Papers

A paper by Project Researcher Hiroshi Habu and Professor Naoki Kondo was published in F1000Research on June 30, 2025. It explores the challenges of applying Pierre Bourdieu’s concept of cultural capital to public health and epidemiology. Drawing on public health, epidemiology and cultural anthropology, the authors identify five core challenges: 1. the epistemological divergence between Bourdieu’s focus on power structures and public health’s focus on health promotion; 2. the need to consider intervention-oriented cultural capital concept; 3. the need to assess cultural capital at the collective level; 4. the need for cultural capital concept that encompasses human nature beyond the social space; and 5. the unclear and inconsistent definitions of culture across research fields.

To address these challenges, the study proposes a new theoretical framework that introduces “cultural determinants of health,” “cultural well-being” and “contextual validity,” laying the groundwork for “cultural epidemiology,” a quantitative approach to evaluating culture’s role in health outcomes. These insights offer a foundation for future empirical research and policy development that integrate cultural factors into health interventions.

Click here for access to the full paper.

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.

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.

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.

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.

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.]

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.

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