Impact of social cohesion on functional recovery after earthquake and tsunami

社会凝聚力对地震和海啸后功能恢复的影响

• 批准号: 10172810
• 负责人: Ichiro Kawachi
• 金额: $ 53.71万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10172810
• 关键词: Address; Affect; Aging; Behavior; Body mass index; Buffers; Chronic Disease; Cities; Cognitive; Cohort Studies; Collection; Communities; Data; Data Collection; Dementia; Disasters; Earthquakes; Elderly; Environment; Evaluation Studies; Event; Gerontology; Glycosylated hemoglobin A; Health; Health Status; Home; Housing; Impaired cognition; Impairment; Incidence; Individual; Japan; Knowledge; Lipids; Literature; Liver Function Tests; Long-Term Care Insurance; Measures; Metabolic; Natural Disasters; Natural experiment; Nutritional status; Odds Ratio; Older Population; Outcome; Overweight; Participant; Physical Function; Physiological; Post-Traumatic Stress Disorders; Prevalence; Recovery of Function; Registries; Research Design; Risk; Risk Factors; Role; Sampling; Sensory; Site; Socialization; Surveys; Survivors; Symptoms; Time; Tsunami; Vulnerable Populations; age related; cognitive change; cognitive function; dietary; disability; disaster survivor; experience; fast food; follow-up; food environment; functional decline; functional disability; functional independence; innovation; interest; protective factors; residence; resilience; social; social capital; social cohesion; symptomatology

PROJECT SUMMARY 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).

项目摘要 建立了Iwanuma研究（R01AG042463-04），目的是研究社会的作用 2011年3月11日地震和海啸的较老生存期间促进灾难恢复能力的凝聚力 在日本东北部。我们的基线数据是作为日本全国队列研究的一部分收集的 - 日本老年学评估研究（JAGES） - 灾难前七个月。其中一个现场站点 Jages队列是地震中心以西80公里的宫城县的伊瓦纳马市。我们 灾难发生大约3年后，设法找到了99.7％的幸存参与者。迄今为止， Iwanuma研究确定：（a）11％的生存经历了严重的PTSD症状三 灾难发生后的几年，以及灾难前的更高水平的社区社会凝聚力降低了 严重PTSD症状的几率（几率0.7，95％CI：0.6 - 0.9）（Am J Epidemiol，2016年3月）； （b）住房 损害和居民搬迁与生存之间的认知障碍有关（Proc Natl Acad Sci， 2016年9月）; （c）与邻居进行非正式社交缓冲灾难经验的不利影响 关于认知能力下降（新闻界的柳叶刀行星健康）。 在这种竞争的续约中，我们试图扩展对灾难体验对健康的影响的后续行动 衰老的表面表面，专门针对三个与衰老有关的结果：认知能力下降，功能障碍， 和超重。我们的项目具有创新性，原因有几个。首先，我们的研究设计利用了独特的“自然” 实验”通过预先预先预期2011年Tohoku灾难的单个数据收集。其次， 我们专注于与受灾难影响的老年人口的健康需求相关的结果，即。 认知功能，功能独立性和营养状况。老年人对两者都受到不成比例的影响 在灾难期间和之后，由于慢性疾病或状况，生理，感觉和 认知变化是衰老的一部分。第三，我们的建议解决了知识的重要差距 通过记录灾难后的长期健康轨迹，与以前的文献相比 专注于直接/短期健康影响。第四，我们的分析将利用四个调查浪潮 在灾难情况下很少有：2010年（灾难前），2013年，2016年，2019年计划的第四波浪潮。 这些数据将使我们至少检查两次生存经历了大规模的 住宅环境的变化。最后，我们的研究将利用客观的暴露措施（例如住房 建筑物检查员评估的损坏； GIS关于当地食物环境的数据）以及健康状况（例如 痴呆症症状和残疾状况从日本长期根据的家庭评估获得 护理保险注册表）。