[Association between health checkups, vaccination, and social isolation among people on public assistance: The case of Izumi Public Health and Welfare Center, Sendai City].

Abstract

Objective　The healthcare management support program for public assistance recipients has been mandated at all welfare centers since 2021 because the importance of healthcare support for them has recently been recognized in Japan. However, the factors that hinder preventive healthcare service utilization have not been empirically investigated. This survey aimed to identify the relationship between health checkups, vaccination services, and social isolation among people on public assistance.Methods　The survey participants were 1,739 public assistance recipients within the jurisdiction of the Public Health and Welfare Center, Izumi Ward, as of January 1, 2022. Data on basic attributes, number of household members, household type, and employment status were obtained from the welfare system. Whether the recipient had received a health checkup or COVID-19 vaccination was determined from the medical receipt. We created four items assessing social isolation. Logistic regression analysis was performed to examine the relationship between the number of health checkups, vaccination, and social isolation.Results　A total of 444 participants (response rate: 25.5%) were included in this analysis. Forty-four (9.9%) participants received a health checkup, and 336 (75.7%) received a vaccination. Logistic regression analysis revealed that attendance at health checkups was positively associated with face-to-face contact, non-face-to-face contact, emotional support, and instrumental support. In particular, the odds ratio of face-to-face contact was 3.59 (95% confidence interval: 1.85-6.94). Vaccination was positively associated with face-to-face contact, non-face-to-face contact, emotional support, and instrumental support. In particular, the odds ratio of instrumental support was 1.58 (95% confidence interval: 1.02-2.54).Conclusion　The findings of this survey revealed that social isolation was an important factor in facilitating the uptake of health checkups and vaccinations among welfare recipients in Sendai. Furthermore, this survey suggests that different types of social support should be incorporated into welfare services depending on the nature of the process by which the recipient accesses preventive services.