Japan is facing a disaster striking the super-aged community
Authors: Hiroaki Saito, Morihito Takita, Toshiki Abe, Chika Yamamoto, Tianchen Zhao
Journal: The Lancet (2024)

A 7·6 magnitude earthquake followed by a tsunami struck the Noto Peninsula, Ishikawa, Japan, on Jan 1, 2024, which led to 245 deaths as of April 9, 2024·1Conroy G Japan earthquakes: the science behind the deadly tremors.Nature. 2024; 625: 228Crossref Scopus (0) Google Scholar, 2Crisis Management OfficeIshikawa PrefectureRegarding the status of damage caused by the 2024 Noto Peninsula earthquake (in Japanese).https://www.pref.ishikawa.lg.jp/saigai/documents/higaihou_120_0409_1400.pdfDate accessed: April 9, 2024Google Scholar This disaster has brought renewed attention to the critical challenges of managing disaster relief efforts in rapidly ageing populations. The epicentre of the earthquake, which hit the northern Noto region, stands out for its substantial population of older adults, where 50·1% of its residents are 65 years or older.3Ishikawa Statistical InformationEstimated population by age of Ishikawa prefecture.https://toukei.pref.ishikawa.lg.jp/search/detail.asp?d_id=4695Date accessed: January 28, 2024Google Scholar A lesson from the 2011 earthquake that hit Japan was the elevated mortality risk in the first month post-disaster due to pneumonia, stroke, heart disease, and cancer, along with injuries and wound infection.4Morita T Nomura S Tsubokura M et al.Excess mortality due to indirect health effects of the 2011 triple disaster in Fukushima, Japan: a retrospective observational study.J Epidemiol Community Health. 2017; 71: 974-980Crossref PubMed Scopus (34) Google Scholar, 5Morita T Tsubokura M Tanimoto T Nemoto T Kanazawa Y A need for tetanus vaccination before restoration activities in Fukushima, Japan.Disaster Med Public Health Prep. 2014; 8: 467-468Crossref Scopus (4) Google Scholar Approximately 30% of deaths in the period were due to pneumonia, indicating a mortality risk three to four times higher than pre-earthquake. This risk intensifies for the older population, particularly those in disrupted health-care settings such as hospitals and nursing homes. The risk of mortality in women aged over 85 years increased by 1·7–2·6 times in the 3 months following the earthquake.4Morita T Nomura S Tsubokura M et al.Excess mortality due to indirect health effects of the 2011 triple disaster in Fukushima, Japan: a retrospective observational study.J Epidemiol Community Health. 2017; 71: 974-980Crossref PubMed Scopus (34) Google Scholar These studies4Morita T Nomura S Tsubokura M et al.Excess mortality due to indirect health effects of the 2011 triple disaster in Fukushima, Japan: a retrospective observational study.J Epidemiol Community Health. 2017; 71: 974-980Crossref PubMed Scopus (34) Google Scholar, 5Morita T Tsubokura M Tanimoto T Nemoto T Kanazawa Y A need for tetanus vaccination before restoration activities in Fukushima, Japan.Disaster Med Public Health Prep. 2014; 8: 467-468Crossref Scopus (4) Google Scholar were performed in the Soma area, Fukushima, Japan, where 25·8% of residents were 65 years or older in 2010. Thus, special safeguards for older people are necessary for evacuees of the Noto earthquake. Beyond immediate threats, long-term consequences of evacuation, such as reduced physical activity, mental health decline, and social isolation, can substantially increase the risk of metabolic and psychiatric diseases. This increased risk is particularly pertinent for older evacuees. In Noto, evacuees prepare to transition from primary shelters, such as gymnasiums at public schools and welfare facilities, to secondary evacuation sites such as hotels and inns. Concurrently, local governments are constructing thousands of temporary housing units. Another insight from the 2011 earthquake highlights the importance of preventive measures, including group exercises, community gatherings, and shared houses called idobata-nagaya. The traditional Japanese communal living style of idobata-nagaya offers an approach to prevent social isolation among evacuees during and after disasters.6Abe T Saito H Moriyama N et al.Idobata-Nagaya: a community housing solution for socially isolated older adults following the great East Japan earthquake.Front Public Health. 2023; 111289552Crossref Scopus (0) Google Scholar These measures are aimed at supporting the long-term health and wellbeing of older individuals. Disaster relief efforts in regions with a higher population of older adults are an emerging global concern as many high-income countries face accelerated population ageing. It is crucial to build the resilience of the community by learning from the Noto disaster as well as past experiences to ensure the health, safety, and wellbeing of ageing populations in future disasters. We declare no competing interests.