The prolonged stay in temporary prefabricated housing structures of evacuees from the Great East Japan Earthquake is taking a toll on their health, with an increasing number of residents requiring nursing care or other support.

On Nov. 1 last year, at one temporary housing community situated on the playground of Shizugawa Elementary School in Minamisanriku, Miyagi Prefecture, residents noticed that the lights in the housing unit of the 69-year-old head of the neighborhood association were still on late into the night. Concerned, they reported the situation. The man was later found inside, dead in his bathroom.

This man had, shortly after the disaster, been one of the evacuees taking refuge at a town gymnasium. As up to around 1,500 evacuees gathered there, he took on the role of head of the shelter’s „neighborhood association.“ Faithfully performing the duties asked of him, he was trusted by the other evacuees. When he moved into temporary housing two months later, he kept his position as head of the neighborhood association, busily working at distributing fliers and gathering people for events.

However, the man rarely showed up at the community’s social events, and multiple residents witnessed him drinking hard liquor at his home from the morning hours.

„Dying at (what was supposed to be) a temporary home … Five years is a long time,“ says the man’s 72-year-old brother, who lives at a different temporary housing community.

Since 2012, the Miyagi Prefectural Government has been checking on the health of evacuees in temporary housing every year. In the latest survey, conducted from September through November last year, in which it received responses from 3,842 households, 19.8 percent of respondents said their health was „not very good“ or „very bad,“ the highest percentage to say so in the prefecture’s surveys in the past four years. Additionally, 7.5 percent of the people in the survey were recognized as strongly tending toward anxiety or depression, higher than the national average of 4.4 percent as found by a 2013 nationwide survey using the same method.

Prolonged living in temporary housing is especially hard on the elderly. At Daiichi Junior High School in Rikuzentakata, Iwate Prefecture, which hosts over 100 temporary residences, 80-year-old Zenichi Kumagai collapsed on the morning of Dec. 7 last year while trying to board a bus to take him to nursing care. It happened just after he had been holed up in his small housing unit for a few days with a cold. His 78-year-old wife Sayoko says, „It seems that his blood circulation worsened because he hadn’t been moving much.“

At the time when the disaster struck, Kumagai had been diagnosed as needing a moderate level of nursing care, but he was capable of walking. After moving into temporary housing, he got outside less often, and the housing unit he and his wife lived in was only around 30 square meters in area and could become very cold. Kumagai’s health worsened, and from October last year he began needing a greater degree of nursing care. He started going as an outpatient nearly every day to receive these services. He lived through his collapse, but in late February this year he moved into a nursing home and is now nearly bedridden.

„If it weren’t for the earthquake disaster, he probably wouldn’t have gotten this bad,“ Sayoko laments.

As of October last year, 18.9 percent of Rikuzentakata’s population of those aged 65 and older was certified as needing care or support, an increase of 3 percentage points over the course of five years and more than the national average of 18.0 percent. The jump in certifications nationwide over the five years averaged 1.36 points, while for the disaster-hit prefectures of Iwate, Miyagi and Fukushima the average increase was 2.04 points.

Yoshiaki Takahashi, head of Rikuzentakata’s long-living society division, says, „We don’t have data to back this up, but with many elderly people living in small temporary housing units, the figures may be related to the fact that they are living in stressful environments.“

Yasutake Tomata, instructor of public hygiene at Tohoku University, who has been conducting health surveys on elderly people in the disaster-hit areas, says, „The activity level of disaster survivors has clearly fallen during their prolonged stay in temporary housing. The change in (living) environment from the disaster is having an effect (on how they live).“