Impact of the 2011 Great East Japan Earthquake on community health: ecological time series on transient increase in indirect mortality and recovery of health and long-term-care system

Uchimura, Mari; Kizuki, Masashi; Takano, Takehito; Morita, Ayako; Seino, Kaoruko

doi:10.1136/jech-2014-204063

Cited by 16 publications

(15 citation statements)

References 13 publications

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“…A previous study hypothesised that postdisaster increases in pneumonia were caused by the swallowing of dust and water carried by the tsunami 33. However, in our findings, more than half of the patients who died from pneumonia were in inpatient medical facilities at the time of the earthquake, making them unlikely to be directly affected by the tsunami.…”

Section: Discussioncontrasting

confidence: 81%

Excess mortality due to indirect health effects of the 2011 triple disaster in Fukushima, Japan: a retrospective observational study

Morita

Nomura

Tsubokura

et al. 2017

J Epidemiol Community Health

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Section: Discussioncontrasting

confidence: 81%

Excess mortality due to indirect health effects of the 2011 triple disaster in Fukushima, Japan: a retrospective observational study

Morita

Nomura

Tsubokura

et al. 2017

J Epidemiol Community Health

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“…Previous studies indicated that the number of hospitalised patients with pneumonia was related to destruction ratios, 21 and showed that the higher percentage of households flooded was associated with a higher risk of indirect mortality. 22 Many tsunami survivors lost their homes and had to flee to shelters in the destroyed environment. The medical staff were not stationed in all shelters.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of pneumonia deaths after an earthquake and tsunami: an ecological study of 5.7 million participants in 131 municipalities, Japan

et al. 2016

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ObjectiveOn 11 March 2011, the Great East Japan Earthquake struck off Japan. Although some studies showed that the earthquake increased the risk of pneumonia death, no study reported whether and how much a tsunami increased the risk. We examined the risk for pneumonia death after the earthquake/tsunami.DesignThis is an ecological study.SettingData on population and pneumonia deaths obtained from the Vital Statistics 2010 and 2012, National Census 2010 and Basic Resident Register 2010 and 2012 in Japan.ParticipantsAbout 5.7 million participants residing in Miyagi, Iwate and Fukushima Prefectures during 1 year after the disaster were targeted. All municipalities (n=131) were categorised into inland (n=93), that is, the earthquake-impacted area, and coastal types (n=38), that is, the earthquake-impacted and tsunami-impacted area.Outcome measuresThe number of pneumonia deaths per week was totalled from 12 March 2010 to 9 March 2012. The number of observed pneumonia deaths (O) and the sum of the sex and age classes in the observed population multiplied by the sex and age classes of expected pneumonia mortality (E) were calculated. Expected pneumonia mortality was the pneumonia mortality during the year before. Standardised mortality ratios (SMRs) were calculated for pneumonia deaths (O/E), adjusting for sex and age using the indirect method. SMRs were then calculated by coastal and inland municipalities.Results6603 participants died of pneumonia during 1 year after the earthquake. SMRs increased significantly during the 1st–12th weeks. In the 2nd week, SMRs in coastal and inland municipalities were 2.49 (95% CI 2.02 to 7.64) and 1.48 (95% CI 1.24 to 2.61), respectively. SMRs of coastal municipalities were higher than those of inland municipalities.ConclusionsAn earthquake increased the risk of pneumonia death and tsunamis additionally increased the risk.

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“…Expenditure on healthcare and long-term care is useful to investigate health status, care needs, and access to health services (Uchimura et al 2014;Morita et al 2016;Kent et al 2017;Matsuyama et al 2018). All Japanese citizens have public health insurance, whereas long-term care insurances target elders who need care (e.g., meal assistance).…”

Section: Introductionmentioning

confidence: 99%

“…In the case of the Fukushima disaster, excess weight was associated with higher healthcare costs (Kent et al 2017). Uchimura et al (2014) reported a decline in long-term care expenditure for 1-5 months immediately after the Fukushima disaster and attributed this decline to upheaval (e.g., losses of their house) related to the disaster. reported that the total expenditure on long-term care services in Minamisoma City, an EOA, was 50% higher in 2014 than the pre-disaster level in 2009.…”

Section: Introductionmentioning

confidence: 99%

Worsening Health Status among Evacuees: Analysis of Medical Expenditures after the 2011 Great East Japan Earthquake and Nuclear Disaster in Fukushima

Hasegawa

Murakami

Nomura

et al. 2019

Tohoku J. Exp. Med.

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After Fukushima disaster in 2011, the health status of the region's residents deteriorated. We analyzed the health status, care needs, and access to health services among evacuees and non-evacuees using healthcare expenditure (for self-employed and unemployed individuals aged < 75 years) and long-term care expenditure (mainly for individuals aged ≥ 65 years). Fukushima Prefecture was divided into four areas according to their evacuation status: non-EOAs (municipalities that did not include evacuation order areas (EOAs)); EOAs/non-EOAs (municipalities that included both EOAs and non-EOAs); short-term EOAs (municipalities where the EOA designation was lifted in most areas by fiscal year (FY) 2011); and long-term EOAs (municipalities where most EOA designations remained in place until the end of FY 2015). Increases in expenditure on healthcare and long-term care per capita in short-term and long-term EOAs were greater in FY 2015 than the average values in FYs 2008-2010. The increases in expenditure were higher in shortterm and long-term EOAs than those in non-EOAs and EOAs/non-EOAs. The increases in dental health expenditure were attributed to enhanced accessibility to dental health facilities. Furthermore, the evacuations contributed to increases in healthcare and long-term care expenditure, independent of aging and improved accessibly to health facilities. Possible explanations for these increases include the poor health status of the evacuees following the evacuations, reduced availability of informal care provided by family members and neighbors, and reduced patient copayments. The findings highlight the necessity of health promotion among evacuees.

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Impact of the 2011 Great East Japan Earthquake on community health: ecological time series on transient increase in indirect mortality and recovery of health and long-term-care system

Abstract: This study showed transient increase in indirect mortality and recovery of health and long-term-care system after the earthquake.

Cited by 16 publications

References 13 publications

Excess mortality due to indirect health effects of the 2011 triple disaster in Fukushima, Japan: a retrospective observational study

Excess mortality due to indirect health effects of the 2011 triple disaster in Fukushima, Japan: a retrospective observational study

Characteristics of pneumonia deaths after an earthquake and tsunami: an ecological study of 5.7 million participants in 131 municipalities, Japan

Worsening Health Status among Evacuees: Analysis of Medical Expenditures after the 2011 Great East Japan Earthquake and Nuclear Disaster in Fukushima

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