News

New paper: Non-financial social determinants of diabetes among public assistance recipients in Japan: a cohort study.

We published a new paper from Journal of Diabetes Investigation.

Nishioka, D., Saito, J., Ueno, K., & Kondo, N. (2020). Non-financial social determinants of diabetes among public assistance recipients in Japan: a cohort study. Journal of Diabetes Investigation.
https://doi.org/10.1111/jdi.13435

Abstract

Aims/Introduction

Poverty is an important social determinant of diabetes. Poverty is a multidimensional concept including non‐financial difficulties, such as social isolation and exclusion from communities. Many countries provide financial social assistance programs for those in need. This study aimed to explore non‐financial social determinants of diabetes among public assistance recipients in Japan, by using linkage data of two municipal public assistance databases and medical assistance claim data.

Materials and Methods

We carried out a retrospective cohort study. Public assistance is provided to households below the poverty line to ensure their income security. We extracted recipients’ sociodemographic factors of January 2016 (household number and employment status as non‐financial social determinants of diabetes) and identified the incidence of diabetes diagnosis until December 2016 as the outcome.

Results

We included the data of 2,698 younger individuals (aged <65 years) and 3,019 older individuals (aged >65 years). A multivariable Poisson regression, with a robust standard error estimator, showed that among 2,144 younger recipients at risk, unemployment and living alone were slightly associated with 1‐year cumulative incidence of diabetes diagnosis (adjusted incidence ratio 1.20, 95% confidence interval 0.93–1.54 and adjusted incidence ratio 1.15, 95% confidence interval 0.89–1.48, respectively). Among 2,181 older recipients at risk, there was no strong association between their sociodemographic factors and incidence of diabetes diagnosis.

Conclusions

Unemployment and living alone might be additional risk factors for diabetes among younger public assistance recipients. Multidimensional supports assuring financial and non‐financial securities are required to prevent diabetes among people living in poverty.

New paper: Primary care approach to frailty: Japan’s latest trial in responding to the emerging needs of an ageing population.

We published a new paper from Integrated Healthcare Journal.

Rosenberg, M., Kondo, K., Kondo, N., Shimada, H., & Arai, H. (2020). Primary care approach to frailty: Japan’s latest trial in responding to the emerging needs of an ageing population. Integrated Healthcare Journal, 2(1), e000049.
http://dx.doi.org/10.1136/ihj-2020-000049

My presentation videos

Here is the list of the videos of the Webinars I attended on YouTube.

Older persons and COVID-19

Dr Naoki Kondo, Presentation: Importance of social connection for health and wellbeing of older people: lessons from Japan Gerontological Evaluation Study

Webinar by Help Age International and more. June 2020

Naoki Kondo. Achieving health equity via community organizing: two real-world intervention studies in Japan

ISBNPA Webinar SIG Socio-Economic Inequalities. March 2020

 

New Book：The Atlas of Health Inequalities in Japan

we published a new book from Springer: The Atlas of Health Inequalities in Japan.

From the book website:

This new health atlas of Japan presents a series of maps about the health of the contemporary Japanese population, i.e. detailed maps of health indicators in small areas using cartograms. This is the first comprehensive small-area based health atlas about contemporary Japan using vital statistics from 1995-2014. Each map is supplemented with concise explanations written by leading epidemiologists and health geographers in Japan. The book employs various cutting-edge methods in spatial epidemiology, Bayesian spatial smoothing for the reliable mapping of mortality indices,  advanced cartographic transformations using the concept of aerial cartograms, and summary statistics of socioeconomic health inequalities. The atlas highlights geographical aspects of social gradients in health by comparing mortality maps with distribution of deprivation index during the recent long-lasting economic stagnation period of Japan known as the lost decades. This health atlas will be a useful resource for international comparisons between Japan and other advanced countries in terms of health and related socioeconomic disparities between regions. It will be of interest to public health practitioners, administrators, researchers and students working on health geography and public health.

 

New paper: stronger associations between oberweight, underweight, and mortality among poor Japanese men

Influence of socioeconomic status on the association between bodymass index and cause-specific mortality among older Japanese adults: The AGES Cohort Study

Miyo Nakade, Daisuke Takagi, Kayo Suzuki, Jun Aida, Toshiyuki Ojima, Katsunori Kondo, Hiroshi Hirai, Naoki Kondo

Preventive Medicine 77 (2015) 112-118
http://dx.doi.org/10.1016/j.ypmed.2015.05.015

Objective.Many studies have suggested a U-shaped curve for the association between body size andmortality risks, i.e., mortality risks increase in those who are both overweight and underweight. The strength of the associationsmay vary according to socioeconomic statuses (SES), as they determine levels of access to healthcare and psychosocial stresses. We investigated the modifying effects of SES on the relationship between body mass index (BMI) and mortality.

Method.We used prospective cohort data of participants in the Aichi Gerontological Evaluation Study in 2003(n=14,931),whowere 65 years or older and physically and cognitively independent at baseline, and residing in eightmunicipalities in Japan. Data on all-causesmortality andmortality from cancer, cardiovascular disease, and respiratory disease was obtained from municipal government registries.

Results. Proportional hazard regression analyses showed that, among men, the associations between overweight (BMI ? 25 kg/m2) and highermortality risks by any causewere stronger among lower incomegroups. Even adjusting for multiple confounding factors, hazard ratios (95% confidence intervals) for mortality by all causes among low income group (household income b 1.5 million yen) were 1.96 (1.02-3.73) for overweight compared with BMIs between 23.0 and 24.9, whereas they were 0.94 (0.57-1.38) among men in high income group (income N 3 million yen). The modifying effects of income were not marked among women.

Conclusion. Household income, which may directly reflect accessibility to healthcare and psychosocial stress among older Japanese men, may be an important modifying factor in the health risks attributable to overweight.