Welcome to the official website of Dr Naoki Kondo, a social epidemiologist at the University of Tokyo.
We published a paper from Asian Pacific Journal of Health Economics and Policy.
Masaki Okuda, Yukinobu Ichida, Keita Yamane, Rika Ohtsuka, Miwa Yamaguchi, Rei Goto, Atsuhiro Yamada, Atsushi Sannabe, Naoki Kondo, Takashi Oshio. Preferences for the forms of co-payment and advance payment in healthcare services; a discrete choice experiment. Asian Pacific Journal of Health Economics and Policy Vol.3 No.2. 【DOI】10.6011/apj.2021.01
We published a paper from Aging & Mental Health.
Inoue Y, Stickley A, Yazawa A, Aida J, Koyanagi A, Kondo N. Childhood adversities, late-life stressors and the onset of depressive symptoms in community-dwelling older adults. Aging Ment Health. 2021 Feb 1:1-6. doi: 10.1080/13607863.2021.1875190. Epub ahead of print. PMID: 33522286.
Objective: Depression is common in older individuals though many factors associated with its occurrence remain under-researched. We examined whether childhood adversities (CAs) and late-life stressors are associated with the onset of depressive symptoms in adults aged ≥ 65 and if these early- and late-life stressors interact in the prediction of depressive symptoms. Methods: Data came from the 2010 and 2013 waves of the Japan Gerontological Evaluation Study (JAGES) (N = 8701). The Geriatric Depression Scale (GDS-15) was used to assess the presence of depressive symptoms (GDS ≥ 5). A Poisson regression analysis was used to examine associations. Results: Both CAs (1 event: incidence rate ratio [IRR] = 1.59, 95% confidence interval [CI]: 1.41-1.79; ≥ 2 events: IRR = 2.36, 95% CI = 1.80-3.10) and late-life stressful events (1 event: IRR = 1.13, 95% CI: 1.02-1.25; ≥ 2 events: IRR = 1.25, 95% CI = 1.05-1.50) were significantly associated with the onset of depressive symptoms. Borderline significant interactions between CAs and late-life stressors (e.g. ≥ 2 CAs and ≥ 2 late-life events: IRR = 0.61, p = 0.087) suggest that late-life stressors may be important in predicting the onset of depressive symptoms especially among individuals with no or fewer CAs compared to those with ≥ 2 CAs. Conclusions: Stressful events in childhood and late adulthood were independently associated with the onset of depressive symptoms in older adults. In addition, stressful experiences in childhood might affect how individuals respond to stressful events in later life.
Keywords: Depression; adverse events (AE); aging; epidemiology.
We published a paper from Scientific Reports.
Stickley A, Baburin A, Jasilionis D, Krumins J, Martikainen P, Kondo N, Leinsalu M. Macroeconomic changes and educational inequalities in traffic fatalities in the Baltic countries and Finland in 2000-2015: a register-based study. Sci Rep. 2021 Jan 27;11(1):2397. doi: 10.1038/s41598-021-81135-5. PMID: 33504848.
This study examined trends and inequalities in road traffic accident (RTA) mortality in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in relation to large-scale macroeconomic changes in the 2000s. Educational inequalities in RTA mortality in 2000-2003, 2004-2007, 2008-2011 and 2012-2015 among 30-74 year olds were examined using census-linked longitudinal mortality data and by estimating the relative and slope index of inequality. Overall RTA mortality decreased substantially between 2000-2003 and 2012-2015. From 2004-2007 to 2008-2011, the RTA mortality decline accelerated but was larger in the Baltic countries. Among men the RTA mortality decline was mostly driven by a larger fall among the high and middle educated. Among women, the changes in RTA mortality by educational level had no clear pattern. From 2000-2003 to 2012-2015 relative educational inequalities in RTA mortality increased among men, although more in the Baltic countries. Among women the pattern was mixed across countries. Absolute inequalities fell in all countries among both sexes. Educational inequalities in male RTA mortality may be growing because of increasingly less access to safer cars and a more hazardous driving culture among the lower educated.
We published a paper from Quality of Life Research.
Hirosaki M, Ohira T, Shirai K, Kondo N, Aida J, Yamamoto T, Takeuchi K, Kondo K. Association between frequency of laughter and oral health among community-dwelling older adults: a population-based cross-sectional study in Japan. Qual Life Res. 2021 Jan 11. doi: 10.1007/s11136-020-02752-7. Epub ahead of print. PMID: 33432445.
Purpose: Oral health has been reported to have an impact on the activities of daily life such as chewing, eating, and laughing, while psychological factors such as depression and loneliness have been reported to affect oral health. Little is known, however, about the association between laughter and oral health in older adults. This study examined the bidirectional association between the frequency of daily laughter and oral health in community-dwelling older Japanese adults.
Methods: Our cross-sectional study employed data from the 2013 Japan Gerontological Evaluation Study’s self-reported survey, which included 11,239 male and 12,799 female community-dwelling independent individuals aged 65 years or older. We defined the oral health status by the number of remaining teeth. The association between the self-reported frequency of laughter (almost every day, 1-5 days per week, 1-3 days per month, or almost never) and oral health was examined using logistic regression analysis.
Results: The participants with 10 or more teeth were significantly more likely to laugh compared with the edentulous participants, after adjusting for all covariates. Compared with those who almost never laughed, those who laughed 1-5 days per week were significantly less likely to be edentulous. After stratifying by sex, similar results were found only in the men for both analyses.
Conclusion: There was a significant bidirectional association between frequency of laughter and oral health that was independent of socioeconomic and lifestyle factors among older adults.
Keywords: Cross-sectional study; Frequency of laughter; Number of remaining teeth; Older adults.
We published a paper from American Journal of Hospice and Palliative Medicine.
Moriki Y, Haseda M, Kondo N, Ojima T, Kondo K, Fukui S. Factors Associated With Discussions Regarding Place of Death Preferences Among Older Japanese: A JAGES Cross-Sectional Study. Am J Hosp Palliat Care. 2021 Jan;38(1):54-61. doi: 10.1177/1049909120954813. Epub 2020 Sep 14. PMID: 32924525.
In Japan, many adults prefer to die at home; however, few have their preferences actually come true. While discussions regarding place of death preferences (DPDPs) are important for older adults, they are poorly documented. Therefore, we investigated the factors associated with older Japanese men and women having DPDPs. We used cross-sectional survey data collected for the Japan Gerontological Evaluation Study (JAGES). We applied multivariable logistic regression analysis to calculate the odds ratio (ORs) of having DPDPs separately between men (n = 2,770) and women (n = 3,038) aged ≥ 75 years. We considered 17 potential factors associated with having DPDPs, which were classified as either demographic, healthcare, family, or community factors. Among participants, 50.1% had DPDPs: 1,288 men (44.3%) and 1,619 women (55.7%). Older adults, DPDPs were associated with 5 additional factors; e.g. having a primary care physician (ORs = 1.47 [men] and 1.45 [women]), as were those who gave family and friends advice (ORs = 1.26 [men] and 1.62 [women]), and having people who listened to their concerns (ORs = 1.70 [men] and 1.81 [women]). Among men, DPDPs were associated with 3 additional factors; e.g. humorous conversations with their spouse (OR = 1.60). Among women, only one factor-reading newspapers (OR = 1.43) was associated with having DPDPs. Social networks with primary care physicians, family members, and friends may be important factors in promoting DPDPs. These gender-based differences in older adults relating to DPDPs should be considered when developing interventions to promote advance care planning that includes DPDPs.
Keywords: Japanese older adults; cross-sectional study; end-of-life care; end-of-life discussions; gender difference; preferences for place of death.
We published a new paper from Journal of Epidemiology.
Hatakeyama N, Kamada M, Kondo N. Parental working hours and children’s sedentary time: a cross-sectional analysis of the J-SHINE. J Epidemiol. 2020 Oct 3. doi: 10.2188/jea.JE20200170. Epub ahead of print. PMID: 33012775.
Abstract
Background: Sedentary behaviors are prevalent among children and can have a detrimental effect on their health. Little is known about the influence of parental time on children’s sedentary behavior. This study examined the association between parental working hours and children’s sedentary time.
Methods: Cross-sectional data were drawn from the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE) in 2010 and 2011. Participants were 886 children aged 7-18 years and their parents. The primary outcome was self-reported sedentary time after school that comprised screen time and non-screen time. The main explanatory variable was parental working hours. We used multiple regression analysis adjusting for sociodemographic factors.
Results: Children’s mean (SD) sedentary time was 222 (123) min/day; 144 (108) min/day screen time and 78 (65) min/day non-screen time. Children whose mothers worked ≥ 20 hours/week had 28 min/day (95% CI, 9 to 48) longer sedentary time than children of homemakers (240 min/day vs 214 min/day). The longer maternal working hours, the longer sedentary time (p for trend < 0.01). In contrast, children whose fathers worked ≥ 48 hours/week had 82 min/day (95% CI, -156 to -7) shorter sedentary time than children of non-working fathers (179 min/day vs 264 min/day). When limited to children whose fathers worked, there was no statistically significant association between children’s sedentary time and paternal working hours.
Conclusions: Children with mothers who work long hours or fathers not working tend to sit more. Supplementing the shortages in resources for childcare may be necessary among those families.
Keywords: adolescents; determinants; sitting time.
The activities of Japan Gerontological Evaluation Study was introduced in the report of UNFPA: Regional COVID-19 monitoring report June 2020_B-1
We published a new paper from American journal of epidemiology.
Abstract
Levels of social capital can change after a natural disaster; thus far, no study has examined how changes in social capital affect the mental health of disaster victims. This study examined how pre-disaster social capital and its changes after a disaster were associated with the onset of mental disorders. In October 2013, we mailed a questionnaire to participants of the Japan Gerontological Evaluation Study living in Mifune town (Kumamoto, Japan) and measured pre-disaster social capital. In April 2016, the Kumamoto earthquake struck the region. Three years after the baseline survey, post-disaster social capital and symptoms of mental disorders were measured using the Screening Questionnaire for Disaster Mental Health (SQD) (n = 828). A multiple Poisson regression indicated that a standard deviation of 1 in pre-disaster social cohesion at community-level reduced the risk of depression (relative risk [RR] = 0.44); a decline in social capital after the disaster elevated the risk among women (RR = 2.44). In contrast to social cohesion, high levels of social participation at community-level were positively associated with the risk of depression among women. Policymakers should pay attention to gender differences and the types of social capital when leveraging social capital for recovery from disasters.
Keywords
depression, natural disaster, natural experiment, social capital, social cohesion, the 2016 Kumamoto earthquake
Koryu Sato,Airi Amemiya,Maho Haseda,Daisuke Takagi,Mariko Kanamori,
Katsunori Kondo,Naoki Kondo. Post-disaster Changes in Social Capital and Mental Health: A Natural Experiment from the 2016 Kumamoto Earthquake.
American Journal of Epidemiology, kwaa041, https://doi.org/10.1093/aje/kwaa041
Published: 30 March 2020
We published a new paper from JAMA Network Open.
Abstract
Importance Childhood maltreatment can have significant consequences on health through the life course, but its association with health care costs in later life is not widely known.
Objective To assess whether a history of childhood maltreatment is associated with additional medical costs among older adults in Japan.
Design, Setting, and Participants This population-based cross-sectional study used data from the Japan Gerontological Evaluation Study, 2013, linked with national health insurance claims data from April 2012 to March 2014 for 1 municipality that participated in the Japan Gerontological Evaluation Study, 2013. The municipality had more than 1.5 million residents, and 978 independent individuals aged 65 to 75 years were included in the analysis. Data were analyzed from October 2017 to February 2019.
Exposures Childhood maltreatment, including physical abuse, emotional neglect, emotional abuse, and witnessing intimate partner violence.
Main Outcomes and Measures Mean annual medical costs between April 2012 and March 2013 and between April 2013 and March 2014.
Results Among 978 independent older adults (mean [SD] age, 70.6 [2.9] years; 426 [43.6%] men), 44 (4.5%) witnessed intimate partner violence, 19 (1.9%) were physically abused, 104 (10.6%) were emotionally neglected, and 56 (5.7%) were emotionally abused in childhood. In total, 176 older adults (18.0%) experienced at least 1 type of childhood maltreatment. Mean annual medical costs of those who experienced any childhood maltreatment were significantly higher than of those who did not (difference, ¥136 456 [US$1255]; 95% CI, ¥38 155-¥234 757 [US$351-US$2160]; P = .007). Those who experienced emotional neglect incurred more mean medical costs than those who did not (difference, ¥161 400 [US$1484]; 95% CI, ¥42 779-¥280 021 [US$394-US$2576]; P = .008). The association of any childhood maltreatment with medical costs remained significant after controlling for age and sex (average marginal effect, ¥116 098 [US$1068]; SE, ¥53 620 [US$493]; 95% CI, ¥11 004-¥221 192 [US$101-US$2034]; P = .03). The estimated additional costs associated with childhood maltreatment would be more than ¥333 billion (US$3.1 million) per year nationwide.
Conclusions and Relevance In this study, childhood maltreatment was associated with additional medical costs among older adults living in Japan. This finding underlines the importance of primary and secondary prevention of child maltreatment.
Aya Isumi, PhD; Takeo Fujiwara, MD, PhD, MPH; Hirotaka Kato, PhD; Taishi Tsuji, PhD; Daisuke Takagi, PhD; Naoki Kondo,MD, PhD; Katsunori Kondo,MD, PhD.(2020) Assessment of Additional Medical Costs Among Older Adults in Japan With a History of Childhood Maltreatment.JAMA Netw Open. 2020;3(1):e1918681. doi:10.1001/jamanetworkopen.2019.18681
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2758407?guestAccessKey=4e542327-5eed-4244-b760-38a64358517e&utm_source=jps&utm_medium=email&utm_campaign=author_alert-jamanetwork&utm_content=author-author_engagement&utm_term=1m
We published a new paper from Resources, Conservation and Recycling.
Highlights
・In Japan, the carbon footprint of health care accounted for 4.6% of total national emissions in 2011.
・By 2015, the annual carbon footprint had increased to 72.0 MtCO2e owing to the growth of medical expenditures.
・The carbon footprint per patient with or without hospitalization was 12 and 2.1 tCO2e/y, respectively.
・Avoiding generation of unused medicines can potentially reduce emissions by 1.24 MtCO2e/y.
・To safeguard planetary health, more options for health promotion and carbon emission mitigation need to be provided.
Abstract
The carbon footprint of Japanese health care services, i.e. the domestic greenhouse gas (GHG) emissions caused by health care expenditures, including the associated fixed capital, were calculated using input-output analysis. In 2011 the total carbon footprint of these services was 62.5 × 106 metric tons of CO2 equivalent (MtCO2e), which is 4.6% of total domestic GHG emissions. Medical services involving hospitalization accounted for the greatest share, at 15.7 MtCO2e. The second highest category, Medical services without hospitalization, accounted for only slightly less: 14.2 MtCO2e. However, the difference in emissions per patient between these two categories was considerable. On average, emissions per patient for Medical services (hospitalization) were 12 tCO2e/patient, whereas for Medical services (non-hospitalization) they were only 2.1 tCO2e/patient, or 5.4 times less. In terms of type of medical condition, the greatest annual emissions were associated with cardiovascular disease (6.2 MtCO2e) and neoplasm (4.0 MtCO2e). In terms of age, emissions attributed to patients aged 65 and over accounted for more than half of total health care emissions. By 2015, the total carbon footprint had increased to 72.0 MtCO2e, a rise of over 15% in four years. Although medical care and pharmaceuticals are the main factors responsible for this increase, emissions associated with nursing services have also risen, suggesting that demographic aging may be having a significant impact on GHG emissions. As a countermeasure, the potential annual GHG mitigation achievable through avoidance of unused prescribed medicines resulting in waste was estimated at 1.24 MtCO2e, comparable with the total carbon footprint of home medicines. To safeguard planetary health, in addition to implementing technological improvements to the supply chains of health care services, it will be necessary to provide citizens further options for achieving health promotion and GHG mitigation simultaneously.
Graphical abstract
Keisuke Nansai , Jacob Fry , Arunima Malik , Wataru Takayanagi , Naoki Kondo(2019) Carbon footprint of Japanese health care services from 2011 to 2015.Carbon footprint of Japanese health care services from 2011 to 2015. Resources, Conservation and Recycling 152.
https://doi.org/10.1016/j.resconrec.2019.104525