Figure 2.

Estimated population average treatment effect (ATE) of home loss on functional limitation indicators in 2013 (2.5 years after the disaster) and 2016 (5.5 years after), Iwanuma, Miyagi, Japan, 2010–2016. Population average effects (i.e., ATEs and confidence intervals (CIs)) of the exposures were estimated via the doubly robust targeted maximum likelihood estimation. Models were estimated data-adaptively via the SuperLearner using generalized linear models, gradient-boosting machine, and neural net as candidate estimators. All models adjusted for the 55 pre-disaster demographic and socioeconomic factors, health conditions, psychosocial variables, and behaviors from the 2010 wave. Instrumental activities of daily living (IADL) status was measured by the 13-item Tokyo Metropolitan Institute of Gerontology Index of Competence. Instrumental activities of daily living scores ranged from 0 to 13 points, where smaller scores indicate lower functional independence. Activities of daily living (ADL) had 3 levels (1 = support needed completely, 2 = support needed partially, and 3 = no help needed). Levels of certified physical disability ranged from 1 (“Cannot roll over in a bed independently”) to 9 (“no physical disability/not requesting care services”), where smaller values indicate greater levels of disability. Thus, decrease in these outcomes indicate increased functional limitation.