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: 8690730
• 负责人: Ichiro Kawachi
• 金额: $ 43.83万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8690730
• 关键词: Activities of Daily Living; Address; Affect; Aging; Area; Authorization documentation; Behavioral Research; Cities; Cohort Studies; Communities; Data; Disasters; Earthquakes; Elderly; Epidemiology; Evaluation Studies; Event; Exposure to; Family member; Friends; Gerontology; Goals; Health; Health Services Accessibility; Health Status; Housing; Hurricane; Incidence; Indian Ocean; Individual; Japan; Life; Location; Measures; Mental Health; NIH Program Announcements; Natural Disasters; Neighborhoods; Outcome; Population; Property; Readiness; Recovery; Recovery of Function; Relative (related person); Reporting; Research; Research Personnel; Severities; Shelter facility; Social Impacts; Surveys; Survivors; Tsunami; United States; Variant; base; cohesion; comparison group; design; disability; experience; follow-up; functional decline; functional disability; functional status; human old age (65+); information gathering; innovation; killings; loved ones; multilevel analysis; physical conditioning; prevent; public health relevance; reconstruction; response; social

DESCRIPTION (provided by applicant): We propose to investigate the trajectories of functional status (mobility, activities of daily living, onset of disability) among survivors of th March 11, 2011 earthquake and tsunami in northeast Japan. Our study is in response to PA-11-263 which calls for "research on the consequences of disaster for the health of the elderly with the ultimate goal of preventing and mitigating harmful consequences". Our proposed study will leverage baseline data that were collected as part of a national cohort study (the J-AGES - the JApan Gerontological Evaluation Study) from a town located in the disaster zone seven months prior to the March 11 event. Some areas of the town of Iwanuma, Miyagi Prefecture, which were close to the shore were inundated by the tsunami, while parts that were further inland were spared. Of the population of 44,184, about 180 residents have been reported dead or missing, while 6,600 were evacuated to temporary shelters. Baseline data prior to the tsunami were obtained from 5,060 residents of Iwanuma who were 65 years and older. The research team has permission to repeat the survey in 2014. This design will allow us to address two specific aims: 1) to examine the impact of exposure to disaster (loss of loved ones, loss/damage to property, disruptions in access to health services) on the trajectory of functional status and disability onset among elders; and 2) to examine the impact of pre- disaster variations in community social cohesion on the trajectory of functional decline among disaster-exposed residents over a period of 3 years. Our proposal is innovative in three ways: 1) Strong causal design. We address the two major limitations of disaster research: the availability of pre-disaster information on health status as well as predictors; and the use of appropriate comparison groups, i.e. residents living in the same town who happened to be in locations that the tsunami did not reach; 2) Focus on the long-term physical health sequelae of disaster in the elderly - in addition to gathering information about mental health; 3) Focus on community-level social determinants of recovery in addition to studying individual-level predictors. We bring together an experienced team of investigators from the United States and Japan noted for their expertise in social epidemiology, multilevel analysis, gerontology and aging.

描述(申请人提供)：我们建议调查2011年3月11日日本东北部地震和海啸幸存者的功能状态(活动能力、日常生活能力、残疾发作)的轨迹。我们的研究是对PA-11-263的响应，PA-11-263呼吁“研究灾害对老年人健康的影响，最终目标是预防和减轻有害后果”。我们提议的研究将利用在3月11日事件发生前七个月从位于灾区的一个城镇收集的基线数据，这些数据是作为国家队列研究(J-AGES-日本老年学评估研究)的一部分收集的。宫城县岩沼镇靠近海岸的一些地区被海啸淹没，而更靠近内陆的部分则幸免于难。在44184人口中，据报道约有180名居民死亡或失踪，6600人被疏散到临时避难所。海啸前的基线数据来自岩沼市5,060名65岁及以上的居民。该研究团队获准在2014年重复这项调查。这一设计将使我们能够解决两个具体目标：1)研究暴露在灾难中(失去亲人、财产损失/损坏、获得医疗服务的中断)对老年人功能状况和残疾发病轨迹的影响；2)研究灾前社区社会凝聚力的变化对遭受灾害影响的居民在3年内功能衰退的影响。我们的建议在三个方面是创新的：1)强因果设计。我们解决了灾难研究的两个主要限制：灾难前的可用性 关于健康状况以及预测因素的信息；以及使用适当的比较组，即居住在同一城镇的居民碰巧在海啸没有到达的地方；2)除了收集有关心理健康的信息外，还侧重于灾难对老年人身体健康的长期后遗症；3)除了研究个人一级的预测因素外，还侧重于社区一级恢复的社会决定因素。我们汇集了来自美国和日本的一支经验丰富的研究团队，他们以在社会流行病学、多层次分析、老年学和老龄化方面的专长而闻名。