Effects of parity on the associations between evacuation and psychological distress and cardiovascular disease among women after the Great East Japan Earthquake : A cross-sectional study of the Fukushima Health Management Survey

Abstract

　Introduction : Women are more likely to be physically, mentally, and socially vulnerable after disasters because of the physical, socioeconomical, and lifestyle-related factors that are often related to their parity. Here, we analyzed the effects of women's parity on the association between evacuation and psychological distress, trauma reactions, and cardiovascular disease (CVD).
　Participants and Methods : The participants were residents living in 13 municipalities in the evacuation zone of Japan's Fukushima Prefecture after the March 11, 2011 Great East Japan Earthquake who responded to the Fukushima Health Management Survey in FY2012. A total of 30,709 women aged 40-90 years were included in the analyses. We performed a logistic regression analysis to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for CVD risk factors.
　Results : A multivariate analysis revealed that among the parous women (n = 19,608), evacuation was associated with psychological distress (adjusted OR 1.30, 95%CI : 1.17-1.44), trauma reactions (OR 1.22, 95%CI : 1.11-1.35), and heart disease (OR 1.14, 95%CI : 1.03-1.26) compared to the non-evacuation status. Among the nulliparous women (n = 1,794), there was no association between the evacuation and any outcomes.
　Conclusion : The evacuation of individuals after the Great East Japan Earthquake was associated with psychological distress, trauma reactions, and heart disease, especially among parous women.