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Gender differences in risk of posttraumatic stress symptoms after disaster among older people: Differential exposure
Aki Yazawa1, Jun Aida2, Katsunori Kondo3
1Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
Background:
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.
Methods:
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).
Results:
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.
Limitations:
We have no information on PTSS prior to the earthquake. Nor do we have clinician diagnoses of PTSD.
Conclusions:
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.
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