Association between Psychological Factors and Evacuation Status and the Incidence of Cardiovascular Diseases after the Great East Japan Earthquake: A Prospective Study of the Fukushima Health Management Survey

Evidence regarding the effect of psychological factors and evacuation on cardiovascular disease occurrence after large-scale disasters is limited. This prospective study followed up a total of 37,810 Japanese men and women aged 30-89 years from the Fukushima Prefecture with no history of stroke or h...

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Bibliographic Details
Published in:International journal of environmental research and public health 2020-10, Vol.17 (21), p.7832
Main Authors: Sanoh, Toshiki, Eguchi, Eri, Ohira, Tetsuya, Hayashi, Fumikazu, Maeda, Masaharu, Yasumura, Seiji, Suzuki, Yuriko, Yabe, Hirooki, Takahashi, Atsushi, Takase, Kanae, Harigane, Mayumi, Hisamatsu, Takashi, Ogino, Keiki, Kanda, Hideyuki, Kamiya, Kenji
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Alcohol
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Confidence intervals
Coronary artery disease
Disasters
Earthquakes
Evacuation
Families & family life
Female
Health hazards
Health risks
Heart
Heart diseases
Humans
Incidence
Japan - epidemiology
Lifestyles
Male
Mental disorders
Mental health care
Middle Aged
Mortality
Nuclear accidents
Post traumatic stress disorder
Prospective Studies
Psychological Distress
Psychological factors
Psychological stress
Questionnaires
Radiation
Risk factors
Seismic activity
Sleep
Statistical models
Stroke
Temporary housing
Trauma
Womens health
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Summary:Evidence regarding the effect of psychological factors and evacuation on cardiovascular disease occurrence after large-scale disasters is limited. This prospective study followed up a total of 37,810 Japanese men and women aged 30-89 years from the Fukushima Prefecture with no history of stroke or heart disease at baseline (2012), until 2017. This period included 3000 cardiovascular events recorded through questionnaires and death certificates. The participants' psychological distress, trauma reaction, and evacuation status were defined, and divided into four groups based on combinations of psychological factors and evacuation status. We calculated the hazard ratios and 95% confidence intervals for only psychological, only evacuation, or both of them compared with neither using Cox proportional hazard models. Psychological factors along with evacuation resulted in approximately 5% to 25% higher magnitude of stroke and heart disease risk than psychological factors only among men. Compared to neither, the multivariable hazard ratios of those with both psychological distress and evacuation were 1.75 for stroke and 1.49 for heart disease, and those of both trauma reaction and evacuation were 2.01 and 1.57, respectively, among men. Evacuation combined with psychological factors increased the risk of stroke and heart disease risks especially in men after the Great East Japan Earthquake.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph17217832