The Significance of Observing the Risk of Non-communicable Diseases afterLarge-scale Disasters and Communicable Disease Epidemics

Hirohito Metoki. JMA J. 2021; in Press.

Non-communicable diseases (NCDs) are a global challenge, accounting for 71% of all deaths worldwide. The spread of coronavirus disease 2019 (COVID-19) and past huge disasters have affected the prevention and treatment of NCDs and require urgent action. In this narrative review, I will discuss several reports on the risk of NCDs during past disasters and propose possible future directions. Hypertension, the most common NCD, carries a high risk of death due to cerebrovascular, renal, and other complications. Effective use of information and communication technology-based telemedicine is necessary to manage the risk of cardiovascular diseases during disasters and pandemics. We observed the cumulative incidence of metabolic syndrome in subjects from tsunami-affected areas. We found that moving into prefabricated temporary housing was a risk factor for a higher incidence of metabolic syndrome in elderly females. Our follow-up of 1,009 subjects showed a slight, but significant, increase in HbA1c values after a state of emergency was introduced, even though the lockdown was not as stringent as in other countries. In a study elucidating the prevalence of wheezing and eczema symptoms and the associated factors after the Great East Japan Earthquake, psychological effects, such as depression and self-reported posttraumatic stress disorder, were observed, particularly in people with allergic diseases. In recent years, new birth cohort studies have been initiated to complement the studies designed to collect information across multiple generations, such as the Lifelines study in the Netherlands and the Avon Longitudinal Study of Parents and Children (ALSPAC) study in the UK. It is desirable to assess the effects of COVID-19 to complement the existing cohort studies in Japan as well.