2019 Volume 68 Issue 2 Pages 111-125
Introduction: Disaster Health Assistance Team (DHEAT) was launched in 2018. Overviews of preparedness and responses regarding disasters and medical surges in Japan were conducted from the viewpoint of community health to improve prospects for scientific practice and assessment.
Methods: Surveys of (1) major disasters, measures, academic papers, Health and Labour Science Research studies, and Community Health Promotion Projects for 30 years, (2) the Public Health Monitoring Report (MR) Committee Report, and (3) activities in community health were conducted.
Results: (1) Post-action reviews have not always been implemented though the guidelines pointed out the necessity to do so. The numbers of papers on both public health and other related fields have been increasing after the Kumamoto earthquake, while only a few papers have described how to improve the coordination system among multiple fields, despite the fact that the supply and demand coordination malfunction is significant. Local governments affected by disasters, namely local governments who accept DHEAT, are responsible for managing their own initiatives. (2) According to the MR Committee Report, there have been few papers on objective analyses for preparedness and response, if any, and those papers are restricted in terms of access. The report has also clarified that each field-specific preparedness and response without an integrated system is insufficient, that each field has initiated practical strengthening of preparedness and response, and that Incident Management Systems should be promoted collaboratively in the industry-academic-government integrated system. The academic background that strengthens organizations to overcome scarcity is also necessary. To conquer these issues, consistent knowledge management in the pre-emergency, emergency and post-emergency periods, standardization of criteria and assessment, maintenance of universality and variability, establishment of academic background, and management of resources and logistics for manpower training and sustainable development are needed. (3) Many precedents are found in community health activities aimed toward improvement. The establishment of Incident Management Systems, including information gathering/analysis/decision-making/action/assessment cycles and academic support, is necessary in order to make preparations and respond to all hazards.
Conclusions: As not all public health centers or local governments have experienced disasters and medical surges, limited responses should be inevitable without systematic academic support. For the time being, the support reception system and the hub function system should be organized. Academic support systems should be investigated with advanced preparedness and response methods in foreign countries. The measures are expected to count preparedness and response reviews from present community health and academic investigations, and steer preparedness and response in Japan for a better future.
