NEWS

New paper: Disability and loneliness in nine countries of the former Soviet Union

We published a paper from Disabil Health J.

Stickley A, Kondo N, Richardson E, Leinsalu M, Waldman K, Oh H, Inoue Y, Shakespeare T, McKee M. Disability and loneliness in nine countries of the former Soviet Union. Disabil Health J. 2021 May 28:101123. doi: 10.1016/j.dhjo.2021.101123. Epub ahead of print. PMID: 34147415.

Abstract

Background: People with disabilities (PWD) often face structural and other barriers to community involvement and may therefore be at risk of loneliness. Yet, so far, this issue has received little attention.

Objective: This cross-sectional study aimed to examine the association between disability and loneliness in nine countries of the former Soviet Union (FSU).

Methods: Data were analyzed from 18000 respondents aged ≥18 that came from the Health in Times of Transition (HITT) survey that was undertaken in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine in 2010/11. Respondents reported on whether they had a disability (no/yes) and its severity. A single-item question was used to assess loneliness. Logistic regression analysis was used to examine the associations.

Results: Across the countries, 6.8% of respondents reported being disabled. In a fully adjusted combined country analysis, disability was associated with higher odds for loneliness (odds ratio: 1.30, 95% confidence interval: 1.06-1.60). In an analysis restricted to PWD, individuals in the most severe disability category (Group 1) had over two times higher odds for loneliness when compared to those in the least severe disability category (Group 3).

Conclusions: Disability is associated with higher odds for reporting loneliness in the FSU countries and this association is especially strong among those who are more severely disabled. An increased focus on the relationship between disability and loneliness is now warranted given the increasing recognition of loneliness as a serious public health problem that is associated with a number of detrimental outcomes.

Keywords: Adult population; Disabled; HITT survey; Lonely.

New paper: Sociodemographic inequities in dental care utilisation among governmental welfare recipients in Japan: a retrospective cohort study

We published a paper from Int J Equity Health.

Nishioka D, Ueno K, Kino S, Aida J, Kondo N. Sociodemographic inequities in dental care utilisation among governmental welfare recipients in Japan: a retrospective cohort study. Int J Equity Health. 2021 Jun 16;20(1):141. doi: 10.1186/s12939-021-01473-8. PMID: 34134717.

Abstract

Background: Maintaining oral health is one of the global public health challenges. Income and out-of-pocket payments for dental care services are predictors of dental care utilisation. Although public assistance programmes guarantee income security for impoverished people, access barriers other than financial costs may cause unmet dental care needs. We aimed to explore the potential sociodemographic factors determining dental care utilisation among recipients of public assistance in Japan using linkage data of public assistance database and medical assistance claim data administered by municipalities.

Methods: This was a retrospective cohort study involving a sample of public assistance recipients. We extracted the recipients’ sociodemographic data (age, sex, household number, employment status, nationality, disability certificates, and long-term care status) in January 2016 and observed them until December 2016 to identify incidences of dental care utilisation as outcomes. We performed a multivariable modified Poisson regression analysis with a robust standard error estimator to calculate the incidence ratio (IR) of dental care utilisation in each variable.

Results: We identified a total of 4497 recipients at risk. Among them, 839 recipients used dental care services. Younger age was associated with a higher incidence of dental care utilisation. The female recipients had a higher incidence of dental care utilisation when compared to the male ones (adjusted IR, 1.22; 95% confidence interval [CI], 1.08-1.38). Immigrant recipients had a higher incidence of dental care utilisation than the Japanese ones (IR, 1.53; 95% CI, 1.16-2.01). Recipients with mental disabilities had higher incidences than those without disability certificates (IR, 1.30; 95% CI, 1.08-1.56).

Conclusions: Non-financial sociodemographic inequities in dental care utilisation stemming from age, sex, nationality, and presence of mental disability were found despite minimum income protection and equitable financial dental service access amongst public assistance recipients in Japan. Providing targeted preventive care and treatments for dental care among underserved populations is required to tackle oral health inequities.

Keywords: Free dental care access, Japan; Oral health inequities; Poverty; Public assistance.

Report: Twitter Live hosted by American Heart Association

On May 25, 2021, Assistant Professor Kosuke Inoue took the stage at a twitter live hosted by the American Heart Association.

He was selected as a speaker for the twitter live because he published a paper in Hypertension in 2020 and the paper was selected as a High Impact Paper for Fall 2020.

Inoue K, Goldwater D, Allison M, Seeman T, Kestenbaum BR, Watson KE. Serum Aldosterone Concentration, Blood Pressure, and Coronary Artery Calcium: The Multi-Ethnic Study of Atherosclerosis. Hypertension. 2020 Jul;76(1):113-120. doi: 10.1161/HYPERTENSIONAHA.120.15006. Epub 2020 May 18. Erratum in: Hypertension. 2021 Mar 3;77(3):e34. PMID: 32418495.

New paper: Disability and loneliness in nine countries of the former Soviet Union

We published a paper from Disability and Health Journal.

Stickley, A., Kondo, N., Richardson, E., Leinsalu, M., Waldman, K., Oh, H., … & McKee, M. (2021). Disability and loneliness in nine countries of the former Soviet Union. Disability and Health Journal, 101123.

Abstract

Background

People with disabilities (PWD) often face structural and other barriers to community involvement and may therefore be at risk of loneliness. Yet, so far, this issue has received little attention.

Objective

This cross-sectional study aimed to examine the association between disability and loneliness in nine countries of the former Soviet Union (FSU).

Methods

Data were analyzed from 18000 respondents aged ≥ 18 that came from the Health in Times of Transition (HITT) survey that was undertaken in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine in 2010/11. Respondents reported on whether they had a disability (no/yes) and its severity. A single item question was used to assess loneliness. Logistic regression analysis was used to examine the associations.

Results

Across the countries, 6.8% of respondents reported being disabled. In a fully adjusted combined country analysis, disability was associated higher odds for loneliness (odds ratio: 1.30, 95% confidence interval: 1.06-1.60). In an analysis restricted to PWD, individuals in the most severe disability category (Group 1) had over two times higher odds for loneliness when compared to those in the least severe disability category (Group 3).

Conclusions

Disability is associated with higher odds for reporting loneliness in the FSU countries and this association is especially strong among those who are more severely disabled. An increased focus on the relationship between disability and loneliness is now warranted given the increasing recognition of loneliness as a serious public health problem that is associated with a number of detrimental outcomes.

Keywords

Disabled
Lonely
HITT survey
Adult population

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

We publshed a paper from J Diabetes Investig.

Nishioka D, Saito J, Ueno K, Kondo N. Non-financial social determinants of diabetes among public assistance recipients in Japan: A cohort study. J Diabetes Investig. 2021 Jun;12(6):1104-1111. doi: 10.1111/jdi.13435. Epub 2020 Nov 18. PMID: 33047513.

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.

Keywords: Poverty; Public assistance; Social determinants of health.

New paper: Physical Activity and Cumulative Long-Term Care Cost among Older Japanese Adults: A Prospective Study in JAGES.

We published a paper from Int J Environ Res Public Health.

Hirai H, Saito M, Kondo N, Kondo K, Ojima T. Physical Activity and Cumulative Long-Term Care Cost among Older Japanese Adults: A Prospective Study in JAGES. Int J Environ Res Public Health. 2021 May 9;18(9):5004. doi: 10.3390/ijerph18095004. PMID: 34065052.

Abstract

This study aimed to determine the impact of physical activity on the cumulative cost of long-term care insurance (LTCI) services in a cohort of community-dwelling people (65 years and older) in Japan. Using cohort data from the Japan Gerontological Evaluation Study (JAGES) on those who were functionally independent as of 2010/11, we examined differences in the cumulative cost of LTCI services by physical activity. We followed 38,875 participants with LTCI service costs for 59 months. Physical activity was assessed by the frequency of going out and time spent walking. We adopted a generalized linear model with gamma distribution and log-link function, and a classical linear regression with multiple imputation. The cumulative LTCI costs significantly decreased with the frequency of going out and the time spent walking after adjustment for baseline covariates. LTCI’s cumulative cost for those who went out once a week or less was USD 600 higher than those who went out almost daily. Furthermore, costs for those who walked for less than 30 min were USD 900 higher than those who walked for more than 60 min. Physical activity among older individuals can reduce LTCI costs, which could provide a rationale for expenditure intervention programs that promote physical activity.

Keywords: care cost; older adults; physical activity.

New paper: Differences in Cumulative Long-Term Care Costs by Community Activities and Employment: A Prospective Follow-Up Study of Older Japanese Adults.

We published a paper from Int J Environ Res Public Health.

Saito M, Kondo N, Aida J, Saito J, Anezaki H, Ojima T, Kondo K. Differences in Cumulative Long-Term Care Costs by Community Activities and Employment: A Prospective Follow-Up Study of Older Japanese Adults. Int J Environ Res Public Health. 2021 May 19;18(10):5414. doi: 10.3390/ijerph18105414. PMID: 34069391.

Abstract

We evaluated differences in the cumulative benefit costs of public long-term care (LTC) insurance services by employment status and frequency of community activities. A baseline survey was conducted on functionally independent older people from 12 municipalities as a nationwide survey from 2010 to 2011. Employment status was dichotomized, and community activity was assessed based on the frequency of participation in hobbies, sports clubs, or volunteering. We followed the respondents’ LTC service costs over a period of 6 years using public LTC claim records (n = 46,616). We adopted a classical linear regression analysis and an inverse probability weighting estimation with multiple imputation for missing values. Compared with non-participation in each community activity, the cumulative LTC costs among individuals who participated in hobbies or sports group activities at least twice a week were 1.23 (95% confidence interval: 0.73-1.72) to 1.18 (0.68-1.67) thousand USD lower per person over the 6-year period (28.7% to 30.1% lower, respectively). Similarly, the costs for employed persons were 0.55 (0.20-0.90) to 0.64 (0.29-0.99) thousand USD per person lower than among retirees (14.5% to 16.9% lower). Promoting employment opportunities and frequent participation in community activities among older adults may help reduce future LTC costs by around 20% as a result of extending healthy longevity.

Keywords: community activities; cumulative cost; employment; older adults; public long-term care insurance.

New paper: Working from home and dietary changes during the COVID-19 pandemic: A longitudinal study of health app (CALO mama) users.

We published a paper from Appetite.

Sato K, Kobayashi S, Yamaguchi M, Sakata R, Sasaki Y, Murayama C, Kondo N. Working from home and dietary changes during the COVID-19 pandemic: A longitudinal study of health app (CALO mama) users. Appetite. 2021 May 15:105323. doi: 10.1016/j.appet.2021.105323. Epub ahead of print. PMID: 34004241.

Abstract

It is plausible that the coronavirus disease pandemic and related changes in work and life patterns affected dietary patterns, but existing studies have limitations owing to a cross-sectional design. Using longitudinal data, we examined dietary changes in people due to the pandemic and work and life patterns. We conducted an online survey on changes in work and life patterns during the pandemic from April 30, 2020, to May 8, 2020, among users of a health app called CALO mama provided in Japan. We retrieved and linked the dietary data for 5,929 participants from January 1, 2020, to May 13, 2020. Generalized linear mixed models were used to estimate the frequencies of food intake associated with the pandemic and work and life patterns. During the state of emergency, the frequency of intake of vegetables, beans, seaweeds, fish, meats, dairy products, and snacks increased, whereas alcohol intake decreased. Working from home was associated with increased intake of vegetables, fruits, dairy products, and snacks but decreased intake of seaweeds, meats, and alcohol. Time spent on childcare was associated with decreased intake of vegetables and fruits but increased intake of meats. Probable depressive symptoms were negatively associated with the frequency of food intake other than snacks and alcohol. We conclude that diet quality improved during the pandemic in general, but attention must be paid to overconsumption of snacks and negative factors such as increased burden of childcare and depression for healthy eating.

Keywords: COVID-19; dietary change; fruit and vegetable intake; snacking; work and life pattern; working from home.

New paper: Community social networks, individual social participation and dietary behavior among older Japanese adults: Examining mediation using nonlinear structural equation models for three-wave longitudinal data

We published a paper from Preventive Medicine.

M. Nishio, D. Takagi, T. Shinozaki, et al., Community social networks, individual social participation and dietary behavior among older Japanese adults: Examining mediation using nonlinear structural equation models for three-wave longitudinal data, Preventive Medicine (2021), https://doi.org/10.1016/j.ypmed.2021.106613

Abstract

Community social networks positively affect older adults’ dietary behavior, but the underlying mechanisms remain uncertain. This study investigated if the relationship between community social networks and dietary behavior is mediated by social participation, and whether the influence of community social networks differs across sociodemographic groups. We conducted a cross-lagged panel mediation analysis employing nonlinear structural equation modeling using panel data from the Japan Gerontological Evaluation Study (JAGES), a longitudinal study of Japanese older adults in 2010, 2013, and 2016, which included 11,347 men and 14,105 women aged over 65. Monodirectional relationships in community social networks, individual social participation, and fruit/vegetable intake were examined. Community social networks were associated with social participation regardless of sociodemographic conditions. Individual social participation was in turn, positively associated with fruit/vegetable intake, with this association being stronger among those living alone. Analyses further showed that individuals’ social participation positively mediated the relationship between community social networks and fruit/vegetable intake. For both genders, the mediating effects were stronger among people living alone than in those living with someone. However, community networks could also directly and negatively affect fruit/vegetable intake among men who live alone unless they participated in community activities. Community social networks may promote social participation, thereby facilitating healthier dietary behavior regardless of sociodemographic status. Social participation in turn may positively contribute to the dietary health of people living alone. Community-based interventions to encourage people living alone to participate in social activities may help reduce inequality in dietary behavior related to cohabitation status.

New paper: Single-parenthood and health conditions among children receiving public assistance in Japan: a cohort study

We published a paper from BMC Pediatrics.

Nishioka D, Saito J, Ueno K, Kondo N. Single-parenthood and health conditions among children receiving public assistance in Japan: a cohort study. BMC Pediatr. 2021 May 3;21(1):214. doi: 10.1186/s12887-021-02682-4. PMID: 33941113.

Abstract

Background: Children’s healthy development is important. While governmental public assistance benefits financially troubled families, it cannot compensate for a lack of social support. Single-parenthood is a health risk factor for children owing to low-income-associated food insecurity and stress. No study has investigated the association between single-parenthood and health status in children from families receiving public assistance. This study aimed to examine the association between single-parent households and children’s health among public assistance recipients in Japan by using linkage data of two municipal public assistance databases and administrative medical assistance data.

Methods: We performed a retrospective cohort study. Public assistance for households below the poverty line ensures income security and medical care. The study population included all children aged 15 or younger availing public assistance in January 2016. We extracted recipients’ sociodemographic factors from January 2016 and identified the incidence of childhood diseases’ diagnosis until December 2016 as the outcome, including 1) acute upper respiratory infections; 2) influenza and pneumonia; 3) injuries, including fractures; 4) intestinal infectious diseases; 5) conjunctivitis; 6) asthma; 7) allergic rhinitis; 8) dermatitis and eczema, including atopic dermatitis; and 9) diseases of the oral cavities, salivary glands, and jaws, such as tooth decay or dental caries.

Results: Among the 573 children, 383 (66.8%) lived in single-parent households. A multivariable Poisson regression, with a robust standard error estimator, showed that single-parenthood is associated with a higher prevalence of asthma (incidence ratio [IR] = 1.62; 95% confidence interval [CI], 1.16-2.26), allergic rhinitis (IR = 1.41; 95% CI, 1.07-1.86), dermatitis and eczema (IR = 1.81; 95% CI, 1.21-2.70), and dental diseases (IR = 1.79; 95% CI, 1.33-2.42) compared to non-single parent households, whereas little association was found between single-parenthood and children’s acute health conditions.

Conclusions: Among public assistance recipients, living in single-parent households may be a risk factor for children’s chronic diseases. The Japanese public assistance system should provide additional social care for single-parent households. Further investigations are necessary using more detailed longitudinal data, including environmental factors, the severity of children’s health conditions, contents of medical treatments, and broader socioeconomic factors.

Keywords: Chronic health conditions; Japan; Poverty; Public assistance; Single-parenthood.