We propose to investigate the trajectories of functional status (mobility, activities of daily living, onset of disability) among survivors of th March 11, 2011 earthquake and tsunami in northeast Japan. Our study is in response to PA-11-263 which calls for """"""""research on the consequences of disaster for the health of the elderly with the ultimate goal of preventing and mitigating harmful consequences"""""""". Our proposed study will leverage baseline data that were collected as part of a national cohort study (the J-AGES - the JApan Gerontological Evaluation Study) from a town located in the disaster zone seven months prior to the March 11 event. Some areas of the town of Iwanuma, Miyagi Prefecture, which were close to the shore were inundated by the tsunami, while parts that were further inland were spared. Of the population of 44,184, about 180 residents have been reported dead or missing, while 6,600 were evacuated to temporary shelters. Baseline data prior to the tsunami were obtained from 5,060 residents of Iwanuma who were 65 years and older. The research team has permission to repeat the survey in 2014. This design will allow us to address two specific aims: 1) to examine the impact of exposure to disaster (loss of loved ones, loss/damage to property, disruptions in access to health services) on the trajectory of functional status and disability onset among elders;and 2) to examine the impact of pre- disaster variations in community social cohesion on the trajectory of functional decline among disaster-exposed residents over a period of 3 years. Our proposal is innovative in three ways: 1) Strong causal design. We address the two major limitations of disaster research: the availability of pre-disaster information on health status as well as predictors;and the use of appropriate comparison groups, i.e. residents living in the same town who happened to be in locations that the tsunami did not reach;2) Focus on the long-term physical health sequelae of disaster in the elderly - in addition to gathering information about mental health;3) Focus on community-level social determinants of recovery in addition to studying individual-level predictors. We bring together an experienced team of investigators from the United States and Japan noted for their expertise in social epidemiology, multilevel analysis, gerontology and aging.

Public Health Relevance

The incidence of natural disasters is increasing worldwide. The significance of our study is that by identifying the individual and community-level factors that predict variations in health outcomes following such events, our study will assist in disaster preparedness as well as the targeting of long-term recovery efforts to groups and communities with greatest need.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Project (R01)
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Community Influences on Health Behavior (CIHB)
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Haaga, John G
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Harvard University
Social Sciences
Schools of Public Health
United States
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Sasaki, Yuri; Aida, Jun; Tsuji, Taishi et al. (2018) Does Type of Residential Housing Matter for Depressive Symptoms in the Aftermath of a Disaster? Insights From the Great East Japan Earthquake and Tsunami. Am J Epidemiol 187:455-464
Matsuyama, Yusuke; Aida, Jun; Tsuboya, Toru et al. (2017) Are Lowered Socioeconomic Circumstances Causally Related to Tooth Loss? A Natural Experiment Involving the 2011 Great East Japan Earthquake. Am J Epidemiol 186:54-62
Saito, Masashige; Kondo, Naoki; Aida, Jun et al. (2017) Development of an instrument for community-level health related social capital among Japanese older people: The JAGES Project. J Epidemiol 27:221-227
Tsuji, Taishi; Sasaki, Yuri; Matsuyama, Yusuke et al. (2017) Reducing depressive symptoms after the Great East Japan Earthquake in older survivors through group exercise participation and regular walking: a prospective observational study. BMJ Open 7:e013706
Hikichi, Hiroyuki; Sawada, Yasuyuki; Tsuboya, Toru et al. (2017) Residential relocation and change in social capital: A natural experiment from the 2011 Great East Japan Earthquake and Tsunami. Sci Adv 3:e1700426
Aida, Jun; Hikichi, Hiroyuki; Matsuyama, Yusuke et al. (2017) Risk of mortality during and after the 2011 Great East Japan Earthquake and Tsunami among older coastal residents. Sci Rep 7:16591
Hikichi, Hiroyuki; Tsuboya, Toru; Aida, Jun et al. (2017) Social capital and cognitive decline in the aftermath of a natural disaster: a natural experiment from the 2011 Great East Japan Earthquake and Tsunami. Lancet Planet Health 1:e105-e113
Tsuboya, Toru; Aida, Jun; Hikichi, Hiroyuki et al. (2017) Predictors of decline in IADL functioning among older survivors following the Great East Japan earthquake: A prospective study. Soc Sci Med 176:34-41
Tsuboya, Toru; Aida, Jun; Hikichi, Hiroyuki et al. (2016) Predictors of depressive symptoms following the Great East Japan earthquake: A prospective study. Soc Sci Med 161:47-54
Hikichi, Hiroyuki; Aida, Jun; Kondo, Katsunori et al. (2016) Increased risk of dementia in the aftermath of the 2011 Great East Japan Earthquake and Tsunami. Proc Natl Acad Sci U S A 113:E6911-E6918

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