Household-and community-level preparedness have been re-emphasized after recent major earthquakes and tsunamis in Japan. The paper examines the prevalence and the determinants of disaster preparedness among the residents of a provincial city in Japan at both levels. Furthermore, it seeks to uncover the associations between household-and community-level preparedness activities to test the hypothesis that a complementary relationship exists between them. We used a subset of a population-based household questionnaire survey of 4000 randomly sampled households in Komoro City in the Nagano Prefecture of Japan in February and March of 2011. The questionnaire included specific questions to measure disaster the preparedness status at both the household and community levels. The characteristics and associations of household-and community-level preparedness were analyzed with multivariable logistic regression models. We found insufficient disaster preparedness at both household and community levels. Older, female, and better educated household heads were associated with better household preparedness, while length at residence, non-single status, presence of an elderly household member, and farming occupations were associated with better community preparedness. Households with one or more household-level preparedness measures were more likely to receive community assistance than those lacking them. The relationship between household and community preparedness was not complementary. Hence, a large proportion of the households were unprepared at both the community and household levels. * Corresponding author.J. Tomio et al. 69

Objectives To describe disaster preparedness among chronically ill patients and to examine how differences in health, functional, and disability conditions are associated with disaster preparedness, focusing on rheumatoid arthritis (RA) patients with various functional and disability levels. Methods In 2007, 1,477 members of a nationwide RA patient group in Japan who lived in municipalities affected by natural disasters between 2004 and 2006 were asked to participate in a questionnaire survey. Three medical preparedness indicators, namely, medication stockpiles, the carrying of medications, and the carrying of prescription/ treatment records, and three general preparedness indicators, namely, having emergency packs, emergency communication plans, and emergency evacuation plans, were used as dependent variables. Multivariable logistic models were applied to examine the associations of health-related vulnerability variables with the preparedness variables. Results Of the 553 subjects included into the analysis, only one-half had taken medical preparedness measures and only one-quarter had taken general preparedness measures. Although physical disability and poorer functional level were associated positively with the medical preparedness, those with poorer perceived health were less likely to carry medications and prescription/treatment records, and those receiving the highest long-term care levels were less likely to carry medications than their healthier counterparts.Conclusions Among the population of chronically ill RA patients surveyed, disaster preparedness was insufficient, and their preparedness status varied with health, functional, and disability conditions. We suggest that policy-makers should give careful thought to the targets they set for disaster preparedness.

To examine the effects of natural disasters on rheumatoid arthritis (RA) patients we conducted a questionnaire survey targeted to 1,477 members of a nationwide RA patient group in Japan who lived in the municipalities affected by natural disasters between 2004 and 2006. Functional statuses measured by the modified Health Assessment Questionnaire and self-rated health statuses before and after the events were retrospectively examined. The associations between the changes in functional and health status and socio-demographics, direct damage, and preparedness status were statistically analyzed. Of the 665 individuals who responded, the data on 192 women RA patients were analyzed. The values at 1 and 6 months post-event were the same, with 14% experiencing deteriorations of functional status, while 22% experienced a worsening of self-rated health status. Those in poorer functional status before the events were more likely to experience deteriorations of functional [odds ratio (OR) 4.4, 95% confidence interval (CI) 1.5-13.6] and health (OR 2.8, 95% CI 1.2-6.7) status at both 1 month and 6 months (OR 3.9, 95% CI 1.3-12.0, and OR 2.8, 95% CI 1.2-6.7, respectively) after the events. Based on these results, we conclude that the functional and health status of women RA patients could worsen due to the consequences of a natural disaster, with a disproportionately large impact upon those with a poorer functional status.

To examine the effects of natural disasters on rheumatoid arthritis (RA) patients we conducted a questionnaire survey targeted to 1,477 members of a nationwide RA patient group in Japan who lived in the municipalities affected by natural disasters between 2004 and 2006. Functional statuses measured by the modified Health Assessment Questionnaire and self-rated health statuses before and after the events were retrospectively examined. The associations between the changes in functional and health status and socio-demographics, direct damage, and preparedness status were statistically analyzed. Of the 665 individuals who responded, the data on 192 women RA patients were analyzed. The values at 1 and 6 months post-event were the same, with 14% experiencing deteriorations of functional status, while 22% experienced a worsening of self-rated health status. Those in poorer functional status before the events were more likely to experience deteriorations of functional [odds ratio (OR) 4.4, 95% confidence interval (CI) 1.5-13.6] and health (OR 2.8, 95% CI 1.2-6.7) status at both 1 month and 6 months (OR 3.9, 95% CI 1.3-12.0, and OR 2.8, 95% CI 1.2-6.7, respectively) after the events. Based on these results, we conclude that the functional and health status of women RA patients could worsen due to the consequences of a natural disaster, with a disproportionately large impact upon those with a poorer functional status.

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