Does the Type of Residential Housing Matter for Depressive Symptoms in the Aftermath of a Disaster? Insights from the Great East Japan Earthquake and Tsunami

Abstract

The 2011 Great East Japan Earthquake and Tsunami resulted in widespread property destruction and over 250,000 displaced residents. We sought to examine whether the type of housing arrangement available to the affected victims was associated with a differential incidence of depressive symptoms. In this prospective cohort study, which comprised participants aged ≥65 years from Iwanuma as a part of the Japan Gerontological Evaluation Study, we had information about the residents’ mental health both before the disaster in 2010 and 2.5 years afterward. The Geriatric Depression Scale was used. Type of accommodation after the disaster was divided into 5 categories: no move, prefabricated housing (temporary housing), existing private accommodations (temporary apartment), newly established housing, and other. Poisson regression analysis was adopted, with and without multiple imputation. Among the 2,242 participants, 16.2% reported depressive symptoms at follow-up. The adjusted rate ratio for depressive symptoms among persons moving into prefabricated housing, compared with those who did not, was 2.07 (95% confidence interval: 1.45, 2.94). Moving into existing private accommodations or other types of accommodations was not associated with depression. The relationship between living environment and long-term mental health should be considered for disaster recovery planning.

High prevalence of toothache among Great East Japan Earthquake survivors living in temporary housing

“…Compared with the nationwide prevalence of subjective toothache among the general population in Japan (1.8% in 2016), the total (3.7%) and highest prevalence (7.9%) observed among the GEJE survivors were potential factors to negatively impact the subjects’ health status. The most crucial finding was that significant association between the housing type and subjective toothache was observed only in the prefabricated temporary housing group, the most distressful residence . In contrast, a previous study indicated that favourable housing conditions may contribute psychological well‐being .…”

“…Recently, people living in prefabricated housing tended to elderly, economically disadvantaged, and health status of prefabricated housing dwellers was exacerbated over time after the GEJE, possibly due to employment and income issues at postdisaster, which were potential factors associated with toothache . Therefore, socio‐demographic characteristics, lifestyle, and health condition variables were included in the analyses as covariates such as the subjects sex, age, subjective economic status, smoking habits (“Yes” or “No”), and psychological distress using the six‐item Kessler Psychological Distress Scale (K6), and insomnia using the eight‐item Athens Insomnia Scale (AIS‐8) …”

“…Over 260 000 survivors were forced to evacuate from their hometowns, and most of them had to relocate to unfamiliar setting . In particular, prefabricated temporary housing, a typical government‐issue emergency accommodation to temporarily secure survivors who lose places of residence in a disaster, are generally poor living environments owing to insufficient air conditioning and acoustic insulation . The local government defined the entry criteria for relocation to prefabricated temporary housing as any person who has lost a place of residence owing to the GEJE and has difficulty securing new dwelling for long‐term occupation through personal efforts, such as household economy .…”

“…Accordingly, almost half of the survivors relocated to prefabricated housing after the GEJE and had to adapt to and/or establish a new socio‐economic situation and lifestyle . Thus, residential issues in prefabricated housing can have additive impact on the psychosocial status of disaster survivors . However, the impact of residence in prefabricated housing on oral health as compared to other residences is unclear.…”

“…3 In particular, prefabricated temporary housing, a typical government-issue emergency accommodation to temporarily secure survivors who lose places of residence in a disaster, are generally poor living environments owing to insufficient air conditioning and acoustic insulation. 4,5 The local government defined the entry criteria for relocation to prefabricated temporary housing as any person who has lost a place of residence owing to the GEJE and has difficulty securing new dwelling for long-term occupation through personal efforts, such as household economy. 6 Accordingly, almost half of the survivors relocated to prefabricated housing after the GEJE and had to adapt to and/or establish a new socio-economic situation and lifestyle.…”