Impact of the COVID-19 Pandemic on Health Check-ups before and after the COVID-19 Downgrade and Employees' Mental Health at Health Check-up Facilities: The Third Nationwide Survey of Healthcare Facilities in Japan Society of Ningen Dock and Preventive Medical Care.

Introduction: Preventive programs, including cancer and diabetes screenings, were disrupted globally by the coronavirus disease 2019 (COVID-19) pandemic and had not returned to pre-pandemic levels even in 2021-2022. In Japan, COVID-19 was downgraded to the lowest-risk category under the Infectious Diseases Control Law in May 2023. However, whether participation in health check-ups recovered after this downgrade remains unclear. Additionally, understanding the impact of the pandemic on employees' mental health and attrition is crucial for maintaining services in future pandemics. To address these issues, we conducted a nationwide survey.

Methods: A questionnaire survey was conducted between December 16, 2023, and February 21, 2024, targeting member facilities of Japan Society of Ningen Dock and Preventive Medical Care. The questionnaires covered COVID-19-related rules before and after the downgrade, the negative impact on employees' mental health, and whether employee resignations increased compared to the pre-pandemic period. Participants also provided data on the number of health check-up examinees from 2019 to 2023.

Results: We emailed 1,381 facilities, of which 856 responded (response rate: 62.0%). An additional 124 facilities responded via the Society's website, yielding a total of 980 participants. While cancer screenings by local governments returned to pre-pandemic levels in 2023, gastric cancer screenings remained low. Nearly 30% of facilities reported a negative impact of the pandemic on employees' mental health, which was associated with factors such as being annexed to hospitals and employees' complaints about strict COVID-19-related rules. This negative impact was strongly linked to increased employee resignations.

Conclusions: While overall cancer screening rates recovered, gastric cancer screenings remained below pre-pandemic levels. Furthermore, the negative impact on employees' mental health was significantly associated with increased attrition, highlighting the need for mental health support for those engaged in preventive medicine to maintain services during future pandemics.