Lifestyle-related factors that explain disaster-induced changes in socioeconomic status and poor subjective health: a cross-sectional study from the Fukushima health management survey

• Main Authors: Masato Nagai (Author), Tetsuya Ohira (Author), Wen Zhang (Author), Hironori Nakano (Author), Masaharu Maeda (Author), Seiji Yasumura (Author), Masafumi Abe (Author), Fukushima Health Management Survey (Author)
• Format: Book
• Published: BMC, 2017-04-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1186/s12889-017-4247-2; 1471-2458
• Keywords: Socioeconomic status; Subjective health; Disaster; Lifestyle; Public aspects of medicine; RA1-1270
• Source: BMC Public Health, Vol 17, Iss 1, Pp 1-9 (2017)

Abstract Background Socioeconomic status (SES) and lifestyle-related factors are determinants of subjective health. However, changes in SES are inevitable in times of natural disaster, while lifestyle-related factors remain modifiable. The aim of this study was to use a cross-sectional approach to examine lifestyle-related factors that may attenuate the negative impact of disaster-induced changes in SES on poor subjective health. Methods We analyzed 33,350 men and women aged 20-64 years who were living in evacuation zones due to the radiation accident in Fukushima, Japan. Disaster-induced changes in SES were defined by living arrangements and working conditions. Using Poisson regression analysis adjusted for confounders (model 1) and lifestyle-related factors as intermediate variables (model 2), we compared the prevalence ratios (PRs) of poor subjective health of participants who did not undergo disaster-induced changes in SES (did not become unemployed, income did not decrease, and living in relative's home/own home) with that of participants who did undergo disaster-induced changes in SES (became unemployed, decreased income, or lived in an evacuation shelter, temporary housing, or rental housing/apartment). We calculated the percentage of excess risks explained by lifestyle-related factors as follows: ((PRmodel 1 − PRmodel 2)/(PRmodel 1-1)) × 100. Results Disaster-induced changes in SES were significantly associated with poor subjective health. The PRs (95% CIs) among participants who underwent disaster-induced changes in SES were 2.02 (1.81-2.24) for men and 1.80 (1.65-1.97) for women. After adjusting for lifestyle-related factors, we found that the PRs in men and women were remarkably attenuated, decreasing to 1.56 (1.40-1.73) and 1.43 (1.31-1.55), respectively. Controlling for lifestyle-related factors resulted in PR attenuation by 45.1% (men) and 46.3% (women). Satisfaction of sleep and participation in recreation and community activity particularly contributed to this attenuation. Conclusions While disaster-induced changes in SES are unavoidable, lifestyle-related factors have the potential to attenuate the impact of these changes on poor subjective health.