Author: Paul

Press Release: Development of a new method for tailor-made health support for public assistance recipients (Assistant Professor Ueno)

Health is the cornerstone of life. Protecting the health of individuals receiving welfare support, including public assistance recipients, is especially important. Since 2021, welfare offices in Japan have been obliged to implement health management support programs for public assistance recipients. To provide health and life support efficiently and effectively, we have developed a new tailor-made support method using a marketing technique.

In marketing, the target audience for services is classified according to their characteristics (segmentation) to identify priority individuals and design services tailored to these characteristics. In applying this approach, we used data on public assistance recipients aged ≥65 years to extract five distinct segments via soft clustering, a machine learning technique. We examined the similarities between the extracted segments and public assistance recipients in practice by interviewing caseworkers at welfare offices. The results showed that caseworkers perceived several segments as those in practice. Moreover, we extracted segments with characteristics that caseworkers had not been aware of previously.

Accordingly, we have been developing a tailor-made health support system that presents support plans for each segment.

 

Article: Ueno, K., Nishioka, D., Saito, J. et al. Identifying meaningful subpopulation segments among older public assistance recipients: a mixed methods study to develop tailor-made health and welfare interventions. Int J Equity Health 22, 146 (2023).

https://doi.org/10.1186/s12939-023-01959-7

 

 

News: The Act on Promotion of Policy for Loneliness and Isolation passed

On May 31, the Act on Promotion of Policy for Loneliness and Isolation passed at the plenary session of the House of Councillors, the upper chamber of the Diet.　[Please click here to view the video recording of this session (in Japanese). Voting begins at approximately 11:50 minutes.]

Also, on May 30, the Committee on Cabinet of the House of Councillors held the debate on this bill.  [Please click here to see this debate (in Japanese). There was a Q&A session, a debate in opposition, a vote, and a supplementary resolution.]

Professor Kondo has been a member of the Cabinet Office’s “Expert Committee on the Priority Plan for Loneliness and Isolation” since FY2021 and has been involved in the formulation of the plan on which this bill is based.
*Cabinet Secretariat (Act on Promotion of Policy for Loneliness and Isolation)  outline.pdf (cas.go.jp)   law.pdf (cas.go.jp)

“Social isolation is an important Social Determinant of Health, and countermeasures are essential to make a society with fewer health disparities. The joint efforts that are based on a legal basis will be promoted, including cross-ministry initiatives across the country and collaborations with industry-academia-government and other diverse players. ” (Professor Naoki Kondo)

News: Health Japan 21 (3rd Round) has been announced (May 31)

On May 31, 2023, the Ministry of Health, Labor and Welfare announced the basic policy of the third term of the “National Health Promotion Campaign in the 21st Century (Healthy Japan 21),” in which Professor Naoki Kondo has been involved as a national council member.

It emphasizes the importance of “social environment improvement (or tackling social determinants of health)” and “creating an environment where people can be healthy naturally (that is, without strong individual health awareness and efforts to continue a healthy lifestyle)” which we have been advocating through empirical research with many of our colleagues.

For example, on page 4: “Efforts will be made to implement initiatives aimed at creating an environment that fosters natural well-being, including promoting a healthy eating environment and encouraging physical activity and exercise, among a wide range of individuals, including those with less health consciousness.”

The explicitly stated “Life-course approach” is another feature that has never been seen in Japan’s health promotion plans so far, on page 5: “We will actively promote the life–course approach, which considers a person’s health throughout their entire lifespan, starting from the fetal period to old age. This approach will be implemented in coordination with other health promotion initiatives and plans.”

Press Release: Retirement is associated with reduced heart diseases and physical inactivity – a longitudinal study of over 100,000 people in 35 countries (Assistant Professor Sato)

Many countries have been increasing their state pension age. Nonetheless, there is little consensus on whether retirement affects the risk of cardiovascular disease.

Using a causal inference approach, Mr. Sato and colleagues found a 2.2%-point decrease in the risk of heart disease and a 3.0%-point decrease in physical inactivity among retirees, compared with workers.
Policymakers need to consider the benefits of raising the state pension age and allowing older people to continue working versus the costs from the potential risk of expensive medical conditions such as cardiovascular disease.

This research has been published in International Journal of Epidemiology, one of top journals in the field of epidemiology.

In addtion, the results of this study were covered by various media outlets.

Article: Sato K, Noguchi H, Inoue K, Kawachi I, Kondo N. Retirement and cardiovascular disease: a longitudinal study in 35 countries. Int J Epidemiol. 2023 May 8 Int J Epidemiol. 2023 May 8: dyad058.

DOI: https://doi.org/10.1093/ije/dyad058

News: Welcome Professor Oliver and Professor Tomas

Professor Amparo Oliver and Professor Jose M. Tomas, both from the University of Valencia have joined the Kondo Lab as visiting scholars.

Professor Amparo Oliver focuses on “the relationships between comprehensive characteristics and the well-being of older adults based on biological, psychological, and social aspects”.
Professor Jose M. Tomas is researching “statistical models to predict healthy aging”.
They plan to stay in Japan for about a month to conduct their research and then hand over the joint research to a Ph.D. student from their university who will visit Japan soon.

This is an excellent opportunity for collaboration and knowledge-sharing between us.

WELCOME!

From left: Prof. Jose M. Tomas, Prof. Amparo Oliver, and Prof. Kondo
From left to right: Prof. Jose M. Tomas, Prof. Amparo Oliver, and Prof. Kondo

Award: The 12th Asian Association of Emergency Medicine RESEARCH PAPER 1st RUNNER-UP (Assistant Professor Ueno)

Assistant Professor Keiko Ueno’s oral presentation was awarded  EMS (Emergency Medical System) RESEARCH PAPER 1st RUNNER-UP at the 12th Asian Conference on Emergency Medicine held in the Philippines from April 28 to April 30, 2023.

Title: Identifying the features of subgroups in adult ambulance users with non-urgent medical conditions in Japan: A segmentation approach

Paper Category: Analytical Study

Title: Identifying the features of subgroups in adult ambulance users with non-urgent medical conditions in Japan: A segmentation approach

Background: In Japan, approximately 60% of adult ambulance users are assessed as having a minor injury or disease by a physician at the emergency department (ED) and, thus, not requiring hospitalization. They are a diverse group that utilizes a large proportion of emergency care resources. Segmentation, which divides a population into subgroups (segments) with similar characteristics, is a useful approach for identifying and providing intervention strategies tailored to the needs of each segment.

Objectives: Our study aimed to define the features of different subgroups of adult ambulance users with non-urgent medical conditions through the interpretation of quantitatively derived segments.

Methods: The study was a population-based observational study using the ambulance transportation records database and ambulance request call records database from Higashihiroshima City, Japan, between January 1, 2016, to December 31, 2020. The participants were ambulance users, aged 18 to 64 years, who were assessed as having a minor injury or disease by a physician at the ED during the study period. A soft clustering method was performed to segment the participants based on 13 variables including their characteristics (age and sex), diagnosis at the ED, the location of the ambulance call, date and time of the ambulance call, emergency status as judged by EMS (Emergency Medical Service), and the accident category. Ethical approval was granted by the Ethics Committee of the Graduate School and Faculty of Medicine of Kyoto University (Approval No: R3745).

Results and Discussion: This analysis included 5,982 adult ambulance users (mean age = 39.3 years, standard deviation [SD] = 14.5, 44.2% women). Six segments were obtained: (1) “Users with neurological diseases or other injuries late at night on weekdays;” (2) “Users injured or involved in fire accidents, with increased on-scene time and multiple hospital inquiry;” (3) “Users transferred between hospitals;” (4) “Users with acute illnesses and transported from home;” (5) “Users involved in motor vehicle accidents”, and (6) “Users transferred to a hospital outside of the area during day time on weekdays.”

Conclusion and Recommendations: The findings suggest that adult ambulance users with non-urgent medical conditions can be categorized into distinct segments using data from population-based ambulance records. Further research is needed to address the user needs of each segment and provide tailored interventions to meet these needs.