Association between relocation and changes in cardiometabolic risk factors: a longitudinal study in tsunami survivors of the 2011 Great East Japan Earthquake

Objectives The aim of this study is to determine changes in atherosclerotic cardiovascular risk factors with and without serious disaster-related mental and socioeconomic problems represented by relocation (REL). Design A longitudinal survey. Setting Multiphasic health check-ups for the general population affected by the 2011 Great East Japan Earthquake and Tsunami. Participants A total 6528 disaster survivors in heavily tsunami-damaged municipalities were recruited. Two sequential surveys were conducted and the data were analysed. Main outcome measures Multiphasic health check-ups including investigation of lifestyle and psychological and socioeconomic measures were performed in two sequential phases (8 and 18months) after the disaster for tsunami survivors with REL (n=3160) and without REL (n=3368). Longitudinal changes in cardiometabolic risk factors between the two phases were compared in the REL and non-REL groups. Results In sex/age-adjusted analysis, we found increases in body weight and waist circumference between the two phases that were significantly greater in the REL group than in the non-REL group (body weight:+0.31 (0.23 approximate to 0.39) versus -0.24 (-0.32 approximate to-0.16) kg, p<0.001; waist circumference:+0.58 (0.48 approximate to 0.68) versus+0.05 (-0.05 approximate to 0.15) cm, p<0.001)). A decrease in serum HDLC levels was found and again was significantly greater in the REL group than in the non-REL group (-0.65 (-0.96 approximate to-0.34) versus -0.09 (-0.39 approximate to 0.21) mg/dL, p=0.009). In addition, deterioration in physical activity, mental health and socioeconomic status was more prevalent in the REL group than in the non-REL group (all p<0.001). Conclusions This study suggests that relocation after the devastating tsunami was related to weight gain and decreasing HDLC among survivors, and this change was associated with prolonged psychological distress and socioeconomic problems after the disaster.