Paul – Department of Social Epidemiology

(Paper publication) Tailor-Made Support for Children in Households Receiving Public Assistance: Establishing a Novel Method Toward Developing an Effective Support System (Visiting Researcher Keiko Ueno）

Poverty adversely affects children’s health and social lives. Children in households receiving public assistance often have diverse health and lifestyle needs that require individualized support tailored to their specific living backgrounds. Moreover, effective support methods vary depending on each child’s circumstances.

To address this issue, a research team led by Keiko Ueno, an assistant professor in the Department of Social Epidemiology at Kyoto University Graduate School of Medicine, utilized responses from a questionnaire survey of 1,275 children. Using a machine learning technique called soft clustering, they categorized the children into small groups (segments) based on differences in their living backgrounds. The researchers then conducted interviews with professionals (including NPO staff, child psychiatrists, public health nurses, and school counselors; hereafter referred to as “experts”) to understand each segment’s lifestyle characteristics and collect opinions on suitable health and life support strategies. As a result, five distinct and expert-validated segments were identified.From the expert interviews, diverse support strategies were suggested, addressing not only physical health but also social and mental well-being. Based on these findings, the team is now developing a tailor-made support system that presents support plans matched to each segment.

This research was published online in the International Journal for Equity in Health on April 16, 2025.

Article：Ueno K, Nishioka D, Shiho K, Naoki K. A data-driven approach to detect support strategies for children living in households receiving public assistance in Japan: a mixed methods study to establish tailor-made health and welfare care. Int J Equity Health. 2025;24:103.

Please click here for the full-text article. The press release is also available here.

Press Release: Older Adults Engaged in Social Participation Are More Likely to Maintain Independence Until the End of Life (Co-researcher: Takayuki Ueno)

A research group led by Takayuki Ueno, a researcher at the Tokyo Metropolitan Institute for Gerontology, and Professor Naoki Kondo of our lab had previously identified five patterns of physical function decline during the last three years of life: “maintained independence until death,” “rapid decline,” “gradual decline,” “moderate maintenance,” and “severe maintenance.” In this study, the group revealed that older adults who participated in social activities at least once a month in 2010 were more likely to follow the “maintained independence” trajectory compared to those who did not engage in social activities.

The findings of this study offer valuable insights into extending healthy life expectancy and improving the quality of life (QOL) for older adults. These results underscore the necessity of promoting social participation in future older adult care policies.

Article: Ueno T, Saito J, Murayama H, Saito M, Haseda M, Kondo K, Kondo N. Social participation and functional disability trajectories in the last three years of life: The Japan Gerontological Evaluation Study. Arch Gerontol Geriatr. 2024 Jun; 121: 105361.

DOI: 10.1016/j.archger.2024.105361

News: Now Available On-Demand – Breaking Barriers for Gender and Health Equity Through Research (Professor Kondo)

We are pleased to announce that the sessions from the recent Nature Conference “Breaking Barriers or Gender and Health Equity Through Research” are now available on-demand. Professor Naoki Kondo participated in this important event and presented a lecture on “Gender Differences in the Impacts of Social Determinants of Health” during Session VI: Sex and Gender in Clinical Trials and Health Research.

If you missed any of the sessions or believe this event would be valuable for a colleague, you can still access the content on-demand.
Click here for more details: Nature Conferences: Access the Event On-Demand.

Thank you, Professor Naoki Kondo, for your continued support in advancing gender and health equity research.

Paper publication: Discovering daily life needs of older public assistance recipient subgroups (Assistant Professor Ueno)

Health disparities have become a major social issue in Japan. To reduce health disparities, it is necessary to shift from individual-level to societal-level interventions. Since 2021, health management support programs for public assistance recipients have been mandated in welfare offices. Assistant Professor Keiko Ueno and her colleagues focused on older public assistance recipients, particularly those in need of health and daily life support, and identified the daily life needs of older public assistance recipient subgroups.

In 2021, we conducted interviews with four caseworkers from the welfare offices in two districts. The results of our previous quantitative study, which identified five subgroups of older public assistance recipients by sex, were presented to caseworkers. They were asked about their daily life needs in each subgroup. The interview results revealed the following five daily life needs among the subgroups of older public assistance recipients: (1) housing, (2) financial,(3) welfare service utilization, (4) medical, and (5) no specific daily life needs. These findings indicate that appropriate support interventions are necessary for each subgroup of older public assistance recipients. Future studies are warranted to conduct interviews with professionals from other fields (such as public health nurses and social workers) to further understand the daily life needs of the subgroups of older public assistance recipients.

Article: Ueno K , Nishioka D, Saito J, Kino S, Kondo N. Understanding the daily life needs of older public assistance recipient subgroups in Japan: A qualitative study.Glob Health Med. 2024. doi: 10.35772/ghm.2024.01029

* Please click here for the Press Release (in English) and here to access the full text article.

Press Release: Living Arrangement Status and Treatment Effectiveness of Cardiovascular Prevention – (Medical Student Kanta Kiyohara)

Medical student Kanta Kiyohara, Associate Professor Kosuke Inoue, Professor Taku Iwami, and Professor Naoki Kondo published a study using data from a large-scale randomized controlled trial to reveal that the effectiveness of intensive glycemic and blood pressure control among patients with diabetes varies by living arrangement status (living alone or not).

This research, published in the Journal of the American Heart Association (JAHA) on June 27, 2024, highlights the need to consider living arrangements, particularly living alone, as a critical social determinant of cardiovascular health that can modify the effectiveness of cardiovascular prevention among individuals with diabetes.

Article: Kiyohara K., Kondo N., Iwami T., Yano Y., Nishiyama A., Node K., et al. Heterogeneous Effects of Intensive Glycemic and Blood Pressure Control on Cardiovascular Events Among Diabetes Patients by Living Arrangements. J Am Heart Assoc. 2024 Jul 2; 13(13): e033860

DOI: 10.1161/JAHA.123.033860

[Click here for detailed information in Japanese.]

News: Media coverage “Community gender norms, mental health and suicide ideation and attempts among older Japanese adults: a cross-sectional study” – JAGES (January-March 2024)

The content of the research, “Community gender norms, mental health and suicide ideation and attempts among older Japanese adults: a cross-sectional study,” was featured in several Japanese newspapers, 福福島民友・下野新聞・日本海新聞・中国新聞・徳島新聞・秋田魁新報・沖縄タイムス・佐賀新聞・山陰中央新報・高知新聞・福島民報・東京新聞夕刊・千葉日報・京都新聞朝刊・愛媛新聞・南日本新聞・琉球新報・岩手日報・岐阜新聞・長崎新聞・新潟日報, 福井新聞、山梨日日新聞, further amplifying its impact and reach.

For details, click here: Press release: Depressive symptoms, suicide ideation and attempts are about twice as common among those who perceive community gender norms as restrictive (Collaborator Kanamori) – Department of Social Epidemiology (kyoto-u.ac.jp)

Press Release: Income and impaired kidney function –the disparities of rapid kidney function decline and hemodialysis were 1.7 times– (Doctoral Student Ishimura)

Ph.D. student Ishimura and her team published a study examining the association between income and the development of impaired kidney function in JAMA Health Forum.
The study showed the lowest income group had 1.7 times higher risks of rapid kidney function decline and initiation of kidney replacement therapy (dialysis or kidney transplantation) than the highest income group, based on the analysis of 5.6 million insured individuals from the Japan Health Insurance Association.

Article: Ishimura N, Inoue K, Maruyama S, Nakamura S, Kondo N. Income Level and Impaired Kidney Function Among Working Adults in Japan. JAMA Health Forum. 2024;5(3):e235445.
DOI link：10.1001/jamahealthforum.2023.5445

News: Professors Inoue and Sato’s Research Featured in Top 5 Highest Impact Factor Journals 2021-2023 (School of Public Health, Kyoto University)

Congratulations to Associate Professor Kosuke Inoue and Assistant Professor Koryu Sato for their outstanding achievement!

Their dedication and pioneering research have significantly contributed to the understanding of Social Epidemiology, leaving an indelible mark on the academic community. Their work has been recognized with publications among the Top 5 highest Impact Factor Journals between 2021-2023 in the School of Public Health at Kyoto University (KUSPH), as evidenced by Web of Science.

For more detailed information, please click here.

News: Joint Statement on Building a Green Healthcare System released by the Japan Health and Global Policy Institute’s Planetary Health Project (Professor Kondo)

The Planetary Health Project of Japan Health and Global Policy Institute (HGPI) released a Joint Statement titled “A Significant Step Towards the Building a Green Healthcare System” on February 16, 2024, with Professor Kondo serving as an Advisory Board Member.

This statement highlights the increasing significance of addressing planetary health challenges, particularly climate changes, as evidenced by the Japanese government delegation’s participation in the Alliance for Transformative Action on Climate and Health (ATACH) at the 154th World Health Organization (WHO) Executive Board in Geneva on January 27, 2024.

For further details, please refer to the information available by clicking here. [English version]

Press release: 3.8 times the risk of depression when moving to temporary housing; however, those who changed their participation in group activities upon moving had a 40% reduction in the risk (Visiting Researcher Matsuoka)

A research group led by Yoko Matsuoka (Chiba University, Center for Preventive Medical Sciences) and Professor Naoki Kondo analyzed the effect of post-disaster relocation on mental health and the factors explaining this effect among the affected older adults of the 2016 Kumamoto earthquake.

Post-disaster relocation is a risk factor for worsening mental health, but the mechanism has not been elucidated. Therefore, we analyzed the effect of relocation on mental health by housing type and what factors explain this effect. We included 828 older adults aged 65 years or older who participated in the 2013 survey before the earthquake and seven months later in the 2016 survey in Mifune Town, Kumamoto Prefecture, which was affected by the April 2016 Kumamoto earthquake. Focusing on participation in group activities, the risk of depression due to relocation to temporary housing was 3.8 times higher for those who had no change before and after the earthquake, but this risk was reduced by 40% for those who had a change in group participation. After the 2016 Kumamoto earthquake, temporary housing facilities were relocated based on lessons learned from past earthquakes and tsunami disasters, including group relocation policies, the establishment of meeting places in proximity, and visitation activities by support centers. There, residents were able to change their involvement in group activities and optimize their connections, which may have led to a reduction in relocation stress.

The paper was published in BMC Public Health in the online edition on October 11, 2023.

The press release is available here.

[Article Information]

Yoko Matsuoka, Maho Haseda, Mariko Kanamori, Koryu Sato, Airi Amemiya, Toshiyuki Ojima, Daisuke Takagi, Masamichi Hanazato & Naoki Kondo. Does disaster-related relocation impact mental health via changes in group participation among older adults? Causal mediation analysis of a pre-post disaster study of the 2016 Kumamoto earthquake. BMC Public Health 23, 1982 (2023).

DOI: https://doi.org/10.1186/s12889-023-16877-0