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Citation
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Suzuki R, Tsubota-Utsugi M, Sasaki R, Shimoda H, Fujino Y, Ikaga T, Kano T, Sakata K. Nippon Koshu Eisei Zasshi 2022; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE Over the course of their lives, people spend most of their time in the home environment. The Community-based Integrated Care System 2018 by the Ministry of Health, Labour and Welfare in Japan declared the importance of "housing" and "living arrangements" as essential elements to enable older adults to live independently and to protect their privacy and dignity in their communities. The present study aims to clarify the relationship between current housing type and "housing" and "living arrangements" among older survivors of the Great East Japan Earthquake (GEJE).
METHODS We used data obtained from 3,856 participants, aged 65 years or older, in the Research project for prospective Investigation of health problems Among Survivors of the GEJE (RIAS). Housing types were categorized as follows: "same housing," "temporary housing," "disaster public housing," "new housing" (in a different area), and "others." Healthy housing scores were calculated using a housing health checklist from the Nationwide Smart Wellness Housing Survey in Japan. "Living arrangements" were assessed based on residential status, social network, and social capital. To determine the risks associated with each "housing" and "living arrangement" category, we used multivariate logistic and linear regression models.
RESULTS The number of participants in each housing type was as follows: 2,531 in "same housing," 146 in "temporary housing," 234 in "disaster public housing," 844 in "new housing," and 101 in "others." Compared with those living in "same housing," those living in "disaster public housing," "new housing," and "others" had a significantly higher healthy housing score, whereas those living in "temporary housing" had a lower score. However, with regards to "living arrangements," the number of residents who were living alone was significantly higher among those in "disaster public housing," and those living in "disaster public housing" as well as "new housing" had low social capital compared with those living in "same housing." The likelihood of having a poor social network was substantially higher for those living in "disaster public housing." Sub-scale analyses indicated that "disaster public housing" was associated with less family support, whereas "new housing" was associated with less support from friends.
CONCLUSION The present results indicate that older survivors-regardless of whether they live in the existing community-find it challenging to establish new social capital and social networks in a new location without the presence of "someone" they knew before the disaster.
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目的 「住まい」は人が最も長く曝露を受ける場である。厚生労働省は地域包括ケアシステムの取り組みの中で，土台としての高齢者のプライバシ—と尊厳が十分に守られた住環境，すなわち騒音やカビ等の「住まい（以下「物理環境」）」，住居状況や社会的支援等の関わりの「住まい方（以下「社会環境」）」の重要性を基本的要素として掲げている。本研究は，災害公営住宅への移転も進んだ2018年度の被災高齢者を対象に，現在の住居形態と「物理環境」「社会環境」の関連を明らかにすることを目的とした。
方法 2011年度に岩手県沿岸部で実施した大規模コホート研究（RIAS Study）に参加した65歳以上のうち，2018年度調査票の回答者3,856人を対象とした。現在の住居形態に関する設問から住居形態は以下の分類とした:“震災前と同じ（同所再建含）”，“仮設・みなし仮設”，“災害公営住宅”，“新所新築”，“その他”。「物理環境」については，国土交通省が行うスマートウェルネス住宅等推進調査事業における住宅健康チェックリストを用い，「社会環境」については，RIAS調査票より，独居，ソーシャルネットワーク，ソーシャルキャピタルについて評価した。“震災前と同じ（同所再建含）”と比較した他の住居形態と，「物理環境」「社会環境」の各項目の関連を，多変量ロジスティック回帰分析，重回帰分析より検討した。
結果 最終的な解析対象は3,856人（男性39.1％，平均年齢74.6歳）であった。住居形態と「物理環境」の関連では，震災前と同じ群と比較し，新所新築，災害公営住宅，その他の群で住まいの健康度が高く，仮設・みなし仮設群の健康度が低かった。一方，「社会環境」との関連では，震災前と同じ群と比較し，災害公営住宅群で独居者が有意に多く，災害公営住宅，新所新築群でソーシャルキャピタルが有意に低かった。また，ソーシャルネットワークでは，震災前と同じ群と比較し，災害公営住宅群で有意に低く，サポートの内訳では，災害公営住宅群では家族からのサポート，新所新築群では友人からのサポートが有意に低かった。
結論 高齢者においては，特に既存コミュニティの有無にかかわらず新たな土地でソ—シャルキャピタルやソーシャルネットワークを築くことが難しいことが示された。地域に出るきっかけづくりを含む，長期的な高齢者支援のあり方について早急な取り組みが求められる。
Language: ja |