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: 8498882
• 负责人: Ichiro Kawachi
• 金额: $ 48.2万
• 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/8498882
• 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（由申请人提供）：我们建议调查日本东北部的2011年3月11日地震和海啸的幸存者之间的功能状况轨迹（​​流动性，日常生活活动，残疾发作）。我们的研究是对PA-11-263的回应，该回应要求“研究灾难对老年人健康的后果，以防止和减轻有害后果的最终目标”。我们拟议的研究将利用作为国家队列研究（J -AGES-日本老年学评估研究）收集的基线数据，该数据是从3月11日事件发生前七个月的一个城镇中收集的。宫城县伊瓦纳马镇的某些地区被海啸淹没了，这些地区被海啸淹没了，而在内陆更远的地方则被保留下来。在44,184人的人口中，大约有180名居民死亡或失踪，而6,600人被撤离到临时庇护所。在海啸之前的基线数据是从65岁及以上的5,060名居民那里获得的。研究小组有权在2014年重复调查。该设计将使我们能够解决两个具体的目标：1）研究灾难的暴露（失去亲人，损失/损害财产，损害/损害卫生服务的破坏）对长者之间的功能状况和残疾发作的轨迹的影响； 2）检查灾难变化对社区社会凝聚力的影响对灾害暴露居民在3年内功能下降的轨迹。我们的建议在三种方面具有创新性：1）强大的因果设计。我们解决了灾难研究的两个主要局限性：灾后的可用性 有关健康状况和预测因素的信息；以及使用适当的比较组，即居住在同一个城镇的居民，这些城镇恰好是海啸未达到的地点； 2）专注于老年人灾难的长期身体健康后遗症 - 除了收集有关心理健康的信息； 3）除了研究个体级别的预测因素外，重点关注恢复社区级别的社会决定因素。我们将来自美国和日本的经验丰富的调查人员团队汇集在一起​​，以其在社会流行病学，多层次分析，老年病和衰老方面的专业知识而闻名。