The Iwanuma Study (R01AG042463-04) was established with the objective to investigate the role of social cohesion in promoting disaster resilience among older survivors of the March 11, 2011 earthquake and tsunami in northeastern Japan. Our baseline data were gathered as part of a nationwide cohort study in Japan ? the JApan Gerontological Evaluation Study (JAGES) -- seven months prior to the disaster. One of the field sites of the JAGES cohort was the city of Iwanuma in Miyagi Prefecture, 80 km west of the earthquake epicenter. We managed to locate 99.7% of the surviving participants approximately 3 years after the disaster. To date, the Iwanuma study has established that: (a) 11 percent of survivors are experiencing severe PTSD symptoms three years after the disaster, and that higher levels of community social cohesion pre-dating the disaster lowers the odds of severe PTSD symptoms (odds ratio 0.7, 95% CI: 0.6 ? 0.9) (Am J Epidemiol, March 2016); (b) housing damage and residential relocation is associated with cognitive impairment among survivors (Proc Natl Acad Sci, September 2016); and (c) informal socializing with neighbors buffers the adverse impact of disaster experience on cognitive decline (Lancet Planetary Health in press). In this competing renewal, we seek to extend our follow-up of the impacts of disaster experience on the health of aging survivors, focusing specifically on three aging-related outcomes: cognitive decline, functional disability, and overweight. Our project is innovative for several reasons. First, our study design leverages a unique ?natural experiment? made possible by the collection of individual data pre-dating the 2011 Tohoku disaster. Secondly, we focus on outcomes that are relevant to the health needs of older populations affected by disaster, viz. cognitive function, functional independence, and nutritional status. The elderly are disproportionally affected both during and after disasters, because of chronic diseases or conditions, impaired physiological, sensory, and cognitive changes experienced as part of aging. Thirdly, our proposal addresses an important gap in knowledge by documenting the long-term health trajectories after disaster, in contrast to previous literature which has mostly focused on the immediate/short-term health effects. Fourthly, our analyses will utilize four survey waves which is seldom available in disaster situations: 2010 (pre-disaster), 2013, 2016, and a 4th wave planned in 2019. These data will enable us to examine at least two occasions on which survivors experienced a large-scale change in residential environment. Lastly, our study will utilize objective measures of exposure (e.g. housing damage as assessed by building inspectors; GIS data on local food environment) as well as health status (e.g. dementia symptomatology and disability status obtained from in-home assessment under Japan?s Long Term Care Insurance registry).

Public Health Relevance

The incidence of natural disasters is increasing worldwide. The significance of our study is that older populations are disproportionally affected by disasters. By focusing on age-related health outcomes (cognitive impairment, functional disability, and metabolic abnormalities) over 4 waves of data collection, our study will assist in understanding the longer-term health impacts of disaster exposure in a vulnerable population.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG042463-07
Application #
9787260
Study Section
Community Influences on Health Behavior Study Section (CIHB)
Program Officer
Karraker, Amelia Wilkes
Project Start
2018-09-30
Project End
2023-05-31
Budget Start
2019-06-01
Budget End
2020-05-31
Support Year
7
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Harvard University
Department
Social Sciences
Type
Schools of Public Health
DUNS #
149617367
City
Boston
State
MA
Country
United States
Zip Code
02115
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
Hikichi, Hiroyuki; Aida, Jun; Tsuboya, Toru et al. (2016) Can Community Social Cohesion Prevent Posttraumatic Stress Disorder in the Aftermath of a Disaster? A Natural Experiment From the 2011 Tohoku Earthquake and Tsunami. Am J Epidemiol 183:902-10
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

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