[Nihon koshu eisei zasshi] Japanese journal of public health最新文献

{"title":"[Educational inequalities in mortality by prefectures in Japan: National census-linked mortality data, 2010-2015].","authors":"Hirokazu Tanaka, Kota Katanoda, Yasuki Kobayashi","doi":"10.11236/jph.24-075","DOIUrl":"10.11236/jph.24-075","url":null,"abstract":"<p><p>Objectives　To examine a comprehensive monitoring framework for health inequalities in Japan, this study aimed to quantify educational inequalities in mortality and its regional variations, which are widely used internationally as outcome measures of health inequalities.Methods　Individual data were obtained from the 2010 Population Census and Vital Statistics death records (2010-2015). We used the combination of \"sex,\" \"birth month/year,\" \"municipality of residence,\" \"marital status,\" and \"age of spouse (married individuals only)\" as a linkage key. Individuals with a unique \"linkage key\" were selected and included in the sample population. We included 7,984,451 Japanese individuals (3,992,202 men and 3,992,249 women) aged 30-79 years (9.9% of the total census population). Death records with a unique \"linkage key\" were linked to these records using the deterministic linkage method (five-year cumulative proportion of deaths; 5.6% for men and 2.5% for women). Inverse probability weights were calculated from the ratio of the total to sample population, using the distributions of sex, age, prefecture, educational attainment, and occupation. Weighted age-standardized mortality rates (ASMR) and ASMR ratios by educational level were calculated, and their variations by prefecture were analyzed.Results　Estimated all-cause ASMRs (per 100,000 population) for men were 1,025 (95% confidence interval [CI]; 1,013-1,037) for high education (university graduation) and 1,245 (95% CI; 1,238-1,253) for middle/low education (junior/senior high school graduation). The respective values for all-cause ASMRs in women were 496 (95% CI: 485-508) and 640 (95% CI: 636-645). Estimated all-cause ASMR ratios between low/middle and high education levels were 1.21 (95% CI; 1.17-1.26) for men and 1.29 (95% CI; 1.17-1.41) for women. The ASMRs were higher for middle/low education than for high education in each prefecture; this trend was particularly pronounced among men. Additionally, no systematic differences were observed, although geographical backgrounds were considered.Conclusion　Using the national census-linked mortality data, ASMR was approximately 1.2-1.3 times higher for \"junior/senior high school graduates\" than for \"university and above graduates\" in Japan. Although regional variations in the ASMR ratio were small, a more accurate mortality database must be constructed for further analysis in prefectures.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"292-302"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of hospitalization status by major classification according to ICD-10 among public assistance recipients considering sex and age].","authors":"Hideyuki Watanabe, Masaaki Matsunaga, He Yupeng, Atsuhiko Ota, Li Yuanying, Kotaro Kuwaki, Shinichi Tanihara","doi":"10.11236/jph.24-068","DOIUrl":"10.11236/jph.24-068","url":null,"abstract":"<p><p>Objectives　We evaluated the number of hospitalizations among public assistance recipients for each major classification according to the International Classification of Diseases 10th Revision (ICD-10), adjusting for sex and age differences in the general Japanese population. This study aimed to provide a comprehensive assessment of hospitalization patterns among public assistance recipients by disease category.Methods　We used indirect methods to adjust for sex and age, with public assistance recipients and the entire Japanese population as the observation and reference groups, respectively. We calculated the standardized hospitalization ratios (SHRs) for each major classification based on the ICD-10. We only used publicly available government statistics, including data from the 2020 Patient Survey, for hospitalization rates according to sex, age, and major classification. Additionally, we used data from the 2020 National Survey on Public Assistance Recipients conducted for the number of public assistance recipients by sex and age groups and data from the 2020 Survey on the Actual Status of Medical Assistance conducted for the number of hospitalizations by major classification.Results　After adjusting for age, the overall SHR was 1.49. The major classifications with the high SHRs for men and women were \"V. Mental and behavioural disorders\" (SHR for men; 4.06, women; 3.45) and \"IV. Endocrine, nutritional, and metabolic diseases\" (SHR for men; 2.40, women; 1.47). Conversely, the major classifications with low SHRs were \"XVI. Certain conditions originating in the perinatal period\" (SHR; 0.43) and \"VII. Diseases of the eye and adnexa\" (SHR; 0.44) for men. For women, these were \"XV. Pregnancy, childbirth, and the puerperium\" (SHR; 0.17) and \"VII. Diseases of the eye and adnexa\" (SHR; 0.27).Conclusion　After adjusting for age, hospitalization status among public assistance recipients was higher overall than in the general Japanese population. However, if divided based on major classifications, higher and lower rates were observed compared with the general population. In assessing the status of medical assistance for public assistance recipients, research should be conducted by disease classification, considering the significant differences in age composition between public assistance recipients and the general Japanese population.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"272-283"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Examination of the reliability and validity of the Japanese version of the patient self-advocacy scale for psychiatric users].","authors":"Yui Hamada, Masako Kageyama, Keiko Yokoyama","doi":"10.11236/jph.24-063","DOIUrl":"10.11236/jph.24-063","url":null,"abstract":"<p><p>Objective　In 2020, > 6 million individuals with mental disorders received psychiatric care. Advocacy is important to ensure that the rights of psychiatric patients, for whom involuntary hospitalization sometimes occurs, are maintained. This study aimed to develop a Japanese version of the Patient Self-Advocacy Scale (PSAS) by Brashers et al. to measure the degree of patient self-advocacy and examine its reliability and validity.Methods　Five researchers translated the original PSAS into Japanese. The translated questionnaire was piloted with five psychiatric users and further revised. The revised content was back-translated by a professional translator and checked by the original author. An online questionnaire was administered to verify the validity and reliability of the completed Japanese PSAS. The questionnaire was distributed to individuals who received mental health services on a mailing list. Some respondents were asked to complete the questionnaire a second time to examine the reliability of the retest method. Reliability was examined by calculating Cronbach's alpha coefficients for the entire scale and subscales and evaluating the results of the correlation coefficients with the retest. For validity, exploratory and confirmatory factor analyses were conducted, and correlation coefficients were calculated using related scales (the Japanese versions of the Desirability of Control, Desire for Autonomy, and Health Locus of Control scales).Results　The questionnaire received 214 responses, and the test-retest questionnaire received 48 responses. Most respondents had been diagnosed with mood disorders (48.1%) or schizophrenia (40.7%), and 46.8% had been receiving psychiatric care for > 10 years. Cronbach's alpha coefficients for the overall scale and subscale analyses and correlation coefficients for retests ranged from 0.66-0.83 and 0.69-0.84, respectively. Regarding validity, exploratory factor analysis revealed three factors with items similar to those in the original version, and confirmatory factor analysis showed goodness of fit (CMIN/DF = 2.834, GFI = 0.896, AGFI = 0.841, RMSEA = 0.093, AIC = 198.542, CFI = 0.888). Correlations with relevant scales were significant with those of most subscales.Conclusion　The Japanese PSAS was valid and reliable. This scale can be used to assess self-advocacy among psychiatric users and may help understand attitudes toward rights and advocacy.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"284-291"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Factors associated with restarting or continuing community activities for older adults during the COVID-19 pandemic].","authors":"Kumiko Nonaka, Sachiko Murayama, Keiko Sugiura, Hiroshi Murayama","doi":"10.11236/jph.24-059","DOIUrl":"10.11236/jph.24-059","url":null,"abstract":"<p><p>Objective　This study examined the factors associated with the status of group activities provided to older adults during the COVID-19 pandemic by community groups aiming to improve the health and social interactions of older adults. Methods　A mail survey was conducted with 372 leaders of neighborhood associations and Senior Citizen Clubs in November 2020 in Ward A, Tokyo. The questionnaire asked leaders about the status of group activities provided by neighborhood associations and the aforementioned clubs for older adults. Leaders responded regarding their group's activity status from April to October 2020 based on three patterns: 1) suspending the activity, 2) carrying out the activity by modifying the content, and 3) performing the activity without modifying the content. Data from 206 groups were analyzed. A latent class analysis (LCA) was performed using activity status to classify each group's activity patterns, and a multiple logistic regression analysis was conducted using activity patterns as dependent variables. Variations in activity content, activity frequency, the average number of participants and volunteers, having participants over 80 years old in the group, and the group's social capital were assigned as covariates. We also included the communication frequency between the volunteers and participants before COVID-19 and during the first state of emergency as covariates. Missing values were supplemented using a multiple imputation model. Results　Four patterns were identified from the LCA results: \"suspended the activity\" from April to October, \"restarted the activity with modified content\" from a specific month, \"continued the activity with modified content\" from April to October, and \"continued/restarted the activity without modified content\" from April to October. The multiple logistic regression, with \"suspended the activity\" as a reference group, demonstrated that a communication frequency of more than once a week was associated with \"continued the activity with modified content\" (odds ratio: = 5.25, 95% confidence interval (CI) = 1.19-23.21), and \"continued/restarted the activity without modified content\" (OR = 4.37, 95%CI = 1.07-17.82). In addition, carrying out the activity more than twice a month (OR = 3.12, 95%CI = 1.10-8.87) and having 6-10 volunteers (OR = 0.32, 95%CI = 0.11-0.89) were associated with \"restarted the activity with modified content.\"Conclusion　This study emphasizes the importance of communicating with participants more than once a week and having fewer volunteers to restart or continue group activities during the COVID-19 pandemic. The study findings can guide municipal governments and public health professionals in assisting community groups during emergencies, such as the COVID-19 pandemic.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"261-271"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Support provided for persons with disabilities and patients with intractable diseases during the COVID-19 pandemic].","authors":"Chisato Tanikake, Jinichi Suzuki, Tatsuko Sugii, Tomoko Tachibana, Yoshimi Hashimoto, Tomoko Kodama","doi":"10.11236/jph.24-091","DOIUrl":"10.11236/jph.24-091","url":null,"abstract":"<p><p>Objectives　Considering the difficulty and importance of supporting persons with disabilities (PWDs) and patients with intractable diseases during the COVID-19 pandemic, we monitored and reported support activities for PWDs and patients with intractable diseases.Methods　We attempted to identify the issues to be resolved by the keywords \"disability\" and \"intractable disease\" from 2019-2022 during the COVID-19 pandemic. The information materials were (1) abstracts from the general meetings of the Japanese Society of Public Health and the Society of Local Public Health journals (2019-2021), (2) foreign academic journals; (3) newspapers (national papers [Asahi Shimbun, Yomiuri Shimbun, Mainichi Shimbun, Sankei Shimbun], in 2021), media information, such as magazines and websites, (4) legislation, notifications, and research expenses, and (5) patient group information. We made several proposals for the Japanese Society of Public Health.Results　In 2020, facilities for PWDs did not have a system for receiving advice from infection control experts. During the COVID-19 pandemic, PWDs experienced trouble because of the characteristics of their disabilities, such as difficulty in accessing COVID-19 information. Children with disabilities felt stressed owing to the closure of daycare facilities. Further web research is necessary, considering the changes in working style. In 2021, local governments were requested to prepare manuals to provide information to PWDs and respond to infections according to the characteristics of each disability, and support from academic societies was anticipated. In 2022, local governments led collaborations with medical care facilities, health, and welfare. Support from academic societies was desirable to eliminate regional disparities, such as creating manuals for infection control and COVID-19.Conclusion　We believe that receiving advice from various experts on supporting welfare systems for facilities for PWDs during the COVID-19 pandemic helped us achieve our initial goals. We hope that all the experts will continue to work from the perspective of whether anyone is left behind concerning health and welfare.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"303-314"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Challenges in implementing evidence-based standardized home visits for newborns, infants, and their caregivers: Lessons from the Republic of Korea].","authors":"Kyoko Yoshioka-Maeda, Saki Doi, Mari Ikeda, Hideki Hashimoto","doi":"10.11236/jph.24-133","DOIUrl":"https://doi.org/10.11236/jph.24-133","url":null,"abstract":"<p><p>Objective　In Japan, home-visit programs for newborns and infants have been implemented based on the Maternal and Child Health Act and Child Welfare Act. However, these programs vary widely across municipalities. This study aimed to examine the current state and challenges of scientifically designed and standardized home-visit programs in the Republic of Korea and obtain practical implications for Japan.Methods　Information was collected through collaboration with individuals affiliated with the Seoul National University College of Medicine and from publicly available sources.Results　In the Republic of Korea, the Maternal and Early Childhood Home Visiting Program targets children aged ≤ 2 years and their mothers. Based on \"the Family Partnership Model,\" the program emphasized partnerships between nurses, social workers, and caregivers. Initiated in Seoul in 2013 as the Seoul First Step Project, it expanded nationwide in 2019 as part of the Early Life Health Management Program. The program integrates the social-ecological model, proportionate universal approach, and life course approach, offering basic visits to all applicants and ongoing visits to families requiring additional support. The coverage rate of home-visit programs relative to the number of births has reached approximately 30%.To address the shortage of nurses, group programs in which mothers learn parenting skills together and the distribution of parenting manuals and leaflets were implemented. A standardized 320-h in-service training program was developed to ensure standardized home visits. Regular supervision and reflection opportunities were provided to the staff to ensure the quality of the home visits. Inspired by the U.S. HomVEE framework, multidimensional evaluation indicators assessed home environment, child safety, growth and development, maternal well-being, and community support.Conclusion　In the Republic of Korea, partnerships between universities, administrative organizations, and healthcare professionals (nurses, social workers, and physicians) have fostered evidence-based program designs, standardized in-service training, and evaluation outcomes. Although Japan has achieved high implementation rates of meticulous home visits, in-service training and evaluation should be improved. To address health inequalities from early life stages, translate evidence into practical applications, and improve the quality of home-visit programs by leveraging the strengths of all stakeholders involved.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Comparison of salt reduction policies and trends levels in dietary salt intake in Japan and other countries: A narrative review].","authors":"Koki Torami, Chika Okada, Mieko Nakamura","doi":"10.11236/jph.24-122","DOIUrl":"https://doi.org/10.11236/jph.24-122","url":null,"abstract":"<p><p>Objectives　This study compared salt reduction policies and trends in dietary salt intake between Japan and other countries to facilitate future implementation of salt reduction initiatives in Japan.Methods　Information on salt reduction policies, salt intake, and target values in G7 member countries (Japan, the United States, Canada, the United Kingdom, Italy, France, and Germany) and countries with similar food cultures (China and Korea) since 2000 has been collected from institutional, article, and report websites. If sodium data were available for a specific country (the United States, Canada, or Korea), the sodium value and the salt equivalent value, calculated by multiplying the sodium value by 2.54, were presented. The percentage reduction was calculated from the baseline and assessment values of salt reduction policies in Japan and the United States. In other countries, it was calculated from near-year values before and after the salt reduction policy because these countries did not confirm the baseline and assessment values. Results　All the target countries set target values for dietary sodium or salt intake. The salt equivalents of the target values ranged from 5.8 g/day (Canada) to 9.9 g/day (Korea). In the United Kingdom, Italy, and France, some food industries, such as bread and pasta, have entered a pact to limit sodium. Korea has been implementing a salt reduction approach, not only in the food industry but also at home, such as the development of salt reduction menus. The main sources of dietary sodium in the United States, Canada, the United Kingdom, Italy, France, and Germany are processed and cooked foods, whereas in Japan, China, and Korea, sodium is consumed at home from condiments. Although the current salt intake could not be compared because of differences in the approach and years studied, it ranged from 6.9 g/day (Canada) to 10.2 g/day (China). Salt intake showed a decreasing trend in all countries, especially Korea and the United Kingdom, with particularly large reductions (32.2% and 14.8%, respectively). The United States and Japan showed lower reductions than other countries (2.2% and 4.7%, respectively). Conclusion　This study revealed that the percentage reduction in salt intake among the Japanese population was lower than that in other countries, highlighting the need for a tailored approach to salt reduction policies in Japan.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Poverty status of households delinquent to paying school lunch fees: A descriptive study using the 2023 JACSIS study].","authors":"Kotone Tanaka, Daisuke Nishioka, Yasutake Tomata, Takahiro Tabuchi","doi":"10.11236/jph.24-097","DOIUrl":"https://doi.org/10.11236/jph.24-097","url":null,"abstract":"<p><p>Objective　This study aimed to describe the living conditions of households that had experienced arrears in school lunch fees for economic reasons and compile basic data to devise measures to address the problem of arrears in school lunch fees and child poverty.Methods　We used data from the JACSIS study (2023), focusing on households with at least one school-age child. A state of arrears in school lunch fees was defined as \"experiencing arrears\" if the participants reported that they had experienced being unable to pay their children's school lunch fees for financial reasons, and \"not experiencing arrears\" otherwise. We employed a set of indicators to evaluate the poverty and living conditions of guardians and children, such as deprivation, household income, changes in income, and food insecurity for household poverty status, and items related to adverse childhood experiences of guardians and children's living conditions. The number and percentage of respondents for each indicator were calculated by school lunch payment status.Results　Of the 1,919 participants, 88 (4.6%) had experienced arrears in school lunch fees, while 1,831 (95.4%) had not. Among those who had experienced arrears, 97.7% were in a state of deprivation, compared to 9.1% of those who had not experienced arrears. Additionally, those who had experienced arrears had a higher percentage of households with an income of less than four million yen (10.0% without experience of arrears vs. 17.1% with experience), reduced income (48.4% vs. 85.2%), and higher food insecurity (11.2% vs. 26.1%). Children from households with arrears were more likely to be respond \"I do not know\" or \"I do not want to answer\" by their guardians on all items related to childhood adverse experiences. They were also more likely to have guardians with mental illness (7.4% vs. 27.3%) and to experience domestic violence (14.4% vs. 80.7%).Conclusion　The findings suggest that households with school lunch fee arrears were likely to be experiencing severe poverty and situations suggestive of child maltreatment. Therefore, identifying arrears in school lunch fees as a sign of poverty may reduce the incidence of such arrears and help protect children's right to a healthy upbringing by connecting families to appropriate support.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Examining the application forms of housing adaptations in the Japanese long-term care insurance system by care need level and professional type: A descriptive study].","authors":"Rumiko Tsuchiya-Ito, Satomi Kitamura, Tomoyuki Ota, Shinji Hattori","doi":"10.11236/jph.24-081","DOIUrl":"https://doi.org/10.11236/jph.24-081","url":null,"abstract":"<p><p>Objectives　Statistical data on housing adaptation services provided by Japanese long-term care insurance are limited. We described the application status by analyzing the application forms of housing adaptation services based on differences in care need levels and health and social welfare professional types.Methods　We obtained data from the application forms of housing adaptation services in Hachioji City, Tokyo in fiscal year 2015. The variables were individual factors (age, care needs level, family status, primary disease, and information about housing) and detailed content of the applied housing adaptations (daily activities expected to improve, expected effects, and types of housing adaptations). We described the number and percentage of individuals according to care need level and type of professional; care managers (long-term care agencies), care manager (community comprehensive support centers), social workers, public health/registered nurses, housing environment coordinators, and certified housing renovation specialists.Results　We analyzed 1,652 participants. The participants were mostly in care needs level 1 (30.2%), and individuals in care needs level 3 (33.3%) applied for housing adaptation during hospitalization. Regarding the daily activities expected to improve, individuals requiring severe care needs likely aimed for toileting (care support level 1; 47.2%, care need levels 4/5; 57.8%) but less likely to expect to improve going outside and up and down the stairs. Individuals with care needs level 1 expected the greatest improvement in their bathing activities (58.1%). Regarding the expected effects, \"fall preventions,\" \"improved ease of activities,\" and \"reducing the applicant's mental burden and anxiety\" were crucial regardless of their care need levels, and \"enabling what cannot be done\" and \"reducing the burden on caregivers\" were more likely to be expected in individuals with more severe care needs. Regarding professional differences, the highest percentages of \"enabling what cannot be done\" were for care managers (long-term care agency) in toileting, bathing, and going outside, and social workers in getting up and down the stairs, and moving indoors. The certified housing renovation specialists emphasize on \"reducing the burden on caregivers.\" The most common type of housing adaptation was the installation of handrails or grab bars.Conclusion　Housing adaptations differ depending on applicants' care needs and professional types. A system that considers the different needs should be designed depending on their care need levels and professional types and has a place in which each profession can understand the differences.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Recommendations for avoiding medical strain: A comparative analysis of regional responses in Hyogo Prefecture during the eighth wave of COVID-19].","authors":"Masanori Hamada, Ryutaro Masago, Kazuo Miyamura, Hiroshi Sumi, Akira Sudou, Masakazu Shinohara","doi":"10.11236/jph.24-096","DOIUrl":"https://doi.org/10.11236/jph.24-096","url":null,"abstract":"<p><p>Objectives　During the eighth wave of COVID-19 in Hyogo Prefecture (October 1, 2022-February 28, 2023), the overwhelming transmissibility of the virus caused a significant strain on the healthcare system. This study focused on Amagasaki Health Center, Akashi Health Center, Sumoto Health Center (island region), and Asago Health Center (rural region) and their unique responses. The difference between the calculated \"required number of critical care beds\" (based on hospitalization recommendations) and the number of secured hospital beds was used as a measure of bed capacity strain, while the number of incidents involving difficulty in emergency transport was used as an indicator of a strain on emergency medical services. The aim of this study was to propose strategies to avoid medical system overload during future infectious disease pandemics based on the responses of each health center and regional healthcare system.Methods　Each fire department provided information on incidents involving difficulties with emergency transport. The \"required number of critical care beds\" was defined as the cumulative daily number of hospitalization recommendations(minus the number of patients who had exceeded the standard 10-day hospitalization period outlined in the guidelines). In the Amagasaki and Akashi Health Center jurisdictions, the number of patients hospitalized daily based on recommendations was recorded. These data were used to evaluate the validity of the calculated required number of critical care beds and assess the effectiveness of back end support operations.Results　Within the Amagasaki Health Center jurisdiction, where a consistent approach was adopted to hospitalize patients at designated medical institutions (from recommendation to discharge), the required number of critical care beds peaked significantly beyond the number of secured hospital beds. This peak coincided with a surge in COVID-19 emergency transport difficulties. In contrast, the Akashi Health Center jurisdiction, with back end support beds, partially mitigated bed-capacity strain and emergency transport difficulties. The Sumoto Health Center's jurisdiction minimized a healthcare strain by prioritizing the continuation of its regular medical care system. In the Asago Health Center jurisdiction, approximately half of the hospital beds were in psychiatric hospitals. Patients in these facilities could continue treatment therein, allowing the region to avoid significant healthcare constraints.Conclusion　Increasing the number of secure hospital beds alone is insufficient for preventing regional healthcare strains in SARS-type pandemics, such as COVID-19. Operating back end support systems and enabling self-contained treatment in facilities, such as care homes for older adults and psychiatric hospitals, are effective measures for avoiding this strain.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}