Healthy community resilient against disaster

After the Great East Japan Earthquake (GEJE) and Tsunami in 2011, the physical and mental health of the affected people showed completely different characteristics from those of earlier disasters. Despite the lower number of injured people compared to those affected by the Great Hanshin Awaji Earthquake (GHAE) in 1995, the health needs were mainly non-communicable diseases and mental health issues. Those needs far exceeded the damaged state of local health care facilities. The nationwide disaster medical system established after GHAE worked fully for the first time, but further improvements of the response system, such as implementation of a disaster medical and public health coordinator, more efficient emergency medical information systems, and the establishment of specialized health care assistance teams including psychiatry, rehabilitation, reproductive health, public health, and oral care, were found to be necessary after GEJE. Reconstruction of the damaged hospitals should be based on the safe hospital concept and the prioritized parts of community reconstruction during this era of aging and urbanization of populations. Disaster risk reduction (DRR) is achieved by decreasing hazard exposure and vulnerability while increasing the capacity for adaptation. The Sendai Framework for DRR 2015–2030 adopted by 185 member states at the Third World Conference 2015 in Sendai, emphasizes the effects of disasters on physical and mental health. The Bangkok Principle was adopted to implement its health aspects. Now it is necessary to accumulate scientific evidence clarifying the relation between health and DRR such as the correlation between life expectancy and the disaster risk index. By incorporating health as a central target of DRR, our community can be made sustainable, healthy, and resilient against disasters.