{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T21:20:52Z","timestamp":1776979252299,"version":"3.51.4"},"reference-count":40,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T00:00:00Z","timestamp":1603670400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Network-type Joint Usage\/Research Center for Radiation Disaster Medical Science","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Evidence regarding the effect of psychological factors and evacuation on cardiovascular disease occurrence after large-scale disasters is limited. This prospective study followed up a total of 37,810 Japanese men and women aged 30\u201389 years from the Fukushima Prefecture with no history of stroke or heart disease at baseline (2012), until 2017. This period included 3000 cardiovascular events recorded through questionnaires and death certificates. The participants\u2019 psychological distress, trauma reaction, and evacuation status were defined, and divided into four groups based on combinations of psychological factors and evacuation status. We calculated the hazard ratios and 95% confidence intervals for only psychological, only evacuation, or both of them compared with neither using Cox proportional hazard models. Psychological factors along with evacuation resulted in approximately 5% to 25% higher magnitude of stroke and heart disease risk than psychological factors only among men. Compared to neither, the multivariable hazard ratios of those with both psychological distress and evacuation were 1.75 for stroke and 1.49 for heart disease, and those of both trauma reaction and evacuation were 2.01 and 1.57, respectively, among men. Evacuation combined with psychological factors increased the risk of stroke and heart disease risks especially in men after the Great East Japan Earthquake.<\/jats:p>","DOI":"10.3390\/ijerph17217832","type":"journal-article","created":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T10:38:35Z","timestamp":1603708715000},"page":"7832","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Association between Psychological Factors and Evacuation Status and the Incidence of Cardiovascular Diseases after the Great East Japan Earthquake: A Prospective Study of the Fukushima Health Management Survey"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4486-8621","authenticated-orcid":false,"given":"Toshiki","family":"Sanoh","sequence":"first","affiliation":[{"name":"Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1598-1847","authenticated-orcid":false,"given":"Eri","family":"Eguchi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4532-7165","authenticated-orcid":false,"given":"Tetsuya","family":"Ohira","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan"},{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6888-6640","authenticated-orcid":false,"given":"Fumikazu","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan"},{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaharu","family":"Maeda","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan"},{"name":"Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4715-2840","authenticated-orcid":false,"given":"Seiji","family":"Yasumura","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan"},{"name":"Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuriko","family":"Suzuki","sequence":"additional","affiliation":[{"name":"National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyos 187-0031, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2668-129X","authenticated-orcid":false,"given":"Hirooki","family":"Yabe","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan"},{"name":"Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0568-8361","authenticated-orcid":false,"given":"Atsushi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan"},{"name":"Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanae","family":"Takase","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan"},{"name":"Department of Community Health and Public Health Nursing, Fukushima Medical University School of Nursing, Fukushima 960-1295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7755-1888","authenticated-orcid":false,"given":"Mayumi","family":"Harigane","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan"},{"name":"Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6244-1763","authenticated-orcid":false,"given":"Takashi","family":"Hisamatsu","sequence":"additional","affiliation":[{"name":"Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiki","family":"Ogino","sequence":"additional","affiliation":[{"name":"Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan"},{"name":"Department of Environmental Medicine, Cooperative Medicine Unit, Research and Education Faculty, Medicine Science Cluster, Kochi Medical School Kochi University, Kochi 783-8505, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideyuki","family":"Kanda","sequence":"additional","affiliation":[{"name":"Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Kamiya","sequence":"additional","affiliation":[{"name":"Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan"},{"name":"Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 734-8553, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"375","DOI":"10.2188\/jea.JE20120105","article-title":"Study protocol for the Fukushima Health Management Survey","volume":"22","author":"Yasumura","year":"2012","journal-title":"J. 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