How can the human dimensions of disaster impacts be more accurately captured and represented in the analysis, modeling and simulation of disasters?
Because we are facing an aging society regardless of the income of a country; we have to include health statistics as the background data to develop the models and simulations of disasters. We should include a disaster by all types of hazards; and its exposure that ignites the cascading effects on the physical; mental; and socioeconomic well-being of the affected people and community. The disaster risk is composed of the function of hazard & exposure; vulnerability; and coping capacity. Thus; the local context of hazards & exposure; the human dimension of vulnerability; and coping capacity will create different damage; response; recovery; reconstruction; anticipation; and preparedness even if the same hazard attacked the community. The number of deaths is easy to count but does not represent the human dimension of disaster impact anymore. The health damage in the affected people has a commonality according to social development; and specificity to the local context. We can classify health needs into several categories; including non-communicable diseases; infectious diseases; mental health issues; injuries; maternal and child health issues; rehabilitation needs; etc. The proportion of categories varies in disaster. The mental health issues remain for months to years; but there are scarce epidemiological statistics on health damages and needs. When the disaster includes chemical; biological; radiological; nuclear; and explosion (CBRNE) hazards; the risk perception of people changes drastically. We have to consider the social response from the viewpoint of risk communication and how people can access scientific evidence and avoid misinformation.
What type of data and supporting research infrastructure would be necessary to enable novel, transdisciplinary approaches to answering these and other human-centered disaster questions?
The INFORM risk index and WHO global health observatory can be a good starting point to develop global and local models and simulations. Both databases are well-structured; updated regularly; and publicly available. There is subnational level data in particular countries. I confirmed the strong negative correlation between disaster risks and life expectancy suggesting that a healthy community is resilient against disaster. I also created the anonymous database of disaster medical records after the 2011 Great East Japan Earthquake to capture the health needs of the affected people in towns stricken by the earthquake and tsunami to various extent. The vital statistics of the affected area; the capacity and preparedness of the health facilities; and health workforces can be the basis of health needs prediction. Health promotion; access to health care; and institutionalization of disaster risk governance can be good indicators of coping capacity. The establishment of the national disaster medical system including mental health services is critical. One of the Sendai Framework’s global targets is to reduce the damage to critical infrastructures for education and health. Not only the structural strengthening but also their non-structural and functional resilience are key measurements. Japan has developed and implemented a minimum dataset for disease surveillance system as a global standard toolkit for the emergency medical team initiative of WHO. Mental health issues can be also captured by this toolkit; but it requires long-term cohort study not only to follow; but also to intervene in the susceptible population.
In what ways can US-Japan collaborations advance these questions in new and important ways?
The strategies for implementation of the health aspect of the Sendai Framework were declared in the 2016 Bangkok Principles that recommend (1) health to DRR; DRR to health. (2) cooperation between health and other stakeholders for DRR. (3) stimulate people-centered investment in DRR including health. (4) integrate DRR into health education and training; health into DRR. (5) disaster data and health data into risk assessment. (6) Advocacy and support by science; information; and technology. (7) national policies and strategies for DRR and health. The transdisciplinary collaboration and breakdown of silos are still the icons of “lessons unlearned”. In this Society 5.0 and the future; any “new” ideas are a combination of existing and emerging ideas. The digital transformation that will create the paradigm shift is necessary. For example; a personal health record (PHR) is now available on mobile devices. The high-throughput ICT with a resilient energy system will make it possible for emergency medical teams to access the health record of affected people in an emergency phase; but it is necessary to utilize this technology for daily use to achieve robustness and usability. The strategies for this paradigm shift are to be proactive; all-hazard; vulnerability and capacity focus; whole-of-society; shared responsibility of health systems; risk management; and planning with communities. Sendai Framework defines the new stakeholders of DRR; i.e.; women; children and youth; people with disability; indigenous people; migrants; older people; practitioners; private sectors; and academia besides the governments. Inclusive strategies in every phase of disaster risk reduction are necessary.