This study was conducted to elaborate on the factors contributing to indirect deaths due to earthquakes between 1995 and 2016 in Japan and to identify their prevalence by focusing on life and health changes. A content analysis was conducted to determine the factors using documents provided by the local government. From the 472 indirect death cases, 12 categories and 137 detailed factors were identified. From the 13 cases related to suicide, six categories and 15 detailed factors were extracted. Among the categories, intense disaster-related work was ranked highest, followed by damage to jobs and property and family changes. For the other 459 non-suicide related causes of death, 12 categories and 122 detailed factors were extracted. The most prevalent categories were related to delay or interruption of treatment due to hospital shutdowns, followed by changes in living conditions. In detailed factor of living conditions, cold or hot environments—which are due to being washed away by tsunamis, weather, drafty shelters, the number of evacuees, damaged infrastructure, and a lack of clothes—were found in 60 cases. In conclusion, maintenance of medical services, promotion of a safe environment, and identification and intervention of high-risk people based on these factors are imperative. Developing assessment tools based on these factors for future research is essential to estimate the size of high-risk populations, assist in the distribution of limited resources, and respond quickly to survivors in disasters.

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