Category Archives: Elderly

The Heat Didn’t Kill Them. The Gap in Their Preparation Did.

I once stood in a flooded industrial park in Thailand listening to managers say, “We never expected the water to reach here.” I heard the same disbelief, decades later, in a report about a family in Lyon, France, whose apartment had quietly turned into an oven. An 84-year-old grandmother with dementia. A husband on medication that made the heat more dangerous than he realized. A son next door who still couldn’t reach them in time. Outside, 42°C. Inside, 38°C by mid-afternoon. Nobody saw it coming, even though everybody did.

This is the story of Europe’s 2025 heatwave, one of the deadliest on record. But the real story isn’t about heat at all — it’s about gaps, between a warning and an action, between living next door and actually being ready. After twenty years studying disasters, I’ve come to believe those gaps are the most dangerous part of any catastrophe.

When and Where: A Disaster Written in the Sky

From April through September 2025, a “heat dome” — a stubborn zone of high pressure — parked itself over western and southern Europe, trapping warm air and blocking nighttime relief. Climatologists now call it the sixth-deadliest heatwave in recorded world history. The western Mediterranean recorded its highest-ever sea-surface temperature anomaly for any month, part of why nights in Spain, France, and Italy stayed brutally warm.

Researchers from the London School of Hygiene and Tropical Medicine and Imperial College London found that human-caused climate change directly caused most of the summer’s excess heat deaths in European cities. That same summer, the International Court of Justice ruled that access to a safe, healthy environment is an enforceable human right. This was never just weather — it was natural, political, and social at once. The real question is why people died in cities with working alert systems and open hospitals. That’s not a meteorology question. It’s a household one.

Who: The Household Is Where Disasters Are Won or Lost

In my own research on Japan’s 2011 tsunami, I learned that a disaster’s outcome is rarely decided by the hazard alone — it’s decided by conditions already sitting inside people’s homes long before disaster strikes. The Lyon family is almost a textbook case.

Picture a fourth-floor apartment in a 19th-century stone building, built to hold heat through cold winters, with no elevator and no air conditioning. Inside: a grandmother who could no longer reliably feel thirst, a daughter on blood pressure medication, a husband on diuretics that quietly worsen dehydration, and a son next door with no formal plan to check on them. None of these facts alone sounds like tragedy. Together, they form a vulnerability map that fits millions of households across Europe.

Three details struck me. Beta-blockers and diuretics are among Europe’s most prescribed drugs, and both impair the body’s ability to cool itself — yet a simple spring conversation with a doctor about this almost never happens. The old stone buildings so many Europeans love were built to keep heat in, not let it out. And proximity isn’t preparedness: the son lived right next door, yet there was no agreed check-in time, nothing written down. Closeness gave a false sense of security that quietly replaced real planning.

Why It Mattered: When Public Help Is There But Not Reachable

I often use a framework from Japanese disaster studies: jijo, kyojo, kojo — self-help, mutual help, and public help. The 2025 heatwave shows this triangle breaking down in a very human way. Public help was technically present: France issued top-level heat alerts, Lyon activated its heat plan, hospitals stayed open. But “present” and “reachable” turned out to be different things — doctors’ phone lines were jammed for three hours, and emergency rooms were overwhelmed within 48 hours. This is the typical failure mode of any major disaster: public systems work as designed, until everyone needs them at once.

That’s exactly why self-help and mutual-help have to be strong enough to fill the gap — and here, they weren’t, at least not at first. No pre-season heat check on the apartment, no rehydration salts on hand, no registration with the city’s vulnerable-persons registry. What ultimately helped wasn’t a government plan; it was a neighbor who lent her portable air conditioner. Real mutual-help, but it shouldn’t have to depend on luck.

How: What Forensic Investigation Reveals

Looking at this through a forensic lens — tracing root causes instead of settling for the obvious explanation — three things stand out. Heat is an invisible disaster: no flooding water, no shaking ground, no siren, so by the time a family notices something is wrong, hours may have passed. Caregiver exhaustion rarely makes the statistics, yet it’s real — one woman here carried nearly all the caregiving alone for five straight days. And an aging population isn’t just background information; it’s a measurable, foreseeable source of future risk, especially in buildings never built for a hotter world.

What strikes me most: everything this family eventually did — buying a portable air conditioner, setting up twice-daily check-ins, reviewing medications, installing reflective window film — could have happened months earlier, for a fraction of the cost of the crisis it prevented.

Why This Matters to You

I’ve spent much of my career arguing that a disaster’s outcome is shaped less by the hazard itself than by the choices made before it arrives. The 2025 heatwave is one more piece of evidence for that. The heat dome was driven by decades of emissions, beyond any one family’s control. But how that family responded was shaped by choices about medications, buildings, and communication made months earlier — the kind of choices any reader in their twenties, thirties, or beyond can make for an aging parent, a neighbor, or themselves.

The Sendai Framework for Disaster Risk Reduction argues resilience is built from the household upward, not handed down from policy alone. I believe that completely. The gap between the alert that reached a phone and the hospital bed that followed wasn’t a failure of warning — it was a failure of preparation. Unlike the climate itself, that gap is one we can close, starting at home, before the next heat dome forms.

Source: When the Heat Dome Becomes a Death Trap: Social Lessons from Europe’s 2025 “Bloody” Heatwave — disasterresearchnotes.site, drawing on the World Meteorological Organization, Copernicus Climate Change Service, LSHTM/Imperial College London, and the International Court of Justice’s 2025 advisory opinion.

When Help Can’t Come: What the 1995 Kobe Earthquake Still Teaches Us About Surviving Disaster

In 15 seconds, 6,434 people lost their lives — and the rescuers who saved the most were not professionals. They were neighbors.
6,434 lives lost in the Great Hanshin-Awaji Earthquake80%+ of deaths caused by building collapse and falling furniture1–2% of survivors rescued by professional emergency services

I was in Kyoto that morning

At around 6 a.m. on January 17, 1995, I was just waking up in Kyoto. I remember feeling a faint tremor. I thought it might be a dream. When I walked to the nearby station to check the trains, and then arrived at my office to find no one there, I turned on the television — and saw images I have never been able to forget: elevated expressways on their sides, rows of wooden homes pancaked flat, smoke rising across an entire district of Kobe.

I was working in tourism at the time. That morning changed the direction of my life. I went on to join the National Research Institute for Earth Science and Disaster Prevention in Japan, investigating disasters from Katrina to Ondoy to the 2011 Great East Japan Earthquake. I now research disaster resilience at Chulalongkorn University in Bangkok. And across every disaster I have studied, one truth keeps surfacing: what happens in the first 15 minutes is determined by what people did — or did not do — in the weeks and months before.

Fifteen seconds. 6,434 lives.

At 5:46 a.m. on January 17, 1995, the Nojima Fault ruptured beneath the northern tip of Awaji Island, generating a Japan Meteorological Agency magnitude-7.3 earthquake. The strongest shaking lasted no more than 15 to 20 seconds. But in those seconds, the outcome for most victims was already decided. More than 80 percent of those who died were crushed or suffocated beneath collapsed buildings and toppled furniture — almost all in wooden structures built before Japan’s 1981 earthquake-resistant building code revision. The majority died almost instantly, before any rescue could have reached them. Over 100 fires broke out simultaneously. A 600-meter section of the elevated Hanshin Expressway toppled sideways. Water mains ruptured across the city, leaving fire crews with no water to fight the flames. More than 300,000 people poured into evacuation centers in mid-January cold.

“Kobe did not fail because rescuers were slow. It failed because, when an entire city is struck at once, professional rescue is physically impossible at scale. That was the lesson. It took the world by surprise.”

Who actually saved people?

A post-disaster survey conducted in one Kobe ward asked survivors rescued from collapsed buildings a single question: who helped you get out? The answer was striking. The overwhelming majority were freed by themselves, by family members, or by neighbors — by people who were physically present in the first minutes. Professional rescue services — fire departments, police, the Self-Defense Forces — accounted for only an estimated 1 to 2 percent of rescues in the acute phase.

This is not a criticism of those services. They responded. But roads were blocked, phones were down, and simultaneous structural collapses across an entire metropolitan area created a physical impossibility: no rescue organization, however skilled or well-resourced, can be everywhere at once when an entire city falls. The real rescuers that morning were the neighbors who grabbed bicycle frames and iron pipes to lever beams off pinned family members in the dark.

This single finding — 1 to 2 percent professional rescue — is widely credited as the moment Japan’s disaster policy pivoted permanently toward community-level preparedness. It gave rise to the framework now central to Japan’s DRR thinking: Jijo–Kyojo–Kōjo.

The survival ratio in a city-scale disaster (acute phase)

Self-help (Jijo)  — 70%Mutual (Kyojo)  20%Public 10%

This is not a rigid formula. It is a policy reminder: in the acute phase of a city-scale disaster, survival is predominantly a household and neighborhood question. Public help is essential — but it is slower and finite. Self-help is the foundation that lets you reach the moment when mutual-help and public-help can act.

The Tanaka family: a story rooted in real experience

In my research, I use case-based scenarios to make these dynamics visible. Consider a composite family — based on documented experiences in Kobe’s Nagata Ward — that I will call the Tanaka household. Hiroshi (42), a shoe-factory worker; his wife Keiko (39); their teenage daughter Aoi and young son Ren; and Hiroshi’s mother Sumiko (71), who has limited mobility from arthritis and takes daily blood-pressure medication. They live in a two-story wooden row house built decades before the 1981 code.

When the quake hit, the second floor partially collapsed onto the first. Hiroshi and Keiko were pinned by a fallen wardrobe. Aoi was trapped under a collapsed beam. Sumiko could not move. It took nearly an hour — with neighbors using a bicycle and a length of pipe — to free Sumiko as fire spread through the block. They evacuated barefoot, in nightclothes, in near-freezing air. Sumiko’s medication bottle was buried in the rubble. So were the bank books, the property deed, and the insurance papers.

Every difficulty this family faced was foreseeable. Almost all of it was preventable. That is the defining lesson of Kobe.

What you can do — starting tonight

As a researcher who has walked through disaster zones from New Orleans to the Philippines to Japan’s Tohoku coast, I am often asked what the single most important thing a household can do is. The honest answer is that it is not one thing — but all of the following are straightforward, low-cost, and evidence-backed.

1. Anchor all tall furniture in your bedroom

The number-one killer in Kobe was not the earthquake itself, but falling wardrobes and bookshelves onto sleeping people. An L-bracket costs less than lunch.

2. Place shoes and a flashlight beside your bed

Glass-covered floors in the dark are a serious injury risk after any structural event. Do this tonight before you sleep.

3. Build a 3-to-7-day stockpile of water and food

3 liters of water per person per day, plus food requiring no cooking. In Kobe, water mains in some areas were not fully restored for months.

4. Keep essential medications grab-ready

At least one week of any chronic-disease prescription, children’s inhalers, or blood pressure drugs — in a sealed pouch outside the collapse zone. For Sumiko, this was a near-fatal omission.

5. Digitize your key documents

Photograph your ID, property deed, insurance policies, and bank documents. Store copies in the cloud and with a relative in another city. Lost documents delay every form of recovery assistance.

6. Agree on two meeting points

One just outside the building, one nearby landmark. Assign who is responsible for each vulnerable member. Do not rely on mobile phones — lines fail in disasters.

7. Run a household drill twice a year

A kit you have never practiced with, with expired medication and no agreed plan, is a false comfort. The preparation is the practice.

Mutual-help: the neighbor you know is the neighbor who digs you out

Self-help has limits. Sumiko survived because neighbors came. In modern cities, it is not uncommon to not know the person living next door. But my field research across Japan, Thailand, and the Philippines confirms the same finding repeatedly: communities that recover fastest — and lose the fewest lives in the acute phase — are communities where people already knew each other before the disaster.

You do not need a formal community organization to start. A brief greeting in the elevator. Passing along a neighborhood bulletin with a few words added. Attending one local meeting. These small acts create familiarity — and familiarity, in a disaster, means you are someone a neighbor will think to check on. That is not sentimentality. It is disaster science.

In the months after the 1995 earthquake, over one million volunteers descended on Kobe from across Japan. That outpouring is remembered as the birth of modern volunteer culture in Japan. It was remarkable. But the real mutual-help happened in the first hour — in the hands of people already there, already awake, already digging.

Disasters are social, not just natural

I want to close with something that three decades of research have made impossible for me to ignore. The scale of deaths in Kobe was not determined by the earthquake alone. It was determined by which buildings people were sleeping in, and which neighborhoods they lived in. Homes built before 1981 — concentrated in older, lower-income districts — collapsed at far higher rates than newer structures. The same magnitude of shaking killed far fewer people in neighborhoods with newer construction.

This is the core argument of disaster research as I practice it: the disaster begins before the disaster. Vulnerability — to poverty, to age, to disability, to housing precarity — shapes who is at risk long before any fault line moves. Individual preparedness matters enormously. But so does the society we build together. Ensuring that the most vulnerable households have access to retrofitting subsidies, medication coverage, and document support is not charity. It is evidence-based risk reduction.

At 5:46 a.m. on January 17, 1995, I was in Kyoto and barely noticed the tremor. Most people in Kobe had no warning at all. The question that has driven my research ever since is simple: what, in the days and weeks before that morning, could have changed what happened in those 15 seconds?

The answer — every time — is: quite a lot.

Key takeaway

The Great Hanshin-Awaji Earthquake proved that when a city is struck all at once, professional rescue is overwhelmed within minutes — and the vast majority of survivors are saved by themselves, their families, and their neighbors. Real resilience is built before disaster strikes: anchor your furniture, stockpile for at least three days, protect medications and documents, agree on how to reunite, and practice. Self-help and mutual-help are not substitutes for public assistance — they are what keep you alive until it arrives.

Sources & further reading

Great Hanshin-Awaji Earthquake documentation: Cabinet Office, Japan (https://www.bousai.go.jp/kyoiku/kyokun/hanshin_awaji/)

Disaster Research Notes (Nakasu): disasterresearchnotes.site (https://disasterresearchnotes.site)

Sendai Framework for DRR (2015–2030): UNDRR (https://www.undrr.org/publication/sendai-framework-disaster-risk-reduction-2015-2030)

Note:

This is my personal experience and knowledge. Disaster preparedness depends entirely on your situation. Please use this article for your reference.

Day_75 : Okushiri Island (2)

The 1993 southwest-off Hokkaido earthquake hit okushiri island severely. The number of casualties was 165. Okushiri town had faced population-decreasing and aging issues before the disaster. After the disaster, Okushiri town had a lot of aids, especially from inside of Japan. Japan had a very good economy at that time, so the situations enabled them to have such huge aids. Even though the large economic assistance, the town’s demographic tendency before the disaster was facilitated. total population is from 4,604 (1990) to 2,662 (2015), and the aging proportion over 65 is from 15.6% (1990) to 38.6% (2015)*.

Below is the graph, which indicates the demographic changes on the island.
okushiri population

Some disaster recovery theories can be referred to explain this tendency clearly We should learn from this lesson to consider for our common sustainable futures.

*Day_43

https://disasterresearchnotes.site/archives/2510

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Day_146 (Rev): A Text Mining : Trends of disaster research on aging

Have just conducted a text mining as follows:

Overviews of the Literature concerning elderly and disasters by text mining.
<Method>
1. Search the keywords in Web of Science (Core Collection)
2. Selected Information (Titles and Abstracts) was gathered into one text file.
3.1st contents analysis has been carried out and omitted the unnecessary words.
4. Cleaning process
5. 2nd contents analysis has been carried out. >>This process was repeated
6. Research findings are examined.
7. Examine the extracted words and phrases by reaching to the original abstracts and original papers.

*To do the text mining, KH Corder was used.

Table 1 Keywords

Keywords_elderly

Co-occurrence network_elderly
Figure 1 A co-occurrence network analysis

Table 2  The hit numbers with disaster management cycles’ stages

disaster management cycle elderly

Table 2 indicates that elderly issues on disasters are more discussed in relation to “response” and “preparedness” than “recovery” and “mitigation” in the disaster management cycles’ stage.

correspond analysis elderly
Figure2 Correspond analysis (The related words with disaster management cycles’ stages)

For example, Figure 2 suggests the close relationship between response and related words such as planning, management, medical, evacuation, vulnerability, and patient. This suggests the elderly’s difficulties for evacuation because of their physical conditions.

**This article is a revised version of Day_26(rev)

Reference:

Collection and Analysis of Overseas Disaster Evacuation Related Papers and Documents(in Japanese)

Day_136 : Disaster-Related Death (1)

Kobe Earthquake : 919 (22Dec.2015)
Great East Japan Earthquake and Tsunami : 3,472 (31Mar.2016)

What are the numbers?

The above numbers are the numbers of disaster-related deaths. The disaster-related death means the death which is not directly caused by hazards such as sickness, disease, and committing suicide. Especially , the disaster-related death number of GEJET is still increasing even 5 years after the disaster. This reflects aging society. The elderly people tends to have sickness and losing hope without family members. Local governments have been working hard to prevent such tragedies. They are visiting and watching the victims individually.

Day_48 : 1995 Kobe Earthquake(2) : Disaster-related death

So many people, especially the elderly, die after the events because of stress, sickness, suicide, and others. We call this a disaster-related death. The Kobe earthquake became the trigger to notice this. Over 1,126 people were reported as dead, not by direct effects of the earthquake. They were old and easy to get sick, which became worse with the circumstances around them, such as cold weather, insanitary situations, and private matters after the disaster. They had stressful conditions. They worried about their future, which they could not see. 3,472 people (2016.3.31)* were reported as dead, disaster-related deaths, after the Great East Japan Earthquake and Tsunami disaster in 2011.

* The disaster-related death number from the 2011 tsunami is still increasing.

http://www.reconstruction.go.jp/topics/main-cat2/sub-cat2-6/20160630_kanrenshi.pdf

Day_43 : Okushiri Island

The 1993 southwest-off Hokkaido earthquake hit okushiri island severely. The number of casualties was 165. Okushiri town had faced population decreasing and aging issues before the disaster. After the disaster, okushiri town had a lot of aids, especially from inside of Japan. The Japan had a very good economy at that time, so the situations enabled them to have such huge aids. Even though the large economic assistance, the town’s demographic tendency before the disaster was facilitated.Total population is from 4,604(1990) to 2,662(2015), an aging proportion, over 65, is from 15.6%(1990) to 38.6%(2015).

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Day_42: 人口と災害【3】:人口研究とアジア[Japanese]

災害に関する人口研究の重要性

William Donner and Havidan Rodriguez(2008)は、気候変動より、人口変動による将来の自然災害によるリスクの重要性を指摘している。現実問題として、将来の気候変動による災害に対する影響などは、IPCCなどの主導による研究に代表されるように多くの研究成果が主に自然科学者などにより実施されているが、人口の変動による将来の災害に対する影響の研究は、指標研究を含めてほとんど語られていないのが現状であり、課題となっている。

アジア地域の脆弱性

Munich Re(ミュンヘン再保険会社)によるデータによれば、1980年から2014年における、アジア、アフリカ、北・中央アメリカ、南アメリカ、オーストラリア/オセアニアに分類した世界全体の地域別自然災害のうち、アジアの占める割り合いは、死者数で、69%、経済損失で40%に及び、最も脆弱な地域であることを示している。また同時にアジアは、沿岸部への人口の集中とともに、高齢化が特に進んでいる地域でもある(大泉 2007)。これらは、アジアにおける自然災害に対する脆弱性は今後ますます高まると言っても過言ではない。将来気候変動が叫ばれるなか、さらに日本では、南海トラフや首都直下地震、さらには、2016年の熊本地震で示されるように、いつどこで起こってもおかしくない地震をはじめ、ハザードの側面、及び、進む少子高齢化など社会的脆弱性の側面、両面からリスクは増加する傾向にあるといってよい。それらのリスクへの対応としては、ハザードすなわち自然現象に対するアプローチは主に工学や自然科学分野で多くなされているが、社会的脆弱性という意味での少子・高齢化などによるリスクへの影響に関する研究は、今後の災害対策を考えるうえでも益々重要な位置づけとなるだろう。

Day_29 : Human Vulnerability Index

I am developing the Human Vulnerability Index.

If you have some ideas about this issue, please let me know.

The HVI was originally developed when I was doing research on the Great East Japan Earthquake and Tsunami (GEJET) disaster in 2011. I needed to compare the disaster impact by municipality for not only the 2011 tsunami but also the 1896, 1933, and 1960 tsunamis. However, it was difficult to compare because geographical and population sizes are different by municipality. So the HVI was developed. A member of JAEE thankfully recognized this for the applications.

The following are just some parts; I will disclose the details in the paper and post the link here in the near future.

1. The HVI can be applied to compare the municipalities not only for the GEJET disaster but also with the historical tsunami events and clarify the historical trends.

2. The recurrent HVI was calculated by a ridge regression analysis using the evacuation-related factors, which this paper estimated based on some theories, such as the PAR model.

3. The HVI was also applied to two international cases: the 2004 Indian Ocean Tsunami and the 2005 Hurricane Katrina.

The HVI-related paper was published with Dr.Yozo Goto.
https://www.researchgate.net/publication/329961277_HUMAN_VULNERABILITY_INDEX_FOR_EVALUATING_TSUNAMI_EVACUATION_CAPABILITY_OF_COMMUNITIES_Eng_Version

Day_26 : A text mining : Trends of disaster research on aging

Have just conducted a text mining as follows:

Overviews of the Literatures concerning elderly and disasters by text mining for the initial stage.
1.Search the keywords at Web of Science (Core Collection)
2.Selected Information (Authors, Titles, and Abstracts) was gathered into one text file.
3.1st contents analysis has been carried out and omitted the unnecessary words for the next analysis.
Cleaning process
4.2nd contents analysis has been carried out. >>This process was repeated
5.Research findings are examined.
6.Check the extracted words and phrases by reaching to the original abstracts and original papers.

*5 and 6 are not finished yet.
**To do the textmining, RH corder was used.

The folloing attached file is the results which I can share
Elderly_disasters_initial_litreview_outline