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Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study

OBJECTIVES: To examine associations between access to medical care, geological data, and infant and child mortality in the area of North-Eastern Japan that was impacted by the Great East Japan Earthquake and Tsunami (GEJET) in 2011. DESIGN: A population-based ecological study using publicly availabl...

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Autores principales: Tashiro, Ai, Sakisaka, Kayako, Okamoto, Etsuji, Yoshida, Honami
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254400/
https://www.ncbi.nlm.nih.gov/pubmed/30478111
http://dx.doi.org/10.1136/bmjopen-2018-022737
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author Tashiro, Ai
Sakisaka, Kayako
Okamoto, Etsuji
Yoshida, Honami
author_facet Tashiro, Ai
Sakisaka, Kayako
Okamoto, Etsuji
Yoshida, Honami
author_sort Tashiro, Ai
collection PubMed
description OBJECTIVES: To examine associations between access to medical care, geological data, and infant and child mortality in the area of North-Eastern Japan that was impacted by the Great East Japan Earthquake and Tsunami (GEJET) in 2011. DESIGN: A population-based ecological study using publicly available data. SETTING: Twenty secondary medical areas (SMAs) in the disaster-affected zones in the north-eastern prefectures of Japan (Iwate, Fukushima and Miyagi). Participants: Children younger than 10 years who died in the 20 SMAs between 2008 and 2014 (n=1 748). Primary and secondary outcome measures: Multiple regression analysis for infant and child mortality rate. The mean values were applied for infant and child mortality rates and other factors before GEJET (2008–2010) and after GEJET (2012–2014). RESULTS: Between 2008 and 2014, the most common cause of death among children younger than 10 years was accidents. The mortality rate per 100 000 persons was 39.1±41.2 before 2011, 226.7±43.4 in 2011 and 31.4±39.1 after 2011. Regression analysis revealed that the mortality rate was positively associated with low age in each period, while the coastal zone was negatively associated with fewer disaster base hospitals in 2011. By contrast, the number of obstetrics and gynaecology centres (β=−189.9, p=0.02) and public health nurses (β=−1.7, p=0.01) was negatively associated with mortality rate per person in 2011. CONCLUSIONS: In 2011, the mortality rate among children younger than 10 years was 6.4 times higher than that before and after 2011. Residence in a coastal zone was significantly associated with higher child mortality rates.
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spelling pubmed-62544002018-12-11 Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study Tashiro, Ai Sakisaka, Kayako Okamoto, Etsuji Yoshida, Honami BMJ Open Public Health OBJECTIVES: To examine associations between access to medical care, geological data, and infant and child mortality in the area of North-Eastern Japan that was impacted by the Great East Japan Earthquake and Tsunami (GEJET) in 2011. DESIGN: A population-based ecological study using publicly available data. SETTING: Twenty secondary medical areas (SMAs) in the disaster-affected zones in the north-eastern prefectures of Japan (Iwate, Fukushima and Miyagi). Participants: Children younger than 10 years who died in the 20 SMAs between 2008 and 2014 (n=1 748). Primary and secondary outcome measures: Multiple regression analysis for infant and child mortality rate. The mean values were applied for infant and child mortality rates and other factors before GEJET (2008–2010) and after GEJET (2012–2014). RESULTS: Between 2008 and 2014, the most common cause of death among children younger than 10 years was accidents. The mortality rate per 100 000 persons was 39.1±41.2 before 2011, 226.7±43.4 in 2011 and 31.4±39.1 after 2011. Regression analysis revealed that the mortality rate was positively associated with low age in each period, while the coastal zone was negatively associated with fewer disaster base hospitals in 2011. By contrast, the number of obstetrics and gynaecology centres (β=−189.9, p=0.02) and public health nurses (β=−1.7, p=0.01) was negatively associated with mortality rate per person in 2011. CONCLUSIONS: In 2011, the mortality rate among children younger than 10 years was 6.4 times higher than that before and after 2011. Residence in a coastal zone was significantly associated with higher child mortality rates. BMJ Publishing Group 2018-11-25 /pmc/articles/PMC6254400/ /pubmed/30478111 http://dx.doi.org/10.1136/bmjopen-2018-022737 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Public Health
Tashiro, Ai
Sakisaka, Kayako
Okamoto, Etsuji
Yoshida, Honami
Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study
title Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study
title_full Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study
title_fullStr Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study
title_full_unstemmed Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study
title_short Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study
title_sort differences in infant and child mortality before and after the great east japan earthquake and tsunami: a large population-based ecological study
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254400/
https://www.ncbi.nlm.nih.gov/pubmed/30478111
http://dx.doi.org/10.1136/bmjopen-2018-022737
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