Impact of Evacuation on the Long-Term Trend of Metabolic Syndrome after the Great East Japan Earthquake

Abstract

There has been an increase in lifestyle-related diseases in Fukushima Prefecture since the Great East Japan Earthquake. However, the overall long-term trends of lifestyle-related diseases in the Fukushima Prefecture according to the evacuation and other area are not reported. Therefore, we examined the long-term trends in the prevalence of metabolic syndrome before and after the Great East Japan Earthquake in Fukushima Prefecture according to these areas using a national database. The target population was approximately 330,000-440,000 per year; Fukushima Prefecture residents aged 40-74 years who underwent specific health check-ups during 2008-2017 participated in the study. Fukushima was divided into mountainous, central, coastal and evacuation areas. Using the Poisson regression model, the prevalence of metabolic syndrome in each fiscal year was determined by gender and age group for each location and compared before and after the disaster as well as between areas. Prevalence increased significantly throughout the observation period, particularly in the evacuation area. Age- and gender-adjusted prevalence rates significantly increased from 16.2% in 2010 to 19.5% in 2012 (prevalence ratios = 1.21) and 20.4% in 2017 in the evacuation area. Among other areas, coastal areas showed the highest increase with 17.9% (2017), followed by central areas with 16.5% (2017) and mountainous areas with 18.3% (2016). These increases were particularly high among men and the elderly. The prevalence of metabolic syndrome increased rapidly after the disaster, especially in evacuation area, and continued for subsequent 6-7 year. Long-term monitoring and measures to prevent lifestyle-related diseases are needed after major disasters, especially in evacuation areas, among men and the elderly.

Keywords: Fukushima; Great East Japan Earthquake; disaster; evacuation; metabolic syndrome; national database.

Figure 1

Mountainous area, central area, coastal area and evacuation area in Fukushima prefecture. Map of Japan highlighting Fukushima Prefecture. This study included all areas in Fukushima: Mountainous area (Aizu), central area (Naka-dori), coastal area (Hama-dori), and evacuation area.

Figure 2

Total prevalence of metabolic syndrome before and after the disaster (fiscal year 2008–2017). Trends in metabolic syndrome prevalence before (2008–2010) and after (2011–2017) the earthquake among four Fukushima areas and the national average. Significant differences in metabolic syndrome prevalence ratios compared with the reference period (2008–2010) are indicated using an asterisk (*). All probability values for statistical tests were two-tailed, and p < 0.05 was regarded as statistically significant.

Figure 3

Prevalence of metabolic syndrome before and after the disaster according to gender and age categories (fiscal year 2008–2017). Trends in metabolic syndrome prevalence before (2008–2010) and after (2011–2017) the earthquake among four Fukushima areas and the national average in men and women, and in older and younger age groups. Significant differences in metabolic syndrome prevalence ratios compared with the reference period (2008–2010) are indicated using an asterisk (*). All probability values for statistical tests were two-tailed, and p < 0.05 was considered as statistically significant.