[Utilizing administrative data to enhance the Health Management Support Program for public assistance recipients aged <40 years: Lessons from Toyonaka City].

Abstract

Objective　The Health Management Support Program for public assistance recipients is now mandatory at welfare offices nationwide and primarily targets recipients aged ≥40 years. However, limited access to data from other health and welfare programs that take priority over public assistance creates structural barriers to evidence-based health support. During development of its 2016 policy to optimize medical assistance, Toyonaka City identified fragmented data and unmet needs among younger recipients. Therefore, health data from other municipal departments were linked to visualize the health status of public assistance recipients. This report describes the data linkage process and summarizes findings on children and young recipients aged <40 years, thereby presenting program outcomes.Methods　Data were obtained and linked to welfare-ledger records: (1) routine vaccination histories from the Immunization Division; (2) municipal health-check and cancer-screening records from the Adult Health Division; (3) infant health-check results from the Maternal and Child Health Division; and (4) school health-check results from the Board of Education. Descriptive analyses were conducted using the integrated dataset.Results　Among 27 children who remained in public-assistance households throughout fiscal 2024, only 18 (66.7%) received the second dose of the measles-rubella vaccine; coverage remained approximately 60% during 2021-2023. Recipients in their 30s showed higher smoking prevalence, greater obesity, and higher blood pressure, lipid, and glucose levels than non-recipients. The 2023 cervical cancer screening rate was 4.7% (48/1,028 eligible female recipients aged 20-69 years). Infant and school health-check data also indicated persistently high rates of obesity and dental caries among children in public-assistance households.Conclusion　Administrative data linkage across departments, supported by provisions of the Public Assistance Act, identified health disadvantages beginning in childhood and continuing into young adulthood. These findings highlight the need for life stage-specific health promotion for children and younger recipients. Toyonaka City is currently planning targeted interventions based on these results.