Postdisaster Changes in Social Capital and Mental Health: A Natural Experiment From the 2016 Kumamoto Earthquake

Role of Individual Social Capital in the Association of Physical Frailty With Functional Ability Among Older Adults

OBJECTIVES

Rich social capital is regarded as an individual's social asset, which may contribute to the maintenance of functional ability, even in a state of frailty. This study examined the moderating role of individual social capital in the association between physical frailty and functional ability among older adults.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

In total, 522 community-dwelling older adults aged ≥60 years were recruited from among visitors to public facilities, including community cultural centers and gymnasiums in Aichi, Japan.

METHODS

Functional ability was assessed using the 5-item subscale of the Tokyo Metropolitan Institute of Gerontology Index of Competence that assesses instrumental self-maintenance, including transportation, finance management, and shopping. Physical frailty was defined by the Fried Frailty Phenotype Questionnaire, including 5 items of fatigue, resistance, ambulation, inactivity, and weight loss, and the participants were classified into 3 groups: non-frailty, pre-frailty, and frailty. Individual social capital was assessed for 2 dimensions: the cognitive dimension (perceptions of community social cohesion) and the structural dimension (informal socializing and social participation).

RESULTS

The participants' mean age (SD) was 74.1 (6.5) years and 78.0% were women. Among the participants, non-frailty was 46.6%, pre-frailty was 47.0%, and frailty was 6.5%. Multivariable linear regression analysis revealed that physical frailty was associated with lower levels of functional ability compared with non-frailty [pre-frailty: β (95% CI) = -0.07 (-0.22 to 0.08), P = .374; frailty: β = -0.67 (-0.99 to -0.35), P < .001]. However, individual structural social capital showed a negative interaction with physical frailty against low functional ability, indicating a moderating association (P = .027).

CONCLUSIONS AND IMPLICATIONS

High levels of individual structural social capital mitigated the adverse association between physical frailty and functional ability. Fostering rich social capital may preserve the functional ability of frail older adults, helping their independent lives in the community.

Interdependent culture and older adults' well-being: Health and psychological happiness in Japanese communities

This review article examined perspectives on the well-being and health of older adults in Japan, a nation renowned for its longevity. We emphasized the impact of social capital and social relationships in local communities, considering both individual and societal factors. The prevailing values in Japanese culture tend to foster a sustained and stable form of interdependent happiness among older adults, suggesting that communal support systems play an important role. This article highlights the value of multi-level datasets, such as the Japan Gerontological Evaluation Study (JAGES) dataset, for understanding the influence of social participation on the health and well-being of older adults. A growing body of evidence underscores the central role of social relationships in the health and well-being of older adults.

Examining the role of community resilience and social capital on mental health in public health emergency and disaster response: a scoping review

The ability of the public to remain psychologically resilient in the face of public health emergencies and disasters (such as the COVID-19 pandemic) is a key factor in the effectiveness of a national response to such events. Community resilience and social capital are often perceived as beneficial and ensuring that a community is socially and psychologically resilient may aid emergency response and recovery. This review presents a synthesis of literature which answers the following research questions: How are community resilience and social capital quantified in research?; What is the impact of community resilience on mental wellbeing?; What is the impact of infectious disease outbreaks, disasters and emergencies on community resilience and social capital?; and, What types of interventions enhance community resilience and social capital?A scoping review procedure was followed. Searches were run across Medline, PsycInfo, and EMBASE, with search terms covering both community resilience and social capital, public health emergencies, and mental health. 26 papers met the inclusion criteria.The majority of retained papers originated in the USA, used a survey methodology to collect data, and involved a natural disaster. There was no common method for measuring community resilience or social capital. The association between community resilience and social capital with mental health was regarded as positive in most cases. However, we found that community resilience, and social capital, were initially negatively impacted by public health emergencies and enhanced by social group activities.Several key recommendations are proposed based on the outcomes from the review, which include: the need for a standardised and validated approach to measuring both community resilience and social capital; that there should be enhanced effort to improve preparedness to public health emergencies in communities by gauging current levels of community resilience and social capital; that community resilience and social capital should be bolstered if areas are at risk of disasters or public health emergencies; the need to ensure that suitable short-term support is provided to communities with high resilience in the immediate aftermath of a public health emergency or disaster; the importance of conducting robust evaluation of community resilience initiatives deployed during the COVID-19 pandemic.

Does disaster-related relocation impact mental health via changes in group participation among older adults? Causal mediation analysis of a pre-post disaster study of the 2016 Kumamoto earthquake

BACKGROUND

Disaster-related relocation is associated with depression and post-traumatic stress disorder, especially in older adults. Disaster-related relocation often deprives survivors of opportunities for social group participation, potentially deteriorating their mental health. On the contrary, the relocation could also be an opportunity for optimizing social relationships, ending/reducing unwanted participation. This study examined the potential mediation effects of changing participation for the link of disaster-related relocation to mental health.

METHODS

We analyzed a pre-post disaster dataset of functionally independent older adults from the Japan Gerontological Evaluation Study. Following the 2013 survey, a follow-up survey was conducted seven months after the 2016 Kumamoto earthquake (n = 828).

RESULTS

The causal mediation analyses indicated that compared to no relocation, the relative risk for experiencing major depressive episodes among those relocating to temporary housing was 3.79 [95% confidence interval: 1.70-6.64] (natural direct effect). By contrast, the relative risk for those renewing (either ceased or started) group participation was 0.60 [95% CI: 0.34-0.94] (natural indirect effect).

CONCLUSIONS

Optimization of social ties according to a renewal of group participation status might have protected older adults in temporary housing against depression.

Factors Related to Physical Activity among Older Adults Who Relocated to a New Community after the Kumamoto Earthquake: A Study from the Viewpoint of Social Capital

Previous studies have shown an association between social capital and physical activity in older adults. Older adults who relocated after the Kumamoto earthquake may become physically inactive, and the extent of this inactivity may be buffered by social capital. Accordingly, this study applied the social capital perspective to examine factors that affect the physical activity of older adults who relocated to a new community after the Kumamoto earthquake. We conducted a self-administered mail questionnaire survey with 1494 (613 male, 881 female, mean age 75.12 ± 7.41 years) evacuees from temporary housing in Kumamoto City, aged 65 years and above, who relocated to a new community after the earthquake. We performed a binomial logistic regression to examine the factors affecting participants' physical activity. The results showed that physical inactivity (decreased opportunities for physical activity, decreased walking speed, and no exercise habits) was significantly associated with non-participation in community activities, lack of information about community activities, and being aged 75 years and over. Lack of social support from friends was significantly associated with lack of exercise habits. These findings encourage participation in community activities, alongside giving and receiving social support in health activities that target older adults who relocated to new communities after the earthquake.

Individual-level social capital is associated with depressive symptoms among middle-aged community dwellers in rural Vietnam: a cross-sectional study

OBJECTIVES

There has been comparatively little research on the association between social capital and depressive symptoms in low- and middle-income countries. To address this deficit this study examined the association among middle-aged adults in rural Vietnam.

DESIGN

A cross-sectional study.

SETTING

Data came from the baseline survey of the Khánh Hòa Cardiovascular Study, which is an ongoing prospective cohort study aiming to elucidate the determinants of cardiovascular diseases.

PARTICIPANTS

A total of 3000 people aged 40-60 years old residing in rural communes in Khánh Hòa province, Vietnam.

EXPOSURE OF INTEREST

Cognitive social capital (ie, low, middle and high) and structural social capital (in terms of social participation; yes or no) were assessed via a questionnaire.

PRIMARY OUTCOME MEASURE

Depressive symptoms were assessed with the 11-item Center for Epidemiologic Studies Depression Scale.

RESULTS

A robust Poisson regression model revealed that adults in the highest versus lowest cognitive social capital tertile had a 61% lower prevalence of depressive symptoms (prevalence ratio (PR)=0.39, 95% CI=0.31 to 0.49). Individuals with higher structural social capital were also significantly less likely to experience depressive symptoms (PR=0.74, 95% CI=0.61 to 0.90).

CONCLUSION

In a cohort of 3000 middle-aged rural residents in Vietnam, both cognitive and structural social capital assessed at the individual level were inversely associated with the prevalence of depressive symptoms.

The value of vaccines

Optimizing vaccine spending depends on recognizing the full value of vaccination (VoV). Existing taxonomies of such value are not comprehensive because they are not guided by general theories. I rely on two such theories: subjective-value theory claims that what has value is determined by what people actually or ideally want in life. A welfarist theory of government states that a fundamental objective of government is to promote social value (or social welfare). These jointly imply that any aspect of life that individuals actually or ideally value and that could be negatively affected by vaccine-preventable diseases (and therefore positively affected by preventive vaccines) is an element of VoV. I build a more comprehensive-value taxonomy than currently exists based on this implication.

COVID-19 Lockdown and Social Capital Changes Among Youths in China

Social capital refers to the effective functioning of social groups through networks of relationships. The lockdown measures due to coronavirus disease 2019 (COVID-19) may change the social capital among youths. This study aimed to evaluate changes in social capital before and during COVID-19 lockdown among Chinese youths. It was based on the online COVID-19 Impact on Lifestyle Change Survey (COINLICS) conducted among 10 540 youths at three educational levels, including high/vocational school, undergraduate, and graduate, before and during COVID-19 lockdown. Measures of perceptions of social capital were adapted from a validated Chinese version of Health-related Social Capital Measurement based on youths' characteristics of living and studying environment. Social capital was measured at four dimensions, including individual social capital (ISC), family social capital (FSC), community social capital (CSC), and society social capital (SSC). Overall, compared to before lockdown, ISC and CSC scores decreased, while FSC and SSC scores increased during lockdown. When stratified by educational levels, the trends for each dimension of social capital were consistent with the overall population. There were 43.9%, 5.7%, 32.1%, and 3.7% of the participants showing decreased scores during lockdown for ISC, FSC, CSC, and SSC, respectively, while 7.2%, 24.0%, 15.3%, and 10.7% of participants showed increased scores for ISC, FSC, CSC, and SSC, respectively. Our timely, large-scale study showed decreased social capital in individual and community dimensions and increased social capital in family and society dimensions during lockdown.

Quantitative methods for climate change and mental health research: current trends and future directions

The quantitative literature on climate change and mental health is growing rapidly. However, the methodological quality of the evidence is heterogeneous, and there is scope for methodological improvement and innovation. The first section of this Personal View provides a snapshot of current methodological trends and issues in the quantitative literature on climate change and mental health, drawing on literature collected through a previous scoping review. The second part of this Personal View outlines opportunities for methodological innovation concerning the assessment of the relationship between climate change and mental health. We then highlight possible methodological innovations in intervention research and in the measurement of climate change and mental health-related variables. This section draws upon methods from public mental health, environmental epidemiology, and other fields. The objective is not to provide a detailed description of different methodological techniques, but rather to highlight opportunities to use diverse methods, collaborate across disciplines, and inspire methodological innovation. The reader will be referred to practical guidance on different methods when available. We hope this Personal View will constitute a roadmap and launching pad for methodological innovation for researchers interested in investigating a rapidly growing area of research.

Depression, Insomnia, and Probable Post-Traumatic Stress Disorder among Survivors of the 2016 Kumamoto Earthquake and Related Factors during the Recovery Period Amidst the COVID-19 Pandemic

The aftereffects of the severe 2016 Kumamoto earthquake were complicated by the COVID-19 pandemic. This study aimed to identify mental health problems and related factors among survivors five years after the earthquake and clarify its long-term effects. A cross-sectional survey was conducted in 2020 among 19,212 survivors affected by the earthquake who moved from temporary to permanent housing. We analysed 8966 respondents (5135 women, 3831 men; mean age 62.25 ± 17.29 years). Logistic regression analysis was conducted to examine associations between mental health problems and socioeconomic factors. Prevalence rates of psychological distress, insomnia, and probable post-traumatic stress disorder were 11.9%, 35.2%, and 4.1%, respectively. Female gender (OR = 1.33, 95% CI = 1.13–1.57; OR = 1.21, 95% CI = 1.08–1.34; OR = 1.81, 95% CI = 1.41–2.32), public housing (OR = 2.14, 95% CI = 1.63–2.83; OR = 1.54, 95% CI = 1.26–1.88; OR = 2.41, 95% CI = 1.62–3.58), loneliness (OR = 9.08, 95% CI = 7.71–10.70; OR = 5.55, 95% CI = 4.90–6.30; OR = 3.52, 95% CI = 2.77–4.49), COVID-19-induced activity reduction (OR = 1.41, 95% CI = 1.19–1.66; OR = 1.86, 95% CI = 1.68–2.07; OR = 1.80, 95% CI = 1.40–2.31), and COVID-19-induced income reduction (OR = 1.33, 95% CI = 1.12–1.57; OR = 1.43, 95% CI = 1.28–1.59; OR = 1.92, 95% CI = 1.51–2.43) were significantly associated with mental health problems. These results suggest that gender, current housing, loneliness, and COVID-19 affected the survivors’ mental health during recovery.

Pre-pandemic individual- and community-level social capital and depressive symptoms during COVID-19: A longitudinal study of Japanese older adults in 2019-21

During a pandemic, it is important to know whether social capital can mitigate the risk of mental disorders, given the restrictions on social interactions. However, evidence using longitudinal data is scarce. This study examined the association between pre-pandemic social capital and depressive symptoms during COVID-19 among older adults. We used longitudinal data from the Japan Gerontological Evaluation Study (JAGES), including 8291 participants aged 65 or older who were physically and cognitively independent and not depressed at baseline. We conducted baseline and follow-up mail surveys in ten municipalities in Japan from November 2019 to January 2020 (pre-pandemic period) and from November 2020 to February 2021 (pandemic period), respectively. We measured depressive symptoms using the 15-item Geriatric Depression Scale. Social capital was measured with three validated subscales, namely, civic participation, social cohesion, and reciprocity. We performed a multilevel logistic regression analysis to examine the association. A total of 1089 (13.1%) participants newly developed depressive symptoms during the pandemic. The logistic regression showed that pre-pandemic individual-level social cohesion (odds ratio = 0.79, 95% confidence interval: 0.73 to 0.86) and reciprocity (0.89, 0.82 to 0.96) and community-level reciprocity (0.93, 0.88 to 0.98) were negatively associated with the odds of depressive symptoms. Even after adjusting for declines in social capital during the pandemic, the observed associations of pre-pandemic social capital remained. Fostering social cohesion and reciprocity may increase resilience to mental disorders during a pandemic of infectious disease.

Social Capital Changes After COVID-19 Lockdown Among Youths in China: COVID-19 Impact on Lifestyle Change Survey (COINLICS)

Introduction: Social capital, the effective functioning of social groups through networks of relationships, can affect mental health and may be affected by COVID-19. We aimed to examine the changes in social capital before and after the COVID-19 lockdown among the Chinese youth.

Methods: A national convenience sample of 10,540 high school, undergraduate, and graduate students, from the COVID-19 Impact on Lifestyle Change Survey (COINLICS), reported their demographic and social capital information before and after the COVID-19 lockdown. Social capital was retrospectively measured at four levels: individual (ISC), family (FSC), community (CSC), and society (SSC). The changes of social capital were also compared across three educational levels.

Results: Overall, ISC and CSC scores generally decreased after lockdown (15.1 to 14.8 and 13.4 to 13.1, respectively), while FSC and SSC scores increased significantly (12.7 to 13.0 and 7.1 to 7.2, respectively). At the individual level, most participants showed a constant perceived social capital; more of the remaining participants showed decreased than increased ISC (30.5% vs. 17.0%) and CSC scores (28.4% vs. 19.1%), while more participants showed increased than decreased FSC (21.7% vs. 9.2%) and SSC scores (10.3% vs. 3.9%). Heterogeneities in social capital changes existed across educational levels.

Conclusions: Our findings would provide health professionals and policy-makers solid evidence on the changes in social capital of youths after lockdowns, and therefore help the design of future interventions to rebuild or improve their social capital after epidemics/disasters.

Depressive symptoms in the aftermath of major disaster: Empirical test of the social support deterioration model using natural experiment

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.