Overview of the Center for Community Health, Tohoku University Graduate School of Medicine, Sendai, Japan

Tohoku University Graduate School of Medicine established the Center for Community Health (CCH) on May 1, 2011 to provide support to local communities within Miyagi Prefecture that were affected by the Great East Japan Earthquake.

Background and mission

After the initial acute phase, in which emergency medical care and humanitarian support were needed, it became important to protect the health of people in affected areas from mid- and long-term perspectives. Many evacuees are currently facing a variety of health risks, including communicable diseases, malnutrition, psychological distress, and physical inactivity. Moreover, many of the local public health systems that were severely damaged by the earthquake remain less than fully functional. These local public health systems must be reconstructed to protect the lives and health of survivors and to aid in the recovery of the community as a whole. Tohoku University Graduate School of Medicine, located in Miyagi Prefecture, the area most severely affected by the earthquake, established the CCH with the aim of providing technical support toward for the recovery of public health systems in affected areas.

Structure of the CCH

Director: Prof. Ichiro Tsuji (Division of Epidemiology)
Vice-directors: Prof. Hitoshi Oshitani (Division of Virology)

Activities of the CCH

◆2011-2012

A total of nine project teams headed by school professors, staff, and students, in addition to other relevant experts outside of the school, participate in supporting activities. Based on a mutual agreement between Miyagi Prefecture and/or affected municipalities and the CCH, the following four activities were identified:

1) To conduct a survey on individual and public health needs, including living environments, general hygiene, and physical and psychological status.
2) Based on the results of the survey, to provide necessary recommendations for the purpose of reconstructing local public health systems.
3) To provide various types of preventive health care, including health counseling, health education, communicable disease prevention, mental health, maternal and child health, exercise, and nutrition.
4) To provide advisory support for overall public health programs.

The CCH has assembled the following nine project teams to carry out the four activities described above.

1) Community survey (Leader: Prof. Ichiro Tsuji, Division of Epidemiology)
Conducting the survey on individual and public health needs and providing necessary recommendations for reconstructing public health systems
2) Health promotion and education (Leader: Prof. Kayoko Hirano, Division of International Nursing Management)
Providing advice and conducting health promotion and education activities for individuals and providing technical advice to public health nurses and relevant health professionals in affected areas
3) Communicable disease prevention (Leader: Prof. Hitoshi Oshitani, Division of Virology)
Assessing the potential risk of communicable diseases in affected areas and providing the guidance necessary to prevent communicable diseases to public health nurses and relevant health professionals
4) Mental health (Leader: Prof. Hiroo Matsuoka, Division of Psychiatry)
Assessing the status of and needs for good mental health, providing necessary support to individuals, and providing technical advice to public health nurses and relevant health professionals
5) Maternal and child health (Leader: Prof. Nobuo Yaegashi, Division of Gynecology and Obstetrics)
Assessing the status and the needs of maternal and child health, providing necessary support to individuals, and providing technical advice to public health nurses and relevant health professionals
6) Physical exercise (Leader: Prof. Ryoichi Nagatomi, Division of Medicine and Science in Sports and Exercise)
Assessing physical activity and functions, conducting exercise and health promotion activities, and providing technical advice to public health nurses and relevant health professionals
7) Nutrition (Leader: Prof. Yuko Minami, Division of Community Health)
Assessing dietary and nutrition status, providing necessary support to individuals, and providing technical advice to public health nurses and relevant health professionals
8) Preventive care (Leader: Prof. Ichiro Tsuji, Division of Epidemiology)
Assessing the risk of increased levels of necessary care for older individuals and providing preventive care support and technical advice to public health nurses and relevant health professionals
9) Dental health (Leader: Prof. Keiichi Sasaki, Dean of Graduate School of Dentistry)
Conducting dental health activities in affected areas and providing technical advice to public health nurses and relevant health professionals

In addition to these team activities, the following three projects were identified as crucial issues for the CCH:

1) Public health assessment
Recommendations in regard to public health recovery should be provided based on the assessment of the public health system and the health needs of people in affected areas.
2) Health survey
A questionnaire survey and physical examination should be conducted every 6 months to monitor the health status of those living in affected areas. The findings of this survey should be utilized by each team in the CCH.
3) Recording and documentation of the public health recovery process
The public health recovery process should be recorded and documented.

◆2013-

The health-related issues of evacuees in affected areas have changed over time with changes in the living environment. To gain a more complete understanding of the variety of health-related issues experienced by evacuees, we will administer health surveys on a regular basis and provide health support as needed.
Based on a mutual agreement between Miyagi Prefecture and the affected municipalities, the CCH performs the following activities:

1) Administer health surveys for evacuees: We administer health surveys to gain an understanding of the health status of evacuees, as well as their living environment and any lifestyle changes (e.g., housing, job/income, community ties).
2) Provide health support to evacuees: We report the results of health surveys individually. We also hold health-related seminars and educational sessions and support the activities aimed to promote physical activity and prevent disability.
3) Provide recommendations on health and hygiene measures in the affected municipalities: We provide recommendations regarding various public health issues to public health nurses and other health professionals in the affected area.
4) Provide recommendations on post-disaster administration of public health measures: We provide guidelines and recommendations regarding how to provide support to evacuees in the most effective manner after a future large-scale disaster.