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

{"title":"[Emotions of family caregivers of individuals with young-onset dementia when seeking support in the early stages after diagnosis].","authors":"Yumi Tomura, Michiyo Hirano","doi":"10.11236/jph.24-062","DOIUrl":"https://doi.org/10.11236/jph.24-062","url":null,"abstract":"<p><p>Objectives　Family caregivers of individuals with young-onset dementia (YOD) often struggle to seek help, despite the heavy burden of care. This study explored their feelings when attempting to find support in the early stages after diagnosis.Methods　This qualitative descriptive study conducted semi-structured interviews with eight family caregivers of patients with YOD at home. The analysis extracted and coded passages related to feelings in situations in which family caregivers sought support. By comparing and examining the meanings of the codes, we identified broader themes and developed categories iteratively.Results　In the early stages after diagnosis, family caregivers were concerned about \"fear and anxiety about developing dementia at a young age,\" \"desire for any information about YOD,\" \"desire to continue currently as long as possible for the future,\" \"desire to protect the dignity of the individual with YOD as a member of society,\" \"hesitation to tell others that he/she has YOD,\" and \"desire to protect their life, mind, and body, which is still in the mid-life.\" These concerns prompted them to seek the support of others.Conclusion　Family caregivers demonstrated earnest wishes for patients with YOD and themselves in the early stages after diagnosis. They dealt with unique YOD-related struggles, including prejudice, the impact on others, and personal hesitations. Seeking support helped alleviate negative feelings arising from the diagnosis process. Family support services should prioritize early outreach at diagnosis, proactively identify difficulties, and tailor them to patients and caregivers. The attitude of the support staff, who anticipate daily life challenges and approach the family, can significantly facilitate support-seeking by caregivers.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048851","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":"[Residential areas, travel burdens, and children with cancer: Analysis of mobility and mortality ratios using data from Japan's national population-based cancer registry].","authors":"Anna Tsutsui, Yoshitaka Murakami, Takako Fujimaki, Masayuki Endo, Yuko Ohno","doi":"10.11236/jph.24-086","DOIUrl":"https://doi.org/10.11236/jph.24-086","url":null,"abstract":"<p><p>Objectives　Although childhood cancer treatment has recently become centralized at specialized hospitals worldwide, the relationship between mortality ratios and living in rural areas or traveling long distances for treatment remains controversial. In the present study, we examined whether regional differences in patient mobility and mortality ratios exist in Japan.Methods　We investigated 10,713 patients with cancer aged ≤18 years, diagnosed between 2016 and 2019, registered in the national cancer registry data. The patients were divided into two categories based on their residence at diagnosis: urban and rural. Urban areas were defined as metropolitan or urban areas according to the 2015 census or as prefectural cities; all other areas were defined as rural. Additionally, we divided the patients into two groups based on the one-way travel time to the treatment hospital (≤1 h or >1 h), as estimated from location information at the community level using route-planner web services. Next, we calculated the percentage of patients who received treatment within their residences in both areas and for each treatment type. We compared the percentage of distant metastasis in all cancers and each diagnosis group between the two areas using the chi-square test. We finally applied Cox proportional hazard models to obtain adjusted mortality hazard ratios for urban versus rural areas and travel times of ≤1 h versus >1 h.Results　Overall, 77% of the patients were classified as urban residents. The percentages of patients receiving treatment within their residency, secondary medical care area, prefecture, and regional block levels were 22-46%, 80-87%, and 95-99%, respectively. Only central nervous system tumors (III) showed a significant difference in the percentage of distant metastases, which were more common in urban areas (6% vs. 3%). The adjusted mortality hazard ratios were not significantly different between urban and rural areas for all cancers or each diagnosis group. The travel time comparison yielded significant differences of 1.17 for all cancers and 2.57 for lymphomas (II).Conclusion　Approximately 80% of the patients received treatment within their prefecture, although a few traveled long distances across regional blocks. We observed no differences in the mortality ratio between urban and rural areas, although significant differences were found in all cancers and one cancer in the travel burden comparison. These results highlight the need for continued evaluation of the increasing trend in patient travel burden and its impact on survival, as childhood cancer treatment has become centralized in Japan.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048273","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 methods and effectiveness to reduce maternal depression and anxiety in Japan: A literature review].","authors":"Ayaka Hanyuda, Kemal Sasaki, Ritei Uehara","doi":"10.11236/jph.24-042","DOIUrl":"https://doi.org/10.11236/jph.24-042","url":null,"abstract":"<p><p>Objectives　In Japan, support services are provided to help postpartum women within one year after childbirth. This study conducted a literature review of these support methods and their effectiveness in reducing depression and anxiety among postpartum women.Methods　We searched for Japanese and English literature published until August 2023 using the PubMed, Igaku Chuo Zasshi, CiNii Research, and Cochrane Library databases. We included original papers that provided support for postpartum women discharged from delivery facilities within one year of childbirth in Japan and assessed changes in depression and anxiety. The included studies were organized according to study design, number of participants, intervention period, support methods, assessment time, and main outcomes. The support methods and their effectiveness in reducing depression and anxiety were examined.Results　This review included 22 studies from PubMed, Igaku Chuo Zasshi, CiNii Research, and Cochrane Library. Regarding support provided after childbirth, the following methods reduced depression and anxiety; support from the childbirth hospital, care services after childbirth, exercise support, and physical contact between the mother and child. For continuous support during pregnancy, the following methods reduced depression and anxiety; continuous support from certain midwives and comprehensive support based on the assessment of the health status and need for support of postpartum women. Concerning other support, the following methods reduced depression and anxiety; health checkups for two weeks after childbirth, coaching based on the assessment of the current status of child-rearing, consultation services using an application, parenting support, and support for Chinese residents in Japan, while focusing on cultural differences and social support. Eight of these support programs were provided through collaborations between various healthcare professionals, such as physicians and nurses.Conclusion　This literature review found that some support methods reduced depression and anxiety among postpartum women. Planning based on the assessment of the mother's health condition and needs and multidisciplinary cooperation enhanced the effectiveness of support services for postpartum women.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048516","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":"[Core values and competencies of public health nurses: A Delphi survey].","authors":"Reiko Okamoto, Emiko Kishi, Tamami Matsumoto, Yuka Dai, Sachiyo Murashima, Kiyomi Asahara, Kazuko Saeki, Mikako Arakida, Aya Iguchi, Hisako Izumi, Saori Iwamoto, Masayuki Endo, Yuichi Karakawa, Sachi Sakata, Yoshimi Furuhashi, Kaori Maeda, Michiko Matsubara, Yasuko Mitsumori, Riho Iwasaki-Motegi, Fumiko Yoshimura","doi":"10.11236/jph.24-026","DOIUrl":"10.11236/jph.24-026","url":null,"abstract":"<p><p>Objectives　This study aimed to clarify the core values and competencies of public health nurses (PHNs) who contribute to improve health issues in transitioning societies, based on a consensus among PHN-related organizations, including practitioners and education researchers.Methods　A draft defining the core values and competencies of PHNs was developed through five consultation sessions with 20 executives and nominees of organizations in each area of PHN practice, education, and research to collect, categorize, and refine the items. The expert panel comprised 534 nominees from six PHN-related organizations, and three rounds of Delphi surveys were conducted. The consensus criteria were ≥70% for agreement and ≥80% for firm agreement.Results　In the first round, 272 expert panel nominees (50.9%) responded, and 217 responded in all rounds. The draft was revised based on the feedback from each round. By round 3, >90% agreed on the core value and competency frameworks and definitions.Conclusion　The Delphi survey revealed the three core value frameworks and definitions of \"social justice in health,\" \"human rights and autonomy,\" and \"health and safety\" and eight core competencies of \"professional autonomy and responsibility,\" \"scientific research and use of information science and technology,\" \"population-based assessment and analysis,\" \"practices for health enhancement and prevention,\" \"building systems to improve public health,\" \"management of healthy community development,\" \"person/community-centered collaboration and cooperation,\" and \"communication for consensus and solutions,\" with a firm agreement. Eventually, these frameworks would be the bases for creating national standards of practice, education, and research to satisfy the consensus levels of PHNs and PHN-related organizations.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"745-755"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302170","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 the uptake rates of countermeasure-type colorectal cancer screening, new cancer detection indices, and number of municipal public health nurses: An ecological study].","authors":"Koji Hirata, Seiki Nagao, Sayaka Tabuchi, Mihoko Okura, Mikiko Ito","doi":"10.11236/jph.23-086","DOIUrl":"10.11236/jph.23-086","url":null,"abstract":"<p><p>Objective　We conducted an ecological analysis of the structures and processes of municipalities implementing countermeasure-type colorectal cancer screening services, which are associated with high mortality and morbidity rates. We analyzed the populations' demographic characteristics, number of public health nurses (PHNs), and human base for such services. The process was evaluated using the screening uptake rates for countermeasure-type cancer screening and detection indices.Methods　The data included municipal population figures, areas, and national health insurance enrolments, all sourced from a government statistics portal (e-Stat). We obtained the number of PHNs per 100,000 population from PHN activity area surveys, information on municipal colorectal cancer screening from public health centers (PHCs) and health promotion project reports, and cancer detection indices from the National Cancer Registry data. The analysis covered 1,234 municipalities with populations of ≥10,000 and ≥50,000, categorized into three groups based on the presence of PHCs. The internal structures were compared using multiple regression analysis.Results　The number of PHNs per 100,000 population was categorized as follows; <50,000 population group (42.9), ≥50,000 population group (24.3), and PHC-present city group (16.4).Among these groups, the mass and individual screening rates were 96.2% and 47.7%, 69.1% and 91.5%, and 83.7% and 69.9%, respectively. The average uptake rates of countermeasure-type screenings and detailed examinations were 10.6-13.7% and 68.4-75.3%, respectively. In both cases, the <50,000 population and PHC-present city groups exhibited high and low values, respectively. However, the proportion of patients with \"early cancer\" detection was approximately 42% in all groups.Multiple regression analysis, using the countermeasure-type screening uptake rate and colorectal cancer detection indices as dependent variables, revealed that in the <50,000 population group, in which mass screening was prevalent, the number of PHNs was significantly positively correlated with the countermeasure-type screening uptake rate and proportion of \"new cancers\" detected by screening.Contrastingly, the PHC-present city group showed no correlation between the number of PHNs and countermeasure-type screening uptake rate, but a highly detailed examination uptake rate was significantly positively correlated with the proportion of \"early cancer\" detection.Conclusion　In municipalities without PHCs, countermeasure-type screening uptake rates, particularly mass screening rates, were positively correlated with the number of PHNs and cancer detection indices. In cities with PHCs, in which individual screening was prevalent, the detailed examination uptake rate through countermeasure-type screening was correlated with detection indices.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"735-744"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302169","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":"[How smokers perceive pictorial and non-pictorial health warnings on cigarette packages: An online survey].","authors":"Erina Iwase, Hiroshi Yamato, Takahiro Tabuchi, Kayo Togawa, Kota Katanoda, Masakazu Nakamura","doi":"10.11236/jph.24-009","DOIUrl":"10.11236/jph.24-009","url":null,"abstract":"<p><p>Objectives　This study aimed to evaluate Japanese smokers' perceptions of health warnings on tobacco packaging by comparing text-only and pictorial warnings.Methods　Data were sourced from the Japan Society and New Tobacco Internet Survey (JASTIS), an online, self-reported study conducted in February and March 2020. Participants included current smokers aged 15-74 years in Japan (n＝2,372). Perceptions regarding five packaging samples were assessed: the old package (text-only warning covering 30% of the pack's front and back before April 2020), the current package (text-only warning covering 50% of the pack's front and back), and three packages with pictorial warnings covering 50% of the front and back. Respondents were asked four questions on a 5-point Likert scale regarding the effectiveness of these warnings in terms of discouraging young people from starting to smoke, encouraging them to quit, communicating the dangers of smoking, and comfort level with the warnings. A t-test was conducted to compare each pair of packages.Results　There were no significant differences observed between the \"text only 30%\" and \"text only 50%\" packages in terms of preventing young individuals from starting to smoke, encouraging quitting, or communicating the dangers of smoking (P＝0.740-0.987). Conversely, packages with pictorial warnings were perceived as more effective than text-only packages (P＜0.01) in all aspects. A significant difference was observed in the respondents' perceptions of comfort levels with the packages, with the pictorial ones deemed more uncomfortable (P＜0.01).Conclusion　The findings indicated that pictorial health warnings are significantly associated with increased awareness of smoking risks, motivation to quit smoking, and prevention of smoking initiation among young people. Accordingly, Japan should consider adopting pictorial health warnings in accordance with the Framework Convention on Tobacco Control.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"756-765"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513945","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":"[Impact of border control measures on public health center operations and staffing at international airports during the emergence of the SARS-CoV-2 B.1.1.529 (Omicron) variant of concern].","authors":"Naomi Seki, Ai Mikami, Takako Kokufu, Tazuru Kusaka, Kayoko Yamaguchi, Chika Takahashi, Takashi Izuno, Tomoya Saito","doi":"10.11236/jph.24-015","DOIUrl":"10.11236/jph.24-015","url":null,"abstract":"<p><p>Objective　Ota City, located in southeastern Tokyo, including Haneda Tokyo International Airport, has numerous scattered lodging facilities. Shortly after the first case of SARS-CoV-2 B.1.1.529 (Omicron) variant was reported abroad, the Japanese government strengthened border control measures, including quarantine procedures and public health official involvement, for incoming travelers. This study aims to propose effective and efficient border control measures to prevent future outbreaks of emerging and re-emerging infectious diseases.Methods　Border control measures implemented between November 2021 and mid-January 2022 were analyzed from three perspectives: chronological changes in government notifications, the situation of in-flight contacts and Omicron cases, and the support system for coronavirus-disease 2019 control department of the Ota City Public Health Center. Additionally, a questionnaire survey was conducted among public health centers with jurisdiction over the top four international airports. This survey aimed to assess the effectiveness of the support system, evaluate cooperation with related organizations, identify common issues faced by public health concerns, and gather suggestions for improvements in future border control measures.Results　The definition and treatment of in-flight contacts of Omicron-positive individuals were initially outlined on November 30, 2021, and underwent frequent revisions until January 14, 2022. Between December 1, 2021, and January 12, 2022, only one Omicron case was identified among the 470 tests conducted on in-flight contacts. However, out of 136 additional domestic specimens collected (including 57 positives for genetic analysis), 40 were confirmed Omicron positive. The results of the questionnaire survey across the four public health centers largely mirrored the issues and suggestions identified by Ota City officials. A significant portion of these issues arose from managing temporary non-Japanese residents staying near international airports.Conclusion　Border control measures should be implemented to delay the domestic spread of the virus. In this reason, it is crucial to avoid placing an undue burden on public health officials responsible for handling domestic infections. Since response policies and target definitions may need to adapt to unknown pathogens, they may be changed frequently, baffling the officials; however, a system for collecting real-time data from frontline sites and making evidence-based decisions is essential. Additionally, deploying liaisons from national and prefectural governments to focal points of emergency response would strengthen the support system by promoting unified instructions and information sharing.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"775-786"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302171","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":"[Relationship between changes in lifestyle and sleep duration due to the spread of coronavirus disease (COVID-19) in older adults: A cross-sectional study].","authors":"Hidehiko Yamada, Nobuaki Moriyama, Natsumi Okamoto, Chihiro Nakayama, Kayoko Sato, Hajime Iwasa, Seiji Yasumura","doi":"10.11236/jph.24-033","DOIUrl":"10.11236/jph.24-033","url":null,"abstract":"<p><p>Objectives　In response to the spread of COVID-19, a state of emergency was declared on April 7, 2020. People were asked to stay at home unless necessary, and studies conducted in Japan and other countries have investigated the impact of these restrictions on the lives and health of older adults. While some studies have focused on sleep, a crucial aspect of the health of older adults, little is known about the relationship between sleep and various lifestyle changes experienced by older adults in Japan during the COVID-19 pandemic. Herein, we aimed to investigate the factors associated with changes in sleep duration among older adults before and after the spread of COVID-19.Methods　A random sample of 1,808 men and women aged 65-84 years who lived in Fukushima City, Fukushima Prefecture, Japan was selected. A self-administered anonymous survey was mailed to the participants. Logistic regression analysis was used to identify the factors associated with decreased sleep duration compared to the COVID-19 pre-pandemic. Factors such as basic attributes, lifestyle changes compared with that during pre-pandemic period, stress levels, and involvement with the community were considered in the analysis.Results　Of the 1,808 distributed surveys, 1,305 were returned (response rate: 72.2%). After excluding participants with missing data (n＝108), 1,197 responses were included in the final analysis (valid response rate: 66.2%). Among these, 155 participants (12.9%) reported decreased sleep duration. Decreased \"social activities/connectedness\" (odds ratio [OR]: 2.55, 95% confidence interval [CI]: 1.54-4.22), reduced \"average duration of exercise on exercise days\" (OR: 2.69, 95% CI: 1.38-5.24), and self-reported \"stress in the past month\" (OR: 2.41, 95% CI: 1.43-4.06) were significantly associated with decreased sleep duration.Conclusion　The spread of COVID-19 was associated with decreased sleep duration among older adults. This decrease was linked to reduced social activity and participation, decreased exercise, and increased stress. To mitigate these effects, maintaining social participation and activities, scheduling regular and manageable exercise routines, and implementing effective stress management strategies while adhering to infection control practices are important.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"766-774"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513946","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":"[Health-promoting activities and facilitating/inhibiting factors in hospitals, clinics, and nursing care facilities: Public interest corporation survey results].","authors":"Teruko Kawabata, Hidenori Uda, Masakazu Nakamura, Takashi Yamada, Noriko Sasaki, Yuichi Imanaka","doi":"10.11236/jph.24-074","DOIUrl":"https://doi.org/10.11236/jph.24-074","url":null,"abstract":"<p><p>Objective　Medical and nursing care services within community-based integrated care systems are vital in community health. This study aimed to assess the current status of health-promoting activities across hospitals, clinics, and nursing homes operated by the Japan Association for Development of Community Medicine and explore differences depending on the type of facility and strategies for expanding these activities.Methods　Between April 2022 and September 2023, we conducted web-based surveys, followed by telephone and email interviews. The survey covered three main areas; health-promoting activities for patients/users, the community, and staff (options), willingness to expand activities (10-point scale), and facilitating and inhibiting factors (open-ended responses). Responses were analyzed according to facility type, and activities were categorized according to the 2020 Standards for Health-Promoting Hospitals and Health Services (The 2020 HPH Standards).Results　The response rate was 100%. Activities were implemented across all facilities. The percentages of facilities that implemented activities in hospitals, clinics, and nursing homes were as follows; patients/users (96.0, 84.5, 94.4, P = 0.011), community (96.0, 83.3, 100.0, P < 0.001), and staff (100.0, 72.9, 94.4, P < 0.001). The implementation rates were significantly lower in clinics than in hospitals and nursing homes. The mean number of activities in small clinics with < 50 staff (S) was significantly lower than that in large clinics with > 50 staff (L) for patients/users (S, L, difference) (4.1, 6.2, P = 0.034), community (4.9, 9.1, P < 0.001), and staff (1.6, 3.8, P < 0.001). Willingness did not vary by facility type (median of 7.0); however, conviction, as a determinant of willingness, was slightly higher in clinics and nursing homes than in hospitals (hospital = 7.0, clinics and nursing homes = 8.0). The most common facilitating factor for hospitals was \"development of organizational structure,\" such as the establishment of a promotion committee, whereas for clinics and nursing homes, it was the \"provision of educational materials and know-how.\" The most common inhibiting factor was \"increasing workload.\" These activities aligned with almost all 2020 HPH standards; however, the evaluation system needed improvement.Conclusion　All facilities are implementing health-promoting activities according to the 2020 HPH standards and have expressed eagerness to expand their activities. Developing organizational structures, ensuring the profitability of activities, developing evaluation indicators for measuring results, and establishing an evaluation system are crucial for expansion.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900859","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":"[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":"https://doi.org/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":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","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}