ABSTRACT
Objective: Municipal National Health Insurance (NHI) in Nagasaki Prefecture in Japan struggles with poor attendance of health check-ups, which was only 39.6% in 2018. This study aimed to evaluate factors that encourage healthy behaviors, including opting for health check-ups, and the characteristics of middle-aged and older individuals who did not undergo health check-ups.Materials and Methods: This cross-sectional study, using a self-administered questionnaire, was conducted in August 2020 in three municipalities of Nagasaki Prefecture. In addition to questions regarding sociodemographic information, such as sex, age, educational status, self-rated economic status, and family structure, the questionnaire included questions on daily lifestyle habits such as alcohol intake and exercise, current medical treatment, self-rated health, and information related to health check-ups. Of the 18,710 questionnaires distributed in the three municipalities, 8,756 (46.8%) were collected by the end of December 2020, of which 7,840 were valid for analysis. The compliance rate for health check-ups was obtained from the Public Health and Welfare Bureau of Nagasaki Prefecture. Statistical analyses were performed according to two age groups: 40−59 and 60−74 years.Results: Among the respondents who did not undergo health check-ups in the year prior to this study, “lack of time” and being “too bothersome” were the most popular reasons for not attending health check-ups. “Living alone” and “low self-rated economic status” were negative factors for receiving health check-ups regardless of age group.Conclusions: Vulnerable middle-aged and older persons, such as those living alone and with low economic status, were less likely to undergo health check-ups. Emphasis on home visits by public health nurses may also be needed to increase awareness of individual health conditions, especially for people living alone and those who are socioeconomically disadvantaged.
ABSTRACT
Objective: The present study aims to investigate the factors related to self-rated ikigai (purpose in life) among older residents participating in hillside residential community-based activities in Nagasaki City.Methods: A self-administered anonymous questionnaire survey was carried out with older residents participating in two hillside residential community-based activities in Nagasaki City, Japan. The questionnaire included questions on sociodemographic information (age, sex, family structure, education, and self-rated economic satisfaction), self-rated health, mental health status measured using Geriatric Depression Scale-15 (GDS-15), and self-rated ikigai score that was estimated using a visual analog scale.Results: A total of 32 older residents (7 males, 25 females) participated in the questionnaire survey. Although self-rated ikigai score was not associated with sociodemographic factors, there were associations between the score, self-rated health (P=0.001), and mental health (GDS-15) (P=0.015). Statistically significant correlations between self-rated ikigai score and social participation (ρ=0.426, P=0.017), self-rated health (ρ=−0.485, P=0.007), and mental health (GDS-15) (ρ=−0.523, P=0.007) were observed.Conclusion: Increasing social participation may increase individual ikigai, preventing poor self-rated health and low mental health status in older people. Maintaining their social participation in the community might be effective for the health promotion of older residents in hillside residential areas of Nagasaki City.
ABSTRACT
Objective: An accidental fire that occurred in a hillside residential area in the city of Nagasaki was evaluated to assess the challenges faced by communities located on sloped terrains and to develop community-based support systems applicable to such hillside residential areas.Methods: Community observations and key-informant interviews were performed in the area affected by the fire. A self-administered questionnaire survey was also conducted among residents of the affected area. Information obtained through community observations of the fire-struck area and key-informant interviews was analyzed and assessed using a two-dimensional (2D) framework.Results: According to community observations and key-informant interviews, initial firefighting efforts were delayed due to lack of preparedness, in addition to geographic factors such as narrow roads and outdoor staircases, which allowed the fire to spread. The livelihood and health support measures for elderly residents requiring evacuation assistance were also insufficient. A hospital neighboring the area affected by the fire accident voluntarily provided some services to evacuees, but support from other nearby organizations/institutions was either not available or not offered. According to the questionnaire answers, elderly residents had little knowledge of the location and proper use of fire hydrants in their area. In addition, 65% of the respondents had never participated in disaster training exercises. From these results, the following three points could be determined: 1) The geographic features of the hillside residential area enhanced the spread of the fire. 2) The multi-sector support systems for evacuees were inadequate, collaboration among the existing systems was insufficient, and the roles of those systems were not fully clarified in advance. 3) Elderly residents in the hillside residential area did not have sufficient the knowledge and/or ability to engage in fire prevention activities and had inadequate firefighting skills.Conclusions: It is important to improve disaster preparedness knowledge and training for local residents on ordinary times. Additionally, cross-sector collaborative disaster response, harmonious management, and support systems must be ensured and sustained before, during, and after disasters.
ABSTRACT
Objective: Participation in social activities is associated with physical and psychological health in the community-dwelling elderly population. We examined the two factors of social relations and community health resources, associated with higher self-rated health levels in the community-dwelling elderly.Methods: A total of 145 community-dwelling elderly people ≥ 65 years old from two neighborhood associations in Nagasaki City were recruited for this study, representing 85% of the officially registered ≥ 65-year-old population in the target area. Face-to-face interviews using a structured questionnaire were conducted by trained interviewers in August 2009, with questions related to sociodemographic characteristics, social relationships, and self-rated health (SRH). Community health resources (type and walking distance from home) were evaluated by one of the authors as a community assessment.Results: Seventy-eight community-dwelling elderly people (25 men and 53 women) participated in the study. Elderly people who reported going out every day were more likely to show higher SRH scores (excellent/good) than those going out less often (OR: 3.7; 95% confidence interval [CI]: 1.0, 14.2; P = 0.056). The numbers of interactions with friends in higher and lower SRH groups were 6.5 ± 8.4 (mean ± standard deviation) and 2.4 ± 1.1 (P = 0.01, Mann-Whitney U test), respectively. The numbers of relatives talking on the phone in higher and lower SRH groups were 2.9 ± 1.3 and 2.2 ± 1.2 (P = 0.031, Mann-Whitney U test), respectively. Meeting scores with friends in higher and lower SRH groups were 7.8 ± 5.8 and 4.5 ± 3.6 (P = 0.068), respectively. The scores of community health resources among higher and lower SRH groups were 21.2 ± 1.5 and 20.9 ± 1.4 (P = 0.547), respectively. The scores of community association/activities in higher and lower SRH groups were 3.9 ± 1.0 and 3.6 ± 0.9 (P = 0.227), respectively.Conclusion: This study indicated the importance of interaction with friends and relatives for maintaining higher SRH among community-dwelling elderly people.