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).

项目总结 岩间研究(R01AG042463-04)的目的是调查社会的作用 凝聚力促进2011年3月11日地震和海啸的老年幸存者的抗灾能力 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)--灾难发生前七个月。的野外遗址之一 JAGES的队列是位于地震震中以西80公里的宫城县岩沼市。我们 在灾难发生约3年后，设法找到了99.7%的幸存参与者。到目前为止， 岩间研究证实：(A)11%的幸存者正在经历严重的创伤后应激障碍症状 灾难发生数年后，灾难发生前较高水平的社区社会凝聚力降低了 严重创伤后应激障碍症状的几率(优势比0.7，95%可信区间：0.6-0.9)(美国流行病学杂志，2016年3月)；(B)住房 损坏和住宅搬迁与幸存者中的认知障碍有关(《自然学报》科学版， 2016年9月)；和(C)与邻居的非正式社交缓解了灾害经历的不利影响 论认知衰退(《柳叶刀·行星健康》出版)。 在这次相互竞争的更新中，我们寻求扩大我们对灾害经历对健康影响的后续行动 特别关注与衰老相关的三种结果：认知能力下降，功能障碍， 而且超重。我们的项目之所以具有创新性，有几个原因。首先，我们的研究设计利用了独特的“自然” 通过收集2011年东北灾难之前的个人数据，使“实验”成为可能。第二， 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。老年人受到的影响不成比例 在灾难期间和之后，由于慢性疾病或状况，生理、感觉和 作为衰老的一部分而经历的认知变化。第三，我们的建议解决了知识方面的一个重要差距 通过记录灾难后的长期健康轨迹，与之前的文献形成对比的是，以前的文献大多 重点关注对健康的直接/短期影响。第四，我们的分析将利用四个调查浪潮， 很少在灾难情况下提供：2010年(灾前)、2013年、2016年，以及计划在2019年进行的第四次浪潮。 这些数据将使我们能够检查至少两次幸存者经历了大规模 居住环境的变化。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；关于当地食品环境的地理信息系统数据)以及健康状况(例如 根据日本长期家庭评估获得的痴呆症状和残疾状况 护理保险登记处)。