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After the 2011 Fukushima Daiichi Nuclear Power Station accident, the Fukushima Health Management Survey was conducted to assess children’s lifestyle and mental health conditions. The participants in this study were 1126 children, aged 0 to 3 years, living in the evacuation zone at the time of the disaster. The parenting confidence of their mothers was assessed using a self-administered questionnaire as a baseline in 2013. We examined the association of parenting confidence level at baseline, using a total difficulty score of the Strengths and Difficulties Questionnaire (SDQ) and reluctance to attend school among children in a follow-up study in 2016 and 2017. As a result, no confidence was reported by 178 (15.8%) mothers, while 477 (42.4%) responded with “not sure” and 471 (41.8%) were confident. In the multiple logistic analysis, after adjusting for covariates such as the child’s sex, age, and current health condition, the group lacking parenting confidence demonstrated a significantly higher risk level for SDQ total difficulties (OR, 2.8; 95% CI, 1.59–4.93) and reluctance to attend school (OR = 1.98, 95% CI: 1.24–3.18) than the confident mothers. After a major disaster, which can have long-term effects on communities, intensive psychological care for mothers with young children is needed to prevent various mental health problems in their children.

After the accident at the Fukushima nuclear power plant in 2011, caused by the Great East Japan Earthquake, some evacuees had no one to consult despite many local care providers offering assistance. This study identified the characteristics of individuals who did not receive consultations and the relevant determinants, and proposed the available measures to address this issue. Altogether, 32,699 participants aged 16 years or older and residing in the disaster area at Fukushima were surveyed. Those with no one to consult showed a significantly higher prevalence of psychological distress (16.2%, p &lt, 0.001) and drinking problems (21.5%, p &lt, 0.001). Multivariate analysis revealed that these behaviors were associated with the middle age group (i.e., 40–64 years old) (odds ratio [OR]: 1.30, 95% confidence interval [CI]: 1.16–1.46), men (OR = 2.46, 95% CI, 2.27–2.66), bad financial circumstances (OR = 2.11, 95% CI, 1.96–2.27), and living alone (OR = 1.53, 95% CI, 1.39–1.68). This research verifies that people with such characteristics were more likely to be isolated and vulnerable to psychiatric problems, such as depression. We suggest that it is integral for local care providers to recognize those who have no one to consult and provide targeted support.

Cardiovascular disease (CVD) and mental distress have been suggested to be associated with post-traumatic stress disorder (PTSD), but the effect of their combination on PTSD is unknown. We reviewed the synergistic effects of the history of CVD and mental distress on the possibility of PTSD among residents in Fukushima after the Great East Japan Earthquake. This cross-sectional study was conducted among 38,392 participants aged 40–74 years in the evacuation area who applied for the Fukushima Health Management Study in Fiscal Year 2011. Relative excess risk due to interaction (RERI), attributable proportion (AP), odds ratio (OR), and 95% confidence interval (CI) were calculated to investigate the combined effect of history of CVD and mental distress on PTSD. We identified 8104 probable cases of PTSD (21.1%). History of CVD, mental distress, and their combination were positively associated with probable PTSD: the multivariable ORs (95% CIs) were 1.44 (1.04, 2.01), 20.08 (18.14, 22.22), and 26.60 (23.07, 30.67), respectively. There was a significant increase in RERI: the corresponding RERI (95% CI) and AP were 6.08 (3.16, 9.00) and 22.9%. Gender-specific analyses showed similar associations. Thus, we found a supra-additive association of history of CVD and mental distress with probable PTSD after the disaster.

The COVID-19 pandemic has caused Japanese workers psychological distress through crises of health, economics, and social relationships. To assess whether these effects are amplified by the gender bias that exists in Japan, we examined male and female worker’s psychological distress and difficulties during the pandemic. An online “COVID-19-related difficulties” questionnaire, based on item response theory, gathered responses from 3464 workers in October and November 2020. The workers’ psychological distress was found concerned to be significantly worse than before the pandemic. Basic stressors related to infection anxiety, economic anxiety, and restrictions on social interactions and outings. Men’s and women’s experiences of difficulties were consistent with traditional gender roles in Japan: men were more likely to face job-related stressors, such as economic insecurity and work-style changes, women were more likely to face non-job-related stressors, such as increased living costs and reduced social interactions. Policymakers and employers should consider the association between gender differences and industry types, and implement measures to strengthen the acceptability of mental health care.

Oral health is closely related to subjective general health and systemic diseases. This cross-sectional study aimed to identify the factors related to oral symptoms and their worsening in relation to psychosocial factors after the Great East Japan Earthquake. In this study, 64,186 residents aged 15–101 years old, who experienced the earthquake on 11 March 2011, were surveyed regarding their oral symptoms, psychological factors, such as post-traumatic reactions and psychological distress, and social factors such as evacuation, work change, and loss of a close person, history of systemic diseases, and lifestyle. Binomial logistic regression analysis was used to calculate odds ratios, and 95% confidence intervals were established for each factor associated with prevalent and exacerbated oral symptoms. The proportions of participants with prevalent and exacerbated oral symptoms were 10.3% and 1.6%, respectively. The multivariate odds ratios and 95% CI of psychosocial factors associated with exacerbated oral symptoms were as follows: post-traumatic stress disorder symptoms, 2.24 (1.64–3.06), work changes, 1.88 (1.34–2.65), history of dyslipidemia, 1.74 (1.27–2.39), and subjective current poor health condition, 2.73 (2.00–3.75). Psychological factors, social factors, and physical factors were associated with both prevalent and exacerbated oral symptoms.

Considering the health effects of radiation accompanying the nuclear power plant accident that occurred in the wake of the Great East Japan Earthquake, this study aimed to examine social participation after the disaster and factors hindering participation among citizens aged ≥ 65 years from designated evacuation zones inside the Fukushima prefecture. The target population comprised 180,604 residents in 13 municipalities containing designated evacuation zones. There were 73,433 valid responses (response rate, 40.7%), of which, data from 19,573 respondents aged ≥ 65 years were analyzed. Multinomial logistic regression analyses were conducted to investigate the factors associated with social participation. In total, 53.0% of older evacuees did not participate in recreational activities or communal services. Stratified analysis showed that living outside the Fukushima prefecture and requiring assistance with activities of daily living were associated with low social participation. This study clarified that the majority of older evacuees did not participate in social activities at the time of the survey within one year of the disaster. Furthermore, where these older individuals were evacuated to and whether they were able to live independently might have affected their social participation. Better subjective health, better sleep quality, and more frequent exercise may be associated with improved social participation.

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&ndash, 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&rsquo, 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.

We investigated the association between the frequency of laughter and lifestyle diseases after the Great East Japan Earthquake. We included 41,432 participants aged 30–89 years in the Fukushima Health Management Survey in fiscal year 2012 and 2013. Gender-specific, age-adjusted and multivariable odds ratios of lifestyle diseases were calculated using logistic regressions stratified by evacuation status. Those who laugh every day had significantly lower multivariable odds ratios for hypertension (HT), diabetes mellitus (DM) and heart disease (HD) for men, and HT and dyslipidemia (DL) for women compared to those who do not, especially in male evacuees. The multivariable odds ratios (95% confidence intervals) of HT, DM and HD (non-evacuees vs. evacuees) for men were 1.00 (0.89–1.11) vs. 0.85 (0.74–0.96), 0.90 (0.77–1.05) vs. 0.77 (0.64–0.91) and 0.92 (0.76–1.11) vs. 0.79 (0.63–0.99), and HT and DL for women were 0.90 (0.81–1.00) vs. 0.88 (0.78–0.99) and 0.80 (0.70–0.92) vs. 0.72 (0.62–0.83), respectively. The daily frequency of laughter was associated with a lower prevalence of lifestyle disease, especially in evacuees.

Many individuals who were affected by the Great East Japan earthquake and tsunami and the subsequent Fukushima Daiichi Nuclear Power Plant accident continue to face a challenging recovery. We reviewed the long-term mental health consequences of three major nuclear power plant accidents: the Three Mile Island (TMI, 1979), Chernobyl (1986), and Fukushima (2011) nuclear disasters. We examined the relevant prospective cohort studies and before-and-after studies that covered more than two timepoints, searching four databases (PubMed, Ichushi, PsyArticles, and PTSDPub). We identified a total of 35 studies: TMI, n = 11; Chernobyl, n = 6; and Fukushima, n = 18. The smaller numbers of early-phase studies (within 6 months) of the Chernobyl and Fukushima disasters may also indicate the chaotic situation at those timepoints, as large-scale interviews were conducted in the early phase after the TMI disaster. Although the patterns of effects on mental health outcomes were diverse, more than half of the participants in the studies we evaluated were categorized into low or under-threshold symptom groups in all three disasters. Across the three disasters, the radiation exposure level estimated by the proximity and stigma were the common risk factors for mental health outcomes. Our findings will contribute to a comprehensive understanding of the impact of the worst nuclear accidents in history on the affected individuals’ mental health, and our results illustrate the longitudinal consequences of such disasters.

We evaluated the association between health-related quality of life (HR-QOL) and intent to return home among former residents of Tomioka Town, Fukushima Prefecture 9 years after the Fukushima Daiichi nuclear accident to support the recovery of the community after the accident. We conducted a questionnaire survey asking residents about their intention to return to their original home, risk perception for radiation exposure, HR-QOL using the HR-QOL Short Form 8 (SF-8), and sense of coherence using the Sense of Coherence Scale (SOC-13). Among the 1029 residents, a total of 138 (13%) had already returned to Tomioka (group 1), 223 (22%) were undecided (group 2), and 668 (65%) had decided not to return (group 3). Group 2 had poorer HR-QOL than groups 1 and 3, especially physical function, body pain, general health, social functioning, and mental health. The ratio of residents with a better sense of coherence was significantly higher in group 1 than in groups 2 and 3. Our present study indicated poorer HR-QOL among residents who were undecided about returning home. It is necessary to provide a model for a multidisciplinary approach for the public during the recovery phase of a nuclear accident., International Journal of Environmental Research and Public Health, 17(18), art.no.6625, ; 2020

After the Fukushima nuclear power plant accident, numerous evacuees reported poor mental health status and high-risk perceptions of the health effects of radiation. However, the temporal associations between these variables have not yet been examined. Using data from the Fukushima Health Survey, we examined changes in risk perception of the health effects of radiation over time and assessed the effects of mental health on such changes using logistic regression analysis. Risk perception for delayed effect pertains a brief on health effect in later life (delayed effect), whereas that of genetic effect pertains a brief on health effect of future children and grandchildren (genetic effect). We found that many participants showed consistently high or low-risk perceptions over all three study years (2011&ndash, 2013) (for delayed effect: 59% and 41% of participants were in the low and high-risk perception groups, respectively, for genetic effect: 47% and 53%, respectively). Stronger traumatic reactions (&ge, 50 on the PTSD Checklist&ndash, Specific) significantly affected the odds of being in the high-risk perception group for the delayed and genetic effects, with the associations being strongest soon after the disaster: The adjusted ORs (95%CIs) were 2.05 (1.82&ndash, 2.31), 1.86 (1.61&ndash, 2.15), and 1.88 (1.62&ndash, 2.17) for the delayed effect in 2011, 2012, and 2013, respectively, and 2.18 (1.92&ndash, 2.48), 2.05 (1.75&ndash, 2.40), and 1.82 (1.55&ndash, 2.15) for the genetic effect. As initial mental health status had the strongest impact on later risk perceptions of radiation, it should be considered in early response and communication efforts.

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.

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&ndash, 0.99) and economic hardship (OR: 0.80, 95% CI: 0.65&ndash, 0.98) were associated with the hindrance of recovery. In contrast, overall good health (OR: 1.47, 95% CI: 1.20&ndash, 1.80), regular physical activity (OR: 1.23, 95% CI: 1.01&ndash, 1.50), social interaction with friends (OR: 1.25, 95% CI: 1.00&ndash, 1.55), and established social roles (OR: 1.44, 95% CI: 1.14&ndash, 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.