title: Impact of the 2011 Great East Japan Earthquake and Tsunami on functional disability among older people: a longitudinal comparison of disability prevalence among Japanese municipalities.
abstract: OBJECTIVE
  To examine the hypothesis that disability prevalence has increased to a greater degree in the areas severely affected by the earthquake and tsunami of 11 March 2011 than in other areas.
  
  
  METHODS
  Longitudinal analysis using public statistics data from the Ministry of Health, Labour and Welfare in Japan. The analysis included 1549 municipalities covered by the Long-term Care Insurance (LTCI) system. 'Disaster areas' were defined as three prefectures (Iwate, Miyagi, Fukushima). The outcome measure was the number of aged people (≥65 years) with LTCI disability certification. Rates of change in disability prevalence from February 2011 to February 2012 were used as the primary outcome variable, and were compared by analysis of covariance between 'Coastal disaster areas', 'Inland disaster areas' and 'Non-disaster areas'.
  
  
  RESULTS
  Regarding disability prevalence at all levels, the mean value of the increase rate in Coastal disaster areas (7.1%) was higher than in Inland disaster areas (3.7%) and Non-disaster areas (2.8%) (p<0.001).
  
  
  CONCLUSIONS
  The areas that were severely affected by the earthquake and tsunami had a significantly higher increase in disability prevalence during the 1 year after the earthquake disaster than other areas.
authors.affiliation: Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, , Sendai, Japan.
authors.forename: Yasutake
authors.initials: Y
authors.lastname: Tomata
authors.forename: Masako
authors.initials: M
authors.lastname: Kakizaki
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Shuji
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Miyuki
authors.initials: M
authors.lastname: Kawado
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tsuji
mesh_terms: D000368:Aged; D004185:Disability Evaluation; D004190:Disasters / Q000706:statistics & numerical data*; D055866:Earthquakes / Q000706:statistics & numerical data*; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008134:Long-Term Care / Q000592:standards / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D015995:Prevalence; D057192:Tsunamis / Q000706:statistics & numerical data*
keywords: DISABILITY; DISASTER RELIEF; EPIDEMIOLOGY; GERONTOLOGY