Redefining shelter: humanitarian sheltering.

Shelter is one of the most 'intractable problems' in humanitarian aid and yet there is little clarity on an overarching definition. Terminology for shelter and housing is often conflated, and the most prominent definition does not fully reflect recent progress in the Shelter and Settlements Sector. This paper explores the varying terminology utilised in definitions of shelter within humanitarian aid since 1990, reflecting on the concepts of 'shelter' and 'housing', alongside surrounding perceptions of 'house' versus 'home', and related measures of adequacy. The current, most prolific definition is also deconstructed, demonstrating ambiguity in some of terminology such as 'dignity' and 'privacy', and revealing that interpretation of this definition depends on the reader's knowledge. Lastly, a new definition of 'sheltering' is proposed, encompassing five key reflections: the concept of process over object; the inclusion of communities and individuals; the commonality of long-term sheltering; the wider effects of shelter; and the impacts on host communities and environment.

Predictors of change in housing status over 12 months among individuals using emergency shelters, temporary housing or permanent housing in Quebec, Canada.

Homelessness is an ongoing societal and public health problem in Canada and other countries. Housing services help homeless individuals along the transition towards stable housing, yet few studies have assessed factors that predict change in individual housing trajectories. This study identified predictors of change in housing status over 12 months for a sample of 270 currently or formerly homeless individuals using emergency shelters, temporary housing (TH) or permanent housing (PH) resources in Quebec. Participants recruited from 27 community or public organisations were interviewed between January and September 2017, and again 12 months later. Sociodemographic variables, housing history, health conditions, service use and client satisfaction were measured. Directors and programme coordinators from the selected organisations also completed a baseline questionnaire measuring strictness in residential codes of living/conduct, interorganisational collaboration and overall budget. Independent variables were organised into predisposing, enabling and needs factors, based on the Gelberg-Andersen Behavioral Model. Multilevel logistic regressions were used to test associations with the dependent variable: change in housing status over 12 months, whether positive (e.g. shelter to TH) or negative (e.g. PH to shelter). Predictors of positive change in housing status were as follows: residing in PH, being female, having children (predisposing factors); having consulted a psychologist, higher frequency in use of public ambulatory services (enabling factors); and not having physical illnesses (needs factor). The findings support strategies for helping this clientele obtain and maintain stable housing. They include deploying case managers to promote access to public ambulatory services, mainly among men or individuals without children who are less likely to seek help; greater use of primary care mental health teams; the establishment of more suitable housing for accommodating physical health problems; and reinforcing access to subsidised PH programmes.

Long-Term Prevalence of Disaster-Related Deep Vein Thrombosis in Minamiaso Village After the 2016 Kumamoto Earthquakes: A Prospective Cross-Sectional Analysis.

OBJECTIVE: This study aimed to examine the prevalence of deep vein thrombosis (DVT) among evacuees in Minamiaso, a village which was temporarily isolated after the earthquakes, from the acute to recovery phase after the 2016 Kumamoto Earthquakes (GLIDE no: EQ-2016-000033-JPN). METHODS: This prospective study, which was approved by Fukui University Medical Research Ethics Committee (approval no. 20160024 and 20160089), enrolled 181 evacuees (73.9 ± 11.6 y) who participated in a series of 3 DVT screenings using portable ultrasound machines conducted over 19 mo. All participants completed a questionnaire before the screenings, and none of the participants attended all 3 screenings. Data analysis was performed using EZR version 1.41. RESULTS: The DVT prevalence was 14.3% (79.4 ± 8.2 y) at first screening of evacuees staying in shelters and 18.5% (71.5 ± 13.1 y) and 12.2% (72.8 ± 10.9 y) in second and third screenings of evacuees staying in temporary housing, respectively. Multivariate analysis revealed age ≥75 y and alcohol consumption as independent risk factors in the entire cohort and in patients aged ≤74 y, respectively. CONCLUSIONS: A high DVT prevalence over a long time period of 19 mo was observed where survivors were temporarily isolated after the disaster.

Mite avoidance decreased mite-specific IgE levels and ameliorated asthma symptoms in subjects who lived in temporary housing after natural disasters.

BACKGROUND: We previously reported an increased prevalence of asthma among patients who had lived in temporary housing after the 2011 Great East Japan Earthquake. We investigated the prognosis of asthma in former residents of temporary housing after allergen avoidance. METHODS: Asthma was diagnosed in adults ≥ 15 years from 2014 to 2019 who had lived in temporary housing in Ishinomaki City for at least 1 year. The disease prognosis after the intervention of allergen avoidance in cases that were followed for more than 3 years during the 6-year study period was analyzed. We measured the Dermatophagoides farinae -specific immunoglobulin E (IgE) levels in serum, and the amount of Dermatophagoides group 1 (Der 1) antigen on their futons or mattresses. We instructed residents in an allergen avoidance strategy that included 32 tasks, including using microfiber bedding covers. RESULTS: Of the 202 examinees who were followed for at least 3 years during the 6-year study period, 72(35.6%) were asthmatic during at least one examination. Of these 72 asthmatics, 55(76.4%) developed the disease after the earthquake, and more than half of the cases that we diagnosed at the examination were mild intermittent asthma. After the allergen-avoidance intervention, both the Der 1 level on the futons or mattresses of residents who were diagnosed with asthma but who were nonasthmatic at the final screening and their serum Der f-specific IgE levels significantly decreased (P < 0.01) at the final examination. CONCLUSION: Antigen avoidance ameliorated mild asthma that was prevalent among residents of temporary housing after the earthquake.

Mite avoidance decreased mite-specific IgE levels and ameliorated asthma symptoms in subjects who lived in temporary housing after natural disasters

Background: We previously reported an increased prevalence of asthma among patients who had lived in temporary housing after the 2011 Great East Japan Earthquake. We investigated the prognosis of asthma in former residents of temporary housing after allergen avoidance. Methods: Asthma was diagnosed in adults ≥ 15 years from 2014 to 2019 who had lived in temporary housing in Ishinomaki City for at least 1 year. The disease prognosis after the intervention of allergen avoidance in cases that were followed for more than 3 years during the 6-year study period was analyzed. We measured the Dermatophagoides farinae -specific immunoglobulin E (IgE) levels in serum, and the amount of Dermatophagoides group 1 (Der 1) antigen on their futons or mattresses. We instructed residents in an allergen avoidance strategy that included 32 tasks, including using microfiber bedding covers. Results: Of the 202 examinees who were followed for at least 3 years during the 6-year study period, 72(35.6%) were asthmatic during at least one examination. Of these 72 asthmatics, 55(76.4%) developed the disease after the earthquake, and more than half of the cases that we diagnosed at the examination were mild intermittent asthma. After the allergen-avoidance intervention, both the Der 1 level on the futons or mattresses of residents who were diagnosed with asthma but who were nonasthmatic at the final screening and their serum Der f-specific IgE levels significantly decreased (P < 0.01) at the final examination. Conclusion: Antigen avoidance ameliorated mild asthma that was prevalent among residents of temporary housing after the earthquake (AU)

Indoor Fungal Contamination in Temporary Housing after the East Japan Great Earthquake Disaster.

To understand fungal contamination in the indoor environment of the disaster region, a field survey was performed to measure the number of fungal counts and identify isolates in the indoor air of prefabricated temporary housing, privately independent-housing, and rented apartments flooded by the East Japan Great Earthquake disaster tsunami. As a result, the period with the highest detected fungal count was from the rainy season to summer in independent-housing and rented apartments. Moreover, in the temporary housing, the fungal number increased further in winter as indicated by the maximum fungal-number throughout the measurement period. The detection frequency of Aspergillus species was relatively higher in the indoor air of temporary housing than in typical housing in the non-disaster area. Since Aspergillus is known as an allergenic genus, it requires careful attention to the health risk for residents. The extremely high level of fungal condensation in indoor air possibly occurred due to high relative humidity and loss of heat insulation in the building attics. It is suggested that this problem commonly happened in the cold region including the entire disaster region of the East Japan Great Earthquake.

Association between Temporary Housing Habitation after the 2011 Japan Earthquake and Mite Allergen Sensitization and Asthma Development.

INTRODUCTION: We previously reported an increased prevalence of asthma in adults who lived in temporary housing after the 2011 Great East Japan Earthquake. The goal of the current study was to investigate changes in asthma prevalence and mite-specific immunoglobulin E (IgE) titers in temporary housing residents during 2014-2019. METHODS: By using the Global Initiative for Asthma guidelines, we diagnosed asthma in Ishinomaki city temporary housing residents aged 15 years or older. We then analyzed serum antigen-specific IgE levels to Dermatophagoides farinae (Der f), Dermatophagoides pteronyssinus (Der p), and Aspergillus fumigatus. RESULTS: The prevalence of asthma exceeded 20% across all age-groups throughout the study period. The proportion of study participants with a "positive" antigen-specific IgE titer (i.e., ≥0.35 IUA/mL) was higher in asthmatics than in nonasthmatics for Der f and Der p but not for Aspergillus fumigatus. Among residents ≥50 years old who were diagnosed with asthma, the percentage with a Der f-specific IgE titer ≥0.10 IUA/mL was higher than the proportion with ≥0.35 IUA/mL. Among study participants, asthma onset occurred before the earthquake, during residence in shelters or temporary housing, and (starting in 2016) after moving out of temporary housing. The Der p-specific IgE level was positively correlated with the duration of temporary housing (p < 0.05, r = 0.41) and inversely correlated with the time elapsed since moving out of temporary housing (p < 0.05, r = -0.35). CONCLUSION: Mite allergen sensitization was found in both asthmatic and nonasthmatic temporary housing residents after the 2011 Japan earthquake and tsunami; asthma developed even after subjects moved out of temporary housing.

Development of Behavior Abnormalities in a Patient Prevented From Returning Home After Evacuation Following the Fukushima Nuclear Disaster: Case Report.

After Japan's major nuclear accident in 2011, approximately 150,000 Fukushima residents were ordered to evacuate. Beginning in 2015, the evacuation orders have been systematically lifted. However, the health impacts of allowing residents to return to homes in areas previously uninhabitable due to nuclear radiation remain poorly understood.Declaring radiation levels to be safe does not necessarily eliminate the concerns of residents about the effects of radiation exposure. Rebuilding medical, welfare, and commercial infrastructure and services takes time. Nontangible community elements, such as mutually dependent social networks, also require time to be re-established. Nevertheless, the Japanese government prioritizes policies that encourage evacuees to return home as soon as it is safe to do so.Post-disaster evacuation situations and subsequent return home pose substantial-and as yet relatively unknown-mental and physical health threats for those affected, especially those in vulnerable groups, such as the sick, the elderly, and children.Here we report a case of an elderly female evacuee with dementia, who was prevented from returning home after her hometown evacuation order was lifted, began exhibiting marked behavioral abnormalities. Loss of emotional ties that were created while she was housed in temporary accommodation appeared to be a critical contributing factor.

Increased incidence of metabolic syndrome among older survivors relocated to temporary housing after the 2011 Great East Japan earthquake & tsunami.

BACKGROUND: Beyond the immediate toll of injuries and deaths, major disasters are often associated with long-term increased risks of chronic disease. We sought to investigate the incidence of metabolic syndrome (MetS) among survivors of the 2011 Great East Japan Earthquake and tsunami. METHODS: Subjects aged ≥18 years from the tsunami-stricken area participated in a prospective cohort study of disaster survivors (the RIAS Study) from 2011 to 2015. After excluding subjects who were previously diagnosed with MetS, we observed the cumulative incidence of MetS across four annual examinations among 7318 subjects (mean age, 59.8 years; 43.5% men). We defined MetS using the International Diabetes Foundation criteria. RESULTS: The 4-year cumulative incidence of MetS was 18.0% in the overall sample. The incidence was significantly higher among older women survivors relocated to prefabricated temporary housing (40.9%, 95% confidence interval, 36.4-44.6), and other types of housing (36.2%, 95% CI: 32.3-40.6) compared to those who were not relocated (34.1%, 95% CI: 30.9-37.4). An increase in incidence of MetS was not observed for older men, or younger survivors aged ≤64 years. CONCLUSION: Relocation to prefabricated temporary housing was a risk factor for increased incidence of MetS in older women.

Postdisaster Housing Stages: A Markov Chain Approach to Model Sequences and Duration Based on Social Vulnerability.

Housing recovery is an unequal and complex process presumed to occur in four stages: emergency shelter, temporary shelter, temporary housing, and permanent housing. This work questions the four-stage typology and examines how different types of shelter align with multiple housing recovery stages given different levels of social vulnerability. This article also presents a Markov chain model of the postdisaster housing recovery process that focuses on the experience of the household. The model predicts the sequence and timing of a household going through housing recovery, capturing households that end in either permanent housing or a fifth possible stage of failure. The probability of a household transitioning through the stages is computed using a transition probability matrix (TPM). The TPM is assembled using proposed transition probability models that vary with the social vulnerability of the household. Monte Carlo techniques are applied to demonstrate the range of sequences and timing that households experience going through the housing recovery process. A set of computational rules are established for sending a household to the fifth stage, representing a household languishing in unstable housing. This predictive model is exemplified on a virtual community, Centerville, where following a severe earthquake scenario, differences in housing recovery times exceed four years. The Centerville analysis results in nearly 5% of households languishing in unstable housing, thereby failing to reach housing recovery. These findings highlight the disparate trajectories experienced by households with different levels of social vulnerability. Recommendations are provided at the end for more equitable postdisaster recovery policies.

Living in temporary housing and later psychological distress after the Great East Japan Earthquake of 2011: A cross-lagged panel model.

Living in temporary housing is a risk factor for psychological distress after a natural disaster. As temporary housing is an essential resource for those affected by disasters, investigation of factors which potentially mediate living in temporary housing and psychological distress is needed. This is a cohort study in general population of areas affected by the Great East Japan Earthquake in 2011. Data were obtained from self-report questionnaires in annual health checks between 2014 and 2016 regarding residential situation (e.g., prefabricated or privately-rented temporary housing), psychological distress, sleep disturbances, social support, and covariates. Mediation effects of sleep disturbances and social support on the relationship between temporary housing and psychological distress were evaluated using a cross-lagged panel model during three time points. Among 3,116 participants in 2014, approximately 12% lived in prefabricated or privately-rented temporary housing. Living in prefabricated (ß = 0.046, p = 0.031) and privately-rented temporary housing (ß = 0.043, p = 0.042) predicted later psychological distress. There was no mediation effect by sleep disturbances (prefabricated temporary housing: ß = 0.001, p = 0.620; privately-rented temporary housing: ß = -0.001, p = 0.467) or social support (prefabricated temporary housing: ß < 0.001, p = 0.748; privately-rented temporary housing: ß < 0.001, p = 0.435). CLPM also showed no relationship between living in temporary housing and increased sleep problems or decreased social support. Mental health support may be required for residents who lived in prefabricated or privately-rented temporary housing three years after a natural disaster, whereas support focusing only on sleep disturbances or social support in residents who lived in temporary housing may not be enough to contribute to reducing psychological distress.

[Trajectory of evacuees' health condition after the Great East Japan Earthquake: Health survey of residents in prefabricated temporary housing and private rented housing in the Miyagi prefecture].

Objectives The Great East Japan Earthquake occurred in March 2011. As of November 2018, 1100 survivors of its still lived in the Miyagi prefecture's temporary housing. Previous studies revealed that the residential relocation to temporary housing from their own houses due to damages caused by the earthquake exacerbated the evacuees' health. However, there is a lack of long-term observation of the trajectory of their health conditions in temporary housing. To the best of our knowledge, there is no study involving residents in public disaster housing. The aim of the present study was to reveal the trajectory of health conditions of residents of temporary and public disaster housing.Method This repeated cross-sectional study included residents aged 20 years and older, residing in private rented housing, prefabricated temporary housing, and public disaster housing. The survey period lasted for six years (2011 to 2017). We used self-rated health as the dependent variable, the year of the survey and type of house as independent variables, and sex and age as covariates. Adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were calculated using multivariate logistic regression analysis.Results In total, 179,255 participants were included in this study. The average age was the highest among the residents of public disaster housing: 63.0 years in 2017. The number of residents who reported poor self-rated health declined yearly of private rented housing, but not of prefabricated temporary housing. The highest number of residents reporting poor self-rated health was from public disaster housing, compared to other temporary housing. Multivariate analysis showed that self-rated health improved in recent years (P for trend <0.001). Compared to the residents of private rented housing, those from public disaster housing reported poorer health conditions (aOR, 1.20 ; 95% CI, 1.15-1.27), although no significant difference was observed among the residents of prefabricated housing.Conclusion Health conditions of residents of temporary housing and public disaster housing tended to improve on a yearly basis. Residents of public disaster housing reported poor health. Therefore, monitoring and adequate intervention should be offered.

Impact of Japanese Post-Disaster Temporary Housing Areas' (THAs) Design on Mental and Social Health.

The phenomenon named kodokushi, meaning death alone without the care or company of anyone inside temporary housing, appeared after the Kobe earthquake in Japan in 1995 with some 250 cases. This paper analyzes the evolution of Japanese temporary houses-to attempt to prevent the problem of kodokushi-from the point of view of management, how services and activities are organized, and design. We will use case studies as our methodological tool, analyzing the responses in 1995 Kobe (50,000 THs), 2004 Chuetsu (3000 THs), 2011 Tohoku (50,000 THs), and 2016 Kumamoto (4000 THs). This article shows how the Japanese THAs follow a single design that has undergone very little variation in the last 25 years, a design which promotes the social isolation of their residents, making recovery-from the psychological perspective-and helping the most vulnerable members of society, more difficult. In small scale disasters (Chuetsu) applying organization and management measures was able to correct the problems caused by design and there were no cases of kodokushi: in large-scale disasters (Tohoku), however, the difficulties to implement the same measures resulted in the reappearance of new cases at rates similar to Kobe's. Our main conclusion is that the design of Japanese THAs must be reconsidered and changed to respond to the real needs of the most vulnerable groups.

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

OBJECTIVES: The Great East Japan Earthquake and subsequent tsunami cause large-scale destruction in the north-eastern coastal areas in Japan, and forced many survivors to relocate to prefabricated temporary housing, a typical emergency accommodation. Based on the hypothesis that higher toothache prevalence among the disaster survivors is associated with postdisaster distress, we determined the impact of temporary residential environment as potential stressor on the subjective toothache prevalence. METHODS: A repeated cross-sectional health survey based on self-reported questionnaire was conducted in 2776 disaster survivors, of whom 1446 participants underwent dental examination by dentists. Housing type was categorized into three groups including the same housing as before the earthquake, temporary housing and rented/new housing. The association of housing type with subjective toothache prevalence was examined using multivariate logistic regression analysis in all subjects and subgroup analysis in dental examination applicants. Stratified analysis by survey wave was applied with inclusion of covariates such as the socio-demographic factors, and presence of insomnia and psychological distress. In subgroup analysis, presence of dental caries and gum problems in dental examination were included as factors of direct exposure to subjective toothache. RESULTS: In the first survey wave, the participants living in the temporary housing had significantly higher odds ratio (OR) for toothache prevalence compared to the participants living in the same housing (OR: 3.76, 95% confidence interval [CI]: 1.85-7.65, P < 0.001); whereas in all other survey waves, there was no significant difference. Subgroup analysis of dental examination applicants confirmed the presence of significant association of subjective toothache prevalence in the temporary housing group alone (OR: 3.27, 95% CI: 1.38-7.76, P = 0.004), but not in the rented/new housing group (OR: 1.50, 95% CI: 0.57-3.91, P = 0.411), even after adjusting for covariates related to oral findings. CONCLUSION: Temporary housing may be a factor to increase the risk of subjective toothache among disaster survivors only at postdisaster acute phase.

Winter morning surge in blood pressure after the Great East Japan Earthquake.

This study investigated the association between winter morning surge in systolic blood pressure (SBP) as measured by ambulatory BP monitoring and the housing conditions of subjects in an area damaged by the Great East Japan Earthquake. In 2013, 2 years after disaster, hypertensives who lived in homes that they had purchased before the disaster (n = 299, 74.6 ± 8.1 years) showed significant winter morning surge in SBP (+5.0 ± 20.8 mmHg, P < 0.001), while those who lived in temporary housing (n = 113, 76.2 ± 7.6 years) did not. When we divided the winter morning surge in SBP into quintiles, the factors of age ≥75 years and occupant-owned housing were significant determinants for the highest quintile (≥20 mmHg) after adjustment for covariates. The hypertensives aged ≥75 years who lived in their own homes showed a significant risk for the highest quintile (odds ratio 5.21, 95% confidence interval 1.49-18.22, P = 0.010). It is thus crucial to prepare suitable housing conditions for elderly hypertensives following a disaster.

Ultrasound cardiography examinations detect victims' long-term realized and potential consequences after major disasters: a case-control study.

BACKGROUND: An increase in cardiovascular diseases has been reported following major disasters. Previous work has shown that ultrasonographic findings from ultrasound cardiography examination (UCG) increased until the 44th month after the tsunami caused by the Great East Japan Earthquake. The present study conducted UCG among victims in the tsunami disaster area and investigated the frequency of disaster-related cardiovascular diseases and changes over time until the 55th month after the disaster. METHODS: The subjects were residents of temporary housing complexes and neighboring housing in Watari-gun, Miyagi Prefecture, Japan. There were 207 subjects in the 18th month, 125 in the 30th month, 121 in the 44th month, and 106 in the 55th month after the disaster. Data were collected through UCG and self-report questionnaire. RESULTS: Significant changes were observed among subjects with clinical findings from the UCG, which increased over the study period-from 42.0 to 60.8, 72.7, and 73.6% beginning in the 18th month after the disaster (p < 0.0001). CONCLUSIONS: It is possible that the UCG can become a useful examination to visualize the potential impact of a major disaster on the cardiac function of victims. Victims with clinical findings continued increasing not only during the acute phase after a disaster but also in the long term. We therefore need to keep this in mind, and note that it is important to establish a support system to control cardiovascular diseases from the early stage of disaster. TRIAL REGISTRATION: UMIN; ID000029802. R000034050 . 2 November 2017.

Ultrasound cardiography examinations detect victims' long-term realized and potential consequences after major disasters: a case-control study

BACKGROUND@#An increase in cardiovascular diseases has been reported following major disasters. Previous work has shown that ultrasonographic findings from ultrasound cardiography examination (UCG) increased until the 44th month after the tsunami caused by the Great East Japan Earthquake. The present study conducted UCG among victims in the tsunami disaster area and investigated the frequency of disaster-related cardiovascular diseases and changes over time until the 55th month after the disaster.@*METHODS@#The subjects were residents of temporary housing complexes and neighboring housing in Watari-gun, Miyagi Prefecture, Japan. There were 207 subjects in the 18th month, 125 in the 30th month, 121 in the 44th month, and 106 in the 55th month after the disaster. Data were collected through UCG and self-report questionnaire.@*RESULTS@#Significant changes were observed among subjects with clinical findings from the UCG, which increased over the study period-from 42.0 to 60.8, 72.7, and 73.6% beginning in the 18th month after the disaster (p < 0.0001).@*CONCLUSIONS@#It is possible that the UCG can become a useful examination to visualize the potential impact of a major disaster on the cardiac function of victims. Victims with clinical findings continued increasing not only during the acute phase after a disaster but also in the long term. We therefore need to keep this in mind, and note that it is important to establish a support system to control cardiovascular diseases from the early stage of disaster.@*TRIAL REGISTRATION@#UMIN; ID000029802. R000034050 . 2 November 2017.

Occurrence of depressive tendency and associated social factors among elderly persons forced by the Great East Japan Earthquake and nuclear disaster to live as long-term evacuees: a prospective cohort study.

PURPOSE: This study examined the incidence of depression and associated factors among elderly persons from Iitate village after the March 2011 earthquake. METHOD: This was a prospective cohort study. As a baseline survey, in May 2010 a self-assessment Basic Checklist (BCL) was distributed to 1611 elderly villagers, of which 1277 responded. Of these respondents, 885 without a tendency to depression (69.3%) were given a follow-up survey in May 2013. The BCL was used to assess depression tendency, instrumental activities of daily living (IADL), physical function, nutritional status, oral function, homeboundness, cognitive function and social activities. Univariate analysis was used to examine differences in risk between those with a presence of depression tendency (PDT) and those without (non-PDT) depending on demographic and BCL variables. Variables found to be significant were analysed by Poisson regression analysis. RESULTS: Of the 438 respondents in the second survey, 163 (37.2%) showed depression tendency. PDT risk was significantly increased by female gender, age, history of diabetes and cognitive disorder. It was significantly reduced by increased IADL. Engagement in social activities decreased PDT risk in rental accommodation. DISCUSSION: Renters faced a higher risk of PDT than persons evacuated in groups to purpose-built housing. The inclusion of social activities in the multivariate Poisson regression analysis weakened this effect. Female gender, a history of diabetes, reduced IADL and a tendency to cognitive disorder each independently affected PDT risk. These findings may inform future responses to earthquakes and the technical disasters that may accompany them.

Effect of Residence in Temporary Housing After the Great East Japan Earthquake on the Physical Activity and Quality of Life of Older Survivors.

OBJECTIVE: This study aimed to compare the physical activity level and health-related quality of life (HRQOL) between older survivors residing in temporary housing after the Great East Japan Earthquake (GEJE; temporary housing group) and older individuals residing in their own homes (control group) and to clarify whether mobility function and muscle strength were correlated with physical activity among older temporary housing residents. METHODS: Subjects were recruited to the temporary housing group (n=64, 19 men and 45 women) or control group (n=64, 33 men and 31 women) according to their residence. Physical activity was assessed by the number of walking steps determined by using a triaxial accelerometer, mobility function by the Timed Up and Go test, muscle strength by the grasping power test, and HRQOL by the Medical Outcome Study 36-Item Short Form Survey v2. RESULTS: In the temporary housing group, reduced physical activity and correlation between physical activity and mobility function in men, and muscle strength in both men and women, were observed. There was no significant difference in HRQOL between groups except for bodily pain in women. CONCLUSION: Support for older evacuees should focus on maintaining their physical activity level as well as on HRQOL to avoid deterioration of health in these survivors. (Disaster Med Public Health Preparedness. 2017;11:701-710).