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Association between relocation and changes in cardiometabolic risk factors: a longitudinal study in tsunami survivors of the 2011 Great East Japan Earthquake.

ABSTRACT: The aim of this study is to determine changes in atherosclerotic cardiovascular risk factors with and without serious disaster-related mental and socioeconomic problems represented by relocation (REL).A longitudinal survey.Multiphasic health check-ups for the general population affected by the 2011 Great East Japan Earthquake and Tsunami.A total 6528 disaster survivors in heavily tsunami-damaged municipalities were recruited. Two sequential surveys were conducted and the data were analysed.Multiphasic health check-ups including investigation of lifestyle and psychological and socioeconomic measures were performed in two sequential phases (8 and 18 months) after the disaster for tsunami survivors with REL (n=3160) and without REL (n=3368). Longitudinal changes in cardiometabolic risk factors between the two phases were compared in the REL and non-REL groups.In sex/age-adjusted analysis, we found increases in body weight and waist circumference between the two phases that were significantly greater in the REL group than in the non-REL group (body weight:+0.31 (0.23∼0.39) versus -0.24 (-0.32∼-0.16) kg, p<0.001; waist circumference:+0.58 (0.48∼0.68) versus+0.05 (-0.05∼0.15) cm, p<0.001)). A decrease in serum HDLC levels was found and again was significantly greater in the REL group than in the non-REL group (-0.65 (-0.96∼-0.34) versus -0.09 (-0.39∼0.21) mg/dL, p=0.009). In addition, deterioration in physical activity, mental health and socioeconomic status was more prevalent in the REL group than in the non-REL group (all p<0.001).This study suggests that relocation after the devastating tsunami was related to weight gain and decreasing HDLC among survivors, and this change was associated with prolonged psychological distress and socioeconomic problems after the disaster.

SUBMITTER: Takahashi S

PROVIDER: S-EPMC4874105 | biostudies-other | 2016

REPOSITORIES: biostudies-other

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Project description:ImportanceTrust is a core component of social cohesion, facilitating cooperation and collective action in the face of adversity and enabling survivors to remain resilient. Residential stability is an important prerequisite of developing trusting relations among community members. However, little is known about whether the movement of internally displaced persons (IDPs) after a disaster might change community relations.ObjectiveWe explored perceived changes in trust within 1 community directly impacted by the 2011 Great East Japan Earthquake and Tsunami.Design, setting, and participantsThis prospective cohort study examined survey data from 3594 residents of Iwanuma City, Japan, aged 65 years or older. Data were obtained from the Iwanuma Study-part of the Japan Gerontological Evaluation Study, a nationwide cohort study established in 2010-approximately 7 months before the disaster. All Iwanuma City residents age 65 years or older (8576 residents) were eligible to participate in 2010. The response rate was 59.0% (5058 residents). A follow-up survey was conducted in 2013, approximately 2.5 years after the disaster. Of the 4380 remaining participants who answered the baseline survey, 3594 were recontacted (follow-up rate, 82.1%). Data analysis was performed from July 1, 2019, to January 9, 2020.ExposuresThe number of temporarily relocated Iwanuma City survivors within 100 m and 250 m of a nonrelocated resident's home address.Main outcomes and measuresPerceived changes in particularized trust (ie, trusting people from the same community) and generalized trust (trusting people from other communities) measured on a 5-point Likert scale.ResultsAmong 3250 nonrelocated residents (1808 [55.6%] women; mean [SD] age, 76.5 [6.2] years) of Iwanuma City included in the analytic sample, multivariable-adjusted multinomial logistic regression analyses found that each standard deviation increase in the influx of internally displaced persons (1 SD = 11 IDPs) within 250 m of a resident's home address was associated with higher odds of a decrease in the resident's particularized and generalized trust (odds ratio, 1.17; 95% CI, 1.04-1.32).Conclusions and relevanceThe influx of IDPs in the host community appeared to be associated with an erosion of trust among locals. To avoid the erosion of social cohesion after a disaster, it may be crucial to provide opportunities for social interaction between old and new residents of communities.

Project description:Importance:Depression and posttraumatic stress disorder (PTSD) represent 2 common mental health sequelae of natural disasters. However, to date, no studies have examined whether postdisaster depression and PTSD are associated with increased risk of mortality among community-dwelling survivors of natural disasters. Objective:To assess whether postdisaster depression and PTSD were associated with mortality in older disaster survivors. Design, Setting, and Participants:In this cohort study, prospective data were retrieved from older Japanese adults in Iwanuma City, Miyagi Prefecture, which was directly affected by the 2011 Great East Japan Earthquake and Tsunami. The baseline was established 7 months before the disaster (August 2010), and follow-up surveys were conducted approximately 2.5 years afterward (October 1, 2013, to January 31, 2014). Invitations were mailed to every citizen 65 years or older in Iwanuma City. Mortality data were obtained through March 4, 2017. Data analysis was performed from December 1, 2018, to June 30, 2019. Exposures:Postdisaster depression (Geriatric Depression Scale Short Form score ?5) and PTSD (Screening Questionnaire for Disaster Mental Health PTSD subscale score ?4) were measured in 2013. Main Outcomes and Measures:Mortality data were obtained by linkage to the national long-term care insurance database. Cox proportional hazards regression models were adjusted for predisaster sociodemographic characteristics, health behaviors, social cohesion, predisaster depression, and disaster experiences. Results:The response rate for the baseline survey was 59.0% (5058 of 8567 individuals), and the follow-up rate was 82.1% (3594 of 4380 eligible respondents). A total of 2965 individuals (mean [SD] age, 73.4 [6.2] years; 1621 [54.7%] female) participated in the study. The mean (SD) follow-up since the 2013 survey was 3.3 (0.5) years. Overall, 974 (32.8%) reported postdisaster depression and 747 (25.2%) reported PTSD. In adjusted models, depression was associated with more than double the risk of mortality (hazard ratio, 2.29; 95% CI, 1.54-3.42); PTSD was not associated with increased risk of mortality (hazard ratio, 1.10; 95% CI, 0.73-1.64). When evaluating the association of the 4-category comorbid depression and PTSD variable with mortality, survivors with depression only (HR, 2.24; 95% CI, 1.43-3.49) as well as those with comorbid depression and PTSD (HR, 2.54; 95% CI, 1.50-4.27) were at increased risk of death during the follow-up period compared with those with neither depression nor PTSD. Conclusions and Relevance:Depression, but not PTSD, was associated with mortality during 3.3 years of follow-up among older disaster survivors. These findings suggest that long-term mental health consequences of natural disasters may exist and that treating depression in older survivors of disasters may be beneficial.

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Association between relocation and changes in cardiometabolic risk factors: a longitudinal study in tsunami survivors of the 2011 Great East Japan Earthquake.

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