Mitigation of disasters through community cohesion
Authors: Carol Brayne
Journal: The Lancet Planetary Health (2017)

The 2011 Great East Earthquake and consequent tsunami that hit Japan was an event in a high-income country with considerable capacity to handle disaster. But the involvement of the nuclear power station positioned for cooling on the coast made it that much worse. The immediate disaster was clear globally, and has been followed by national and international analysis of acute responses for each type of event (earthquake, tsunami, and nuclear power station failure), including population health protection and societal responses for the aftermath of destruction of infrastructure, deaths, health impacts, and displacements. This is challenging and costly for any individual nation. Going further and assessing long-term impact is even less straightforward. How do we really know what the effects on populations of disaster, whether man-made or natural, will be, or the increasing likelihood of the two intimately entangled? These will be short, medium, and long term and will be influenced by many factors, including wealth of nations, culture, social capital, coherence, and investment in infrastructure before and after. Earlier research from other disasters has suggested that disruption to the living environment and social environment can be followed by major long-term distress. Rarely though is there the opportunity to examine individuals across the time of a disaster and to examine carefully potential mitigating as well as exacerbating influences. The study published here by Hiroyuki Hikichi and colleagues1Hikichi H Tsuboya T Aida J et al.Social capital and cognitive decline in the aftermath of a natural disaster: a quasi-experiment from the 2011 Great East Japan Earthquake and Tsunami.Lancet Planet Health. 2017; 1: e105-e113Summary Full Text Full Text PDF Scopus (65) Google Scholar in The Lancet Planetary Health uses the opportunity provided by the existence of a routine health survey within Japan, which is done at regular intervals and collected wider data too, to undertake a before and after analysis of key factors that could be affected by the consequences of the disaster, but also those factors that might mitigate negative outcomes. This builds on an earlier analysis, which suggests that there is some, limited, cognitive deterioration related to housing damage in those re-interviewed at 2 and a half years after the event. In the analysis presented here, social capital is explored using the existing data marshaled into factors with a cognitive dimension and a structural dimension. These are characterised as perceptions of community cohesion and informal socialising and social participation, respectively. These factors showed that the second concept, not the first, mitigated the impact of housing damage on incidence of cognitive impairment. There are potential caveats and limitations to this work, which include the availability of data for individuals before and after, the particular area chosen, the exact measures which have been taken to measure mitigating and exacerbating factors, as well as the outcome measurement of cognition. But the finding is robust and no other study can be put in place to provide better data. This type of research is to be welcomed. It is important that we understand better how societies do mitigate adverse outcomes following adverse events. These have happened to Homo sapiens and our forebears since time immemorial, and are part of our evolution as a species. However, it seems likely that with the pressures on global resources, increasing societal uncertainty and conflicts, increasing life expectancy, and the way that man-made influences such as climate change are coming together over this decade and those to come will increase in frequency. There is an important research agenda, which has been noted for post conflict societies, including generational populations living as refugees, as having profound impact on children and potentially their whole lives. In addition to this enormously important attention, we need to pay attention to how we, as whole societies, best mitigate the disasters that will come, and how this mitigation relates to contextual and cultural factors. The research that is needed includes transdisciplinary work, capacity investment, and the kinds of background investment that has allowed Japan to inform the world on the impact of a particular type of disaster. Such a strengthening of our capacity and the discussions that lead to this and are informed by such new capacity should have wider global benefits. Our disaster planning should be better and perhaps it will also help, through evidence, to shift our politicians and wider systems to address the upstream issues to work collectively and more effectively to anticipate those events that could be mitigated and, indeed, avoidable. I declare no competing interests. Social capital and cognitive decline in the aftermath of a natural disaster: a natural experiment from the 2011 Great East Japan Earthquake and TsunamiImproved informal socialising and social participation reduces the risk of cognitive decline due to housing damage in the aftermath of natural disasters. Interventions to promote civic participation should be tried to promote cognitive resilience of older survivors. Full-Text PDF Open Access