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Background: Dietary patterns may be linked to the incidence of type 2 diabetes mellitus (T2DM) after disasters. We investigated the association between dietary patterns and new-onset T2DM in evacuees of the Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Methods: Among the 22,740 non-diabetic participants aged 20–89 years who completed the dietary assessment in the Fukushima Health Management Survey between July 2011 and November 2012, the incidence of T2DM was evaluated until 2018. Principal component analysis with varimax rotation was applied to derive dietary patterns based on a validated, short-form food frequency questionnaire. The identified dietary patterns were categorized as typical Japanese, juice, and meat. Results: The cumulative incidence of T2DM was 18.0 and 9.8 per 1000 person-years in men and women, respectively, during the follow-up period. The multiple-adjusted hazard ratio (95% confidence interval) of the highest vs. lowest quartile of the typical Japanese pattern scores for T2DM was 0.80 (0.68, 0.94; P for trend = 0.015) in total, 0.85 (0.68, 1.06; P for trend = 0.181) in men, and 0.76 (0.60, 0.95; P for trend = 0.04) in women. Conclusions: A typical Japanese dietary pattern may be associated with a reduced new-onset T2DM risk in evacuees, especially women, after the Great East Japan Earthquake and the FDNPP accident.

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.

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.

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.

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.