Post-Disaster Recovery, Cancer Care, and Family Well-Being in Japan: A Structural Equation Modeling Study
Akemi Hara, Akihiko Ozaki, Yoshitake Takebayashi, Yasuhiro Kotera, Hiroaki Saito, Toyoaki Sawano, Naomi Ito, Kenji Gonda, Masahiro Wada, Kazunoshin Tachibana, Masaharu Tsubokura, Hiromichi Ohira, Michio MurakamiAbstract
Objective
This study examined how subjective disaster recovery and cancer-care satisfaction jointly shape family well-being in Japan, and when better cancer care accompanies higher well-being.
Methods
A quota-stratified web survey of 2,179 adults aged 20-69 was conducted across Japan (September 2019), with quotas by Fukushima residency and family cancer experience. Subjective recovery from any major disaster within 10 years (unexposed; recovered or in prospect; no prospect), household cancer experience, and Short FAMCARE satisfaction were modeled against latent well-being by structural equation modeling.
Results
Among non-cancer households (n = 1,324), unrecovered damage was associated with lower well-being (β = −0.08, 95% CI −0.13 to −0.03, P = 0.001), with no association in cancer-affected households (β = 0.00, P = 0.98). Among cancer-affected families (n = 855), high satisfaction was associated with higher well-being (β = 0.17, P < 0.001), more so in recovered than unrecovered households (contrast 0.149, 95% CI 0.031 to 0.268, P = 0.014). Resting on small subgroups, this interaction is exploratory.
Conclusions
Better cancer care did not offset incomplete disaster recovery; its association with higher well-being was confined to households with recovery achieved or in prospect. These cross-sectional findings are consistent with delivering reconstruction and cancer care together.