[Paper Publication] Actual Situation and Risk Factors of Hospitalization Among Children Receiving Public Assistance in Japan: Financial Support Alone May Not Ensure Children’s Health (Associate Professor Daisuke Nishioka)

A research team led by Program-Specific Associate Professor Daisuke Nishioka has, for the first time, mapped the characteristics and hospitalization risk of 1,990 children on public assistance (seikatsu-hogo) across six Japanese municipalities. By linking public assistance registers with medical assistance receipt data and following recipients for one year, the study found that 4.6 % of these children were hospitalized, with younger age groups and those holding disability certificates at particularly elevated risk. It is notable that hospitalization rates varied by household composition, including single-parent families and households with both parents working, and differed significantly between municipalities, emphasizing that the financial relief provided by seikatsu-hogo alone cannot fully mitigate health risks for children living in poverty.

These findings highlight the multidimensional nature of child poverty in Japan and call for policy measures beyond economic support to address social and environmental determinants of health. The authors recommend further research incorporating more granular data on non-recipients alongside recipients to inform targeted interventions.

Click here for access to the full paper.

[Media Coverage] Towns with More Library Books Tend to Have Longer, Healthier Life Expectancy: Each Additional Library Book per Person Is Associated with a 4% Lower Risk of Needing Long-Term Care among Older Adults

Our research paper, “Public libraries and functional disability: A cohort study of Japanese older adults,” analyzed data from 73,138 community-dwelling adults aged 65 and older across 19 Japanese municipalities (mean follow-up 7.3 years) and demonstrated that each additional library book per person corresponded to a 4% reduction in the risk of requiring long-term care.

This finding was featured exclusively in Japanese media, most notably in medical journalist Naoko Iwanaga’s newsletter, which provides an accessible overview of the study alongside commentary from Koji Fujisaka, former director of Nagoya City Shidami Library.

Click here to read the Japanese newsletter. The full paper in English is available here.

(Paper publication) Vegetable Intake Increased by 10.7%! Quiz-Based Incentives via Health App Show Promise for Behavior Change (Associate Professor Akira Kyan)

A study led by Associate Professor Akira Kyan of the University of the Ryukyus (formerly of Kyoto University), in collaboration with Assistant Professor Koryu Sato (Keio University, Faculty of Policy Management) and Professor Naoki Kondo (Kyoto University, Department of Social Epidemiology), found that a quiz-based incentive campaign delivered via a health app significantly increased vegetable intake among residents of a Japanese city.

As part of a long-running health communication campaign, 786 participants answered quizzes on vegetable nutrition and earned points that could be exchanged for product vouchers. Participants who completed all three quizzes consumed 10.7% more vegetables than non-participants.

Using multiple regression analysis and dietary data from the previous year (from 605 individuals), the study confirmed a statistically significant increase in vegetable consumption among frequent quiz participants.

These findings provide strong evidence that gamified, incentive-based interventions delivered through digital toolscan support improvements in dietary behavior and contribute to the prevention of noncommunicable diseases.

Article: Kyan A, Sato K, Kondo N. Increased vegetable consumption in Japan using an incentivized health communication campaign with a quiz. J Nutr Sci 2025 Apr 2; 2(14): e30.

Please click here for the full-text article.

(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