Abstract
The health of communities has been observed to recover at differential rates in the wake of disasters. In the present study, the 5-year trends in poor self-rated health (SRH) in three municipalities of Iwate Prefecture following the 2011 Great East Japan Earthquake and Tsunami were compared. Annual surveys were conducted from 2011 to 2015 in three municipalities (Otsuchi, Rikuzentakata, and Yamada) that were heavily damaged by the tsunami. We tracked the prevalence of poor SRH in 10,052 participants (mean age, 61.0 years; 39.0% men). Trends in the prevalence of poor SRH were analyzed using generalized linear mixed effect models with control for covariates. Immediately after the disaster (2011), all three municipalities reported similar prevalences of poor SRH (around 15%). Among people under the age of 65 years, there was a gradual improvement in health for residents of Rikuzentakata and Yamada, but the prevalence of poor SRH remained persistently high in Otsuchi. Among people over the age of 65 years, the prevalence of poor SRH remained constant in Rikuzentakata and Yamada but increased over a 5-year follow-up period in Otsuchi. The delayed health recovery in Otsuchi may be due to the characteristics of the local health system. Examination of the variations in health recovery may provide clues about the sources of disaster resilience.
Highlights
Ten years have passed since the 2011 Great East Japan Earthquake that devastated coastal cities in the Tohoku region of Japan
While the prevalence of poor self-rated health (SRH) was high in Otsuchi among participants aged years or younger, the prevalences of poor SRH were not significantly different in the three municipalities among participants aged years or older
The variables that we adjusted for in Model 2 and Model 3 partially explained the disparity in poor SRH between municipalities, viz., functional disability, living conditions, self-assessed economic situation, employment status, health habits, psychosocial factors, and disease markers in people aged 65 years or older
Summary
Ten years have passed since the 2011 Great East Japan Earthquake that devastated coastal cities in the Tohoku region of Japan. Disaster resilience is affected by various factors including the level of preparedness in the community, strength of the health system to deal with mass emergencies, and level of resources available during the long recovery phase. Descriptive studies of this type are the first step toward gaining a better understanding of disaster resilience. The aim of this study was to document the trajectories of health status among residents of three municipalities in Iwate Prefecture over a period of 5 years following the 2011 Great East Japan Earthquake
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