Risk of social isolation among Great East Japan Earthquake survivors living in tsunami-affected Ishinomaki, Japan

Vulnerability of Evacuees Having No One to Consult after the Fukushima Nuclear Disaster: The Fukushima Health Management Survey

After the accident at the Fukushima nuclear power plant in 2011, caused by the Great East Japan Earthquake, some evacuees had no one to consult despite many local care providers offering assistance. This study identified the characteristics of individuals who did not receive consultations and the relevant determinants, and proposed the available measures to address this issue. Altogether, 32,699 participants aged 16 years or older and residing in the disaster area at Fukushima were surveyed. Those with no one to consult showed a significantly higher prevalence of psychological distress (16.2%, p < 0.001) and drinking problems (21.5%, p < 0.001). Multivariate analysis revealed that these behaviors were associated with the middle age group (i.e., 40–64 years old) (odds ratio [OR]: 1.30; 95% confidence interval [CI]: 1.16–1.46), men (OR = 2.46; 95% CI, 2.27–2.66), bad financial circumstances (OR = 2.11; 95% CI, 1.96–2.27), and living alone (OR = 1.53; 95% CI, 1.39–1.68). This research verifies that people with such characteristics were more likely to be isolated and vulnerable to psychiatric problems, such as depression. We suggest that it is integral for local care providers to recognize those who have no one to consult and provide targeted support.

Disasters and the Disablement Process framework: an analysis of the great east Japan earthquake and tsunami of 2011

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.

Motivation for and Effect of Cooking Class Participation: A Cross-Sectional Study Following the 2011 Great East Japan Earthquake and Tsunami

We explored the association between the motivation for and effects of cooking class participation in disaster-affected areas following the 2011 Great East Japan Earthquake and Tsunami. We conducted questionnaire surveys in January and February 2020, and applied three Poisson regression models to a cross-sectional dataset of participants, analyzing three perceived participation effects: increase in new acquaintances and friends, increase in excursion opportunities, potential for gaining motivation, and a new sense of life purpose. We also applied the interaction term of motivation variables and usual eating patterns (eating alone or with others). We obtained 257 valid responses from 15 cooking venues. The interaction term for participants’ motivation and eating patterns was associated with their perceived participation effects. “Motivation for nutrition improvement × eating alone” was positively associated with an increase in new acquaintances and friends (IRR: 3.05, 95% CI, 1.22–7.64). “Motivation for increasing personal cooking repertoire × eating alone” was positively associated with increased excursion opportunities (IRR: 5.46, 95% CI, 1.41–21.20). In contrast, the interaction effect of “motivation of increasing nutrition improvement × eating alone” was negatively associated with increased excursion opportunities (IRR: 0.27, 95% CI, 0.12–0.69). The results show that the cooking class was effective, as residents’ participation improved their nutritional health support and increased their social relationships.

Occurrence of Cerebrovascular Diseases Decreased after the Great East Japan Earthquake and Tsunami of 2011

Background

A temporary increase in the occurrence of cerebrovascular diseases (CVDs) after the Great East Japan Earthquake and Tsunami of 2011 was reported; however, no studies have been conducted to investigate long-term effects. We assessed the long-term impact of the disaster on the incidence of CVDs.

Methods

Incidence data for CVDs from 2008 to 2017 were acquired from the population-based Stroke Registry with an inventory survey of Iwate Prefecture, Japan. Part of the coastal area in Iwate Prefecture was mildly flooded and the other part was severely flooded. Age-adjusted incidence rates of CVDs (according to the Japanese standard population) were calculated for each area. The relative risk (RR) of incidence based on the years before the disaster (2008–2010), adjusted by stratified age groups, was calculated for the year of the disaster (2011), and the years after the disaster (2012–2017) in each area.

Results

The age-adjusted incidence rates gradually decreased in all areas, with the exception of a temporary increase among men who lived on the coast the year the disaster occurred. The adjusted RR in the disaster year were not significant in any area and those of the postdisaster years were 0.91 (95% CI 0.87–0.96) for all inland men, 0.93 (0.89–0.97) for all inland women, 0.85 (0.78–0.93) for all coastal men, 0.87 (0.81–0.94) for all coastal women, 0.88 (0.80–0.98) for men at mildly flooded coast, 0.82 (0.75–0.89) for women at mildly flooded coast, 0.79 (0.68–0.91) for men at severely flooded coast, and 0.98 (0.86–1.11) for women at severely flooded coast.

Conclusions

The occurrence of CVDs in the flooded coastal areas did not increase in the year of the Great East Japan Earthquake and Tsunami; furthermore, it decreased for men according to the severity of flood damage in the subsequent years; this can be attributed to supportive activities for the tsunami victims and the migration of the population.

Associations Between Social Support and Subjective Symptoms in Disaster-Stricken Ishinomaki, Japan

OBJECTIVES

Natural disasters affect long-term health by directly disrupting or destroying health-care systems and social support. We examined the associations between social support and subjective symptoms (SS) among disaster victims living in their homes approximately 1-2 years after the Great East Japan Earthquake and tsunami on March 11, 2011, which devastated the northeastern Japan seaboard and far inland, focusing on Ishinomaki, Miyagi Prefecture.

METHODS

The Health and Life Revival Council of Ishinomaki District conducted door-to-door household surveys between April 2012 and January 2013. Replies to 12 questions regarding social support, specifically emotional, informational, and instrumental, were investigated. SS prevalence was calculated as the proportion of those having any of 8 predetermined symptoms including back pain, neck stiffness, sleep difficulty, dizziness, heart palpitations, poor appetite, or stomachache. Logistic regression analysis by sex was used to obtain crude and adjusted odds ratios for the association between SS prevalence and forms of social support.

RESULTS

From 4023 households, self-reported data on 2593 individuals from 1709 households were obtained. SS prevalence was 29.1%. Adjusted logistic regression analysis revealed that instrumental support with others and emotional support with personal and others were specific associated with SS in men and women, respectively.

CONCLUSIONS

Our findings suggest that providing social support depending on needs is potentially effective in preventing SS in disaster areas.

Pre-disaster social support is protective for onset of post-disaster depression: Prospective study from the Great East Japan Earthquake & Tsunami

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.

Did kindergarteners who experienced the Great East Japan earthquake as infants develop traumatic symptoms? Series of questionnaire-based cross-sectional surveys: A concise and informative title: traumatic symptoms of kindergarteners who experienced disasters as infants

BACKGROUND

The Great East Japan Earthquake (GEJE) and tsunami of March 11, 2011 left behind many survivors, including children. This study aimed to assess changes in traumatic symptoms with time among kindergarteners who experienced GEJE as infants and to discuss the relationship between these symptoms and the disaster experience.

METHODS

The 15-item Post-Traumatic Stress Symptoms for Children (PTSSC-15) questionnaire were distributed to the parents of kindergarteners (children aged 4-5 years) at 8, 20, 30, and 42 months after GEJE. Questionnaires regarding environmental damage conditions affecting the children were distributed to teachers 8 months after the tsunami.

RESULTS

The number of kindergarteners was 262, 255, 236, and 202 at 8, 20, 30, and 42 months after the disaster. The PTSSC-15 total score was not different between kindergartners with and without environmental damage conditions. After 8 and 20 months, the PTSSC-15 total score of children who usually ate breakfast was significantly higher than that of children who did not. Moreover, after 30 and 42 months, the PTSSC-15 total score of kindergarteners who usually ate breakfast was not significantly higher than that of kindergarteners who did not.

CONCLUSIONS

The traumatic symptoms of kindergarteners were not related to disaster experiences.

Meaning in Life: A conceptual model for disaster nursing practice

This study aimed to develop a conceptual model for understanding meaning in life (MIL) using respondents' quotations in the primary qualitative studies. The primary studies were selected from the PsycINFO, PsycARTICLES and CINAHL databases using keywords 'meaning in life', 'meaning of life', 'purpose in life' and 'will to meaning'. Respondents' quotations in the primary studies were analysed interpretatively to identify MIL from the respondents' perspectives. The data were synthesized to integrate findings from 10 selected primary studies. The findings identified (i) six sources of MIL (e.g. having a significant others, having new experiences and performing spiritual activities); (ii) eight components of MIL (e.g. focusing on self, connecting to others, contributing to others and having a sense of direction and purpose); and (iii) the emotional outcomes of having MIL: happiness, satisfaction and joy. Through a discussion of the findings, a conceptual model of MIL emerged.

Perspectives acquired through long-term epidemiological studies on the Great East Japan Earthquake

The Great East Japan Earthquake (GEJE) and subsequent tsunamis that occurred in 2011 caused extensive and severe structural damage and interrupted numerous research activities; however, the majority of such activities have been revived, and further public health researches and activities have started to follow the population affected by the disaster. In this mini-review, we overview our recent activities regarding epidemiologic studies in Miyagi Prefecture, the region most affected by the GEJE. Through our study processes, we were able to identify the particular characteristics of vulnerable populations, and provide ideas that may help save lives and reduce the amount of damage caused by a future disaster. Long-term follow-up and care of survivors is essential in affected areas, and health professionals should pay particular attention to various diseases, e.g., cardiovascular complications and mental disorders. Furthermore, building up resilience and social relationships in the community is beneficial to survivors. Ongoing cohort studies conducted before disasters can help minimize biases regarding the survivors’ pre-disaster information, and emerging cohort studies after disasters can find potential helpful novel indices. To identify characteristics of vulnerable populations, save lives, and reduce the amount of damage caused by a future disaster, constant research that is consistently improved by new data needs to be performed.

Mental health and psychological impacts from the 2011 Great East Japan Earthquake Disaster: a systematic literature review

Background

On March 11, 2011, Japan experienced an unprecedented combination of earthquake/tsunami/nuclear accidents (the Great East Japan Earthquake; GEJE). We sought to identify mental health and psychosocial consequences of this compound disaster.

Method

A systematic literature review was conducted of quantitative research articles addressing mental health of survivors and the psychological impact of the GEJE. For articles between March 2011 and December 2014, PubMed, PsychINFO, and EMBASE databases were searched with guidance on literature review method.

Results

Forty-nine studies met the inclusion criteria. A substantial proportion of the affected individuals experienced considerable psychological distress. Mental health outcomes included, but were not limited to, posttraumatic stress disorder, depression, and anxiety symptoms. Physical health changes, such as sleeping and eating disturbances, also occurred. In Fukushima, radioactive release induced massive fear and uncertainty in a large number of people, causing massive distress among the affected residents, especially among mothers of young children and nuclear plant workers. Stigma was additional challenge to the Fukushima residents. The review identified several groups with vulnerabilities, such as disaster workers, children, internally displaced people, patients with psychiatric disorders, and the bereaved.

Conclusions

Following the GEJE, a considerable proportion of the population was mentally affected to a significant degree. The affected individuals showed a wide array of mental and physical consequences. In Fukushima, the impact of nuclear disaster was immense and complex, leading to fear of radiation, safety issues, and stigma issues.