『保健医療科学』 2021 第70巻 第4号 p.407-417（2021年10月）
連載：東日本大震災からの10年―国立保健医療科学院からの発信̶ ＜総説＞
避難所・応急仮設住宅の現状と課題―高齢者・障がい者への配慮や健康影響の視点から―
阪東美智子
国立保健医療科学院生活環境研究部
Current status and issues of evacuation shelters and temporary housing among older adults and people with disabilities
BANDO Michiko
Department of Environmental Health, National Institute of Public Health
抄録
災害時には，災害による直接的な死亡だけでなく，避難生活等において亡くなる震災関連死や健康被害などの問題があり，その多くが高齢者・障がい者などの要配慮者・避難行動要支援者である．本稿は，避難所・応急仮設住宅の供与について，高齢者・障がい者への配慮や健康影響の視点から，東日本大震災以降の動向や今後取り組むべき課題を整理することを目的とする．
内閣府や復興庁，厚生労働省などの行政資料や，医中誌等を中心に主に東日本大震災後に発表された研究論文・資料を収集し整理した．
東日本大震災では，その被害規模の大きさや津波被害地での避難所・応急仮設住宅の開設が困難であったことなどから，様々な工夫を凝らした避難所・応急仮設住宅の設置・運営が行われた．たとえば，賃貸型応急仮設住宅の導入がその例である．一方，災害救助法が想定していなかった「在宅被災者」など新たな課題も表出した．避難所・応急仮設住宅に関する研究の蓄積と，それを反映した制度の改革などにより，徐々に状況は改善しているが，避難所・応急仮設住宅の物理的環境の問題は依然として解消されていない．また，結露やカビ・ダニなどの室内環境の問題も残されている．
今後も高齢化が進む中，高齢者・障がい者に配慮した避難所・応急仮設住宅の環境整備は，震災関連死の予防やその後の健康被害の予防のためにも早急に取り組むべき課題である．
キーワード：東日本大震災，避難所，応急仮設住宅，高齢者，障がい者
Abstract
There are many deaths and health hazards that occur during evacuation apart from disaster-related deaths. Most of these deaths are among older adults and people with disabilities.
The purpose of this paper is to assess trends in evacuation after the Great East Japan Earthquake and address future implications regarding the supply of evacuation shelters and emergency temporary housing for older adults and people with disabilities and health issues.
Data were obtained from the Cabinet Office, the Reconstruction Agency, the Ministry of Health, Labour and Welfare, and research papers and materials published after the Great East Japan Earthquake, and analysed.
Owing to the magnitude of the damage caused by the Great East Japan Earthquake and the difficulty in opening evacuation shelters and temporary housing in tsunami-damaged areas, various ingenious evacuation shelters and temporary housing systems were installed and operated. For example, rental type emergency temporary housing was introduced. However, the Disaster Relief Act had to deal with other issues such as “refugee at home” that it had not envisioned.
The situation has gradually improved because of increased research on evacuation shelters and emergency temporary housing, and the system reforms based on them. However, the physical environment issues, such as barrier-free of evacuation shelters and emergency temporary housing have not yet been resolved. In addition, problems with the indoor environment, such as dew condensation, mould, and mites, continue to remain.
As the Japanese population continues to age, improving the environment for evacuation shelters and temporary housing for older adults and people with disabilities is an issue that should be addressed immediately to prevent disaster-related deaths and any subsequent health hazards.
keywords: Great East Japan Earthquake, evacuation shelter, emergency temporary housing, older adults, people with disabilities
