Masqueraders Around Disaster: Clinical Features of Scrub Typhus in Fukushima, Japan.

Background: Scrub typhus (ST) is endemic in Fukushima, with the largest number of cases reported in Japan from 2009 to 2010. Although ST is highly treatable, its atypical clinical presentation impedes diagnosis, causing delays in treatment. Methods: We review the clinical features of ST in adults from 2008 to 2017 at Ohta Nishinouchi General Hospital in Fukushima, Japan. Results: Fifty-five cases (serotype Karp 24, Irie/Kawasaki 21, Hirano/Kuroki 10) of ST were confirmed via serology based on elevated immunoglobulin (Ig)M and IgG and polymerase chain reaction positivity of eschar samples. The mean age was 69 years, and 64% were female. The case fatality rate was 1.8% (1/55). Approximately 70% of cases (38/55) were not diagnosed as ST upon the initial clinic visit. Inappropriate use of antibiotics was identified in 22% of cases (12/55). In terms of atypical clinical features, 1 or more of the manifestations, fever, rash, and eschar, was absent in 31% of cases (17/55). Approximately 11% of cases presented without eschar (6/55; Karp 1, Irie/Kawasaki 1, Hirano/Kuroki 4). Moreover, severe complications were observed with shock and disseminated intravascular coagulation in 7% of cases (4/55), Thus, while 53% of cases presented with the typical triad (29/55), unusual complications and atypical features occurred in 40% (22/55). Conclusions: Diagnosis of ST becomes clinically challenging in the absence of typical features. In Fukushima, an endemic area of ST, an atypical presentation involving multisystem disease is common.

An experimental verification of fungal overgrowth in temporary houses at the site of the Great East Japan Earthquake.

Fungal contamination in the indoor air of prefabricated temporary houses at the site of the Great East Japan Earthquake revealed extremely high levels compared to those found in conventional residences. We experimentally investigated fungal growth levels on different interior materials to support fungal overgrowth in prefabricated temporary houses. Three species each of allergenic fungi and invasive fungi observed in temporary housing were selected for inoculation tests with various interior materials. The experiments with fungal inoculation were conducted in conformance with standards for industrial products described in the Japanese" JIS Z 2911:2018 Methods of test for fungus resistance" with small modifications. After incubation, visual and stereomicroscopic assessments were performed to determine fungal growth levels. The viability of the fungi varied according to the interior material type. Our findings demonstrate the importance of antifungal measures in indoor environments and the need for additional research on the growth levels of fungal species on various interior materials.

Progress report of the Tohoku Medical Megabank Community-Based Cohort Study: Study profile of the repeated center-based survey during second period in Miyagi Prefecture.

BACKGROUND: The purpose of this study was to report the basic profile of the Miyagi Prefecture part of a repeated center-based survey during the second period (2nd period survey) of the Tohoku Medical Megabank Community-Based Cohort Study (TMM CommCohort Study), as well as the participants' characteristics based on their participation type in the baseline survey. METHODS: The 2nd period survey, conducted from June 2017 to March 2021, included participants of the TMM CommCohort Study (May 2013 to March 2016). In addition to the questionnaire, blood, urine, and physiological function tests were performed during the 2nd period survey. There were three main ways of participation in the baseline survey: Type 1, Type 1 additional, or Type 2 survey. The 2nd period survey was conducted in the same manner as the Type 2 survey, which was based on the community support center (CSC). RESULTS: In Miyagi Prefecture, 29,383 (57.7%) of 50,967 participants participated in the 2nd period survey. The participation rate among individuals who had visited the CSC was approximately 80%. Although some factors differed depending on the participation type in the baseline survey, the 2nd period survey respondents in the Type 1 and Type 2 survey groups at baseline had similar traits. CONCLUSIONS: The 2nd period survey of the TMM CommCohort Study provided detailed follow-up information. Following up on the health conditions of the participants will clarify the long-term effects of disasters and contribute to personalized prevention.

Associations Between Lifestyle Factors and Constipation Among Survivors After the Great East Japan Earthquake: A 9-year Follow-up Study.

BACKGROUND: Disaster survivors experience deterioration in lifestyles and an increase in constipation. After the Great East Japan Earthquake in 2011, some survivors were evacuated for a long term, even after moving to temporary housing and public reconstruction housing. However, annual changes in constipation and the association between lifestyles and constipation among the survivors are still unknown. METHODS: Overall, 9,234 survivors aged 18 years or older participated in this 9-year follow-up survey after the disaster. Information about the prevalence of constipation and lifestyle factors (diet, physical activity, and mental health) was collected using a self-reported questionnaire. Their dietary intake was categorized into the following two dietary patterns: prudent (fish and shellfish, soybean products, vegetables, fruits, and dairy products) and meat (meat and eggs). Odds ratios for constipation according to lifestyle factors were calculated using a generalized linear mixed model. RESULTS: In women, the prevalence of constipation was the highest at baseline (8.7%) and remained around 5% afterward. In both men and women, older age, poor mental health, and poor physical activity were significantly associated with higher odds ratios of constipation. Moreover, a lower frequency of meals and a lower prudent dietary score were significantly associated with women's constipation. CONCLUSION: The prevalence of constipation was the highest at baseline and remained around 5% in women. Lifestyle factors, such as poor mental health, physical inactivity, and low frequency of meals were associated with constipation. Our findings suggest continuous support for the survivors with constipation for medium- to long-term after disasters.

Influence of post-disaster evacuation on childhood obesity and liver dysfunction: The Fukushima Health Management Survey.

BACKGROUND: After the Great East Japan Earthquake and subsequent Fukushima Daiichi Nuclear Power Plant accident in 2011, the Fukushima Prefectural Government launched a long-term health management survey for the population of Fukushima. Results of the Comprehensive Health Check (CHC) showed that some children aged 6-15 years, who resided in the evacuation area at the time of the disaster, had obesity, hyperlipidemia, liver dysfunction, and/or renal dysfunction from as early as 2011. The aim of the present study was to determine the long-term trend of obesity and hepatic enzyme abnormalities in Fukushima children. METHODS: We evaluated the changes in body mass index standard deviation score (BMI-SDS), aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transpeptidase from 2011 to 2018. RESULTS: Obesity (BMI-SDS ≥ 2) was significantly associated with hepatobiliary enzyme abnormalities. The mean BMI-SDS was significantly higher in 2011 after the disaster, but then soon showed a gradual decrease. The frequency of obesity did not increase significantly after the disaster. There were no significant differences in the prevalence of hepatobiliary enzyme abnormalities in the children aged 6-15 years of either sex from 2011 to 2018. CONCLUSIONS: In the present study, we found that the increase in the mean BMI-SDS after the disaster was temporary, suggesting that the frequency of obesity and liver dysfunction might not have been significantly influenced by the disaster.

Blood data trends of children in Fukushima after the Great East Japan Earthquake: Fukushima health management survey.

BACKGROUND: After the Great East Japan Earthquake on March 11, 2011 and the subsequent accident at the Tokyo Electric Power Company-operated Daiichi Nuclear Power Plant, the Fukushima Prefecture government initiated the Fukushima Health Management Survey (FHMS) to assess the long-term health effects of the disaster on Fukushima residents. The blood tests of children aged ≤15 years between 2011 and 2012 did not reveal any changes regarding peripheral blood data; however, long-term monitoring is still necessary. Therefore, this study aimed to investigate the long-term health status of children aged ≤15 years who had evacuated the Fukushima Prefecture. METHODS: From 2011 to 2018, 71,250 evacuees aged 15 years or younger participated in the FMHS and were subjected to blood tests. By analyzing the data of the comprehensive health check survey managed by the FHMS, we examined the changes in hemoglobin (Hb) levels, white blood cell (WBC) counts, including fractions, and platelet (PLT) counts among children from 2011 to 2018. RESULTS: Minor fluctuations in Hb levels, PLT counts, and WBC counts were observed during the study period, but the central 95% intervals of distribution of the laboratory values were generally within previously reported reference intervals. In particular, there was no increase in the proportions of patients with anemia, polycythemia, or deviating WBC counts. CONCLUSION: From 2011 to 2018, there was no increase in the percentages of children with anemia, polycythemia, or deviating WBC counts among the Fukushima Prefecture evacuees.

Association between Social Isolation and the Risk of Incident Functional Disability in Elderly Survivors after the Great East Japan Earthquake.

Social isolation is frequently observed among survivors of disaster. However, there is limited evidence regarding the association between social isolation and adverse health outcomes among survivors of disaster. The purpose of this study was to investigate the association between social isolation and the risk of incident functional disability (IFD) among survivors of the 2011 Great East Japan Earthquake (GEJE). We conducted a prospective cohort study of 1,039 residents aged ≥ 65 years who lived in four areas affected by the GEJE. Information regarding social isolation and other lifestyle factors was collected between June and November 2011 via a self-reported questionnaire. Social isolation was assessed using the Lubben Social Network Scale-6 (LSNS-6). Data regarding the incidence of functional disability were retrieved from the Long-term Care Insurance database. The Cox model was used to calculate multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) for IFD. During 7,030 person-years of follow-up, 300 cases of IFD were certified (42.7disability events per 1,000 person-years). Social isolation was associated with increased risk of IFD in disaster survivors (HR = 1.32, 95% CI = 0.98-1.76). In addition, this association tended to be more remarkable among men and those whose houses were completely/seriously damaged. The present results suggest us that it would be possible to identify those who are more likely to be affected by social isolation after disaster. This finding would be useful in screening and supporting high risk group right after the occurrence of disaster.

The risk of withdrawal from hypertension treatment in coastal areas after the Great East Japan Earthquake: the TMM CommCohort Study.

This study aimed to examine whether risk of withdrawal from HTTx was higher in coastal areas that were severely damaged by tsunami than in inland areas. We conducted a cross-sectional study of 9218 participants aged ≥20 years in Miyagi, Japan. The odds ratios (ORs) and confidence interval (CI) for withdrawal from HTTx in coastal and inland groups were compared using multivariate logistic regression analysis, adjusting for potential confounders. In total, 194 of 5860 and 146 of 3358 participants in the inland and coastal groups, respectively, withdrew from HTTx treatment. OR (95%CI) of withdrawal from HTTx in the coastal group was 1.46 (1.14-1.86) compared to the inland group. According to housing damage, ORs (95% CI) in the no damage, partially destroyed, and more than half destroyed coastal groups compared with the no damage inland group were 1.62 (1.04-2.50), 1.69 (1.17-2.45), and 1.08 (0.71-1.65), respectively. In conclusion, the risk of HTTx withdrawal for participants whose homes in coastal areas were relatively less damaged was significantly higher compared with those in inland areas, while the risk of HTTx withdrawal for participants whose homes were more than half destroyed was not. Post-disaster administrative support for disaster victims is considered vital for continuation of their treatment.

Turkey-Syria Earthquake: The Importance of Providing a Direct Cross-border Support.

The 7.8 magnitude earthquake that occurred in southern Turkey on February 6, 2023, has resulted in over 40,000 and 5,000 confirmed deaths in Turkey and Syria, respectively, including substantial infrastructure damage. While Turkey has received assistance from various countries and international organizations, the level of support Syria has received remains unclear. The Assad regime has demanded that aid be sent to the capital Damascus, but this may hinder the delivery of assistance to the areas most severely affected by the earthquake because the affected regions were mainly controlled by rebel forces. One of the biggest challenges in providing aid is accessing the affected region, as the earthquake occurred close to the border between Syria and Turkey, where roads and other infrastructure are poorly constructed. Furthermore, the northwest area of Syria shelters many internally displaced people, and more than 50% of medical facilities are not functioning due to the ongoing conflict, making the situation more hazardous. In light of the experience of the Great East Japan Earthquake, securing direct support routes and dispatching medical personnel to the affected areas is crucial for a gradual recovery from the disaster. Therefore, it is essential for the international community, including Japan, to negotiate with the Assad regime to expand direct support routes and provide support for the dispatch of medical personnel who will remain and work in the affected areas. Humanitarian assistance and political issues should be kept separate to avoid further hindrances to aid delivery.

Exploring the experiences and learning of young primary care physicians in disaster-affected areas: A qualitative study on the Great East Japan Earthquake.

Background: Primary care physicians (PCPs) play a critical role in disaster medicine. However, it is unclear how PCPs who provide chronic support to disaster-affected areas learn from their experiences. Methods: This qualitative study investigates the learnings of young PCPs who provided medical care during the chronic phase of the Great East Japan Earthquake disaster. Results: Thematic analysis of interviews with five physicians revealed the challenges faced by them and their learnings in providing medical support to disaster-affected areas. Conclusions: They not only learned medical skills but also humanistic aspects such as empathizing with the survivors' loss.

Association between Low Back Pain and Neck Pain: A 3-Year Longitudinal Study Using the Data of the People after the Great East Japan Earthquake.

Low back pain (LBP) and neck pain (NP) are common health problems worldwide. LBP often coexists with NP; however, the association between these pains remains unclear. The purpose of this study was to clarify the association between LBP and NP, focusing on dose-dependent effects. This study used a 3-year longitudinal cohort data of people living in disaster-stricken areas after the Great East Japan Earthquake (n = 2,118). LBP and NP were assessed at 4, 5, 6, and 7 years after the disaster. LBP was categorized according to its frequency. Multivariate logistic regression analyses were performed to assess the association between LBP and NP, and the effect of preceding LBP on the subsequent onset of NP, according to the frequency of LBP. LBP was significantly associated with NP, and the association was stronger with increased frequency of LBP. Adjusted odds ratios (95% confidence intervals) were 2.40 (1.71-3.37) for "1", 3.99 (2.82-5.66) for "2", and 6.08 (4.40-8.41) for "≥ 3" in frequency when the absence of LBP was used as a reference (p for trend < 0.001). Furthermore, preceding LBP was significantly associated with subsequent onset of NP, and the effect was stronger with increased frequency of LBP. Adjusted odds ratios (95% confidence intervals) were 2.44 (1.62-3.68) for "1" and 2.68 (1.77-4.05) for "≥ 2" in frequency when the absence of LBP was used as a reference (p for trend < 0.001). LBP is associated with NP in a dose-dependent manner. The association between LBP and NP should be considered to effectively treat these pains.

Chlorinated persistent organic pollutants in human breast milk in the Miyagi Prefecture disaster-affected area 1 year after the Great East Japan Earthquake of 2011.

BACKGROUND: In the Great East Japan Earthquake of 11 March 2011, an earthquake and accompanying tsunami struck the Tohoku region of northeastern Japan. Buildings collapsed and the tsunami spread waste, including hazardous materials. This study aimed to determine the concentrations of persistent organic pollutants (POPs) in the breast milk of mothers living in the disaster-affected area of Sendai 1 year after the earthquake. Temporal trends in the POPs concentrations were evaluated by comparison with previous studies. METHODS: One hundred breast milk samples were obtained from lactating mothers at a hospital in Sendai in 2012. The results were compared with those from other years to examine whether there were changes in the POPs concentrations after the earthquake. We measured polychlorinated biphenyls (PCBs) and organochlorine pesticides, such as chlordanes, using gas chromatography-mass spectrometer (GC-MS) with negative chemical ionization, and dichlorodiphenyl trichloroethane (DDT) and its metabolites using GC-MS with electron impact ionization. RESULTS: The mean total PCBs (11 congeners), total chlordane, and total DDT concentrations were 76.2 ng/g lipid, 39.8 ng/g lipid, and 73.5 ng/g lipid, respectively. For the samples collected in 2012, the concentrations of POPs in breast milk showed minimal changes compared with results from previous years for samples collected at the same hospital in Sendai. CONCLUSIONS: Our study demonstrates that 1 year after the earthquake and tsunami, the concentrations of chlorinated POPs in breast milk had not changed substantially.

Association between personality and the risk of ischemic heart disease mortality before and after the Great East Japan Earthquake: Data from the Miyagi Cohort Study.

BACKGROUND: The purpose of the present study was to investigate the association between personality and the risk of IHD mortality among Great East Japan Earthquake (GEJE) survivors, and to investigate whether personality traits affected the increase in IHD mortality observed after the GEJE. METHODS: We analyzed data for 29,065 men and women in the Miyagi Cohort Study who were 40-64 years old at baseline. We divided the participants into quartiles based on scores for each of the four personality subscales (extraversion, neuroticism, psychoticism, and lie), using the Japanese version of the Eysenck Personality Questionnaire-Revised Short Form. We divided the eight years before and after the GEJE event (11 March 2011) into two period, and examined the relationship between personality traits and the risk of IHD mortality. Cox proportional hazards analysis was used to estimate the multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of IHD mortality according to each personality subscale category. RESULTS: In the four years before the GEJE, neuroticism was significantly associated with an increased risk of IHD mortality. Compared with the lowest category for neuroticism, the multivariate-adjusted HR (95% CI) for IHD mortality in the highest category was 2.19 (1.03-4.67) (p-trend = 0.12). In contrast, no statistically significant association between neuroticism and IHD mortality was observed in the four years after the GEJE. CONCLUSION: This finding suggests that the observed increase in IHD mortality after the GEJE can be attributed to risk factors other than personality.

The Association Between Music Preferences and Well-Being After the Fukushima Disaster: A Cross-Sectional Study.

OBJECTIVE: Those affected by the Fukushima disaster have reported a decline in well-being. Although listening to music is expected to promote well-being, no study has revealed this association after a disaster. This study's objective is to clarify the association between well-being and music listening habits in the aftermath of the Fukushima disaster. METHODS: A self-report online survey was conducted with 420 residents who were asked to rate 5 types of well-being: life satisfaction, positive emotion, negative emotion, psychological distress, and mental health changes after the Fukushima disaster. To meet inclusion criteria, the participants had to be research company monitors between the ages of 20 and 59 and living in Fukushima Prefecture at the time of the survey. Their music listening habits (eg, recent favorite music) and demographic information (eg, evacuation experience due to the disaster: 20.7%) were also collected. We examined the associations between well-being and music listening habits by univariate analysis followed by a logistic analysis with an adjustment for covariates. RESULTS: Positive emotions were significantly associated with any type of music listening habits that participants practiced. We also observed gender and age differences between the associations. CONCLUSION: This study provides foundational insights into the role of music in improving post-disaster well-being.

Longitudinal Trends in Blood Pressure Associated with The Changes in Living Environment Caused by the Great East Japan Earthquake: The Fukushima Health Management Survey.

The Great East Japan Earthquake occurred on 11 March 2011, forcing Fukushima Prefecture residents to change their living environment. Such sudden changes possibly have long-term effects on cardiovascular-related diseases. We therefore sought to identify temporal relationships between living environment changes and blood pressure levels over three years following the earthquake. Participants included 14,941 men and 21,533 women aged 16 years or older who answered self-administered questionnaires, including questions on living environment changes at baseline (2012). Blood pressure levels were measured each year from 2012 to 2015. Linear mixed-effects models were used to analyze associations between living environment changes and blood pressure levels. Men with changes in living environment (i.e., those living in shelters or in temporary housing, rental apartments, relatives' houses, or others) showed significantly higher diastolic blood pressure levels than those who lived in their home at baseline (77.3 mmHg vs. 77.8 mmHg; p < 0.001). The time-dependent effect of diastolic blood pressure levels associated with living environment was not statistically significant, indicating a sustained difference in diastolic blood pressure associated with living environment changes at baseline after three years. The effect of living environment changes on diastolic blood pressure increment was also evident in men without antihypertensive medication use during the study period and in men who were current drinkers at baseline. There were no associations between living environment changes and diastolic blood pressure levels among women. Sudden changes in living environment due to the disaster had an impact on the long-term effects of higher diastolic blood pressure among middle-aged men.

Risk communication regarding radiation exposure by experts using two concepts of regulatory science and ALARA.

In the Tohoku region of Japan, risk communication programs on radiation exposure are of great importance, especially with respect to reducing the stress and anxiety among those affected by radiation exposure. Although the concepts of 'as low as reasonably achievable' (ALARA) and regulatory sciences (RS) were very important for the smooth operation of risk communication among a wide range of stakeholders, our previous research showed that only 23.5% and 16.5% of medical doctors in Japan had an accurate awareness of them, respectively. To make risk communication more effective, this study examined the levels of awareness of the concepts of ALARA and RS among academic experts in Japan and compared their level of awareness of technical terms regarding radiation to that of the expected level for a layperson. This study also showed that, even among faculty working at graduate schools in Japan, only 29.8% and 39.4% had an accurate knowledge of ALARA and RS. To improve the knowledge of laypeople and experts on these concepts, they should be added to the primary education curriculum. This study demonstrated that among experts in many academic fields, a significant range of estimates existed of lay knowledge of technical terms regarding radiation. The highest scores were assigned by faculty in the field of humanities. Thus, before conducting risk communications, experts from all fields should identify the expected level of awareness among laypeople on the topic. In addition, risk communications regarding radiation should be conducted by academic experts and healthcare professionals together with facilitators or lecturers.

The Impact of the COVID-19 Pandemic on Suicide Rate Trends in the Tsunami-Disaster-Affected Area Following the Great East Japan Earthquake.

Background: People who experienced the Great East Japan Earthquake (GEJE) were expected to have additional levels of psychological burden resulting from the stressful conditions imposed during the coronavirus disease 2019 (COVID-19) pandemic; consequently, suicide rates may increase. Aim: We aimed to carry out continuous monitoring of suicide rates in the affected area following the GEJE under COVID-19 pandemic conditions. Method: This descriptive study monitored the suicide rates of the coastal area of Miyagi Prefecture, where disaster-related mental health activities have been continuing following severe damage caused by the tsunami disaster. An exponential smoothing time-series analysis that converted suicide rates into a smooth trend was conducted. Results: Although the suicide rate in the affected area was higher than the national average in February 2020, it showed a declining trend during the COVID-19 pandemic, while showing an increase trend in the national and non-affected areas. Limitations: Uncertainty about the direct reasons for suicide and the short time-scale observation are the limitations of this study. Conclusion: Although the national suicide rate increased, this was not the case for the affected area. Our findings may provide important lessons for suicide prevention during the COVID-19 pandemic, which needs careful regional monitoring of the state of suicide and of high-risk approaches such as disaster-related mental health activities.

Association Between Changes in Alcohol Consumption Before and After the Great East Japan Earthquake and Risk of Hypertension: A Study Using the Ministry of Health, Labour and Welfare National Database.

BACKGROUND: The 2011 Great East Japan Earthquake has resulted in a nuclear accident, forcing residents of the surrounding areas to evacuate. To determine any association between excessive drinking and hypertension in the setting of disaster, we assessed whether the proportion of excessive drinkers increased and if post-disaster excessive drinking was a risk factor for hypertension. METHODS: This retrospective study assessed data from the Japanese National Database. Cumulative population data for Fukushima Prefecture (3,497,576 people) were analyzed by categorizing residents into four areas-evacuation, coastal, central, and mountainous-to calculate the proportion of excessive, heavy (equivalent to binge drinking), and at-risk drinkers for 2008-2017. The hazard ratios (HRs) for the incidence of hypertension for 2012-2017 were examined in association with changes in drinking status pre- and post-disaster, which included 136,404 people who received specific health checkups pre-disaster (2008-2010) and post-disaster (2011-2012). RESULTS: The proportion of excessive drinkers among women increased after the disaster in all areas examined. The association between excessive drinking and the incidence of hypertension was determined among men and women in all areas; it was stronger among women in the evacuation areas, with the sex- and age-adjusted HRs for the incidence of hypertension of 1.41 for pre-disaster excessive drinking, 2.34 for post-disaster excessive drinking, and 3.98 for pre- and post-disaster excessive drinking, compared with not excessive drinking pre- and post-disaster. CONCLUSION: Excessive drinking post-disaster may be associated with an increased risk of hypertension among men and women, especially among women in the evacuation areas.

[Environmental risks to housing and living arrangements among older survivors of the Great East Japan Earthquake and their relationships with housing type: The RIAS Study].

Objective　Over the course of their lives, people spend most of their time in the home environment. The Community-based Integrated Care System 2018 by the Ministry of Health, Labour and Welfare in Japan declared the importance of "housing" and "living arrangements" as essential elements to enable older adults to live independently and to protect their privacy and dignity in their communities. The present study aims to clarify the relationship between current housing type and "housing" and "living arrangements" among older survivors of the Great East Japan Earthquake (GEJE).Methods　We used data obtained from 3,856 participants, aged 65 years or older, in the Research project for prospective Investigation of health problems Among Survivors of the GEJE (RIAS). Housing types were categorized as follows: "same housing," "temporary housing," "disaster public housing," "new housing" (in a different area), and "others." Healthy housing scores were calculated using a housing health checklist from the Nationwide Smart Wellness Housing Survey in Japan. "Living arrangements" were assessed based on residential status, social network, and social capital. To determine the risks associated with each "housing" and "living arrangement" category, we used multivariate logistic and linear regression models.Results　The number of participants in each housing type was as follows: 2,531 in "same housing," 146 in "temporary housing," 234 in "disaster public housing," 844 in "new housing," and 101 in "others." Compared with those living in "same housing," those living in "disaster public housing," "new housing," and "others" had a significantly higher healthy housing score, whereas those living in "temporary housing" had a lower score. However, with regards to "living arrangements," the number of residents who were living alone was significantly higher among those in "disaster public housing," and those living in "disaster public housing" as well as "new housing" had low social capital compared with those living in "same housing." The likelihood of having a poor social network was substantially higher for those living in "disaster public housing." Sub-scale analyses indicated that "disaster public housing" was associated with less family support, whereas "new housing" was associated with less support from friends.Conclusion　The present results indicate that older survivors-regardless of whether they live in the existing community-find it challenging to establish new social capital and social networks in a new location without the presence of "someone" they knew before the disaster.