Kawachi Ichiro, Aida Jun, Hikichi Hiroyuki, Kondo Katsunori
Harvard University.
Tohoku University Graduate School of Dentistry.
J R Soc N Z. 2020;50(2):263-278. doi: 10.1080/03036758.2020.1722186. Epub 2020 Feb 4.
Recovery after major disaster poses a unique set of challenges for the older population, including disruption of medical care for pre-existing conditions, functional limitations that impede recovery, and social isolation following involuntary resettlement. In this review, we summarize the lessons about disaster resilience that have been learned (so far) from a unique ongoing field study based in a community that was affected by the 2011 earthquake and tsunami in Japan. In the Iwanuma Study, baseline information about the health status and living conditions of older residents was collected seven months before the disaster. A follow-up survey was conducted 2.5 years after the disaster, allowing us investigate the risk and protective factors for a range of disaster-related health sequelae, including mental illness and cognitive disability. A consistent finding to emerge from our studies is the critical role of social connections (the "social capital" of a community) in protecting against the deleterious after-effects of psychological trauma and involuntary resettlement following the disaster. In contrast to the emphasis on investing in material infrastructure to prepare for disasters, a review of our studies suggests that repairing (or at least preserving) the social fabric of people's lives is a crucial ingredient in disaster resilience.
重大灾难后的恢复对老年人群体构成了一系列独特的挑战，包括针对既往疾病的医疗护理中断、妨碍恢复的功能限制以及非自愿重新安置后的社会隔离。在本综述中，我们总结了（截至目前）从一项正在进行的独特实地研究中学到的有关灾难复原力的经验教训，该研究基于日本一个受2011年地震和海啸影响的社区。在石卷研究中，在灾难发生前七个月收集了老年居民健康状况和生活条件的基线信息。灾难发生2.5年后进行了随访调查，使我们能够调查一系列与灾难相关的健康后遗症（包括精神疾病和认知障碍）的风险和保护因素。我们研究中一个一致的发现是社会联系（社区的“社会资本”）在预防灾难后心理创伤和非自愿重新安置的有害后遗症方面的关键作用。与强调投资物质基础设施以应对灾难不同，对我们研究的综述表明，修复（或至少保留）人们生活的社会结构是灾难复原力的关键要素。
