Background: Associations between nuclear disasters and suicide have been examined to a limited extent. Aim: To clarify the suicide rates in evacuation areas after the nuclear disaster in Fukushima, which occurred in March 2011. Method: This descriptive study used monthly data from vital statistics between March 2009 and December 2015. Suicide rates in areas to which evacuation orders had been issued, requiring across-the-board, compulsory evacuation of residents from the entire or part of municipalities, were obtained and compared with the national average. Results: Male suicide rates in evacuation areas increased significantly immediately after the disaster, and then began to increase again 4 years after the disaster. Female suicide rates declined slightly during the first year and then increased significantly over the subsequent 3-year period. Moreover, male rates in areas where evacuation orders were issued for the total area declined over the course of approximately 2 years, but then began to increase thereafter. Analysis by age revealed postdisaster male rates in evacuation areas decreased for those aged 50–69 years and increased for those aged ≤ 29 years and ≥ 70 years. Limitations: The number of suicides among females and the female population in the evacuation area was small. Conclusion: Our findings suggest the need to keep in mind that, when providing post-disaster mental health services, suicide rates can eventually increase even if they initially decrease.

This longitudinal study aimed to investigate the prevalence of newly-started drinkers and their continuing drinking behaviors after the Great East Japan earthquake. Moreover, the relationships between newly-started drinking and psychological factor, disaster-related experience, and perceived radiation risk were examined. We used data from 37,687 pre-disaster non-drinkers who participated in the 2012 and 2013 surveys conducted in Fukushima. We defined newly-started drinkers as those who did not drink before the disaster but who began drinking after the disaster, based on information collected retrospectively. In 2012, 9.6% of non-drinkers began drinking, of which the prevalence of heavy drinkers was 18.4%. The prevalence of continued drinking among newly-started drinkers in 2013 was 53.8%. Logistic regression analyses revealed post-disaster newly-started drinking was significantly associated with being male, less than 65 years old, sleep dissatisfaction and psychological distress (Kessler 6 ≤ 13) when this model was adjusted for disaster-related experience and perceived radiation risk. Moreover, psychological distress and heavy drinking were significant risk factors for continued drinking among newly-started drinkers. Newly-started drinkers might use alcohol to cope with disaster-related stress. Thus, they may be targeted for disaster-related health services. Moreover, early intervention should encourage responsible drinking, since post-disaster heavy drinkers were likely to continue heavy drinking.

Following the accident at the Fukushima Nuclear Power Plant in March 2011, both experts and the national government provided insufficient information on radiation, leading to widespread distrust in the community. This study aimed at clarifying the association between anxiety about radiation and health literacy among residents in evacuation and non-evacuation areas in Fukushima. A questionnaire survey was sent to randomly sampled residents between August and October 2016, and data from 777 responses (38.9% valid response) were analyzed. The questionnaire assessed current radiation anxiety and discrimination and prejudice based on radiation exposure through seven items and communicative and critical health literacy through five items. Multiple regression analysis of the association between radiation anxiety and health literacy showed that the level of health literacy was significantly negatively associated with radiation anxiety in the evacuation areas (marginally in the non-evacuation areas) and marginally negatively associated with discrimination and prejudice in the evacuation areas but not in the non-evacuation areas. Therefore, improving health literacy could alleviate radiation anxiety.

Objective: The Great East Japan Earthquake, which occurred on March 11, 2011, caused unprecedented damage. To address evacuees’ psychosocial issues, our disaster mental health team provided psychosocial support in the form of careful listening and providing information for reconstruction.Methods: To summarize evacuees’ psychosocial issues, we reviewed records of our daily activities and analyzed factors related to continuation or termination of support. Terminated support was defined as the resolution or improvement of psychological issues relative to the time of initial support.Results: Based on logistic regression analysis, living in prefabricated temporary housing (odds ratio [OR]: 0.37; 95% confidence interval [CI]: 0.19-0.72), a high number of improved stress symptoms (0.81; 95% CI: 0.67-0.99), and higher support frequency (0.84; 95% CI: 0.78-0.90) were significantly associated with a lower likelihood of continuing support. Conversely, economic and resettlement issues (2.75; 95% CI: 1.63-4.64) and high numbers of stress symptoms (1.24; 95% CI: 1.06-1.45) were strongly and significantly associated with continuing support, particularly in the mid- to long-term phase following the earthquake (ie, after August 1, 2011). No significant association was found between support status and alcohol problems or disaster-related experiences (eg, loss of family or housing).Conclusion: Our findings highlight the need to be aware of evacuees’ social issues such as resettlement in the mid- to long-term post-disaster phase. (Disaster Med Public Health Preparedness. 2017;11:439–450)

Objective: The aim of this study is to assess the risk factors for incident functional disability among long-term evacuees of Iitate village after Great East Japan Earthquake and nuclear disaster (GEJE). We also investigated the effectiveness of exercise classes as an intervention measure in this situation. Methods: 1159 subjects (75.2 ± 5.8 years, 57.5% female) were included at baseline, and followed-up for four years. Cox proportional hazard regression analysis was used to estimate the hazard ratio (HR) of incident functional disability according to the presence of risk factors evaluated by the municipality’s self-assessment Basic Checklist (BCL). Evacuees from Iitate who participated in the exercise classes and those who did not were matched using the propensity scores, which were then used to obtain the HR of incident functional disability. Results: New functional disability occurred in 280 (24.2%) participants during the follow-up. Participants who scored negative for the “Physical function” domain in the BCL had a HR of 2.04 (95% CI: 1.54–2.69) for incident functional disability when compared to those who scored positive for this domain. Similarly, the HR for “Cognitive function” was 1.37 (CI: 1.06–1.77), and 1.60 (CI: 1.24–2.08) for “Depression”. Using a Cox proportional hazard regression model, both the group with low-participation in the exercise program and the group with high-participation in the exercise program had a significantly lower rate of incident functional disability compared to those who did not participate at all (HR = 0.27, CI: 0.16–0.46; HR = 0.30, CI: 0.12–0.74, respectively). Conclusions: Pre-disaster BCL domains were useful to identify individuals at risk of functional disability after a major socio-technical disaster. Therefore, this instrument can be used to identify at-risk older adults who would benefit from early exercise programs to prevent incident functional disability.

The 2011 Fukushima nuclear accident resulted in the exposure to radiation and evacuation, which has created psychological distress among the Fukushima residents. With the provision of multi-faceted support and the progress of the reconstruction, their mental health has appeared to show signs of recovery. However, there have been few studies investigating their recovery. To clarify the related factors associated with mental health recovery, a cross-sectional questionnaire survey was conducted. Subjects whose answers were associated with Resilience, Recovery, and Remitting patterns of mental health status were categorized in the Recovery group, while those associated with Delayed/Chronic dysfunction were placed in the Non-recovered group. In a multivariable logistic regression analysis, disaster-related unemployment (odds ratio (OR): 0.80, 95% CI (confidence interval): 0.65–0.99) and economic hardship (OR: 0.80, 95% CI: 0.65–0.98) were associated with the hindrance of recovery. In contrast, overall good health (OR: 1.47, 95% CI: 1.20–1.80), regular physical activity (OR: 1.23, 95% CI: 1.01–1.50), social interaction with friends (OR: 1.25, 95% CI: 1.00–1.55), and established social roles (OR: 1.44, 95% CI: 1.14–1.82) were associated with the promotion of recovery. In conclusion, our study showed a positive association between mental health recovery and a desirable lifestyle and social network, particularly with social roles. Thus, the provision of active social roles can promote recovery related to a disaster as with multi-faceted support.