Workplace social capital and refraining from seeking medical care in Japanese employees: a 1-year prospective cohort study

Effect of social activities on health checkups and recommended doctor visits: a fixed-effects analysis in Japan

Health checkups are considered to promote occupational and public health. This study aimed to investigate the extent to which participation in social activities encourages middle-aged people to participate in health checkups and adhere to doctor-visit recommendations. We analyzed 337,024 longitudinal observational studies involving 33,420 individuals aged 50-59 yr in the baseline year (2005) derived from a nationwide, population-based, 14-wave survey. We estimated fixed-effects logistic models to elucidate how people's participation in health checkups and recommended doctor visits are affected by participation in social activities. Attending health checkups was positively associated with participation in social activities, with an odds ratio (OR) of 1.19 (95% confidence interval [CI]: 1.15-1.22) and a marginal effect of 3.3% (95% CI: 2.7%-3.9%). Adherence to doctor-visit recommendations was also positively associated with participation in social activities, with an OR of 1.15 (95% CI: 1.08-1.23) and a marginal effect of 3.3% (95% CI: 1.8%-4.8%), although the association was observed only among regular employees. These results provide new insights into the effectiveness of health checkups.

Impact of Japan's State of Emergency Due to the COVID-19 Pandemic on Trends in Diabetes Care: A Descriptive and Retrospective Study

OBJECTIVE

This study examined the impact of Japan's state of emergency on trends in diabetes care during the coronavirus disease 2019 (COVID-19) pandemic.

DESIGN

A descriptive and retrospective study.

SETTING

Showa University Hospital, Japan.

PARTICIPANTS

Patients with diabetes who received medical treatment from 2018 to 2020. Determinants of interest: Number of patients with diabetes visiting the hospital per week. To examine the impact of the Japan's state of emergency, the number of hospital visitations by patients with diabetes was summarized from 28 weeks of data for each year, from calendar week 8 to calender week 35.

RESULTS

Compared with the mean of 2018 and 2019, no significant difference was found between the three periods (before, during, and after the state of emergency). However, the numbers of patients from both inside and outside Tokyo increased at 7 weeks after the state of emergency was lifted.

CONCLUSIONS

A significant increase in the numbers of patients with diabetes was seen compared with the same period in 2018 and 2019, suggesting that the state of emergency may have hindered diabetes care. Therefore, patients with diabetes should receive continuous follow-up regarding their diabetes care, keeping a close eye on relvent measurements.

The quantity and quality of scientific evidence about the health of working women in occupational health of Japan: A scoping review

OBJECTIVE

We aim to investigate the quantity and quality of scientific evidence dealing with comprehensive health issues of working women in occupational health.

METHODS

This scoping review of original articles that investigated comprehensive health issues of working women aged 19-64 years in Japan was published in PubMed (1967-2022) and Igaku Chuo Zasshi (or Ichu-shi, 1982-2022). Using identical broad search terms, we first identified 17 122 English and 6154 Japanese articles. We excluded those with clinically relevant topics, or ethnicity other than Japanese and included 853 English and 855 Japanese articles for review and classified them into nine research areas considered to be critical factors for women in the workforce and five study design groups to investigate the quality of the evidence accumulated.

RESULTS

Among 853 English-language articles in PubMed, "Mental health" was the most frequent area studied, followed by "Work-related disease" and "Lifestyle-related disease." Among 855 Japanese-language articles from Ichu-shi, "Mental health" was the most frequently studied area followed by "Work and balance," and "Work-related disease." "Infertility, pregnancy, and childbirth" and "Menstruation, menopause, and genital disease" were well studied in Ichu-shi but scarcely published in PubMed. "Harassment and discrimination" were sparsely reported in both databases. As for research designs, many articles in both PubMed and Ichu-shi employed descriptive or cross-sectional study designs. However, a few studies employed cohort/longitudinal or interventional studies.

CONCLUSION

The results underscored the need for higher-quality study designs with more scientific evidence on working women's health in the field of occupational health.

Low Adaptation to Management Philosophy and Refraining From Seeking Medical Care in Japanese Employees: A 1-Year Prospective Study

OBJECTIVE

We examined the prospective association of low adaptation to management philosophy with refraining from seeking medical care (RSMC) among Japanese employees in a company with a management philosophy of "pursuing employees' well-being."

METHODS

We surveyed 2791 employees (2059 men and 732 women) from 2 factories of a Japanese manufacturing company following the management philosophy of "pursuing employees' well-being." Using a self-administered questionnaire, we measured adaptation to management philosophy at baseline and RSMC at a 1-year follow-up. We conducted robust Poisson regression analysis.

RESULTS

Low adaptation to management philosophy was significantly associated with RSMC (incidence rate ratio, 1.17; 95% confidence interval, 1.03-1.35).

CONCLUSIONS

Adaptation to management philosophy may be an important factor associated with the decision of employees working at a company following the "pursuing employees' well-being" management philosophy to seek medical care for their perceived health issues.

Impact of the state of emergency on trends in the care of three major diseases at Showa University Hospital, Japan: a retrospective and descriptive study

Introduction

This study aimed to examine the trends in patient consultations for three major diseases (cancer, heart disease, and stroke) at Showa University Hospital, Japan during the state of emergency for the Coronavirus 2019 (COVID-19) pandemic.

Methods

The present study was a retrospective and descriptive study of Showa University Hospital in Tokyo, Japan. Subjects were patients who had received medical treatment at Showa University Hospital and were diagnosed from 2017 to 2020. To examine the impact of the state of emergency, the number visits to hospital by the top three causes of death or other diseases were summarised from 21 weeks of data, from week 8 to week 28, for each year.

Results

Compared to the average of the previous 3 years, a comparison of the three periods before and after the state of emergency showed a V-shaped curve in 2020, with a large drop in the number of cancer patients during the state of emergency, both from within Tokyo and from outside the city.

Conclusions

This study showed a long-term decrease in cancer patient visits to Showa University Hospital since the beginning of the COVID-19 pandemic compared to the previous 3 years. It is also possible that medical care that would have been available may not have been provided due to the state of emergency, so it is necessary to follow up patients while keeping a close eye on measures other than infectious diseases.

Social capital and use of assisted reproductive technology in young couples: Ecological study using application information for government subsidies in Japan

BACKGROUND

Assisted reproductive technology (ART) is a globally established treatment; however, large disparities exist in ART use among young couples. We investigated regional-level factors associated with ART use in Japan.

METHODS

We calculated the use rate of ART using the number of women aged <35 years who applied for government subsidies in 2017; we divided that figure by the number of women aged 20-35 years in each prefecture. Prefectural-level average household income; social capital indicators including voting rate, volunteer rate, and move-in rate; and Gini coefficients as indicators of income inequality were linked to ART use, adjusting for prefectural size, the mean age of women at first marriage, number of ART facilities, and additional prefectural subsidies.

RESULTS

The rate of ART use (per 10,000 women) varied significantly from 22.0 to 58.8 across Japan's 47 prefectures. Multivariate analysis demonstrated that the use rate increased by 0.048 (95% confidence interval [CI], 0.007 to 0.088) for each 10,000-yen increase in average household income and 1.5 (95% CI, 0.65 to 2.3) for each 1% increase in volunteer rate. Conversely, the use rate decreased by 18.4 (95% CI, -28.6 to -8.1) for each 1% increase in the move-in rate. There was no significant association between ART use and income inequality.

CONCLUSION

Although we cannot infer causal relationships, the findings suggest that improving financial access and enhancing social capital may increase access to ART. Further research, particularly multilevel analysis using individual data, is required to confirm these findings.

Determining whether periodic health checkups have any preventive effect on deterioration in health among middle-aged adults: A hazards model analysis in Japan

OBJECTIVES

We aimed to examine the long-term impact of periodic health checkups (PHCs) on health outcomes among middle-aged adults.

METHODS

We used longitudinal data from 29 770 individuals (15 399 men and 14 371 women) aged 50-59 years in the baseline year (2005), obtained from a population-based 14-wave survey. PHC participants were defined as those who underwent PHCs for the first three consecutive waves, and we investigated the onset of inpatient care for five types of non-communicable diseases (diabetes, heart disease, stroke, hypertension, and dyslipidemia) as well as poor self-rated health and problems in the activities of daily living in the subsequent 11 waves. Cox-proportional hazards models were used to estimate the impact of PHCs on health outcomes by employing the propensity score matching (PSM) method.

RESULTS

Participation in PHCs was closely related to a respondent's socioeconomic status and health behavior. After controlling for these factors by PSM, the hazard models showed that PHCs postponed the onset of inpatient care for hypertension (hazard ratio, 0.56; 95% confidence interval: 0.36-0.85) among men, but PHCs had no impact on any other health outcomes in men or women.

CONCLUSIONS

The preventive impact of PHCs on health deterioration is generally limited among middle-aged adults. Future studies should address policy measures to enhance the effectiveness of PHCs.