Abstract TU258: Height Loss Predicts All-Cause and Cardiovascular Disease Mortality among Residents of Evacuation Zones Following the Great East Japan Earthquake: The Fukushima Health Management Survey

Abstract

Introduction: Major disasters such as the Great East Japan Earthquake and prolonged displacement can exacerbate undernutrition, psychological stress, and limited medical access. These factors increase the risk of lifestyle-related disorders and functional decline, thereby accelerating long-term height loss. Height loss has been associated with increased all-cause and cardiovascular disease (CVD) mortality. However, the predictive value of height loss in postdisaster settings remain unclear. Using data from the Comprehensive Health Check (CHC) of the Fukushima Health Management Survey, we aimed to examine annual height loss among residents of evacuation zones in Fukushima Prefecture and its association with postdisaster all-cause and CVD mortality. Hypothesis: Pronounced long-term height loss after a disaster predicts increased all-cause and CVD mortality. Methods: We analyzed 36,856 residents of evacuation zones (15,427 men and 21,429 women) aged 40–90 years who participated in at least one CHC in both fiscal years (FY) 2011–2013 and FY 2014–2016. All-cause and CVD deaths were identified from the date of the last CHC through December 31, 2020. Annual height loss (mm/year) was calculated as: [(height at last CHC [mm] – height at baseline CHC [mm]) / follow-up years]. Participants were divided into sex-specific quintiles, with the highest quintile defined as the stature-decline group. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between height loss and mortality outcomes. Models were adjusted for age, sex, body mass index, anemia, number of comorbid lifestyle-related diseases, smoking status, alcohol consumption, exercise habits, and evacuation experience at the final CHC. Results: Over a mean follow-up of 4.5 years, 1,974 all-cause and 441 CVD deaths occurred. The height loss group included a higher proportion of evacuees (55.0%) than the no-height loss group (52.4%). Pronounced height loss was significantly associated with increased all-cause (multivariate HR: 1.50; 95% CI: 1.37–1.65), CVD (1.63; 1.34–1.98), heart disease mortality (1.70; 1.35–2.14), and stroke mortality (1.47; 1.01–2.13) (Table 1). Conclusions: Height loss is a simple predictor of both all-cause and CVD mortality in disaster-affected populations.