM CommCohort study. BMC Public Health 2021; 21:925. [PMID: 33992096 PMCID: PMC8122535 DOI: 10.1186/s12889-021-10896-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/19/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Social isolation and mental health issues have become a severe problem in disaster areas in the Great East Japan Earthquake. This study examined whether the combination of the house damage and social isolation or the combination of the death of family members and social isolation is associated with depressive symptoms among survivors using the baseline study data of the Tohoku Medical Megabank Project Community-Based Cohort Study (TMM CommCohort Study). METHODS We used cross-sectional data from a baseline survey of 48,958 participants (18,423 males, 30,535 females; aged 60.1 ± 11.2 years) to examine the association between social isolation measured by the Lubben social network scale 6 (LSNS-6) and depressive symptoms measured by the Center for Epidemiological Studies-Depressive Scale (CES-D). The presence of social isolation and depressive symptoms was defined by an LSNS-6 score of < 12 and a CES-D score of ≥16, respectively. We performed a logistic regression analysis to determine the multivariable-adjusted odds ratio (95% confidence interval) [AOR (95% CI)] for depressive symptoms according to sex in the social isolation in comparison to without social isolation, and the associations of the combination of the house damage or the death of family members and social isolation and depressive symptoms. RESULTS Social isolation was significantly associated with depressive symptoms (males: OR = 1.87; 95% CI = 1.72-2.04, females: OR = 2.13; 95% CI = 2.00-2.26). Both males and females respondents with severe house damage and social isolation had a greater risk of depressive symptoms in comparison to those with an undamaged house and without social isolation (males: OR = 3.40; 95% CI = 2.73-4.24, females: OR = 2.92; 95% CI = 2.46-3.46). The risk of depressive symptoms was also higher in both males and females respondents with the death of family members and social isolation in comparison to those without the death of family members and without social isolation (males: OR = 2.18; 95% CI = 1.90-2.50, females: OR = 2.60; 95% CI = 2.35-2.88). CONCLUSION The findings suggested that a combination of social isolation and severe house damage and the death of family members caused by a large-scale natural disaster was associated with a higher risk of depressive symptoms although the interaction was not statistically significant.
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Affiliation(s)
- Yuka Kotozaki
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Shiwa, Iwate, 028-3694, Japan.
| | - Kozo Tanno
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Shiwa, Iwate, 028-3694, Japan
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Kiyomi Sakata
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Shiwa, Iwate, 028-3694, Japan
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Eri Takusari
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Kotaro Otsuka
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Shiwa, Iwate, 028-3694, Japan
- Department of Neuropsychiatry, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Hiroaki Tomita
- Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Division of Disaster Medical Science, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Ryohei Sasaki
- Division of Physical Education, Department of Human Sciences, Iwate Medical University Center for Liberal Arts and Sciences, Iwate, Japan
| | - Nobuyuki Takanashi
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Shiwa, Iwate, 028-3694, Japan
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Takahiro Mikami
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Shiwa, Iwate, 028-3694, Japan
- Department of Anatomy, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Atsushi Hozawa
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Department of Health Science, Saitama Prefectural University, Koshigaya, Japan
| | - Naho Tsuchiya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Akira Narita
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Yasuyuki Taki
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Department of Radiology and Nuclear Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Atsushi Shimizu
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Shiwa, Iwate, 028-3694, Japan
- Division of Biomedical Information Analysis, Institute for Biomedical Sciences, Iwate Medical University, Iwate, Japan
| | - Jiro Hitomi
- Department of Anatomy, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Mamoru Satoh
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Shiwa, Iwate, 028-3694, Japan
- Division of Biomedical Information Analysis, Institute for Biomedical Sciences, Iwate Medical University, Iwate, Japan
| | - Makoto Sasaki
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Shiwa, Iwate, 028-3694, Japan
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Iwate, Japan
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Kino S, Aida J, Kondo K, Kawachi I. Persistent mental health impacts of disaster. Five-year follow-up after the 2011 great east Japan earthquake and tsunami: Iwanuma Study. J Psychiatr Res 2021; 136:452-459. [PMID: 32948310 PMCID: PMC7443179 DOI: 10.1016/j.jpsychires.2020.08.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/10/2020] [Accepted: 08/14/2020] [Indexed: 11/06/2022]
Abstract
Few studies have tracked the long-term mental health outcomes following major disaster. We sought to document the trajectories of depressive symptoms and post-traumatic stress symptoms (PTSS) in the aftermath of the 2011 Great East Japan earthquake and tsunami. A cohort of community-dwelling older adults were followed for 5.5 years after the disaster at 3 waves (2010, 2013 and 2016). Depressive symptoms were measured by the Geriatric Depression Scale Short Form, while PTSS was assessed by the Screening Questionnaire for Disaster Mental Health. We examined the trajectories of mental illness symptoms based on the probabilities of persistence, recovery, and delayed onset. Among people without pre-disaster depressive symptoms, 13.6% had developed depressive symptoms 2.5 years after the disaster. Of these, half of those had recovered and half had persisted at the 5.5 year follow-up. 11.1% of survivors reported post-traumatic stress symptoms in 2013; of these, 58% recovered by 2016, while 4.8% experienced delayed onset. Job loss was associated with persistent PTSS (OR 2.03; 95%CI 1.01-4.12) while a drop in subjective economic status predicted delayed onset of PTSS (OR 2.13; 1.34-3.39). However, disaster-related experiences were unrelated to the trajectory of depressive symptoms at 5.5 years. The probabilities of remission (58%) and delayed onset (5%) of PTSS are consistent with prior disaster research. The experience of job loss and drop in subjective economic status appeared to exert a lingering influence on the persistence or delayed onset of PTSS. Depressive symptoms after the disaster had remitted in roughly half of the survivors after 5.5 years.
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Affiliation(s)
- Shiho Kino
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA; Department of Health Education and Health Sociology, The University of Tokyo, Tokyo, Japan.
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan,Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Chiba University, Center for Preventive Medical Sciences, Chiba, Japan,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
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Six-year follow-up study of residential displacement and health outcomes following the 2011 Japan Earthquake and Tsunami. Proc Natl Acad Sci U S A 2021; 118:2014226118. [PMID: 33397722 DOI: 10.1073/pnas.2014226118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Studies examining the long-term health consequences of residential displacement following large-scale disasters remain sparse. Following the 2011 Japan Earthquake and Tsunami, victims who lost their homes were resettled by two primary means: 1) group relocation to public housing or 2) individual relocation, in which victims moved into public housing by lottery or arranged for their own accommodation. Little is known about how the specific method of residential relocation affects survivors' health. We examined the association between residential relocation and long-term changes in mental and physical well-being. Our baseline assessment predated the disaster by 7 mo. Two follow-up surveys were conducted ∼2.5 y and 5.5 y after the disaster to ascertain the long-term association between housing arrangement and health status. Group relocation was associated with increased body mass index and depressive symptoms at 2.5-y follow-up but was no longer significantly associated with these outcomes at 5.5-y follow-up. Individual relocation at each follow-up survey was associated with lower instrumental activities of daily living as well as higher risk of cognitive impairment. Our findings underscore the potential complexity of long-term outcomes associated with residential displacement, indicating both positive and negative impacts on mental versus physical dimensions of health.
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Multilevel Social Mechanisms of Post-Disaster Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020391. [PMID: 33419131 PMCID: PMC7825536 DOI: 10.3390/ijerph18020391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/24/2020] [Accepted: 12/28/2020] [Indexed: 11/25/2022]
Abstract
This exploratory study empirically shows how community social capital is related to post-disaster depression, whereas most disaster mental health research has focused on posttraumatic stress disorder. We tested the validity of earlier found multilevel social and individual mechanisms of posttraumatic stress for symptoms of post-disaster depression. We used data (n = 231) from a community study after a flood in Morpeth (2008), a rural town in northern England. At the salutary community level, our multilevel analyses showed that, in communities with high social capital, individuals employ less individual social support and coping effort, which protects individuals from developing symptoms of depression. Yet, on the ‘dark’ individual level of our model, we found that perceiving the disaster as less traumatic after a year was related to more feelings of depression in contrast to previous findings for posttraumatic stress. Our explanation of this finding is that, when the appraisal of the disaster as threatening fades into the background, individuals may perceive the full scope of the disaster aftermath and start to feel depressed. We also found that more social support is related to more depression. Although depressed people may attract or receive more social support, this social support can paradoxically become disabling by reinforcing a sense of dependence, thereby undermining self-esteem and leading to feelings of helplessness. Our results imply that to curb post-disaster depression, boosting community level social capital may be an important starting point for building resilience. At the same time, interventionists need to identify risk groups for whom the stressful experience becomes less intrusive and who experience the burden of dependency on an unequal relationship with ones’ social inner circle.
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Sannabe A, Aida J, Wada Y, Ichida Y, Kondo K, Kawachi I. On the Direct and Indirect Effects of the Great East Japan Earthquake on Self Rated Health through Social Connections: Mediation Analysis. JAPAN AND THE WORLD ECONOMY 2020; 56:101039. [PMID: 35814635 PMCID: PMC9262148 DOI: 10.1016/j.japwor.2020.101039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The Great East Japan Earthquake created health hazards for many people. Using Panel Data gathered in Iwanuma city, Japan, at two points in time (in 2010 before the quake, and in 2013 after the quake), we found that the high degree of housing damage negatively affected victims' self rated health (SRH) (direct effect), and decreased the levels of their social connections, which in turn also had a harmful effect on their SRH (indirect effect). We also found that although the direct impacts of earthquakes disappear relatively quickly, the harmful indirect effects associated with a decrease in social connections are slower to dissipate. We conducted a first-difference two-step GMM estimation to consider the possible problem of endogeneity. The results support the above conclusion, and show that in the short-term, the indirect impacts of the earthquake accounted for 55% of all the impacts experienced.
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Affiliation(s)
- Atsushi Sannabe
- Ryutsu Keizai University, Chiba, Japan and Doctoral Institute for Evidence Based Policy, Tokyo, Japan
| | - Jun Aida
- Tohoku University Graduate School of Dentistry, Department of International and Community Oral Health, Sendai, Japan
| | - Yuri Wada
- Doctoral Institute for Evidence Based Policy, Tokyo, Japan
| | | | - Katsunori Kondo
- Chiba University, Center for Preventive Medical Sciences, Chiba, Japan
| | - Ichiro Kawachi
- Harvard T. H. Chan School of Public Health. Department of Social and Behavioral Sciences, Boston, USA
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Shiba K, Yazawa A, Kino S, Kondo K, Aida J, Kawachi I. Depressive symptoms in the aftermath of major disaster: Empirical test of the social support deterioration model using natural experiment. WELLBEING, SPACE AND SOCIETY 2020; 1:100006. [PMID: 36238446 PMCID: PMC9555822 DOI: 10.1016/j.wss.2020.100006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION We examined the extent to which the post-disaster deterioration of social support and social capital mediates the associations between disaster-related experiences and depressive symptoms among survivors to test the social support deterioration model. METHODS We used unique natural experiment data (n = 3567) stemming from the 2011 Great East Japan Earthquake. The follow-up survey was conducted 2.5 years after the disaster. We examined associations between changes in depressive symptoms, disaster-related experiences (loss of loved ones, changes in household income, loss of job, drop in subjective economic status, and home loss), and post-disaster deterioration of four different types of social support (i.e., kin emotional, kin instrumental, non-kin emotional, and non-kin instrumental support), as well as two dimensions of individual-level social capital (i.e., informal socializing and social cohesion). We then performed causal mediation analysis. RESULTS We found that there was deterioration of social support and social capital among individuals with disaster-related experiences. We also found associations between deterioration of social support/capital and worsening of depressive symptoms for specific categories of disaster experiences (i.e., drop in subjective economic status, loss of job, and home loss). However, causal mediation analysis showed little evidence of mediation by post-disaster deterioration of social support/capital. There was some evidence to suggest exposure-mediator interaction such that the association between social support/capital deterioration and depressive symptoms was weaker among those with disaster experiences. DISCUSSION The social support deterioration model was not empirically supported among older-adult disaster survivors of the 2011 Great East Japan Earthquake, after accounting for exposure-mediator interactions.
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Affiliation(s)
- Koichiro Shiba
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Aki Yazawa
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Shiho Kino
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Department of Health Education and Health Sociology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi 474-8511, Japan
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
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Pruchno R, Wilson-Genderson M, Heid AR, Cartwright FP. Type of Disaster Exposure Affects Functional Limitations of Older People 6 Years Later. J Gerontol A Biol Sci Med Sci 2020; 75:2139-2146. [PMID: 31678995 PMCID: PMC7566386 DOI: 10.1093/gerona/glz258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Natural disasters, including earthquakes, tsunamis, tornadoes, and hurricanes, are traumatic events that simultaneously affect the lives of many people. Although much is known about the effects that natural disasters have on mental health, little is known about how natural disasters affect physical health. These analyses add to the literature by examining the ways in which four types of disaster exposure (geographic, peri-traumatic stress, personal and property loss, and poststorm hardship) experienced by older people during and after Hurricane Sandy affected functional limitations. METHODS We analyzed five waves of data from the ORANJ BOWL panel ("Ongoing Research on Aging in New Jersey: Bettering Opportunities for Wellness in Life") using multilevel mixed-effects models. RESULTS We found that although peri-traumatic stress and poststorm hardship each had independent effects on functional limitations, the effects of peri-traumatic stress dominated and were evident 6 years after the hurricane. Geographic exposure and personal/property loss were not associated with functional limitations. CONCLUSIONS These findings add important information to what is known about older people who experience a natural disaster and suggest opportunities for intervention. Finding that an individual's emotional response during the disaster plays an important role in the development of functional limitations suggests that reduction of exposure to traumatic stress during a storm (ie, evacuation from a storm area) may be important for older people. Likewise, interventions immediately after a disaster that target older people who experience high levels of peri-traumatic distress may be needed in order to alleviate functional limitations before they develop.
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Affiliation(s)
- Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford
| | | | - Allison R Heid
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford
| | - Francine P Cartwright
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford
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Mediation of the relationship between home loss and worsened cardiometabolic profiles of older disaster survivors by post-disaster relocation: A natural experiment from the Great East Japan earthquake and tsunami. Health Place 2020; 66:102456. [PMID: 33010662 DOI: 10.1016/j.healthplace.2020.102456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/19/2020] [Accepted: 09/23/2020] [Indexed: 12/16/2022]
Abstract
The underlying mechanism for deterioration in cardiometabolic health after major natural disasters is unknown. We leveraged natural experiment data stemming from the 2011 Great East Japan Earthquake and Tsunami (n = 1165) to examine whether specific types of post-disaster accommodations explain the association between disaster-related property damage and objectively measured cardiometabolic profiles of older disaster survivors. Causal mediation analysis showed that relocation to trailer-style temporary shelters largely mediated the associations between home loss and unhealthy changes in anthropometric measures (72.6% of 0.65 kg/m2 for body mass index and 62.3% of 3.89 cm for waist circumference), but it did not mediate the associations with serum lipid measures. This study demonstrates that there are outcome-specific pathways linking disaster damage and health of survivors.
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Li L, Reinhardt JD, Pennycott A, Li Y, Chen Q. Prevalence of and Risk Factors for Depression Among Older Persons 6 Months After the Lushan Earthquake in China: A Cross-Sectional Survey. Front Psychiatry 2020; 11:853. [PMID: 33132921 PMCID: PMC7549460 DOI: 10.3389/fpsyt.2020.00853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 08/05/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Older persons are particularly vulnerable to the impact of earthquakes and are more likely to suffer from depression. OBJECTIVES We aimed to estimate the prevalence of depression, to compare the prevalence between disaster-affected and non-disaster affected areas, and to explore additional risk factors for depression 6 months after the Lushan earthquake. DESIGN A cross-sectional study was conducted. SETTING A magnitude 7.0 earthquake occurred in Lushan County, Ya'an Prefecture, Sichuan Province, on April 20, 2013. In total, 196 people were killed, and 11,470 were injured over 5 days. PARTICIPANTS A multistage cluster sampling strategy was used. A total of 1,509 older persons (aged 60 or older) participated. METHODS The Geriatric Depression Scale-15, the University of California Los Angeles Loneliness scale, the Activities of Daily Living Scale, the Social Support Rating Scale, and the Family Apgar Index scale were used to evaluate symptoms of depression, loneliness, dependence with respect to activities of daily living, perceived social support, and family function, respectively. A generalized linear regression model and multiple logistic regression analysis were employed to identify risk factors for depression. RESULTS Using a cutoff score of 8, the prevalence of depression was 29.16% in the hardest-hit disaster area, 29.06% in the hard-hit disaster area, 31.61% in the moderately-hit disaster area, 17.94% in the remote non-disaster area, and 12.28% in the neighboring non-disaster area. The prevalence was significantly higher in the disaster areas than in the non-disaster areas. Risk factors for depression included an educational level of elementary school or lower, a greater number of chronic illnesses, feelings of loneliness, limitations in activities of daily living, family dysfunction, and low levels of social support. CONCLUSION Depression was highly prevalent in elderly survivors and was significantly more prevalent in disaster areas than in non-disaster areas. Psychological interventions and care should focus on older survivors.
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Affiliation(s)
- Lan Li
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, China
- School of Nursing, Southwest Medical University, Luzhou, China
- The Hong Kong Polytechnic University Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, China
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Jan D. Reinhardt
- The Hong Kong Polytechnic University Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, China
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Andrew Pennycott
- Sensory-Motor Systems Lab, Department of Health Science and Technology ETH Zürich, Zürich, Switzerland
| | - Ying Li
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Chen
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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Ikeda T, Aida J, Kawachi I, Kondo K, Osaka K. Causal effect of deteriorating socioeconomic circumstances on new-onset arthritis and the moderating role of access to medical care: A natural experiment from the 2011 great east Japan earthquake and tsunami. Soc Sci Med 2020; 264:113385. [PMID: 33032081 PMCID: PMC7577562 DOI: 10.1016/j.socscimed.2020.113385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/01/2020] [Accepted: 09/18/2020] [Indexed: 12/25/2022]
Abstract
Socioeconomic disadvantage is a risk factor for arthritis, but its causal relationship remains unclear. This study examined the causal relationship between socioeconomic circumstances and new-onset arthritis by taking advantage of the "natural experiment" that resulted from the Great East Japan Earthquake and Tsunami. The baseline survey was conducted in August 2010, 7 months before the disaster. Self-reported questionnaires were mailed to all eligible residents of Iwanuma City in Miyagi Prefecture. The earthquake and tsunami occurred on March 11, 2011. The follow-up survey was conducted in October 2013, as well as the gathering of information about disaster damage (housing damage and subjective deterioration of economic circumstances) and health-related information. We used a two-stage least squares instrumental variable model to analyze 2360 survivors who did not have arthrosis at baseline, of whom 95 (4.0%) developed arthritis over the 2.5-year follow-up period. We used the linear probability model for the estimations. Our results revealed that both the subjective deterioration of economic circumstances and housing damage were associated with the development of arthritis (95% confidence interval [CI], 0.08 [0.03-0.12] and 0.02 [0.01-0.04], respectively). In addition, we also found that the disruption of access to orthopedics was associated with the development of arthritis. Our findings added robust evidence of the causal relationship between worsening economic circumstances and the development of arthritis. Our study emphasized the importance of recovery as well as the establishment of the post-disaster orthopedic medical system in the aftermath of a disaster.
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Affiliation(s)
- Takaaki Ikeda
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan; Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan.
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Miyagi, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
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Kino S, Aida J, Kondo K, Kawachi I. Long-term Trends in Mental Health Disorders After the 2011 Great East Japan Earthquake and Tsunami. JAMA Netw Open 2020; 3:e2013437. [PMID: 32797173 PMCID: PMC7428812 DOI: 10.1001/jamanetworkopen.2020.13437] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Posttraumatic stress symptoms (PTSS) and depressive symptoms are common among survivors of a major disaster, yet few longitudinal studies have documented their long-term persistence at the community level. OBJECTIVE To examine the trajectories of PTSS and depressive symptoms for as long as 5.5 years after the 2011 Great East Japan earthquake and tsunami. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from 2781 participants in 3 waves of the Iwanuma Study (2010, 2013, and 2016), a cohort of community-dwelling older adults (≥65 years in August 2010) in Iwanuma, Japan, who were directly affected by the 2011 disaster. The baseline assessment of mental health predated the disaster by 7 months, and survivors were followed up for 5.5 years after the disaster. Data analysis was performed from October 2019 to February 2020. EXPOSURES The March 11, 2011, Great East Japan earthquake and tsunami. MAIN OUTCOMES AND MEASURES PTSS were measured by 9 questions on the Screening Questionnaire for Disaster Mental Health, while depressive symptoms were measured by 15 items on the Geriatric Depression Scale short form. RESULTS The analytic samples for trajectories of PTSS and depressive symptoms included 2275 and 1735 respondents, respectively. In the study population at baseline, there were slightly more women (1262 of 2275 [55.5%] and 882 of 1735 [50.8%]), and most participants were aged 65 to 74 years (1533 [67.4%] and 1224 [70.5%]) and married (1664 [76.2%] and 1319 [77.7%]). Overall, there was a 13.6% (95% CI, 11.7%-15.6%) incidence of depression among individuals who did not have depression before the disaster, while a further 11.1% (95% CI, 9.8%-12.4%) reported PTSS after the disaster. By 5.5 years of follow-up, approximately half of the survivors with new depressive symptoms in 2013 (85 of 168 [50.6%]) and PTSS (147 of 253 [58.1%]) had recovered. The prevalence of depression in the community remained remarkably stable (between 504 participants [29.0%] and 506 participants [29.2%]) comparing predisaster and postdisaster data. CONCLUSIONS AND RELEVANCE In this study, mental illness symptoms persisted for more than 5 years among half of disaster survivors, but the community-wide prevalence of depression remained stable, suggesting that the community itself was resilient.
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Affiliation(s)
- Shiho Kino
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts
| | - Jun Aida
- Tohoku University Graduate School of Dentistry, Department of International and Community Oral Health, Sendai, Japan
| | - Katsunori Kondo
- Chiba University, Center for Preventive Medical Sciences, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts
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Osaki Y, Maesato H, Minobe R, Kinjo A, Kuwabara Y, Imamoto A, Myoga Y, Matsushita S, Higuchi S. Changes in smoking behavior among victims after the great East Japan earthquake and tsunami. Environ Health Prev Med 2020; 25:19. [PMID: 32527213 PMCID: PMC7291441 DOI: 10.1186/s12199-020-00858-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/01/2020] [Indexed: 05/30/2023] Open
Abstract
Background In areas affected by the tsunami of the great East Japan Earthquake, smoking behavior may have deteriorated due to high stress and drastic changes in living environment. Surveys were conducted to reveal changes in smoking behaviors among victims. Methods A population-based random-sample home-visit interview survey of victims in Iwate and Miyagi Prefectures affected by the tsunami disaster was conducted in 2012 (n = 1978), while a population-based nationwide survey was conducted in 2013 (n = 1082). A panel survey in 2014 was conducted with respondents of the 2012 survey (n = 930). Multiple logistic regression analysis was performed to reveal factors related to smoking status after the disaster. Results There was high smoking prevalence of both sexes in the tsunami disaster area (current smoking rate in coastal area, 50.0% for male, 21.4% for female; inland area, 34.7% for male, 7.6% for female). Low prevalence of male quitters was observed (quitter rate in coastal area, 20.8% for male, 8.0% for female; inland area, 23.4% for male, 5.5% for female). The prevalence of nicotine-dependent people assessed by FTND (Fagerström Test for Nicotine Dependence) in the coastal area was also higher than in the inland area or other areas of Japan. Smoking behavior among victims worsened after the disaster and did not improve 3 years from the disaster. Post-disaster factors related to smoking were living in coastal area, complete destruction of house, and living in temporary housing. Conclusions Smoking prevalence and the level of nicotine dependence of tsunami victims were still high even 3 years after the disaster. It is important to emphasize measures for smoking control in the disaster areas for an extended time period.
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Affiliation(s)
- Yoneatsu Osaki
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan.
| | - Hitoshi Maesato
- National Hospital Organization Kurihama Medical and Addiction Center, 5-3-1 Nobi, Yokosuka, Kanagawa, 239-0841, Japan
| | - Ruriko Minobe
- National Hospital Organization Kurihama Medical and Addiction Center, 5-3-1 Nobi, Yokosuka, Kanagawa, 239-0841, Japan
| | - Aya Kinjo
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan
| | - Yuki Kuwabara
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan
| | - Aya Imamoto
- Department of Pediatrics, Tottori University Hospital, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan
| | - Yoshinori Myoga
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori, 683-8503, Japan
| | - Sachio Matsushita
- National Hospital Organization Kurihama Medical and Addiction Center, 5-3-1 Nobi, Yokosuka, Kanagawa, 239-0841, Japan
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, 5-3-1 Nobi, Yokosuka, Kanagawa, 239-0841, Japan
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Kawachi I, Aida J, Hikichi H, Kondo K. Disaster Resilience in Aging Populations: Lessons from the 2011 Great East Japan Earthquake & Tsunami. J R Soc N Z 2020; 50:263-278. [PMID: 33716382 PMCID: PMC7954223 DOI: 10.1080/03036758.2020.1722186] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/21/2020] [Indexed: 01/26/2023]
Abstract
Recovery after major disaster poses a unique set of challenges for the older population, including disruption of medical care for pre-existing conditions, functional limitations that impede recovery, and social isolation following involuntary resettlement. In this review, we summarize the lessons about disaster resilience that have been learned (so far) from a unique ongoing field study based in a community that was affected by the 2011 earthquake and tsunami in Japan. In the Iwanuma Study, baseline information about the health status and living conditions of older residents was collected seven months before the disaster. A follow-up survey was conducted 2.5 years after the disaster, allowing us investigate the risk and protective factors for a range of disaster-related health sequelae, including mental illness and cognitive disability. A consistent finding to emerge from our studies is the critical role of social connections (the "social capital" of a community) in protecting against the deleterious after-effects of psychological trauma and involuntary resettlement following the disaster. In contrast to the emphasis on investing in material infrastructure to prepare for disasters, a review of our studies suggests that repairing (or at least preserving) the social fabric of people's lives is a crucial ingredient in disaster resilience.
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Affiliation(s)
| | - Jun Aida
- Tohoku University Graduate School of Dentistry
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Sasaki Y, Tsuji T, Koyama S, Tani Y, Saito T, Kondo K, Kawachi I, Aida J. Neighborhood Ties Reduced Depressive Symptoms in Older Disaster Survivors: Iwanuma Study, a Natural Experiment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17010337. [PMID: 31947798 PMCID: PMC6981381 DOI: 10.3390/ijerph17010337] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/31/2019] [Accepted: 01/01/2020] [Indexed: 11/16/2022]
Abstract
Objective: As most studies relating to mental health and disasters have employed cross-sectional or follow-up assessments about psychological health with post-disaster information, the association between changes in social ties and mental health remains unclear. We examined the relationship between the changes in survivor neighborhood ties and depressive symptoms before and after a natural disaster. Methods: Participants were 3567 individuals aged ≥65 years living in Iwanuma city who had responded to questionnaires by the Japan Gerontological Evaluation Study both predating the 2011 Great East Japan Earthquake and Tsunami, and 2.5 years afterward. Changes in the depressive symptoms were assessed using the geriatric depression scale (GDS) at the baseline and follow-up survey. Changes in the neighborhood ties were assessed by asking the participants about their interactions with people in their neighborhood. Possible confounders were adjusted in a linear regression model. Results: Among the 3111 participants in this analysis, 1073 (34.5%) had increased GDS score after the disaster. There were 336 (10.8%) individuals who had neighborhood ties before the disaster, but had no ties afterward; their mean GDS score increased from 2.93 points in 2010 to 3.19 points in 2013. Among those who had not had ties before and after the disaster the mean GDS score remained almost stable, from 2.19 points in 2010 to 2.12 points in 2013. The participants with post-disaster ties were significantly less likely to have an increased GDS score compared with those who had not had ties before and after the disaster (β = −0.39; 95% confidence interval: −0.72, −0.06). Conclusions: Increased neighborhood ties after the disaster reduced the risk of depressive symptoms even when survivors suffered disaster damages. The study reinforces the importance of social capital in disaster recovery and suggests to local governments and local communities that fostering horizontal, neighborhood ties may improve disaster preparedness and mental health resilience.
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Affiliation(s)
- Yuri Sasaki
- Department of International Health and Collaboration, National Institute of Public Health, Wako, Saitama 351-0197, Japan
- Correspondence:
| | - Taishi Tsuji
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba 263-8522, Japan; (T.T.); (K.K.)
| | - Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, Osaka 541-8567, Japan
| | - Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;
| | - Tami Saito
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Moriokacho 7-430, Japan;
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba 263-8522, Japan; (T.T.); (K.K.)
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Moriokacho 7-430, Japan
- Center for Well-Being and Society, Nihon Fukushi University, Aichi 470-3295, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA 02115, USA;
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi 980-8577, Japan;
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Pre-disaster social support is protective for onset of post-disaster depression: Prospective study from the Great East Japan Earthquake & Tsunami. Sci Rep 2019; 9:19427. [PMID: 31857658 PMCID: PMC6923367 DOI: 10.1038/s41598-019-55953-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 12/03/2019] [Indexed: 12/12/2022] Open
Abstract
We examined whether pre-disaster social support functions as a disaster preparedness resource to mitigate post-disaster depressive symptoms among older survivors of the 2011 Great East Japan earthquake and tsunami. The participants were 3,567 individuals aged ≥65 years living in Iwanuma city who completed a baseline survey as part of the nationwide Japan Gerontological Evaluation Study seven months before the disaster. A follow-up survey was administered approximately 2.5 years after the disaster. The analysis included a total of 2,293 participants, and social support (giving and receiving emotional & instrumental help) before the disaster was measured using four items. Depressive symptoms were assessed using the GDS with a cut-off score of 4/5 (not depressed/depressed). We discovered that participants who gave and received emotional and instrumental support before the disaster were significantly less likely to develop depressive symptoms after the disaster compared to those without support (ARR = 0.70; 95% CI: 0.56–0.88). The risk of the onset of depressive symptoms was 1.34 (95% CI: 1.03–1.74) among those who experienced disaster damages but had also given and received social support, and 1.70 (95% CI: 1.03–2.76) among those who experienced damages but lacked support. Strengthening social aid may help cultivate psychological resilience to disasters.
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Moosavi S, Nwaka B, Akinjise I, Corbett SE, Chue P, Greenshaw AJ, Silverstone PH, Li XM, Agyapong VIO. Mental Health Effects in Primary Care Patients 18 Months After a Major Wildfire in Fort McMurray: Risk Increased by Social Demographic Issues, Clinical Antecedents, and Degree of Fire Exposure. Front Psychiatry 2019; 10:683. [PMID: 31620033 PMCID: PMC6760025 DOI: 10.3389/fpsyt.2019.00683] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 08/23/2019] [Indexed: 11/13/2022] Open
Abstract
Objectives: To assess prevalence of likely posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) in patients attending the only out-of-hours primary care clinic in Fort McMurray some 18 months following a major fire. Methods: A quantitative cross-sectional survey was used to collect data through self-administered paper-based questionnaires to determine likely PTSD, MDD, and GAD using the PTSD Checklists for Diagnostic and Statistical Manual (DSM) 5, Patient Health Questionnaire (PHQ) 9, and GAD-7, respectively, from residents of Fort McMurray who were impacted by the wildfires. This was carried out eighteen (18) months after a major wildfire, which required the rapid evacuation of the entire city population (approximately 90,000 individuals). Results: We achieved a response rate of 48% and results from the 290 respondents showed the 1 month prevalence rate for likely PTSD was 13.6%, likely MDD was 24.8%, and likely GAD was 18.0%. Compared to self-reported prevalence rates before the wildfire (0%, 15.2%, and 14.5% respectively), these were increased for all diagnoses. After controlling for other factors in a logistic regression model, there were statistically significant associations between individuals who had likely PTSD, MDD, and GAD diagnoses and multiple socio-demographic, clinical, and exposure-related variables as follows: PTSD: History of anxiety disorder and received counselling had odds ratios (ORs) of 5.80 and 7.14, respectively. MDD: Age, witnessed the burning of homes, history of depressive disorder, and receiving low level support from friends and family had ORs of 2.08, 2.29, 4.63, and 2.5, respectively. GAD: Fearful for their lives or the lives of friends/family, history of depressive disorder, and history of anxiety disorder had ORs of 3.52, 3.04, and 2.68, respectively. There were also associations between individuals with a likely psychiatric diagnosis and those who also had likely alcohol or drug abuse/dependence. Conclusion: Our study suggests there are high prevalence rates for mental health and addiction conditions in patients attending the out-of-hours clinic 18 months after the wildfires, with significant associations between multiple variables and likely PTSD, MDD, and GAD. Further studies are needed to explore the impact of population-based mental health interventions on the long-term mental health effects of the wildfires.
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Affiliation(s)
- Shahram Moosavi
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Bernard Nwaka
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Idowu Akinjise
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Sandra E. Corbett
- Department of Psychiatry, Northern Lights Regional Health Centre, Fort McMurray, AB, Canada
| | - Pierre Chue
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Andrew J. Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Peter H. Silverstone
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Vincent I. O. Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Hikichi H, Aida J, Kondo K, Kawachi I. Persistent impact of housing loss on cognitive decline after the 2011 Great East Japan earthquake and tsunami: Evidence from a 6-year longitudinal study. Alzheimers Dement 2019; 15:1009-1018. [DOI: 10.1016/j.jalz.2019.04.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 04/01/2019] [Accepted: 04/30/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Hiroyuki Hikichi
- School of Public Health; The University of Hong Kong; Pokfulam Hong Kong
| | - Jun Aida
- Department of International and Community Oral Health; Tohoku University Graduate School of Dentistry; Sendai Miyagi Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences; Chiba University; Chiba Japan
- Center for Gerontology and Social Science; National Center for Geriatrics and Gerontology; Aichi Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences; Harvard T.H. Chan School of Public Health; Boston MA USA
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Temporal Transitions in Patterns of Posttraumatic Stress Disorder and Depression Among Adolescents Following the Wenchuan Earthquake. Child Psychiatry Hum Dev 2019; 50:494-504. [PMID: 30600421 DOI: 10.1007/s10578-018-0859-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Posttramatic stress disorder (PTSD) and depression are persistent disorders with heterogeneous comorbidity. Cross-sectional design limitations have prevented previous studies from examining symptom pattern transitions, which limits the understanding on the change of mental health over time since trauma. This study examined transition patterns of PTSD and depression comorbidity and assessed the role of personality. PTSD, depression, and personality scales were used to assess 619 adolescents 1 year after the Wenchuan earthquake and then to longitudinally assess 332 adolescents 2 years post-earthquake. Data were analyzed using latent transition analysis and logistic regression. Four PTSD and depression comorbidity patterns were identified at both times: moderate comorbidity, high comorbidity, no symptoms, and depression. Patterns of PTSD and depression changed in 23.4% of adolescents: 4.4% and 7.1% transitioned from no symptoms to depression and from depression to moderate comorbidity, respectively; 7.5% transitioned from moderate comorbidity to depression. Extraversion and conscientiousness were more likely and openness was less likely to be associated with moderate comorbidity symptoms transitioned to depression symptoms. These findings indicated that patterns of PTSD and depression in adolescents are heterogeneous and show temporal change.
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Li X, Buxton OM, Hikichi H, Haneuse S, Aida J, Kondo K, Kawachi I. Predictors of persistent sleep problems among older disaster survivors: a natural experiment from the 2011 Great East Japan earthquake and tsunami. Sleep 2019; 41:4991879. [PMID: 29726979 DOI: 10.1093/sleep/zsy084] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Indexed: 01/18/2023] Open
Abstract
Study Objectives To examine prospectively the associations of disaster experiences and social support with sleep problems in older adults. Methods Data came from a natural experiment caused by the 2011 Great East Japan earthquake and tsunami. Participants in an ongoing prospective cohort (3547 Japanese individuals aged 65 years or older) were inadvertently exposed to the disaster due to their residential location (Iwanuma city) after the 2010 baseline survey. We conducted a follow-up survey in 2013 to inquire about disaster-related experiences and short sleep duration, sleep insufficiency, poor sleep quality, insomnia symptoms, and sleep medication use. Poisson regression models adjusted for baseline socio-demographic and lifestyle covariates. Results Financial hardship predicted increased risks of short sleep duration (relative risk [RR] = 1.40; 95% confidence interval [CI] [1.03, 1.90]), sleep insufficiency (RR = 1.29; 95% CI [1.01, 1.66]), poor sleep quality (RR = 1.47; 95% CI [1.26, 1.70]), and insomnia symptoms (RR = 1.13; 95% CI [1.01, 1.28]). Home destruction predicted sleep medication use while health care disruption predicted poor sleep quality. Loss of close relatives or friends did not predict any sustained sleep problems. Additionally, having instrumental support reduced risks of all sleep problems while having emotional support reduced risk of poor sleep quality. Conclusions Approximately 2.5 years after the disaster, older survivors' sleep problems were more durably linked to material aspects of disaster damage than to loss of loved ones. Findings could inform targeted recovery efforts for groups with greatest need to promote older survivors' sleep health and overall well-being.
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Affiliation(s)
- Xiaoyu Li
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA.,Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
| | - Orfeu M Buxton
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA.,Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA.,Department of Biobehavioral Health, Pennsylvania State University, University Park, PA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Hiroyuki Hikichi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba-shi, Chiba, Japan.,Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
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Adverse childhood experiences, exposure to a natural disaster and posttraumatic stress disorder among survivors of the 2011 Great East Japan earthquake and tsunami. Epidemiol Psychiatr Sci 2019; 28:45-53. [PMID: 28502272 PMCID: PMC5685946 DOI: 10.1017/s2045796017000233] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
AIMS To investigate whether adverse childhood experiences (ACEs) modify the impact of exposure to a natural disaster (the 2011 Great East Japan earthquake and tsunami) on the occurrence of posttraumatic stress disorder (PTSD) among older people. METHODS Data were collected as part of the Japan Gerontological Evaluation Study (JAGES), which is an on-going epidemiological survey investigating social determinants of health among older people across Japan. Information on PTSD symptoms based on the Screening Questionnaire for Disaster Mental Health, traumatic exposure to the earthquake (i.e., house damage and loss of relatives/friends during the earthquake/tsunami) and ACEs was obtained from 580 participants aged 65 or older living in Iwanuma City, Miyagi Prefecture, which suffered severe damage as a result of the earthquake and the subsequent tsunami in March 2011. Associations were examined using Poisson regression analysis with a robust variance estimator after adjusting for covariates. RESULTS The prevalence of PTSD was 9.7% in this population; compared to those with no traumatic experience, the prevalence of PTSD was approximately two times higher among those who experienced the loss of close friends/relatives (PR = 1.84, 95% CI = 1.11-3.03, p = 0.018), or whose house was damaged (PR = 2.15, 95% CI = 1.07-4.34, p = 0.032). ACE was not significantly associated with PTSD. Stratified analyses by the presence of ACE showed that damage due to the earthquake/tsunami was associated with PTSD only among those without ACEs; more specifically, among non-ACE respondents the PR of PTSD associated with house damage was 6.67 (95% CI = 1.66-26.80), while for the loss of a relative or a close friend it was 3.56 (95% CI = 1.18-10.75). In contrast, no statistically significant associations were observed among those with ACEs. CONCLUSION Following the Great East Japan earthquake/tsunami in 2011 a higher risk of developing PTSD symptoms was observed in 2013 especially among older individuals without ACEs. This suggests that ACEs might affect how individuals respond to subsequent traumatic events later in life.
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Kurisaki R, Ueyama H, Maeda Y, Sakamoto T, Nakahara K, Nakane S, Yamashita S, Ando Y. Impact of major earthquakes on Parkinson's disease. J Clin Neurosci 2018; 61:130-135. [PMID: 30446368 DOI: 10.1016/j.jocn.2018.10.107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/27/2018] [Indexed: 10/27/2022]
Abstract
In April of 2016, major earthquakes occurred in Kumamoto, Japan. There is limited information on how major earthquakes affect patients with Parkinson's disease (PD). This study investigates the effect of major earthquakes on patients with PD. The participants were outpatients with PD from hospitals located in areas heavily damaged by the earthquakes. We performed an anonymous survey at nine medical institutions to investigate the condition of these patients during the month following the earthquakes. We collected questionnaires from 335 patients with PD. The mean age was 72.6, and the mean disease duration was 7.4 years. Regarding physical conditions, 29.3% of the patients worsened, 1.5% improved, and 68.1% had no change. The mental health of 35.2% of the patients worsened, 2.4% improved, and 57.9% had no change. The most frequently exacerbated neurologic symptoms included bradykinesia (56.1%), gait disturbance (51.0%), freezing of gait (40.8%), extension of "off" time (38.8%), and constipation (38.8%). The worsening mental conditions included fear of an aftershock (77.1%), anxiety (49.2%), insomnia (47.5%), melancholy feelings (45.8%), and fatigability (38.1%). Patients forced to evacuate reported significantly more physical and mental health symptoms (p < 0.01). The influences of major earthquakes on patients with PD were identified. After major earthquakes, we should consider the care required for patients' physical and mental health especially for those who experienced evacuation.
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Affiliation(s)
- Ryoichi Kurisaki
- Department of Neurology, National Hospital Organization, Kumamoto Saishunso National Hospital, Koshi, Kumamoto 861-1196, Japan.
| | - Hidetsugu Ueyama
- Department of Neurology, National Hospital Organization, Kumamoto Saishunso National Hospital, Koshi, Kumamoto 861-1196, Japan.
| | - Yasushi Maeda
- Department of Neurology, National Hospital Organization, Kumamoto Saishunso National Hospital, Koshi, Kumamoto 861-1196, Japan.
| | - Tetsuro Sakamoto
- Department of Neurology, Kumamoto City Hospital, Kumamoto 862-8505, Japan; Department of Neurology, National Hospital Organization, Kumamoto-minami National Hospital, Uki, Kumamoto 869-0593, Japan.
| | - Keiichi Nakahara
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Shunya Nakane
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Satoshi Yamashita
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
| | - Yukio Ando
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
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Wilson-Genderson M, Heid AR, Pruchno R. Long-term effects of disaster on depressive symptoms: Type of exposure matters. Soc Sci Med 2018; 217:84-91. [PMID: 30296694 PMCID: PMC7001525 DOI: 10.1016/j.socscimed.2018.09.062] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 09/17/2018] [Accepted: 09/30/2018] [Indexed: 12/22/2022]
Abstract
RATIONALE Natural disasters have the potential to change the lives of older people, yet most studies rely on small convenience samples, few include assessments of people prior to the disaster, and only a handful examine the effects of different types of exposure. OBJECTIVE Our analyses add new knowledge to the literature by examining the ways in which four types of exposure (i.e., geographic, peri-traumatic stress, personal and property loss, and post-storm hardship) affect depressive symptoms experienced by older people over a five-year period. METHOD We analyzed four waves of data from the ORANJ BOWL panel using multilevel mixed effects models. RESULTS We found that although each type of exposure had an independent effect on depressive symptoms, the effects of peri-traumatic stress were dominant. CONCLUSIONS As nearly 20% of people in the United States will experience a natural disaster during the course of their lives, it is critical to understand how disaster exposure can influence mental health because each type of exposure demands a different response. Finding that an individual's emotional response during the disaster plays an important role in the development of depressive symptoms suggests that reduction of exposure to traumatic stress during a storm (i.e., evacuation from a storm area) is important for older people. Likewise, immediate interventions following a disaster that target people experiencing high levels of peri-traumatic distress may be particularly effective and that failing to attend to these people may miss a critical opportunity and result in years of suffering.
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Affiliation(s)
| | - Allison R Heid
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA.
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Mental Health Recovery of Evacuees and Residents from the Fukushima Daiichi Nuclear Power Plant Accident after Seven Years-Contribution of Social Network and a Desirable Lifestyle. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112381. [PMID: 30373233 PMCID: PMC6265751 DOI: 10.3390/ijerph15112381] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/17/2018] [Accepted: 10/25/2018] [Indexed: 11/24/2022]
Abstract
The 2011 Fukushima nuclear accident resulted in the exposure to radiation and evacuation, which has created psychological distress among the Fukushima residents. With the provision of multi-faceted support and the progress of the reconstruction, their mental health has appeared to show signs of recovery. However, there have been few studies investigating their recovery. To clarify the related factors associated with mental health recovery, a cross-sectional questionnaire survey was conducted. Subjects whose answers were associated with Resilience, Recovery, and Remitting patterns of mental health status were categorized in the Recovery group, while those associated with Delayed/Chronic dysfunction were placed in the Non-recovered group. In a multivariable logistic regression analysis, disaster-related unemployment (odds ratio (OR): 0.80, 95% CI (confidence interval): 0.65–0.99) and economic hardship (OR: 0.80, 95% CI: 0.65–0.98) were associated with the hindrance of recovery. In contrast, overall good health (OR: 1.47, 95% CI: 1.20–1.80), regular physical activity (OR: 1.23, 95% CI: 1.01–1.50), social interaction with friends (OR: 1.25, 95% CI: 1.00–1.55), and established social roles (OR: 1.44, 95% CI: 1.14–1.82) were associated with the promotion of recovery. In conclusion, our study showed a positive association between mental health recovery and a desirable lifestyle and social network, particularly with social roles. Thus, the provision of active social roles can promote recovery related to a disaster as with multi-faceted support.
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Kusama T, Aida J, Sugiyama K, Matsuyama Y, Koyama S, Sato Y, Yamamoto T, Igarashi A, Tsuboya T, Osaka K. Does the Type of Temporary Housing Make a Difference in Social Participation and Health for Evacuees of the Great East Japan Earthquake and Tsunami? A Cross-Sectional Study. J Epidemiol 2018; 29:391-398. [PMID: 30344193 PMCID: PMC6737186 DOI: 10.2188/jea.je20180080] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background Although the majority of survivors of the huge Great East Japan Earthquake and Tsunami evacuated to two types of temporary housings, prefabricated housing and rented housing, health effects of these different environments were unclear. We examined whether prevalent social participation in prefabricated housing brought larger health benefits than in rented housing using the largest health survey data of the disaster survivors. Methods This cross-sectional study used a 2012 survey by the Miyagi Prefectural Government, in which almost all of evacuees were targeted (response rate: 61.6%). Self-rated health (SRH) and psychological distress measured via K6 score were the dependent variables, and social participation was the independent variable. Odds ratios of the social participation on health variables were estimated using logistic regression models. To assess the contribution of social participation, the population attributable fraction (PAF) was estimated. Results The participants lived in prefabricated and rented housing numbered 19,726 and 28,270, respectively. Participants in prefabricated housing had poorer SRH and K6 than those in rented housing. The proportions of participants engaging in social participation of prefabricated and rented housing were 38.2% and 15.4%, respectively. The absence of social participation was significantly associated with poor SRH and K6 among participants in both housing types. The PAFs of social participation with good SRH were 39.5% in prefabricated housing and 14.4% in rented housing. For K6, the PAFs were 47.1% and 19.5% in prefabricated and rented housing, respectively. Conclusion Compared to the residents in rented housing, residents in prefabricated housing had more frequent opportunities for social participation, which was associated with larger health benefits.
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Affiliation(s)
- Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry.,Miyagi Prefectural Government Office
| | - Kemmyo Sugiyama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Yusuke Matsuyama
- Department of Global Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU).,Japan Society for the Promotion of Science
| | - Shihoko Koyama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry.,Division of Community Oral Health Science, Department of Community Medical Supports, Tohoku Medical Megabank Organization
| | - Yukihiro Sato
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry.,Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University
| | - Takafumi Yamamoto
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Ayaka Igarashi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Toru Tsuboya
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry.,Disaster Medical Science Division, Disaster Related Oral Health, International Research Institute of Disaster Science
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Ruskin J, Rasul R, Schneider S, Bevilacqua K, Taioli E, Schwartz RM. Lack of access to medical care during Hurricane Sandy and mental health symptoms. Prev Med Rep 2018; 10:363-369. [PMID: 29868393 PMCID: PMC5984240 DOI: 10.1016/j.pmedr.2018.04.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/26/2018] [Accepted: 04/21/2018] [Indexed: 11/17/2022] Open
Abstract
Destruction caused by natural disasters compromises medical providers' and hospitals' abilities to administer care. Hurricane Sandy was particularly devastating, resulting in massive disruptions of medical care in the region. This study aimed to determine whether a lack of access to medical care during Hurricane Sandy was associated with posttraumatic stress disorder (PTSD) symptoms and other mental health/substance abuse outcomes. A secondary aim was to examine whether having a chronic illness moderates those associations. Self-reported medical access and mental health symptomatology were obtained from New York City and Long Island residents (n = 1669) following Hurricane Sandy under the Leaders in Gathering Hope Together project (10/23/2013–2/25/2015) and Project Restoration (6/5/2014–8/9/2016). Multivariable logistic regressions were utilized to determine the relationship between lack of access to medical care and mental health outcomes. Of the 1669 participants, 994 (59.57%) were female, 866 (51.89%) were white, and the mean age was 46.22 (SD = 19.2) years old. Those without access to medical care had significantly higher odds of showing symptoms of PTSD (AOR = 2.71, CI = [1.77–4.16]), as well as depression (AOR = 1.94, CI = [1.29–2.92]) and anxiety (AOR = 1.61, CI = [1.08–2.39]) compared to those with access. Lack of access to care was associated with a 2.12 point increase in perceived stress scale score (SE = 0.63). The interaction between having a chronic illness and lack of access to medical care was not significantly associated with any outcomes. The findings emphasize the importance of making medical care more accessible to patients, both chronically and acutely ill, during natural disasters to benefit their physical as well as their mental health. Individuals without access to medical care had asignificantly higher odds of showing symptoms of mental health difficulties. Chronic illness did not moderate the relationship between a lack of access to care and mental health outcomes. Access to medical care during natural disasters may benefit the mental health of survivors with and without chronic illness.</span>
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Affiliation(s)
- Julia Ruskin
- Department of Occupational Medicine Epidemiology and Prevention, Northwell Health, Great Neck, NY, United States
- Feinstein Institute for Medical Research, Manhasset, NY, United States
- Joint Center for Trauma, Disaster Health and Resilience at Mount Sinai, Stony Brook University, and Northwell Health, United States
| | - Rehana Rasul
- Department of Occupational Medicine Epidemiology and Prevention, Northwell Health, Great Neck, NY, United States
- Feinstein Institute for Medical Research, Manhasset, NY, United States
- Joint Center for Trauma, Disaster Health and Resilience at Mount Sinai, Stony Brook University, and Northwell Health, United States
- Biostatistics Unit, Feinstein Institute for Medical Research
- Department of Occupational Medicine Epidemiology and Prevention, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Samantha Schneider
- Department of Occupational Medicine Epidemiology and Prevention, Northwell Health, Great Neck, NY, United States
- Feinstein Institute for Medical Research, Manhasset, NY, United States
- Joint Center for Trauma, Disaster Health and Resilience at Mount Sinai, Stony Brook University, and Northwell Health, United States
| | - Kristin Bevilacqua
- Department of Occupational Medicine Epidemiology and Prevention, Northwell Health, Great Neck, NY, United States
- Feinstein Institute for Medical Research, Manhasset, NY, United States
- Joint Center for Trauma, Disaster Health and Resilience at Mount Sinai, Stony Brook University, and Northwell Health, United States
| | - Emanuela Taioli
- Joint Center for Trauma, Disaster Health and Resilience at Mount Sinai, Stony Brook University, and Northwell Health, United States
- Department of Population Health Science and Policy and Institute of Translational Epidemiology, The Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Rebecca M. Schwartz
- Department of Occupational Medicine Epidemiology and Prevention, Northwell Health, Great Neck, NY, United States
- Feinstein Institute for Medical Research, Manhasset, NY, United States
- Joint Center for Trauma, Disaster Health and Resilience at Mount Sinai, Stony Brook University, and Northwell Health, United States
- Biostatistics Unit, Feinstein Institute for Medical Research
- Department of Occupational Medicine Epidemiology and Prevention, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
- Department of Population Health Science and Policy and Institute of Translational Epidemiology, The Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Corresponding author at: Department of Occupational Medicine, Epidemiology and Prevention (OMEP), Northwell Health Physician Partners, Hofstra Northwell School of Medicine, 175 Community Drive 2nd floor, Great Neck, NY 11021, United States.
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Brown LA, Fernandez CA, Kohn R, Saldivia S, Vicente B. Pre-disaster PTSD as a moderator of the relationship between natural disaster and suicidal ideation over time. J Affect Disord 2018; 230:7-14. [PMID: 29355729 PMCID: PMC6576262 DOI: 10.1016/j.jad.2017.12.096] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 11/23/2017] [Accepted: 12/31/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Natural disasters are associated with a variety of negative health consequences, including enhanced suicide risk. Factors that moderate the relationship between disaster exposure and enhanced suicide risk are unknown. The aim of the current study was to determine whether pre-disaster PTSD moderates the association between change over time in thoughts of death, suicidal ideation (SI), suicide plans, and suicide attempts (SA) from pre- to post-disaster. METHODS Participants (n = 2832) were recruited from Chile as part of the larger PREDICT study and completed a measure of lifetime PTSD and panic disorder at baseline and a lifetime death/suicide measure at baseline in 2003 and again 6, 12, and 24 months later (i.e. "pre-disaster"). One year following a major earthquake and tsunami in 2010 (i.e., "post-disaster"), participants completed another death/suicide measure. RESULTS Both those with and without pre-disaster PTSD experienced significant increases in SI from pre- to post-disaster. However, pre-disaster PTSD was associated with significantly accelerated increases in thoughts of death and SI from pre-to post-disaster. At nearly all time-points, pre-disaster PTSD was associated with higher thoughts of death and SI, suicide planning, and SA. In contrast, panic disorder did not moderate the association between time and changes in SI. LIMITATIONS There was a long time-gap between pre-disaster and post-disaster, with limited data about what occurred during this time. CONCLUSION Pre-disaster PTSD is an important predictor of increased SI following a natural disaster, and groups with pre-disaster PTSD should be prioritized for receipt of mental health resources following a natural disaster.
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Affiliation(s)
- Lily A Brown
- University of Pennsylvania, Department of Psychiatry, United States
| | - Cristina A Fernandez
- Harvard University, T.H. Chan School of Public Health, United States; Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, United States
| | - Robert Kohn
- Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, United States
| | - Sandra Saldivia
- Departamento de Psiquiatría y Salud Mental, Universidad de Concepción, Concepción, Chile
| | - Benjamin Vicente
- Departamento de Psiquiatría y Salud Mental, Universidad de Concepción, Concepción, Chile.
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Nagashima H, Fujimura I, Nakamura Y, Utsumi Y, Yamauchi K, Takikawa Y, Yokoyama Y, Sakata K, Kobayashi S, Ogawa A. Changes in pulmonary function of residents in Sanriku Seacoast following the tsunami disaster from the Great East Japan Earthquake. Respir Investig 2018; 56:184-188. [PMID: 29548658 DOI: 10.1016/j.resinv.2017.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Residents in the district struck by the Great East Japan Earthquake Tsunami (GEJET) suffered from adverse living conditions and various pulmonary diseases. OBJECTIVES To evaluate the influence of GEJET, we performed serial assessment of pulmonary function of approximately 10,000 residents in the district struck by GEJET. METHODS Using a spirometer, we assessed the pulmonary function of approximately 10,000 residents older than 18 years in the Sanriku seacoast, which was struck by the tsunami. Measurements were performed in 2011 and 2012. RESULTS We compared FVC (forced vital capacity) % pred. and FEV1 (forced expiratory volume in 1second) % pred. of subjects between 2011 and 2012, by serial spirometry. Of the 7053 subjects studied, including 2611 men and 4442 women, FVC% pred. and FEV1% pred. were significantly higher in 2012 than in 2011. Physical indices including height, body weight and the body mass index (BMI) did not change significantly during this period. Smoking prevalence changed significantly between 2010, 2011, and 2012. Both FVC% pred. and FEV1% pred. of subjects who had quit smoking increased significantly on spirometry carried out in 2012, compared with those in 2011. CONCLUSIONS The pulmonary function expressed as FVC% pred. and FEV1% pred. were significantly higher in 2012 than in 2011 among the subjects studied. The changes in the smoking status may be one of the reasons for the increase in values observed. However, other undetermined factors during recovery from a disaster might have resulted in improved pulmonary function.
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Affiliation(s)
- Hiromi Nagashima
- Division of Pulmonary Medicine, Allergy and Rheumatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Japan
| | - Itaru Fujimura
- Division of Pulmonary Medicine, Allergy and Rheumatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Japan
| | - Yutaka Nakamura
- Division of Pulmonary Medicine, Allergy and Rheumatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Japan
| | - Yu Utsumi
- Division of Pulmonary Medicine, Allergy and Rheumatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Japan
| | - Kohei Yamauchi
- Division of Pulmonary Medicine, Allergy and Rheumatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Japan.
| | - Yasuhiro Takikawa
- Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Japan
| | - Yukari Yokoyama
- Faculty of Social Welfare, Department of Social Welfare, Nihon Fukushi University, Mihama-cho, Japan
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, Iwate Medical University School of Medicine, Japan
| | | | - Akira Ogawa
- Iwate Medical University School of Medicine, Morioka, Japan
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