Gender differences in risk of posttraumatic stress symptoms after disaster among older people: Differential exposure or differential vulnerability?

• Published in: Journal of affective disorders 2022-01, Vol.297, p.447-454
• Main Authors: Yazawa, Aki, Aida, Jun, Kondo, Katsunori, Kawachi, Ichiro
• Format: Article
• Language: English
• Subjects: Aged; Disaster; Disasters; Earthquakes; Female; Gender disparity; Gerontology; Humans; Male; Posttraumatic stress disorders; Sex Factors; Social support; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - etiology; Tsunamis
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2021.10.094

•The mechanism remains poorly understood on the gender gaps in PTSS risk.•Prospective follow-up of the Great East Japan Earthquake and Tsunami was conducted.•Women had housing damages and loss of relatives more than men (explained ∼21% of the gap).•Women had greater deterioration of social support than men (explained ∼21% of the gap). Women have been observed to have a higher risk of developing posttraumatic stress symptoms (PTSS) after disaster compared to men. In a study of survivors of an earthquake, we sought to investigate: whether there was differential exposure to disaster-related trauma by gender; whether women and men have differential vulnerability to trauma; and what factors could explain the gender difference in PTSS. Data from a cohort of community-dwelling older survivors of the 2011 Great East Japan Earthquake and Tsunami was used. Data were obtained before (2010) and 2.5-years after the disaster (n = 3,334). Women suffered 1.6 times higher prevalence of PTSS than men (31.0% vs. 19.4%). Women were more likely to experience loss of relatives (29.2% vs. 23.2%), while men were more likely to report loss of friends (17.1% vs. 14.5%) and separation from work (7.5% vs. 4.6%). We did not find evidence for differential vulnerability to disaster-related trauma. Indeed, the gender gap in PTSS was larger among individuals who did not experience trauma. Women experienced greater deterioration of non-kin instrumental support, which significantly mediated the association between gender and PTSS. We have no information on PTSS prior to the earthquake. Nor do we have clinician diagnoses of PTSD. Women experienced housing damages and loss of relatives more often than men, which explained ∼21% of the gender gap in PTSS after disaster. Women reported more non-kin support prior to the disaster, but they also experienced greater deterioration of it, which explained ∼21% of the gender gap.