Health emergencies and disaster risk management (Health-EDRM)

People across the world are faced with the risks associated with health emergencies and disasters. Reducing such risks and their consequences is vital to health security and resilience across communities. Research and knowledge management on Health EDRM is critical in designing policies and programs. 

The importance of sound risk management has been emphasized as part of the implementation of the Sustainable Development Goals (SDGs), including Universal Health Coverage (UHC), the Sendai Framework for Disaster Risk Reduction 2015-2030 (Sendai Framework), International Health Regulations (IHR) (2005), the Paris Agreement on Climate Change (Paris Agreement), and other frameworks.

To improve the scientific evidence base, WHO established the Thematic Platform for Health EDRM Research Network (TPRN). WHO HQ and all six Regional Offices are involved in the operation of TPRN and work together to discuss research needs, facilitate international research collaboration and knowledge management. WHO Kobe Centre (WKC) acts as the secretariat of TPRN.  

To address the need for stronger methods for Health EDRM research, WKC coordinates the development of the WHO Guidance on Research Methods for Health EDRM. The guidance is comprehensive and covers the design, implementation and reporting of research during and after emergencies and disasters.

What is our research focus?

Based on the 2018 Kobe Expert Meeting on Health EDRM Research Needs, WKC focuses on the below research themes. 

To provide effective health support in disaster relief and recovery, accurate and comprehensive data is essential. WKC promotes and coordinates research on methodology and tools for health data collection for use before, during and after emergencies and disasters.

​​Emergencies and disasters can place significant and persistent mental health pressures on those affected, including the responders. Mental health and psychosocial support (MHPSS) is an essential part of Health-EDRM. WKC coordinates research on enhancing health systems for effective MHPSS.

Long-term Psychosocial Impact of Natural Disasters on Survivors in Japan

Development of Specific Care Strategies to Maintain and Recover Survivors’ Health after Disasters

Inclusivity is a key principle of Health-EDRM. This requires understanding the vulnerabilities and capacities of communities and specific vulnerable sub-populations. How communities perceive and manage risks also greatly affects the health consequence of emergencies and disasters. WKC works on research for better understandings and countermeasures on this research theme. 

Health workforce development is an overarching research theme of Health-EDRM WKC supports research to address this gap and including capacity building. 

Why is this important?

These research activities help countries to strengthen their capacities in emergency risk management and will ultimately contribute to one billion more people safe during emergencies.

Related links

Health Emergency and Disaster Risk Management Framework

Health Emergency and Disaster Risk Management Fact Sheets

 

Consult all archived projects here

 

Determinants of long-term mental health outcomes after disasters and health emergencies: A systematic review and establishment of the Asia Pacific Disaster Mental Health Network

Background

The Asia Pacific experiences more disasters than any other region (Below & Wallemacq, 2018). Exposure to disaster-related traumas, together with the cascading effects of displacement, bereavement, and resource loss, have potential to cause significant psychological distress. Increased incidence of post-traumatic stress disorder, depression and anxiety have been documented across disaster-affected populations globally (Beaglehole et al., 2018; Norris et al., 2002); and a growing cross-cultural evidence base indicates that trauma is expressed through psychological, spiritual and social expressions in many populations (Gibson, Haslam, & Kaplan, 2019; Kohrt & Hruschka, 2010). Although for most people the effects of grief and trauma lessen over time, many will continue to experience psychological distress in the months and years following disasters (Bryant et al., 2018; Santiago et al., 2013). Despite growing evidence that disaster exposure is associated with ongoing psychological difficulties, it is not clear whether patterns of mental health outcomes are consistent across hazards and populations. Systematic review of the long-term trajectories of disaster-related mental health outcomes is needed to inform best practice in the field and to tailor evidence-based disaster risk reduction policies (Chan & Murray, 2017; Newnham, Titov, & McEvoy, 2020). Identifying modifiable risk and protective factors, i.e. the biological, individual, family, community and societal level characteristics associated with higher incidence of negative or positive mental health outcomes (respectively), will inform intervention targets for groups at elevated risk.

Goals

This study aims to:

  1. Determine the risk and protective factors associated with long-term mental health trajectories in the years following disasters and health emergencies.
  2. Assess the quality of monitoring and evaluation evidence in the field of disaster mental health research, in line with the IASC Common Monitoring and Evaluation Framework for Mental Health and Psychosocial Support in Emergency Settings.
  3. Establish the Asia Pacific Disaster Mental Health Network to support best practice within the region.

Methods

  1. A systematic review of the English, Japanese and Chinese-language scientific and grey literature will be conducted to determine longitudinal patterns of mental health outcomes (post-traumatic stress disorder, depression and anxiety), and identify risk and protective factors associated with psychological distress in the years (12 months and beyond) following disasters.
  2. The evidence base will be mapped according to the IASC Common Monitoring and Evaluation Framework for Mental Health and Psychosocial Support in Emergency Settings to determine the quality and breadth of evidence for mental health programming in disasters.
  3. A regional network of interdisciplinary scholars and practitioners will be established to inform research, policy, and practice for mental health among disaster-affected communities.
  4. Evidence-informed policy guidance will be developed to support effective and sustainable mental healthcare following disasters.

Expected outputs

  1. Three peer-reviewed publications will be developed, outlining the findings of the systematic review, IASC Monitoring and Evaluation Framework assessment, and regional network.
  2. Two policy briefs will be developed by the research team and regional network, outlining recommendations for improvements in mental health service development and delivery during and after disasters.

Related publication

Newnham, E.A.; Dzidic, P.L.; Mergelsberg, E.L.P.; Guragain, B.; Chan, E.Y.Y.; Kim, Y.; Leaning, J.; Kayano, R.; Wright, M.; Kaththiriarachchi, L.; Kato, H.; Osawa, T.; Gibbs, L. The Asia Pacific Disaster Mental Health Network: Setting a Mental Health Agenda for the Region. Int. J. Environ. Res. Public Health 2020, 17, 6144. https://doi.org/10.3390/ijerph17176144

A Scoping Review of the Impacts of Climate-related Disasters and Health Adaptation on Vulnerable Populations in China, Viet Nam and Indonesia

Background

Climate change amplifies disasters across the globe, and this will result in a significant public health burden. Effective adaptation strategy and measures are critical to mitigating health risks and maintaining the efforts for continuous improvement. Globally, noteworthy health adaptation programmes are growing, but the scientific literature on this topic lacks synthesis poses challenges for country leadership to implement and spur adequate adaptation activities. Countries such as China, Indonesia and Viet Nam are rapidly developing and extremely susceptible to climate change.

Goal

The project aims to review existing studied vulnerable population, health impacts, and measures to address health risks for vulnerable populations affected by climate-related disasters in China, Indonesia and Viet Nam.

Methods

  1. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review (PRISMA-ScR) checklist will be applied to carry out the review and reporting.
  2. The review includes peer-reviewed and grey literature identified in Medline, Scopus, Embase and Google Scholar dated since 1997 (Kyoto Protocol), which published in English, Chinese, Vietnamese o r Indonesian.
  3. Data extraction including author, publication date, journal, study characteristic, tools used to measure intervention (e.g., barriers, success factors, outcomes) and any facilitating factors reported associated with health adaptation in climate-related disasters (e.g., law, policy, higher risk of flood, past disasters experience).

Expected outputs from the research

  1. A peer-reviewed publication on countries' health adaptation activities for climate related disasters and tools used to measure its implementation, based on the result of the scoping review.
  2. Policy briefs to inform practices in China, Indonesia, Viet Nam and countries with similar context.  

Health Workforce Development in Health EDRM: Literature Review, Case Studies and Expert Consultations

Background

The Sendai Framework for Disaster Risk Reduction called for resilient national health systems, by integrating disaster risk management into primary, secondary and tertiary health care, especially at the local level. The health workforce is key to successful implementation of health emergency and disaster risk management (Health-EDRM). Effective health workforce development strategies are urgently needed but significant gaps exist in the evidence for training, retention, motivation and deployment, local workforce development, smooth coordination between external and local health workers, and the common knowledge and competencies for Health-EDRM.

Goals

  1. To describe and classify the current Health-EDRM workforce development situation and identify key common competencies for educational activities.
  2. To summarize the human resource strategies for recruitment, deployment, retention, and protection of health and non-health workers in emergency situations.
  3. To review effective and non-effective collaborations of local and external health workforce.
  4. To study how country income level affects priorities for health workforce development.

Methods

  1. A systematic review of the English, Japanese and Chinese published studies (using MEDLINE from 1966, EMBASE from 1980, CINAHL from 1980) and the grey literature (from 1990).
  2. To supplement the literature review, at least twelve case studies will be conducted covering various hazard types from all six WHO regions through different methodologies including questionnaire-based interview of key experts as well as secondary data source (CRED, EMDAT, DesInventar, WHO/UN resources, GIDD, etc.).
  3. Expert consensus research to inform policy and practice in countries will be conducted based on the findings of the systematic review and case studies to gather various strategies and best practices with their strengths and weaknesses. Given the potential differences between priorities and needs for the LMICs and HICs, separate consensus plans will be sought for these two groups.

Expected outputs from the research

  1. Three peer-reviewed publications and two international conference presentations with conference papers will be developed, outlining the findings of the systematic review, case studies and expert consensus research.
  2. A policy brief will be developed by the research team, outlining recommendations by expert consensus for effective Health-EDRM workforce development for LMICs and HICs.

 

 

Systematic Review of Health Data Management Before, During and After Emergencies and Disasters

Background

The Sendai Framework on Disaster Risk Reduction 2015-2030 highlighted the health imperative in disaster risk management and the importance of scientific evidence for Health-EDRM. Reliable health data before, during and after emergencies and disasters are essential for evidence-based policy and programmes, but effective data collection systems and mechanisms are not fully established in many countries and emergency settings. Synthesizing existing knowledge and case analysis of recent implementation of WHO Emergency Medical Team (EMT) Minimum Data Set (MDS) and Japan Surveillance in Post Extreme Emergencies and Disasters (J-SPEED) as a globally standardized medical data collection system at emergency sites would provide evidence and inform policies.

Goals

  1. To understand the evidence gaps on the health data management before, during and after emergencies and disasters.
  2. To identify facilitators and barriers for successful implementation of standardized health data collection systems in different settings.

Methods

  1. A systematic review of the English and Japanese published studies from 2000 to 2020 using five electronic databases including PubMed and EMBASE (English), US National Library of Medicine, National Diet Library, Japan (Japanese) and grey literature.
  2. Case study analysis on the implementation of EMT MDS at Mozambique Cyclone Idai 2019 and J-SPEED at Hokkaido Earthquake 2018 and West Japan Heavy Rain 2018.

Expected outputs from the research

  1. At least one manuscript on the key facilitators and barriers for successful implementation manuscript for a peer-reviewed journal.
  2. A draft revision plan of the current EMT MDS with the relevant supporting tools based on the result of the study to be submitted to WHO EMT.
  3. Conference papers and presentations at four academic conferences.

 

 

WHO Thematic Platform for Health-EDRM Research Network (TPRN)

Background

The growing recognition of health as a core dimension in disaster risk management has catalyzed the development of Health Emergency and Disaster Risk Management (Health-EDRM), a field which encompasses emergency and disaster medicine, disaster risk reduction, humanitarian response, community health resilience, and health system resilience. In response to the Sendai Framework for Disaster Risk Reduction 2015-2030, WHO has established the “WHO Thematic Platform for Health EDRM Research Network” (TPRN) as a subgroup of the Thematic Platform for Health-EDRM. It aims to strengthen research and promote knowledge and evidence in Health-EDRM. The TPRN aligns with the World Health Organization’s 13th General Programme of Work 2019-23 (GPW13), which is a critical tool for WHO Member States to set and approve the priorities of the Organization, define the targets to be delivered, and to monitor their achievements. The GPW13 is structured around three strategic priorities, and one specifically addresses health emergencies and aims to build and sustain resilient health systems required to keep the world safe from epidemics and other health emergencies.

 

Methods
The TPRN comprises the core group, participants, and the information-sharing network. The core group includes WHO staff at all levels and regions, the Secretariat (WHO Kobe Centre), and other external key stakeholders. The core group facilitates the development of TPRN and coordinates its activities.
The participants consist of global stakeholders who contribute to updating the knowledge and scientific evidence of H-EDRM through active participation in one or more thematic groups. The information sharing network expands the TPRN and includes members who will receive a periodical newsletter from the TPRN Secretariat with information of official WHO meetings, publications, research funding, and information updates from the TPRN. The WHO Kobe Centre has acted as the Secretariat of the TPRN since 2019.

 

Results
The Terms of Reference of the TPRN (1), and its operational plan (2), were developed respectively in 2018 and 2019. Leading experts from the TPRN and other key partners have identified, through a meeting convened by the WHO Kobe Centre in 2018, five research priority areas: health data management; mental health and psychosocial support; addressing specific health needs of subpopulations; health workforce development; and research methods and ethics. A detailed description of the expert meeting and its findings were published in a series of papers (3-6), and on a project page on the WHO Kobe Centre website (7). In 2019, the WHO Kobe Centre launched the first call for proposals on Health-EDRM addressing the first four priority areas, while the WHO Guidance on Research Methods for H-EDRM currently underway specifically addresses the fifth research priority. WHO has also published the WHO Health Emergency and Disaster Risk Management Framework which maximize the contribution of the TPRN to research, policy and practice of Health-EDRM.

 

Conclusions
The TPRN serves as an international, multi-stakeholder and inter-disciplinary platform to exchange information, share views and advise WHO about Health-EDRM research and evidence. It promotes partnerships among stakeholders to enhance the scientific and technical work on Health-EDRM, influence the international Health-EDRM research agenda and advocate greater health input within the wider disaster risk reduction community.

 

Related web articles:

Project page: Kobe Expert Meeting, October 2018: “Scientific Evidence in Health-EDRM” 

WHO Guidance on Research Methods for Health and Disaster Risk Management

Rationale and background

Health Emergency and Disaster Risk Management (Health-EDRM) has recently emerged as a critical field for research, policy, and practice as a result of the growing recognition of health as a core dimension in disaster risk management. Global frameworks such as the WHO 13th General Programme of Work (GPW13)the Sendai Framework for Disaster Risk Reduction 2015-2030, the Sustainable Development Goals (SDGs), and the International Health Regulations (IHR) have goals, targets, and indicators that monitor the health impact of disasters and emergencies and resilience in health systems and communities. Policies and actions guided by the best possible evidence are therefore critical for managing the health risks of emergencies and disasters. However, the evidence base in Health-EDRM is very limited, reflecting the overall lack of research in this area. To address this gap, the WHO Thematic Platform for Health EDRM Research Network (Health EDRM RN) set out to develop a reference book about methods to guide Health-EDRM research.

Development process

The WHO Guidance on Research Methods for Health EDRM is the culmination of many face-to-face and virtual consultaitions among experts from WHO, Member States and partner organizations, who have contributed to the development and review of this document. The Guidance is derived from the existing scientific evidence in Health EDRM, and is delineated in 43 chapters that cover a wide range of research fields.  

In October 2018, the WHO Kobe Centre convened an expert meeting to identify key research needs for Health-EDRM, bringing together leading experts from the Health EDRM RN and other key partners. “Research methods and ethics” was identified as one of the five research priorities (see Related publications 1 and 2), in recognition of the urgent need for a methods reference in conducting research to inform Health-EDRM. The Guidance aims to fill this gap, notably through harmonizing terms for Health-EDRM research; identifying mechanisms for ethical review processes; encouraging stronger community participation and stakeholder involvement in the research process; and identifying effective means of research to policy.

The Guidance was developed through an extensive process informed throughout by WHO's work with partners and countries, including WHO country and regional offices and more than 160 global experts who authored chapters and participated in peer-review between January 2019 and July 2020, led by the capable editorial team.  

Features of the book

The WHO Guidance on Research Methods for Health-EDRM is a living reference document. The contents will be updated in response to the new and important scientific evidence. Given the current context of the COVID-19 pandemic, WHO plans to continually update the contents in 2021, and also include additional chapters on COVID-19 and other emerging topics. This Guidance offers practical advice about how to plan, conduct and report on a wide variety of quantitative and qualitative studies that can inform questions about policies and programs for health-related disasters and emergencies across different settings and level of resources. Case studies of direct relevance to Health EDRM provide real-life examples of research methods and how they have modified policies.

The book is useful for health professionals in Health-EDRM, academia, government agencies and ministries, international organizations, and community groups and civil society organizations.  

 

Contents and download

Full Guidance: under preparation

Glossary: DOWNLOAD

Abbreviations: under preparation

 

Section and chapters

1: Introduction 

1.1 Introduction by Jonathan Abrahams, Ryoma Kayano, Mike Clarke, Emily Y.Y. Chan and Virginia Murray.  DOWNLOAD  

1.2 Background: Health EDRM and research by Jonathan Abrahams, Ryoma Kayano, Mike Clarke, Emily Y.Y. Chan and Virginia Murray.  DOWNLOAD 

1.3 Historical developments in Health EDRM policy and research: the case study of Japan by Shinichi Egawa, Hiroyuki Sasaki, Anawat Suppasri, Hiroaki Tomita, Fumihiko Imamura, Fuji Nagami, Yasuhiro Kanatani, Akiko Eto, Yuichi Koido, Tatsuhiko Kubo, Hiroshi Kato, Yoshiharu Kim, Sonoe Mashino and Ryoma Kayano. DOWNLOAD

2: Identifying and understanding the problem

2.1 Using epidemiological principles to assess impacts of emergencies and disasters by Thomas D. Waite and Virginia Murray.  DOWNLOAD

2.2 Measuring the health impacts of disasters by Ronald Law.  DOWNLOAD  

2.3 Disease burden: generating evidence, guiding policy by Shuhei Nomura and Aya Ishizuka.  DOWNLOAD  

2.4 Databases and registers as tools for disaster epidemiology by Philip J. Schluter and Hyun M. Kim.  DOWNLOAD 

2.5 Identifying and engaging high-risk groups in disaster research by Elizabeth A. Newnham, Janice Y. Ho and Emily Y.Y. Chan.  DOWNLOAD

2.6 The current state of the evidence: Mapping the evidence and systematic reviews by Irshad A. Shaikh, Philip Davies and Asta Man.  

2.7 Prioritization of research by Mona Nasser, Roderik Floris Viergever and John Martin. 

3: Determining the scope of your study

3.1 Asset mapping to consider outcome measurement and stakeholder engagement by Mélissa Généreux, Shannon Tracey and Tracey O'Sullivan.  DOWNLOAD   

3.2 Disaster risk factors - hazards, exposure and vulnerability by Dell D. Saulnier, Amod Mani Dixit, Ana Raquel Nunes and Virginia Murray.  DOWNLOAD

3.3 Designing a research intervention for Health EDRM by Carol K.P. Wong and Emily Y.Y. Chan.  DOWNLOAD  

3.4 Ethics in research by Caroline Dubois, Katharine Wright and Michael Parker.  

3.5 Determining the research question by Mike Clarke and Yonggang Zhang.  DOWNLOAD 

3.6 Assessing the problems and developing a scoping review by Clara Affun-Adegbulu and Ali Ardalan.   DOWNLOAD  

3.7 Research resources to support policy and new research by Claire Allen, Phil Davies and Ben Heaven Taylor.  DOWNLOAD

Section 4: Study design

4.1 Basic principles in designing studies to assess the effects of interventions by Mike Clarke and Dimuthu Rathnayake.  DOWNLOAD  

4.2 Measuring the problem: Basic statistics by Christopher Garimoi Orach, Ngoy Nsenga, Olushayo Olu and Megan Harris.  DOWNLOAD

4.3 Cluster randomized trials by Matthew Coldiron and Rebecca F. Grais.  DONWLOAD  

4.4 Collection and management of good quality data by Fernando Gouvea-Reis, Marcelo Farah Dell'Aringa and Virginia Murray.  DOWNLOAD   

4.5 Advanced statistical techniques by Marcella Vigneri and Howard White.  DOWNLOAD

4.6 Health-related risk modelling by Holly C.Y. Lam, Zhe Huang and Emily Y.Y. Chan.  DOWNLOAD    

4.7 Evaluating economic impacts in health emergency and disaster risk management by Lorcan Clarke and Michael F. Drummond.  DOWNLOAD

4.8 Geographic information systems by Qian Ye and Shihui Guo.  DOWNLOAD

4.9 Real-time syndromic surveillance by Alex J. Elliot, Helen E. Hughes, Sally E. Harcourt, Roger A. Morbey, Sue Smith and Gillian E. Smith.  DOWNLOAD    

4.10 Using logic models in research and evaluation of Health EDRM interventions by Dylan Kneale, Mukdarut Bangpan, James Thomas and Hugh Sharma Waddington. DOWNLOAD

4.11 Researching communication and communicating research in Health EDRM by Alistair Humphrey, Lisa Robinson, Joseph Bonney and Sue Turner.  DOWNLOAD  

4.12 Qualitative research by Christina J. Pickering, Suzanne Phibbs, Christine Kenney and Tracey O'Sullivan.  DOWNLOAD  

4.13 Addressing complexity through mixed methods by Tracey O'Sullivan and Yasmin Khan.  DOWNLOAD  

4.14 Natural experiments in a hazard context by Hyun M. Kim, Alex G. Stewart and Philip J. Schluter.  DOWNLOAD  

4.15 Monitoring and evaluation by Heidi Hung, Gloria K.W. Chan and Emily Y.Y. Chan.  DOWNLOAD

5. Special topics to demonstrate research processes and benefits

5.1 Disaster mental health research by Elizabeth A. Newnham, Lennart Reifels and Lisa Gibbs.  DOWNLOAD

5.2 Crowdsourcing to gather data by Kerri Wazny.  DOWNLOAD  

5.3 Refugees and internally displaced populations by Ammar Saad, Kevin Pottie and Cheuk Pong Chiu.  DOWNLOAD  

5.4  Indigenous peoples by Sandra Del Pino, Julie Davis, Alex Camacho and Enrique Perez-Gutierrez.  DOWNLOAD

6. How to become a researcher

6.1 How to become a successful researcher by Paul Barach and André AJ Van Zundert.  DOWNLOAD

6.2 How to identify and access reports of existing research by Anne Brice and Caroline De Brún.  DOWNLOAD  

6.3 How to write a successful grant application for a research study by May Pui Shan Yeung and Emily Y.Y. Chan.  DOWNLOAD  

6.4 Getting ethical approval for your research by Siu Kai Lo, Holly C.Y. Lam and Emily Y.Y. Chan.  

6.5 Doing Health EDRM research in the field by Lucy Fagan, Katie Carmichael and Virginia Murray.  DOWNLOAD  

6.6 How to write up your research by Roderico H. Ofrin, Anil K. Bhola and Nilesh Buddha.  DOWNLOAD  

6.7 Doing research in Health EDRM by Juan Pablo Sarmiento.  DOWNLOAD 

 

 

 

Development of Specific Care Strategies to Maintain and Recover Survivors’ Health after Disasters

Background

The increasing scale and frequency of disasters has placed a priority on the mitigation of disaster risk and impact. Of special interest is disaster risk management for health, with attention towards vulnerable populations. Older adults are more likely to have physical, cognitive and mental vulnerabilities, such as multiple chronic diseases that can worsen during and after disasters and be complicated by mental health issues such as post-traumatic stress disorder (PTSD) and depression. Healthcare and social service providers affected by disasters are also of concern in terms of the prevention of PTSD and depression, as they are required to keep working under stressful environments.

The current research project was conducted within the context of the 2016 Kumamoto earthquakes that affected over 180,000 people in Japan. It included two studies. The first study aimed to identify the needs and health status of older adults in Town X, one of the most severely damaged areas close to the hypocentre. The second study evaluated the impact of a two-day therapeutic programme among healthcare and social service providers directly affected by the Kumamoto earthquakes. The programme included a psychoeducation intervention, open and individual consultations, and a small-group psychotherapy designed to prevent post-traumatic stress disorder (PTSD) and depression.

Goal

  1. To assess the health status, quality of life, needs for long term care, and changes in lifestyle of people over 65 years affected by the 2016 Kumamoto Earthquakes.

  2. To conduct a therapeutic intervention programme among healthcare and social service providers affected by disasters to evaluate its feasibility, relevance, acceptability and impact on the prevention of PTSD and depression.

Methods

  1. A letter-based questionnaire was sent to all 9,215 citizens over 65 years in Town X three years after the Kumamoto earthquake to collect information about socio-demographic characteristics; disaster effects (e.g. house damage; effect on household finance; requirement of evacuation); lifestyle change after the disaster (e.g. eating habits; daily activities; social activities; and change in health needs before and after the disaster (e.g. long term care,  health-related quality of life (HRQoL) as measured with the Short Form (SF)-8.

  2. To evaluate the impact The Centre for Epidemiologic Studies Depression Scale (CES-D); SF-8; and a sheet of dynamic change for trauma response (DCTR)) before, one month, three months, and six months after the intervention.

Results

A total of 3,692 older adults affected by the earthquake (40% of targeted participants) responded to the letter-based survey. Thirty percent of the participants reported a decrease in the frequency of going out and socialization after the earthquake. The need for long term care and support increased three years after the earthquake, and deterioration of the level of needed care and support was observed in 7% of the respondents. Lastly, respondents’ HRQoL scores were lower compared to the national standards: 48.2 versus 49 in males and 46.4 versus 49.3 in females for the physical component score of HRQoL, and 49.3 versus 51.3 in males and 47.6 versus 50.7 in females for the mental health component score of HRQoL.

The therapeutic intervention programme included 254 participants, of which 92.5% were nurses. Between the baseline and 6 months post intervention, the level of PTSD declined from 39% to 19% (p < 0.01), the CES-D average score decreased from 22.8 to 22.3 (p<0.05); and the DCTR average score declined from 8.3 to -2.4 (p<0.01). However, the change in HRQoL was not statistically significant: the average physical component score declined from 43.5 to 41.1 (p >0.05), while the average mental component score was increased from 40.9 to 42.6 (p >0.05).

Implications

Our sample of older adult survivors of the Kumamoto earthquakes displayed lower levels of HRQoL and experienced increased need for care and support three years after the earthquake. The proportion of healthcare and social providers with PTSD was reduced by half following the intervention; however, the lack of a comparable control group limits the assessment of the effectiveness of this therapeutic intervention.

 

 

 

 

Long-term Psychosocial Impact of Natural Disasters on Survivors in Japan

Over the past few decades, the frequency and severity of natural disasters have increased. Growing population, unplanned urbanization, ageing and related demographic trends have contributed to this change. The 3rd UN World Conference for Disaster Risk Reduction, Sendai Framework for Disaster Risk Reduction 2015-2025 (SFDRR), highlights the fundamental role of health in disaster risk management (DRM) and emphasizes the need for scientific evidence in this area. In practice, the majority of attention to DRM has focused on preparedness and response. However, the long-term psychosocial impact and needs of survivors during the recovery phase have not been well documented nor have there been many studies about possible interventions.

Research Background

In cooperation with NCNP Japan (the institute leading this research), Hyogo Institute for Traumatic Stress and the WHO Kobe Centre Working Group for this project (including 21 Japanese experts) will conduct a comprehensive review of DRM in Japan with a focus on psychosocial interventions.

Research Outline

  1. Develop a review paper on policy and social innovations for disaster mental health in Japan based on gaps and needs for important natural
    disasters.
  2. Convene an expert consultation meeting to identify fundamental gaps in knowledge and required actions for better long-term mental health
    management for disaster survivors.
  3. Conduct a systematic literature review to understand global research gaps.
  4. Conduct a nationwide comprehensive survey of researchers, local/national government officers and NGO and community workers to
    complement and strengthen the key findings of the expert consultation.
  5. Integrate the results of the survey into the results of the consultation meeting and literature review to develop evidence-based policy
    suggestions.​

Goals

The project will

  1. Identify fundamental gaps in knowledge and required actions in long-term psychosocial management for disaster survivors.
  2. Contribute to evidence-based policy options for better long-term psychosocial management after disasters.
  3. Provide scientific evidence for health emergency and disaster risk management by sharing lessons and evidence from Japan.