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

{"title":"[Long-term differences in cumulative long-term care costs according to risk assessment scale scores for functional disability: A 12-year JAGES cohort study].","authors":"Masashige Saito, Taishi Tsuji, Ryota Watanabe, Masaki Fukusada, Katsunori Kondo","doi":"10.11236/jph.26-058","DOIUrl":"https://doi.org/10.11236/jph.26-058","url":null,"abstract":"<p><p>Objectives　A previous study reported that future long-term care (LTC) costs differ according to risk assessment scores for incident functional disability. This study uses extended long-term follow-up data to examine cumulative LTC cost differences across various follow-up periods.Methods　As part of the Japan Gerontological Evaluation Study (JAGES), a baseline survey was conducted in August 2010 and January 2011 among individuals aged ≥ 65 years in five Japanese municipalities (response rate: 63.7%). These individuals were not certified as requiring public LTC insurance benefits. Using public LTC claim records, LTC service costs were tracked for 21,626 individuals aged over 12 years following the baseline survey. The risk assessment scale for incident functional disability (0-48) comprises 12 items including sex and age. An ordinary linear regression model, Tobit regression model, and a linear regression model with multiple imputation for missing values were applied.Results　During the follow-up period, 9,368 (43.3%) participants were certified as requiring LTC or support, and 7,137 (33.0%) died. Even at the 12-year follow-up, the higher-risk group (risk score ≥17) was positively associated with the cumulative cost of LTC services per person, duration of LTC service use, and the proportion of people certified as requiring LTC or support. Compared with the difference between high- and low-scoring groups at the 1-year follow-up, the magnitude of the difference increased exponentially: a 59.7-fold increase at 6 years, a 120.2-fold increase at 9 years, and a 185.6-fold increase at 12 years. After adjusting for confounders, the 12-year cumulative LTC cost increased by approximately 80,900 yen (95% confidence interval [CI]: 68.6-93.2) per 1-point increase in the risk score. The corresponding estimates were 63,000 yen (95%CI: 49.3-76.6) in the low-score group (risk score ≤16) and 110,400 yen (95%CI: 80.6-140.2) in the high-score group (risk score ≥17). Total expenditure increased with longer observation periods, although the increase plateaued after approximately 10 years in the high-score group. The major results and trends were generally consistent across the different model specifications.Conclusion　The baseline risk assessment scale for incident functional disability can be used to estimate the subsequent occurrence of LTC certification and cumulative LTC expenditure over a 12-year follow-up.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901513","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":"[Achievements and future prospects of a nationwide training workshop on pathogen genomic data analysis for municipal public health institutes].","authors":"Junji Seto, Takayuki Wada, Ryohei Nomoto, Yoshihiro Yasui, Jun Kawase, Yusuke Yodotani, Akie Sakagami, Katsumi Mizuta, Kazuhisa Yoshimura, Kenji Sadamasu","doi":"10.11236/jph.26-040","DOIUrl":"https://doi.org/10.11236/jph.26-040","url":null,"abstract":"","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901549","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":"[Primary role of public health management centers in patient safety].","authors":"Hanae Okajima, Shun-Ichi Nakamura, Nobuya Kusunoki","doi":"10.11236/jph.25-042","DOIUrl":"https://doi.org/10.11236/jph.25-042","url":null,"abstract":"<p><p>Objectives　In 2023, the Kobe City Public Health Management Center (KCPHMC) conducted an extraordinary on-site inspection based on the Medical Care Act and provided administrative guidance after a whistleblower report regarding Hospital A. However, owing to repeated legal violations, the KCPHMC eventually issued an improvement measure. In this study, we evaluated the various steps of the interventions implemented by the KCPHMC to establish a patient safety management system (PSMS), clarified the role of a public health management center, and identified the remaining unresolved issues.Methods　A factual overview is provided based on the relevant documents in this case. Subsequently, the KCPHMC-induced interventions were divided into four verification items, including the processes of extraordinary on-site inspections under the Medical Care Act, fact-finding and guidance, evaluation of improvements, and decision making, and analyzed retrospectively. We evaluated the validity of the inspection methods following the detection of the case and its legitimacy, the impact of the identification of root causes and providing guidance, and the utility of the methods used by KCPHMC to evaluate improvements and the decision-making processes.Results　The application of Article 25(2) of the Medical Care Act for on-site inspections was found to be valid. The process-from the selection of investigation targets and fact-finding processes for the determination of legal violations to the issuance of an improvement order-was appropriate. Identifying the organizational background as the root cause led to fundamental improvements. In addition to the guidance of the KCPHMC, expert advice regarding the PSMS enabled Hospital A to incorporate advanced measures into the improvement plans. The check system to evaluate PSMS improvement, using improvement-verification tables that were cross-verified by the KCPHMC and Hospital A, promoted PSMS activities and the establishment of a PSMS culture. As the concern strongly affected the regional medical system, discussions and policy decisions were made by departments other than the KCPHMC in Kobe City, depending on the nature of the case.Conclusions　In case of a dysfunctional PSMS, the hospital faces difficulties in self-correction. KCPHMC-instituted interventions, including extraordinary inspections, fact-finding, improvement orders, root-cause analysis, formulation of fundamental improvement plans, and subsequent evaluations, were crucial for the reconstruction of the PSMS. In such cases, where there is a potential threat to citizens' lives and an impact on the regional medical system, proactive intervention by the health center is important. Simultaneously, we noticed a shortage of expertise and human resources in this process. Further knowledge regarding effective interventions and guidance by health centers is required.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901560","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 pertussis incidence trends before and after the COVID-19 pandemic: Investigation of factors behind the surge in pertussis cases in Kanagawa Prefecture (Week 1, 2018 - Week 33, 2025)].","authors":"Mutsumi Kimura, Chie Kaneto, Mai Ito, Ryosuke Shinohara, Emi Fujii, Ryoko Yokoyama, Eiji Azegami, Asami Takai, Aya Maruyama, Tomohiro Arai, Tamaki Ishino, Haruko Sekido, Keiko Tanaka-Taya","doi":"10.11236/jph.26-028","DOIUrl":"https://doi.org/10.11236/jph.26-028","url":null,"abstract":"<p><p>Objective　To investigate the causes of the sharp increase in pertussis cases, by comparing the trends in pertussis incidence in Kanagawa Prefecture before and after the COVID-19 pandemic.Methods　Epidemiological data of pertussis cases reported in Kanagawa Prefecture from epidemiological week 1 of 2018 to week 33 of 2025 were examined based on infectious disease surveillance. Since changes in pertussis trends may have been influenced by behavioral changes that were implemented during the COVID-19 pandemic, such as droplet infection prevention and social distancing, the study period was divided into two sections: before and after the pandemic. The number of cases was compared across variables, including age group, vaccination history, symptoms, and diagnostic methods.Results　A pertussis outbreak was observed between 2018 and 2020, and a large-scale outbreak starting in 2024 continued to persist as of week 33 of 2025. Comparing the periods before and after the COVID-19 pandemic, the age group with the highest number of case reports shifted from children aged 5-10 years to those aged 10-15 years. Moreover, the number of reported cases has decreased in infants under 6 months of age, who are at the highest risk of severe complications from pertussis. Regarding vaccination history, in both time frames, the proportion of cases with \"four doses received\" was the highest; after the COVID-19 pandemic, an increase in the number of cases for those with four doses of DPT or DPT-IPV vaccines was observed in the 7-15 age group. Regarding symptoms, the percentage of patients with nocturnal cough, dyspnea, staccato, whoop, vomiting, apnea, cyanosis, and leukocytosis decreased. In terms of diagnostic methods, the frequency of genetic testing and rapid diagnostic tests increased compared to serological techniques.Conclusion　Factors contributing to the sharp increase in pertussis cases included the accumulation of susceptible individuals due to droplet and contact infection control measures and behavioral restrictions during the COVID-19 pandemic, waning immunity due to the time elapsed following pertussis vaccination, a possible increase in the number of reported cases due to an expanded set of diagnostic methods, and an increase in macrolide-resistant Bordetella pertussis strains. Advancing the starting age of routine vaccinations to 2 months contributed to the prevention of infant pertussis. However, additional DPT vaccinations at the ages of 5-7 and 11-12 years, as recommended by the Japanese Pediatric Society, are considered necessary.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901593","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":"[Conflicts and responses of municipal public health nurses during the COVID-19 pandemic: A focus group interview].","authors":"Yumi Sagara, Ikumi Nakaita","doi":"10.11236/jph.25-084","DOIUrl":"10.11236/jph.25-084","url":null,"abstract":"<p><p>Objectives　This study clarified the practical activities undertaken by municipal public health nurses (PHNs) during the coronavirus disease 2019 (COVID-19) pandemic and ethical and emotional conflicts they experienced to derive implications for strengthening community health responses and capacity building during future health crises.Methods　This qualitative descriptive study was conducted using focus group interviews with eight municipal PHNs, with an average of 23.88 years of experience. Interview transcripts were transcribed verbatim and analyzed using inductive content analysis to extract themes regarding participants' activities and emotional experiences during the pandemic.Results　Under crisis conditions, six categories describing PHNs' activities included (1) coping with rapidly increasing responsibilities under uncertain conditions, (2) supporting vulnerable populations and their caregivers, (3) restoring maternal and child health services, (4) initiating organizational and interagency collaborations to mitigate social deterioration, (5) collecting and sharing information to minimize the negative impacts of restrictions, and (6) working with community leaders and professionals to sustain residents' well-being.　Seven categories emerged regarding ethical and psychological conflicts; (1) confusion from expanded roles, (2) frustration at being unable to support those in need, (3) self-doubt about service effectiveness, (4) barriers to collaboration with health centers and other institutions, (5) discrepancies between organizational policies and community realities, (6) re-examination of the meaning of public health nursing during pandemics, and (7) challenges due to insufficient infection control knowledge and systems. A key competency theme was the need to reacknowledge the PHNs' role during health crises.Conclusion　During the COVID-19 pandemic, municipal PHNs have experienced limitations in providing individual support and changes in their professional roles. However, they continued to support residents via trust-based relationships with the community and the foundation of public health services, which has been built during normal times. Furthermore, they frequently face ethical dilemmas if prioritizing tasks and responding to residents, which often entails emotional burdens.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"729-737"},"PeriodicalIF":0.0,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724774","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":"[Bathing regimen and cold-like upper respiratory tract infections: A case-control study in young children and their parents].","authors":"Misuzu Kotsugai, Yoji Okugawa, Nobuyuki Nakanishi, Toshiyuki Ojima, Shinya Hayasaka","doi":"10.11236/jph.25-029","DOIUrl":"10.11236/jph.25-029","url":null,"abstract":"<p><p>Objectives　In this study, we investigated associations between a bathing regimen for young children and the incidence of cold-like upper respiratory tract (URT) infections by analyzing URT infection data in young children aged 3-5 years and their parents. We hypothesized that a standardized bathing regimen, defined by water temperature of 39°C-40°C, immersion level from chest to shoulders, and immersion time of 7-20 min, would be effective in preventing viral URT infections, based on evidence from clinical studies of adult bathing. Associations between this regimen and URT infections in young children and parents were examined as the primary and secondary endpoints, respectively.</p><p><strong>Methods: </strong>Young children and parents who consulted or did not consult a medical institution for URT infection between November 1 and 30, 2024, were included. Cases were defined as individuals diagnosed with viral URT infection, and controls were defined as those without URT symptoms who did not undergo medical examination. The study population comprised young children and their caregivers meeting these criteria, totaling 1,968 participants. Bathing elements, including water temperature, immersion level, and bathing duration, as well as the defined bathing regimen, were considered exposures, while URT infection status was the outcome. Associations were evaluated using logistic regression analyses, with odds ratios and 95% confidence intervals (CI) calculated. Lifestyle factors were included as adjustment variables.</p><p><strong>Results: </strong>In analyses of bathing temperature among young children, multivariate models adjusted for lifestyle factors showed odds ratios of 0.641 (95% CI: 0.442-0.931) for 39°C-40°C and 0.928 (95% CI: 0.627-1.370) for ≥41°C, using ≤38°C as the reference. Multivariate analysis of the bathing regimen in young children yielded an odds ratio of 0.802 (95% CI: 0.644-1.000). A corresponding analysis in caregivers demonstrated an odds ratio of 0.810 (95% CI: 0.692-0.949) after adjustment for lifestyle factors and basic attributes.</p><p><strong>Conclusion: </strong>Bathing at a temperature of 39°C-40°C was associated with a lower incidence of cold-like URT infections in young children, supporting the study hypothesis. Furthermore, the bathing regimen was associated with reduced infection incidence among caregivers. These findings suggest that structured household bathing practices may contribute to infection control.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"707-716"},"PeriodicalIF":0.0,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724771","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":"[Association between health interest and practice of frailty prevention behaviors: A cross-sectional analysis of the Wako Cohort Study].","authors":"Yuri Yokoyama, Yu Nofuji, Takumi Abe, Takayuki Ueno, Kumiko Nonaka, Hiroshi Murayama","doi":"10.11236/jph.25-138","DOIUrl":"10.11236/jph.25-138","url":null,"abstract":"<p><p>Objectives　Health Japan 21 (Third Term) emphasizes measures targeting individuals who are indifferent to their health. We examined associations between health interest levels and the practice of the three key elements of frailty prevention (regular exercise, food intake diversity, and participation in social activities). We further investigated whether this association differed by participant characteristics.Methods　We obtained data from a mailed survey conducted in 2023 targeting 14,013 residents aged ≥65 years living in Wako City, Saitama Prefecture, who had not been certified as requiring level 3 or higher long-term care. We analyzed data from 6,429 valid respondents. We assessed the implementation status of each of the three key elements of frailty prevention: regular exercise (at least once per week), food intake diversity (Dietary Variety Score ≥ 4), and participation in social activities (participation in at least one of the following: employment, volunteer groups, sports groups or clubs, hobby groups, learning or cultural groups, groups for preventing long-term care, senior citizens' clubs, or neighborhood associations). Health interest levels were assessed using the Health Interest Scale (score range: 12-48 points). Participants were categorized into five groups according to the quintiles of their health interest scores. Modified Poisson regression analysis adjusted for major confounding factors was performed to estimate prevalence ratios with 95% confidence intervals (CIs). We also assessed the interactions between health interests and basic respondent characteristics (sex and age group).Results　Among all respondents, 22.9% practiced all three elements of frailty prevention, and the mean Health Interest Scale score was 36.6 ± 5.2. Compared with the group with the highest health interest level (5th quintile), the group with the lowest level (1st quintile) had fewer people who regularly exercised (prevalence ratio = 0.64, [95%CI = 0.59-0.68]), consumed various foods (0.65 [0.59-0.71]), or participated in social activities (0.83 [0.78-0.90]), and fewer people who practiced all three elements (0.45 [0.38-0.53]). Additionally, a significant interaction was observed between health interest and age group with respect to participation in social activities (P = 0.031). The association between low health interest and non-participation in social activities was stronger among those aged ≥75 years than among those aged 65-74 years.Conclusion　Individuals with low health interests were less likely to engage in frailty prevention behaviors. Frailty prevention interventions should consider an individual's health awareness level.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"696-706"},"PeriodicalIF":0.0,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724790","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":"[Reconsidering \"Kenko\" and \"Hoken\" in the AI era: A conceptual analysis].","authors":"Yoshihisa Yamashita","doi":"10.11236/jph.26-016","DOIUrl":"10.11236/jph.26-016","url":null,"abstract":"","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"681-684"},"PeriodicalIF":0.0,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220976","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":"[Legionnaires' disease outbreak caused by an electric fireplace-like interior product generating ultrasonic aerosols].","authors":"Yuko Kuwahata, Ryuto Morikawa, Aiko Misawa, Kohei Yamashita, Yasuko Murai, Yu Watanabe, Chieko Muto, Moeko Umetsu, Teruaki Kinoshita, Tomoe Shimada, Junko Amemura-Maekawa","doi":"10.11236/jph.25-143","DOIUrl":"10.11236/jph.25-143","url":null,"abstract":"<p><p>Objectives　An epidemiological study was conducted of 43 cases of Legionnaires' disease reported to the Tokyo Metropolitan Tama-Kodaira Public Health Center and other health centers between September 30 and November 30, 2024. This report describes the methods used to identify an electric fireplace in a restaurant as the source of infection for some patients and the subsequent administrative measures implemented.Method　The epidemiological investigation involved mapping and case interviews. The restaurant identified as the suspected source of the outbreak was inspected on-site, and water samples collected from the vapor tray of an electric fireplace installed as interior decor were submitted to the Tokyo Metropolitan Institute of Public Health for Legionella isolation testing. Environmental isolates obtained from the restaurant and clinical isolates from patients' sputum were analyzed using sequence-based typing (SBT) and pulsed-field gel electrophoresis (PFGE). For the patient group without common behavioral histories, places of residence and living areas were analyzed.Results　Initially, no clusters of Legionnaires' disease were identified in specific residential areas, and no shared exposure risks were apparent. However, detailed interviews revealed that several patients had dined at the same restaurant equipped with an electric fireplace. This device generated water vapor using a mechanism similar to ultrasonic mist generators. Legionella pneumophila SG1 and L. feeleii SG1 were detected at a total concentration of 3 million CFU/100 mL in water samples. PFGE analysis demonstrated indistinguishable patterns between L. pneumophila environmental isolates and clinical isolates, all of which were assigned to sequence type 23 by SBT. Twenty-one patients developed Legionnaires' disease after visiting the restaurant, had no other shared behavioral history, and showed concordant genotyping results, indicating that the outbreak was caused by aerosols generated by the electric fireplace. Among patients without common behavioral histories, 95% resided or lived within a 3 km radius.Conclusions　To our knowledge, this is the first reported outbreak of Legionnaires' disease associated with an electric fireplace in Japan. Prompt tracing investigations and on-site inspections following identification of the suspected source, combined with immediate confirmation of device use and issuance of administrative guidance, prevented additional cases. Repeated educational initiatives addressing the etiology of Legionnaires' disease and appropriate hygiene management of products with similar functions are necessary to prevent future occurrences.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"738-746"},"PeriodicalIF":0.0,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724808","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":"[Influence of road distance from home to activity hubs on participation in resident-led preventive care activities: The Yabu Cohort Study].","authors":"Yu Nofuji, Takayuki Ueno, Kaito Iwamoto, Satoshi Seino, Yuri Yokoyama, Takumi Abe, Yuka Yoshida, Tomomi Mori, Masaya Uesugi, Kenji Narazaki, Shoji Shinkai, Yoshinori Fujiwara, Hiroshi Murayama","doi":"10.11236/jph.25-125","DOIUrl":"10.11236/jph.25-125","url":null,"abstract":"<p><p>Objectives　In Japan, resident-led prevention care activities (Kayoi-no-ba) are promoted, and many older individuals are expected to participate in these activities to prevent isolation and declining functional disability and support their daily lives. However, as older adults' travel ranges reduce with age, access to activity hubs is a barrier to participation. This study aimed to examine the association between road distance from home to activity hubs and participation in resident-led preventive care activities in locations in which hubs were established within walking distance in each administrative district.Methods　Mail surveys were sent in 2017 and 2022 to individuals aged ≥65 years in Yabu City, Hyogo Prefecture, Japan. Of the respondents, the analysis included 1,369 individuals living in 53 districts in which activity hubs were established in the period between the two surveys. Modified Poisson regression analysis was performed with participation in resident-led preventive care activities by 2022 as the objective variable, road distance from home to activity hubs calculated using Geographic Information Systems (GIS) as the explanatory variable, and baseline demographic variables, socioeconomic status, health concerns, health status, social interaction, car use, the year the hub was established, and mean slope angle to the activity hub (calculated using GIS) as covariates. Restricted cubic splines were used to examine the dose-response relationship between distance and participation.Results　In the period between the two surveys, 478 (34.2%) residents participated in the resident-led preventive care activities. Adjusted analyses revealed that participants residing in the highest tertile of road distance (≥327 m) were less likely to participate in the activities compared to those in the lowest tertile (<171 m) (PR = 0.66, 95% CI; 0.55-0.79, P < 0.001). In sex-stratified analyses, distance and participation were significantly associated only in women. In spline analysis, using the shortest distance as the reference, the PR decreased as the distance increased. A statistically significant difference emerged at distances >350 m.Conclusions　Even in areas in which activity hubs were established within walking distance, the road distance from home to activity hubs was a barrier to participation in resident-led preventive care activities, and a closer hub placement was important for promoting participation. This effect was observed regardless of car use. These findings provide scientific evidence to support the development of activity environments that enable continued participation among older adults.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"685-695"},"PeriodicalIF":0.0,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678954","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}