Longitudinal health checkup access pattern following a triple disaster using latent class growth analysis: The Fukushima Health Management Survey

Objectives

The aim of this study was to assess the longitudinal patterns of access to health checkups among residents of municipalities most affected by the triple disaster in Fukushima, Japan.

Study design

A prospective cohort study.

Methods

Participants included residents in 12 municipalities in Fukushima, Japan. All residents in these municipalities were eligible for the Comprehensive Health Check between 11 March 2011 and 1 April 2012. Data were sourced from the Fukushima Health Management Survey in 2021. A total of 167,479 participants aged ≥20 years at the time of the Great East Japan earthquake disaster, with complete data on age, sex, municipality (2011, 2017) and health checkup visits between 2011 and 2018, were analysed. Annual health checkup participation rates were also reported. Latent class growth analysis was performed to classify the trajectory of access to health checkups, and multinomial logistic regression analysis was performed to determine factors associated with each group.

Results

In total, 29.7 % of participants accessed the health checkup in 2011, decreasing to 19.9 % in 2018. This study identified the following three longitudinal health checkup pattern groups: (1) frequent access to health checkups (15.2 %); (2) declining access to checkups (19.3 %); and (3) rare access to checkups (65.5 %). Notably, females and older adults were positively associated with frequent health checkup participation.

Conclusions

Participation in health checkups declined over time following the disaster. Comprehensive strategies are needed to promote participation in health checkups.