Long-Term Associations between Disaster-Related Home Loss and Health and Well-Being of Older Survivors : Nine Years after the 2011 Great East Japan Earthquake and Tsunami

BACKGROUND: Little research has examined associations between disaster-related home loss and multiple domains of health and well-being, with extended long-term follow-up and comprehensive adjustment for pre-disaster characteristics of survivors. OBJECTIVES: We examined the longitudinal associations between disaster-induced home loss and 34 indicators of health and well-being, assessed similar to 9 y post-disaster. METHODS: We used data from a preexisting cohort study of Japanese older adults in an area directly impacted by the 2011 Japan Earthquake (n = 3,350 and n = 2,028, depending on the outcomes). The study was initiated in 2010, and disaster-related home loss status was measured in 2013 retrospectively. The 34 outcomes were assessed in 2020 and covered dimensions of physical health, mental health, health behaviors/sleep, social well-being, cognitive social capital, subjective well-being, and prosocial/altruistic behaviors. We estimated the associations between disaster-related home loss and the outcomes, using targeted maximum likelihood estimation and SuperLearner. We adjusted for pre-disaster characteristics from the wave conducted 7 months before the disaster (i.e., 2010), including prior outcome values that were available. RESULTS: After Bonferroni correction for multiple testing, we found that home loss (vs. no home loss) was associated with increased posttraumatic stress symptoms (standardized difference = 0.50; 95% CI: 0.35, 0.65), increased daily sleepiness (0.38; 95% CI: 0.21, 0.54), lower trust in the community (-0.36; 95% CI: -0.53, -0.18), lower community attachment (-0.60; 95% CI: -0.75, -0.45), and lower prosociality (-0.39; 95% CI: -0.55, -0.24). We found modest evidence for the associations with increased depressive symptoms, increased hopelessness, more chronic conditions, higher body mass index, lower perceived mutual help in the community, and decreased happiness. There was little evidence for associations with the remaining 23 outcomes. DISC
Funding Agencies|National Institutes of Health; Japan Society for the Promotion of Science [R01 AG042463]; Health Labour Sciences Research Grant from the Japanese Ministry of Health, Labour, and Welfare [KAKENHI 23243070, KAKENHI 22390400, KAKENHI 20H00557, KAKENHI 24390469]; Strategic Research Foundation Grant-Aided Project for Private Universities from the Japanese Ministry of Education, Culture, Sports, Science, and Technology [H24-Choju-Wakate-009]; Japan Agency for Medical Research and Development [S0991035]; Well-being for Planet Earth Foundation [JP17dk0110017, JP18dk0110027, JP18ls0110002, JP18le0110009, JP19dk0110034, JP19dk0110037, JP20dk0110034]; Japan Society for the Promotion of Science Research Fellowship for Young Scientists; Swedish Research Council [KAKENHI 21J01171]; Royal Swedish Academy of Letters, History, and Antiquities, Stockholm, Sweden