Ishinomaki is one of the municipalities most severely damaged from the GEJE and subsequent tsunamis (Table
1) [
13,
14]. After the GEJE, approximately 8,700 families in Ishinomaki remained at home, despite serious structural damage; many of these residents were living entirely on the second floor of their homes because the tsunami had completely swept away everything on the first floor [
13,
14]. This vulnerable population, referred to as the stay-at-home victims, was provided with less support by governmental agencies than those living in temporary shelters. To identify and evaluate stay-at-home survivors for providing more rapid and appropriate support in response to their needs, the Health and Life Revival Council in Ishinomaki District (RCI) conducted a face-to-face survey. We used a semi-structured questionnaire composed of the following three sections: household demographics; social background; and health condition of individuals most in need of medical support. The first-term survey was started approximately 6 to 12 months after the GEDE (Table
1) [
14].
Initially, data from 4,176 households were analyzed, with 4,023 household members agreeing to be interviewed using the written form in the first-term and future surveys [
14]. Factors associated with sleep difficulties which frequently begin as stress-related phenomena including natural disaster [
15] were loss of pleasure in life (OR, 1.37; 95% CI, 1.07–1.76), living on a pension (versus living on salary: OR, 1.58; 95% CI, 1.09–2.27) or public livelihood assistance (versus living on salary: OR, 4.40; 95% CI, 1.53–12.65), or women (OR, 2.67; 95% CI, 2.07–3.46) [
14]. Interacting with neighbors by visiting one another was positively associated with sleep (OR, 0.42; 95% CI, 0.24–0.74) [
14]. Among survivors living at home around 2 years after the GEJE, participants with emotional social support (OR, 2.05; 95% CI, 1.35–3.11) and informational social support (OR, 1.55; 95% CI, 1.08–2.21) had lower rates of sleep difficulties, [
16] suggesting that relatively strong neighborhood networks help prevent sleep difficulties. Loss of pleasure in life (OR, 1.25; 95% CI, 1.00–1.57), changes in family structure (OR, 1.46; 95% CI, 1.15–1.85), and changes in work status (OR, 1.30; 95% CI, 1.06–1.59) were also significant factors associated with psychological distress [
17]. Contrary to the hypothesis, the elderly (>65 years) were more likely to have close neighbors and social/family interactions; non-elderly men living alone represented the highest proportion of people without social/family interactions, and persons living alone were less likely to have social/family interactions [
18]. Strengthening social ties before and after disasters is important in building a resilient community capable of supporting the physical and mental health of its citizens.