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This study aimed to investigate the prevalence of heart failure (HF) among adults aged ≥ 40 years using health checkup and medical claim data in Fukushima from 2015 to 2021. Joinpoint regression and age-period-cohort analyses were conducted to estimate temporal trends. Age-standardized prevalence and hospital admission rates for HF were 37.0 and 7.4/1000 and 25.9 and 5.3/1000 for men and women, respectively. The prevalence was significantly higher in the coastal area and evacuation zone designated after the 2011 disaster compared to the prefecture overall. In men, the prevalence increased continuously, with an average annual percentage change (AAPC) ranging from 0.72% (evacuation zone) to 1.15% (mountainous area) ( P  < 0.05). In total residents, the AAPC was significant only in the mountainous areas (0.78%, P  = 0.021). Age-period-cohort analysis showed a net drift of 2.50% (95% CI 1.88–3.13%) in men and 0.76% (95% CI − 0.17–1.70%) in women. Cohort rate ratios increased significantly in men born between 1925 and 1975, while in women, they decreased for those born between 1925 and 1960 but increased for those born between 1960 and 1970. The prevalence of HF varied across post-disaster areas of Fukushima. Given that pathological changes and modifiable risk factors for HF accumulate gradually, continuous monitoring among middle-aged adults is essential to enable timely prevention and targeted intervention.

Personal values developed in adolescence may influence mental health and well-being over the life course. Using data from 684 respondents in the Youth Development Study (61.9% of respondents in the baseline survey), we explored the effects of work values at ages 14–15 on positive and negative emotions, as well as psychological resources (self-esteem and mastery), at ages 37–38. We adjusted for socioeconomic status and the baseline scores of these outcomes using linear regression analyses. Having the work value of getting ahead in adolescence was positively associated with self-esteem in adulthood. Work values in adolescence did not predict positive emotions, negative emotions, or mastery in adulthood. Valuing one’s growth in adolescence may help develop self-esteem in adulthood.

Background: To develop an empirically informed support measure for workers, we examined mental health distress and its risk factors among prefectural public servants who were affected by the Great East Japan Earthquake and faced a demanding workload in the midterm of the disaster. Methods: We conducted a self-administered health survey of all public servants in the Miyagi prefectural government two and seven months after the Great East Japan Earthquake (3743 workers, 70.6% of all employees). We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for mental distress (defined as K6 score ≥10) in the domain of disaster-work-related stressors, work-related stressors, and disaster-related stressors. Results: Among those with better levels of workplace communication, the only factor that increased the risk of mental distress was not taking a non-work day each week (adjusted OR 2.55, 95% CI 1.27-5.14). Among those with poorer levels of workplace communication, in addition to not taking a non-work day each week (adjusted OR 3.93, 95% CI 3.00-5.15), handling residents' complaints (adjusted OR 1.55, 95% CI 1.00-2.42), having dead or missing family members (adjusted OR 2.87, 95% CI 1.53-5.38), and living in a shelter more than two months after the disaster (adjusted OR 2.80, 95% CI 1.32-5.95) increased the risk of mental distress. Conclusions: All workers should be encouraged to take a non-work day each week. Among workers with poor workplace communication, special attention should be given to those who handle residents' complaints, have lost a family member(s), and are living in a shelter for a prolonged period of time.

[Abstract]: [Objectives]: To examine whether disaster-related variables, in addition to known work-related risk factors, influence burnout and its subscales (exhaustion, cynicism, and lack of professional efficacy) among public servants who experienced a major disaster. [Methods]: Cross-sectional studies were conducted among public servants of Miyagi prefecture at 2 and 16 months after the Great East Japan Earthquake (n=3,533, response rate 66.8%); burnout was assessed at 16 months using the Japanese version of the Maslach Burnout Inventory-General Survey. We examined the relationships between burnout and its subscales with disaster-related variables at 2 months after the disaster, while controlling for age, gender, and work-related variables at 16 months after the disaster. [Results]: After controlling for age, gender, and work-related variables, a significant risk factor of burnout was having severe house damage. For the each subscale of burnout, living someplace other than their own house increased the risk of both exhaustion and cynicism, while handling residents' complaints did so only for exhaustion. Notably, workers from health and welfare departments showed an increased risk of burnout, exhaustion, and cynicism, but not lack of professional efficacy. [Conclusions]: The findings suggest that special attention is needed for workers with severe house damage to prevent burnout, as well as those who lived someplace other than their own house to prevent exhaustion and cynicism after a major disaster. Interventions directed at workers of the health and welfare department should focus more on limiting exhaustion and cynicism, rather than promoting professional efficacy.

After the Fukushima Daiichi Nuclear Power Plant accident in March 2011, residents perceived a radiation exposure risk. To address the concerns about radiation exposure and the subsequent effects on their health, we developed the gatekeeper training program for radiation health anxiety and mental health issues. The program consisted of a presentation and roleplay, with educational objectives to the increase knowledge and understanding around radiation health anxiety, alcoholism, depression, and suicide. Twenty-six counselors participated in the program as a single-arm intervention. To measure the outcomes, the subjects reported self-confidence when they counselled with residents with radiation health anxiety and other mental health issues. Comparing the answers to pre- and 2-month follow-up surveys, the confidence levels were higher after 2 months than at baseline, especially for the question “How confident are you at supporting a resident with mental health issues?”, which showed the largest increase (p < 0.001). Regarding radiation health anxiety the questions “Can you communicate coping skills to a resident with radiation health anxiety?” (p = 0.007) and “Can you refer a resident with radiation health anxiety to professionals who can cope appropriately?” (p = 0.016) showed significant increases in their confidence levels. This program could be useful for on-going health activities and future nuclear disasters.

Background Worry about radiation is a long-lasting concern among community residents after a nuclear power plant accident. We aimed to explore the reasons behind this persistent worry based on descriptions collected from the affected population. Methods We analyzed the descriptions provided in a questionnaire survey by those who worried about radiation even seven years after the 2011 Fukushima nuclear power plant accident. We divided the 422 respondents into three groups according to their change in worry since the accident: those whose worry increased ( N  = 40), remained unchanged ( N  = 179), and decreased ( N  = 203). Among them, 35 (87.5%), 141 (78.8%), and 152 (74.9%) respondents described the reasons for their increased, unchanged, and decreased worry about radiation, respectively. Using content analysis, we categorized the descriptions within each group. Results A characteristic category in the increased worry group was “the increase in worry due to the increase in knowledge and information.” Some in this group referred to their “current health conditions” as well, which deteriorated after the accident. While many in the decreased worry group referred to the passage of time and the implemented countermeasures for radiation contamination, those in the unchanged worry group pointed to the “unchanged circumstances” after the accident. Conclusions Even when countermeasures for radiation contamination had been implemented and information on radiation had been disseminated, those who did not recognize that these changes have been made since the disaster might keep their worry about radiation, and some might increase their worry by having new information or health problems that occurred after the accident.

We aimed to investigate the relationships between use of media to obtain information on radiation and radiation anxiety among community residents in Fukushima, 5.5 years after the nuclear power plant accident. A questionnaire survey was administered between August and October 2016 to 2000 randomly sampled residents in Fukushima prefecture. Radiation anxiety toward health and regarding discrimination and prejudice were assessed with 4- and 3-item scales, respectively. Participants nominated their most-used media for acquiring information on radiation by choosing up to 3 sources from 12 information sources listed (eg, local newspaper, TV news, websites, social networking sites [SNS], local government newsletter, word of mouth). We investigated associations of most-used media types and radiation anxiety, controlling for sociodemographic characteristics and anxiety regarding radiation's health effects immediately after the accident, using multivariate linear regression analyses. Valid responses were obtained from 790 (39.5%) residents. Acquiring information about radiation by word of mouth was related to higher radiation anxiety toward health. Regarding radiation anxiety concerning discrimination and prejudice, SNS use was related to higher anxiety, whereas acquiring information through Nippon Hoso Kyokai (NHK) TV news was related to lower anxiety. Interpersonal interactions rather than gaining information from media - characterized by unidirectional information exchange - may increase radiation anxiety.

Background Obesity indices that combine anthropometric and lipid measurements, such as the atherogenic index of plasma (AIP), cardiometabolic index (CMI), lipid accumulation product (LAP), metabolic score for insulin resistance (Mets-IR), triglyceride-glucose (TyG) index, and visceral adiposity index (VAI), have been recommended as surrogates for assessing cardiometabolic risk. This study aimed to examine the association between these indices and type 2 diabetes mellitus (T2DM) incidence risk using large routine health checkup data. Methods This retrospective cohort study involved 195,989 participants aged 35–74 years who attended the Specific Health Checkups in 2015 and were observed until 2021 in Fukushima, Japan. We used multivariable Cox regression analysis to examine the associations between the indices and T2DM risk and evaluated the diagnostic utility of the indices. Results The accumulated T2DM incidence rate per 100,000 person-years over a mean follow-up of 4.61 years was 706.6 in males and 441.2 in females. Multiple adjusted hazard ratios were significantly higher in the highest quartile of indices (1.33–4.22 fold higher) compared to the lowest quartile. The increased risk in the higher quartiles was more pronounced in participants aged < 50 years than in those aged ≥ 50 years for both sexes. The areas under the receiver operating characteristic curves (AUC) of AIP, CMI, LAP, and VAI were between 0.821 and 0.844, whereas those of Mets-IR and TyG were between 0.756 and 0.780. For both sexes, AUCs for AIP, CMI, and LAP showed no significant differences ( P values > 0.05), but other pairwise indices had significant differences ( P values < 0.001). AUCs were higher in participants with a body mass index (BMI) of < 25 kg/m 2 or aged < 50 years than in those with a BMI ≥ 25 kg/m 2 or aged ≥ 50 years, respectively. Net reclassification improvements of models for CMI and LAP were similar to AIP, while those for Mets-IR, TyG, and VAI were significantly lower than AIP. Conclusions Obesity indices are positively associated with and applicable for predicting new-onset T2DM in Japanese adults, particularly AIP, CMI, and LAP.

Worry about radiation persists long after nuclear power plant accidents. Young age, low socioeconomic status, being married, and disaster-related experiences are known to be associated with greater worry about radiation. This study explored the duration of the effects of these risk factors on worry about radiation after the 2011 Fukushima nuclear power plant accident, using the longitudinal data of randomly sampled non-evacuee community residents who were followed five to ten years after the accident. Questionnaire surveys were conducted five times with 1825 respondents (37.2% of the 4900 initial targets). We examined the interaction of time and risk factors of worry about radiation using a mixed model. Fear or anxiety immediately after the accident had effects on worry about radiation that continued even after 10 years, though it slightly attenuated with time. Family problems stemming from the disaster retained their effects. While direct damage and evacuation experience were significantly associated with worry about radiation in the early phase, their effects diminished and became non-significant during the study period. Being under the age of 65, having low educational attainment, and being married were significantly associated with worry about radiation, although the association with age weakened over time. Individuals who experience intense fear or anxiety post-nuclear power plant accidents or disaster-related family problems may need continuous monitoring for their worry about radiation even 10 years after such accidents.

Background People living in temporary housing for long periods after a disaster are at risk of poor mental health. This study investigated the post-disaster incidence and remission of common mental disorders among adults living in temporary housing for the 3 years following the 2011 Great East Japan Earthquake. Methods Three years after the disaster, face-to-face interviews were conducted with 1089 adult residents living in temporary housing in the disaster area, i.e., the shelter group, and a random sample of 852 community residents from non-disaster areas of East Japan. The World Health Organization Composite International Diagnostic Interview was used to diagnose DSM-IV mood, anxiety, and alcohol use disorders. Information on demographic variables and disaster experiences was also collected. Results Response rates were 49 and 46% for the shelter group and the community residents, respectively. The incidence of mood/anxiety disorder in the shelter group was elevated only in the first year post-disaster compared to that of the general population. The rate of remission for mood and anxiety disorders was significantly lower in the shelter group than in the community residents. The proportion seeking medical treatment was higher in the shelter group. Conclusions The onset of common mental disorders increased in the first year, but then levelled off in the following years among residents in temporary housing after the disaster. Remission from incident post-disaster mental disorders was slower in the shelter group than in the general population. Post-disaster mental health service could consider the greater incidence in the first year and prolonged remission of mental disorders among survivors with a long-term stay in temporary housing after a disaster.