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Men who have sex with men (MSM) are significantly more likely to report poor health compared to the general population in Japan and internationally. Social capital has been observed as an important component of positive health and well-being outcomes among MSM. However, there is limited research investigating how alter sexuality (possessors of actual resources embedded in social capital networks) mitigates health outcomes. In an online survey of 1564 MSM in Japan, we investigated social correlates of poor self-rated health among MSM, including MSM and heterosexual social networks. Multiple logistic regression revealed that poor health was associated with older age, lower education, and part-time and unemployment. Poor health was inversely correlated with bisexual behavior and high MSM or heterosexual social capital. In order to decrease health disparities among MSM in Japan, interventions focusing on increasing social capital among deprived groups, such as those with lower socio-economic status, older MSM, and those whose sex partners are exclusively male, may be effective. [ABSTRACT FROM AUTHOR]

Despite encouraging multi-generational cohabitation, the population of Japanese people living alone has increased. However, little is known about the association between health and multigenerational cohabitation. This study examined the relationship between self-rated health and living arrangements among Japanese adults using data from the Japan Multi-Institutional Collaborative Cohort Study (2013-2017). The analysis employed multivariate logistic regression to examine the associations. Our results showed no association between living arrangements and self-rated health when stratified by gender. Living alone was found to be associated with poor self-rated health among women aged 65 and above. A similar association may exist among men in the same age group. Among women aged < 65 years, two-generation cohabitation was associated with a good self-rated health, similar to those living alone. Among men aged < 65 years, neither living alone nor two-generation cohabitation was significantly associated with good self-rated health. We found no association between three- or plus-generation cohabitation and self-rated health. Therefore, our findings indicate associations between multigenerational cohabitation and self-rated health, but they vary by gender and age. Invested stakeholders in the public health field should consider the potential impact of living arrangements on health based on gender and age. [ABSTRACT FROM AUTHOR]

In response to the distinctive healthcare requirements of independent, healthy, community-dwelling older adults in Japan and other developed countries with aging populations, the current study examined the differences in factors associated with self-rated health (SRH) between the following two age groups: young–old (65–74) and old–old (75 and above). Age-stratified analysis was used to provide a comprehensive understanding of the unique health challenges faced by these demographic segments and to inform the development of targeted interventions and health policies to improve their well-being. The results of a cross-sectional study of 846 older adults in Yokohama, Japan, who completed self-administered questionnaires, revealed that high SRH was consistently linked with the low prevalence of concurrent medical issues in both age groups (<75 and ≥75) (β: −0.323, p < 0.001 in the <75 group; β: −0.232, p < 0.001 in the ≥75 group) and increased subjective well-being (β: 0.357, p < 0.001 in the <75 group; β: 0.244, p < 0.001 in the ≥75 group). Within the ≥75 age group, higher SRH was associated with more favorable economic status (β: 0.164, p < 0.001) and increased engagement in social activities (β: 0.117, p = 0.008), even after adjusting for age, sex, and economic status. These findings may inform the development of targeted interventions and policies to enhance the well-being of this growing population in Japan and other developed countries. [ABSTRACT FROM AUTHOR]

Although unhealthy lifestyle behaviors are well-known risk factors for poor health, the impact of insufficient infection control against COVID-19 at the workplace on health is unknown. This study suggested that promoting infection control measures at the organizational level may reduce the adverse effects on health of Japanese workers. Objective: This study investigated whether workers who practiced unhealthy lifestyles but worked under organizations with insufficient control against coronavirus disease 2019 (COVID-19) would pose a synergistic risk of poor self-rated health (SRH). Methods: A total of 22,637 workers (men, 48.5%) were extracted from an online survey during the COVID-19 pandemic in Japan (December 2020). Multiple logistic regression analyses were performed to estimate adjusted odds ratio (AOR) against poor (poor, fair) SRH. Results: Accumulation of unhealthy lifestyle behaviors (AOR, 1.49 to 4.40; P < 0.05) and insufficient infection control (AOR, 1.80; P < 0.05) were independently related to poor SRH; however, when these factors were combined, SRH was additively worsened (AOR, 2.14 to 7.72; P < 0.05). Conclusions: This study highlights that not only unhealthy lifestyle practices but also poor organizational management against infection would worsen workers' SRH during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

This study examined the association between occupation and health status among Japanese employees. The data from the Comprehensive Survey of Living Conditions in Japan encompassed 102,575 employees (55,399 males and 47,176 females), who were employed workers aged 15–44 years. Self‐rated health was used as an indicator of health status in the health questionnaire. A multiple logistic regression analysis of the association between health status and occupation was conducted to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) with an adjustment for confounding factors. When the non‐regular employees were assessed, many of their occupations were linked to poorer health tendencies in general, with the exception of male Service workers (OR 0.75, 95% CI 0.60–0.94). Finally, particular employment and occupations were observed as having better or worse health tendencies than other types of work. [ABSTRACT FROM AUTHOR]

This study examined the association between occupation and health status among Japanese employees. The data from the Comprehensive Survey of Living Conditions in Japan encompassed 102,575 employees (55,399 males and 47,176 females), who were employed workers aged 15–44 years. Self‐rated health was used as an indicator of health status in the health questionnaire. A multiple logistic regression analysis of the association between health status and occupation was conducted to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) with an adjustment for confounding factors. When the non‐regular employees were assessed, many of their occupations were linked to poorer health tendencies in general, with the exception of male Service workers (OR 0.75, 95% CI 0.60–0.94). Finally, particular employment and occupations were observed as having better or worse health tendencies than other types of work. [ABSTRACT FROM AUTHOR]

Background: Health literacy (HL) has gained increasing attention as a factor related to health behaviors and outcomes. This study aimed to investigate geographic differences in HL levels and effect modification by geographic area on their relationship with self-rated health in the Japanese population using a nationwide sample. Methods: Data for this study were derived from a nationally representative cross-sectional survey on health information access for consumers in Japan using a mailed self-administered questionnaire in 2020 (INFORM Study 2020). Valid responses from 3,511 survey participants, selected using two-stage stratified random sampling, were analyzed in this study. HL was measured using the Communicative and Critical Health Literacy Scale (CCHL). Multiple regression and logistic regression analyses were conducted to examine the associations between geographic characteristics and HL and effect modification on the association between HL and self-rated health by geographic area, controlling for sociodemographic characteristics. Results: The mean HL score was 3.45 (SD = 0.78), somewhat lower compared with previous studies on the Japanese general population. HL was higher in Kanto area than in Chubu area, after controlling for sociodemographic factors and municipality size. Furthermore, HL was positively associated with self-rated health after controlling for sociodemographic and geographic factors; however, this association was more evident in eastern areas than in western areas. Conclusion: The findings indicate geographic differences in HL levels and effect modification by geographic area on the relationship between HL and self-rated health in the general Japanese population. HL was more strongly associated with self-rated health in eastern areas than in western areas. Further investigation is needed to explore the moderating effects of areal features, including the distribution of primary care physicians and social capital, when formulating strategies to improve HL in different contexts. [ABSTRACT FROM AUTHOR]

Objective This study aimed to examine the association between job dissatisfaction (JD) and health outcomes among middle-aged workers. Methods This study used longitudinal data comprising 156 823 observations of 24 056 workers (13 177 men and 10 879 women) collected from a 14-wave nationwide population-based survey in Japan that began in 2005, involving individuals aged 50-59 years. Mixed models were estimated to examine the association between JD and the risk of psychological distress (PD), poor self-rated health (SRH), and health-related resignation (HRR). Results Across all waves, 20.9-32.5% of participants were dissatisfied with their jobs for at least one year before each wave. Mixed model results showed that this JD experience was associated with higher risks of PD, poor SRH, and HRR, with odds ratios (OR) of 1.96 [95% confidence interval (CI) 1.75-2.20], 1.33 (95% CI 1.26 -1.40), and 1.57 (95% CI 1.40 -1.75), respectively. A longer JD duration was associated with a higher risk of poor health. No substantial differences between genders were found regarding the association between JD and health outcomes. A separate analysis showed reverse causation from poor health to JD; poor health was significant in predicting later JD even when it was controlled for. Conclusions The results confirm that JD was predictive of poor health among middle-aged workers. Therefore, policymakers and managers should monitor the JD of their employees and improve their work environments to enhance their occupational health. [ABSTRACT FROM AUTHOR]

Despite encouraging multi-generational cohabitation, the population of Japanese people living alone has increased. However, little is known about the association between health and multigenerational cohabitation. This study examined the relationship between self-rated health and living arrangements among Japanese adults using data from the Japan Multi-Institutional Collaborative Cohort Study (2013-2017). The analysis employed multivariate logistic regression to examine the associations. Our results showed no association between living arrangements and self-rated health when stratified by gender. Living alone was found to be associated with poor self-rated health among women aged 65 and above. A similar association may exist among men in the same age group. Among women aged < 65 years, two-generation cohabitation was associated with a good self-rated health, similar to those living alone. Among men aged < 65 years, neither living alone nor two-generation cohabitation was significantly associated with good self-rated health. We found no association between three- or plus-generation cohabitation and self-rated health. Therefore, our findings indicate associations between multigenerational cohabitation and self-rated health, but they vary by gender and age. Invested stakeholders in the public health field should consider the potential impact of living arrangements on health based on gender and age., Competing Interests: The authors declare that this study was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.

With population aging, increasing numbers of elderly people in Japan are expected to enter aged care facilities (ACFs). Although research has shown that access to community gardens (CGs) is generally beneficial to older people's psychological well-being, the mechanisms by which the usage and quality of CGs influence the well-being of older adults in ACFs remain insufficiently studied. Therefore, this study aims to explore the associations between garden factors (i.e., garden visit frequency and perceived garden quality) and older adults' psychological well-being outcomes (i.e., positive well-being and self-rated health) and to investigate the mediating role of neighborhood social environment factors (i.e., outing frequency, social participation, perceived neighborhood social cohesion, and perceived neighborhood attachment) in these associations. We conducted a questionnaire survey with 322 older adults from twelve elderly housing with care services (EHCSs) in the Tokyo metropolitan area (TMA) of Japan. The multiple regression models showed that both garden factors were positively associated with positive well-being and self-rated health. The parallel mediation models showed that higher garden visit frequency and perceived garden quality were associated with higher outing frequency and perceived neighborhood social cohesion and, in turn, with higher positive well-being. Moreover, higher garden visit frequency and perceived garden quality were associated with greater social participation and thereby with better self-rated health; higher perceived garden quality was also associated with higher perceived neighborhood attachment and thus with better self-rated health. Our findings elucidate the potential mechanisms underlying the beneficial associations between CGs and the psychological well-being of older adults in ACFs, emphasizing the important role of cultivating friendly social environments in CGs in enhancing healthy aging. • Garden factors were positively correlated with positive well-being and self-rated health. • Outing frequency and neighborhood social cohesion mediated the associations of garden factors with positive well-being. • Social participation mediated the association of garden visit frequency and perceived garden quality with self-rated health. • Perceived neighborhood attachment mediated the association of perceived garden quality with self-rated health. • Links between CGs and the psychological well-being of EHCS residents were not moderated by socioeconomic variables. [ABSTRACT FROM AUTHOR]

Background: Area-level deprivation is well known to have an adverse impact on mortality, morbidity, or other specific health outcomes. This study examined how area-level deprivation may affect self-rated health (SRH) and life satisfaction (LS), an issue that is largely understudied.Methods: We used individual-level data obtained from a nationwide population-based internet survey conducted between 2019 and 2020, as well as municipality-level data obtained from a Japanese government database (N = 12,461 living in 366 municipalities). We developed multilevel regression models to explain an individual's SRH and LS scores using four alternative measures of municipality-level deprivation, controlling for individual-level deprivation and covariates. We also examined how health behavior and interactions with others mediated the impact of area-level deprivation on SRH and LS.Results: Participants in highly deprived municipalities tended to report poorer SRH and lower LS. For example, when living in municipalities falling in the highest tertile of municipality-level deprivation as measured by the z-scoring method, SRH and LS scores worsened by a standard deviation of 0.05 (p < 0.05) when compared with those living in municipalities falling in the lowest tertile of deprivation. In addition, health behavior mediated between 17.6 and 33.1% of the impact of municipality-level deprivation on SRH and LS, depending on model specifications.Conclusion: Results showed that area-level deprivation modestly decreased an individual's general health conditions and subjective well-being, underscoring the need for public health policies to improve area-level socioeconomic conditions. [ABSTRACT FROM AUTHOR]

Background: Self-rated health (SRH), a subjective perception of an individual's overall health, is widely used in public health assessment. The transition from adolescence to young adulthood is a critical period involving substantial changes in lifestyle and dietary habits. Therefore, it is important to understand SRH among young Japanese females. The present study aimed to investigate the relationships between SRH among female healthcare students and their lifestyle factors, such as living status (living with others or living alone), smoking habit, alcohol consumption, frequency of breakfast consumption (FBC), physical activity, insomnia, and physique recognition.Methods: A cross-sectional survey was conducted on 1101 female healthcare students in Japan. The body mass index was calculated from the body height and weight using data from periodic health examinations. Self-reported sociodemographic, lifestyle or dietary habits, physical activity, and SRH were used through a self-administered questionnaire. Participants were classified as having either good SRH (excellent, very good, or good) or impaired SRH (fair or poor). Multivariate logistic regression analysis was performed to investigate the independent relationships between SRH and lifestyle factors.Results: A total of 11.4% participants demonstrated impaired SRH. Multivariate logistic regression analysis showed that the University of California Los Angeles activity score, Athens Insomnia Scale, and physique recognition were associated with SRH.Conclusions: It was suggested that public health activities that consider physical activity, sleep, and physique recognition may help maintain and improve SRH in female university students in Japan. [ABSTRACT FROM AUTHOR]

Aim: The incidence of anemia increases with aging, and it is considered to affect mortality through complex pathophysiological outcomes. Although it has been suggested that self-rated health may also contribute to the prognosis of anemia in older people, the relationship between anemia and self-rated health is not well understood. This study thus examined the actual status of anemia in older community-dwelling Japanese people and clarified the relationship between anemia and self-rated health. Methods: We conducted medical interviews, physical measurements and blood testing in 2083 people aged 69-91 years who participated in the long-term observational Septuagenarians, Octogenarians, Nonagenarians, Investigation with Centenarians (SONIC) study. Subjects were divided into two groups according to whether they had anemia. Logistic regression analyses were used to assess the relationship between anemia and self-rated health after adjusting for possible confounding factors. Results: The prevalence of anemia was 22.3% in all participants, 7.2% in men and 11.6% in women aged 69-71 years, 27.4% in men and 26.3% in women aged 79-81 years, and 55.8% in men and 44.9% in women aged 89-91 years. Multivariate analysis revealed a correlation between the presence of anemia and poor self-rated health in all (odds ratio 0.67, 95% confidence interval 0.48-0.93) and aged 69-71 years (odds ratio 0.47, 95% confidence interval 0.25-0.86). Conclusions: Anemia was associated with self-rated health in older Japanese people, suggesting that careful management of anemia may contribute to health and longevity. Geriatr Gerontol Int 2020; 20: 720-726. [ABSTRACT FROM AUTHOR]

In this study, we conducted a quantitative cross-sectional evaluation of the relationships between self-related health and occupational form, occupational performance, and occupational satisfaction. The participants were 675 community-dwelling subjects (283 men, 392 women) who completed a self-administered questionnaire. From this data, we performed a multiple logistic regression analysis using the high and low values of self-rated health as the dependent variables and the characteristics of occupational form, occupational performance, and occupational satisfaction as the independent variables. There were three analysis models: Model 1, which mutually adjusted for all the independent variables; Model 2, with adjustment of the basic attributes, in addition to the first model; and Model 3, which was based on Model 2, but also adjusted for diseases. In all three models, high self-rated health was significantly correlated with high occupational performance scores. These findings confirmed that supporting occupational performance improvement is useful for improving self-rated health. [ABSTRACT FROM AUTHOR]

Objective This study examines relationships between municipal age structure and two types of self-rated health: general (SRH) and comparison with similar-aged peers (C-SRH). Methods Using a national sample of almost 5,000 Japanese older adults over two decades, we employ hierarchical growth curve models to estimate health trajectories. For municipal age structure, we consider both the relative prevalence of elderly adults in the local population and the pace of aging over time. Results Living in the oldest municipalities was generally associated with worse health, particularly between the ages of 70 and 80 years. For SRH, the speed of municipal population aging was also independently associated with worse health. For C-SRH, worse health in older areas was partially explained by less favorable economic conditions in those municipalities. Results also suggest that higher levels of employment and social integration among older adults living in the oldest municipalities operate in the opposite direction. That is, these attributes partially "protect" individuals from other factors that contribute to worse health. Discussion Relative differences in municipal age structure and the pace of population aging are largely unexplored and potentially important correlates of older adult health. This line of research is increasingly salient in a world with substantial and growing regional variation in population aging. [ABSTRACT FROM AUTHOR]

Arts festivals have become increasingly popular in various parts of Japan in recent years. The purpose of this study was to investigate the relationships between arts festival activities participation at the Setouchi Triennale and the health of residents in the town of Naoshima. This was a cross-sectional study. Questionnaires were distributed to all residents of Naoshima who were 20 years old or older (n=2,588). We analyzed responses from 708 people. The associations between arts festival activities participation and health (measured by self-rated health) were analyzed using logistic regression analysis as the primary outcome. Kessler's psychological distress scale scores were also analyzed in the same manner as the primary outcome. The participating group had an adjusted odds ratio of 1.86 (95% confidence interval: 1.03-3.33) for higher self-rated health compared with those who did not participate. Kessler's psychological distress scale results showed that the participating group had an adjusted odds ratio of 3.23 (95% confidence interval: 1.19-8.81) for lower psychological distress compared with those who did not participate. In conclusion, arts festival activities participation was associated with higher self-rated health and lower psychological distress. However, caution must be taken in regard to generalizability and causality when interpreting these results., Competing Interests: No potential conflict of interest relevant to this article was reported.

No epidemiological studies have examined the health effects of daily bathing in radon hot springs. In this cross-sectional study, we investigated the associations between radon hot spring bathing and health conditions. The target population was 5,250 adults ≥ 20 years old in the town of Misasa, Japan. We collected information about the participants' bathing habits and alleviation of a variety of disease symptoms, and their self-rated health (SRH). Unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CI) were calculated. In both the adjusted and unadjusted models of hypertension, significant associations between the > 1×/week hot spring bathing and the alleviation of hypertension symptoms were observed compared to the group whose hot spring bathing was <1×/week: adjusted model, OR 5.40 (95%CI: 1.98-14.74); unadjusted model, 3.67 (1.50-8.99) and for gastroenteritis: adjusted model, 9.18 (1.15-72.96); unadjusted model, 7.62 (1.59-36.49). Compared to the no-bathing group, higher SRH was significantly associated with both bathing < 1×/week: unadjusted model, 2.27 (1.53-3.37) and > 1×/week: adjusted model, 1.91 (1.15-3.19). These findings suggest that bathing in radon hot springs is associated with higher SRH and the alleviation of hypertension and gastroenteritis., Competing Interests: No potential conflict of interest relevant to this article was reported.

Objectives: The purpose of this study was to assess the relationship between economic security and self-rated health for elderly Japanese residents living alone.Design: A secondary analysis of a cross-sectional study.Setting: N City, H. Prefecture, Japan.Participants: Survey questionnaires were distributed to 2,985 elderly residents living alone, aged ≥70 years, of which, 1,939 (65.0%) were returned and treated as valid responses.Measurements: The survey included questions about gender, age, number of years spent in N City, self-rated health, economic security, number of years spent living alone, reason for living alone, life satisfaction, cooking frequency, frequency of seeing a doctor, long-term care service usage, as well as whether they enjoyed their lives, participated in social organizations.Results: Of the respondents, 1,563 (80.6%) reported that they were economically secure, and 376 (19.4%) responded that they were insecure. The odds ratio predicting poor self-rated health for the economically insecure participants was significantly high (odds ratio: 3.19, 95%, Confidence Interval (CI): 2.53−4.02, and P < 0.001). Similarly, the adjusted odds ratio for poor self-rated health was significantly high for the economically insecure participants in multivariate analyses controlling for factors such as age, gender, cooking frequency, and social participation (adjusted odds ratio: 2.21, 95%, CI: 1.70−2.88, and P < 0.001). Furthermore, a similar trend was observed in stratified analyses based on gender and age groups.Conclusion: Economic security predicted self-rated health independently of confounders, including social participation and cooking frequency, among the elderly Japanese living alone in communities. [ABSTRACT FROM AUTHOR]

Background: Education has attracted more attention as a key determinant of health in later life. In this study, the hypothesis that widened educational disparities in health can be observed in later life was investigated, and the factors that mediated the association between education and changes in health were also assessed.Methods: Using the 9-year (10-wave) longitudinal data of 20,024 individuals (9320 men and 10,704 women) aged 50-59 years at baseline, collected from a nationwide population survey in Japan (2005-2014), the changes in self-rated health, functional limitations, and psychological distress between educational levels were compared. Mediation analysis was further conducted to assess the factors that mediated the association between education and changes in health, with reference to six types of potential mediators (household spending, social participation, leisure-time physical activity, smoking, problem drinking, and regular health check-ups). The analyses were conducted separately for men and women.Results: All three health variables rapidly deteriorated among lower-educated men and women. For men, the six potential mediators mediated 55.2%, 64.3%, and 47.3% of the associations between educational levels and changes in self-rated health, functional limitations, and psychological distress, respectively. The proportions for women were 42.0%, 49.5%, and 58.8%, respectively. Social participation was the primary mediator, followed by physical activity, regular health check-ups, and smoking. In general, no substantial or consistent differences were observed between men and women.Conclusions: The results suggested that policy measures that encourage social participation and promote healthy behaviors can improve educational disparities in health in later life. [ABSTRACT FROM AUTHOR]

• We examined psychosocial changes after surrendering driver's licence in older adults. • Elapsed years after surrender was considered to examine acute trend after transition. • Social interactions with friends decreased within three years after surrendering. • This trend was not moderated by the number of public transportations in neighbourhood. This study aimed to examine how the associations between surrendering driving licence and changes in self-rated health and social interactions among older adults differ by the years elapsed since surrendering and the number of public transportation systems (PTS) in the neighbourhood. We used the 2013 and 2016 survey data from the Japan Gerontological Evaluation Study targeting residents aged ≥65 years in 30 municipalities in Japan. Two-waves longitudinal data from 4894 older adults were evaluated. Based on the difference-in-differences method, the interaction terms of respondents' driving status, which was the categorical exposure variable representing respondents' driving status for three years during the study period, and a dummy variable of year (2016) were used as explanatory variables in logistic regression analyses to examine changes in outcomes (poor self-rated health and infrequent meeting with friends) between 2013 and 2016 by driving status during this period. Analyses were stratified based on neighbourhood PTS ('more PTS' and 'fewer PTS' groups). We found that, while surrendering licence within three years was associated with increased probability of poor self-rated health in more PTS group, the confidence interval was large. Although surrendering licence within three years was associated with decreased social interactions, this association weakened if licence was surrendered more than three years ago. These associations were not markedly affected by neighbourhood PTS. Our findings suggested that, regardless of neighbourhood PTS, support and care to promote social interactions at or shortly after surrendering licence may be beneficial to the well-being of older adults who lost their driving licence. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate whether the well-being of caregivers is mediated by the association between behavioral and psychological symptoms in elderly relatives and the quality of sleep experienced by caregivers using a mediational model. The participants were 105 working family caregivers in Japan. We assessed well-being based on the Kessler Scale 10, self-rated health, and satisfaction in daily life. Our results showed that the well-being in working family caregivers was impacted by the severity of behavioral and psychological symptoms in elderly relatives. Well-being in working family caregivers was also affected by quality of sleep. Maintaining good quality of sleep in working family caregivers is important for reducing caregiver burden and psychological distress, and for improving the balance between work and family life. [ABSTRACT FROM AUTHOR]

Background: self-rated health (SRH) is a strong predictor of mortality, but it is unclear if SRH independently predicts a decline in instrumental activities of daily living (IADL). Objective: to verify whether SRH is an independent predictor of IADL decline. Design: a population-based longitudinal cohort study. Setting: two local municipalities in Nara, Japan. Subjects: community-dwelling older adults 65 years or older (2,638 males and 3,346 females) with independent IADL at baseline. Methods: SRH was assessed using a single-item measure. IADL was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Multiple logistic regressions were used to examine the association of SRH with IADL decline. Results: during the 3-year follow-up, 13.2% of males and 8.2% of females developed IADL decline. After adjusting for age, family, body mass index, economic situations, chronic diseases, alcohol, smoking, depression, cognitive functioning and ADL, poorer SHR was significantly associated with IADL decline in both genders. Compared with very good SRH, the odds ratios of good, poor and very poor were 1.69 (95% confidence interval: 1.14-2.51), 2.10 (1.25-3.55) and 3.11 (1.50-6.45) for males, and 0.88 (0.54-1.42), 2.08 (1.16-3.75) and 3.42 (1.57-7.42) for females, respectively. Significant associations were not affected by chronic diseases, cognitive functioning or ADL but observed only among subjects aged 65-74 or those without depression. Conclusions: this study confirms that SRH is an independent predictor of IADL decline among non-disabled community-dwelling older adults. Our findings suggest that SRH is an effective tool for identifying older people with future risk for IADL decline, particularly among the young--old or those without depression. [ABSTRACT FROM AUTHOR]

Aims The present study examined the impact of serious spousal illness or hospitalization on community-dwelling older adults' self-rated health ( SRH), and explored the moderating effects of sex and residential proximity to adult children using a prospective and representative survey design. Methods The sample was obtained from a 2-year longitudinal survey of non-institutionalized men and women aged 65 years and older carried out in the Fukui Prefecture, Japan ( n = 1573). The effect of serious spousal illness or hospitalization on SRH during the survey period was examined after controlling for baseline SRH, sex, age, socioeconomic status, chronic illness and other baseline covariates. Results Overall, 15.7% of respondents had experienced a serious spousal illness or hospitalization within the previous year. After controlling for covariates, spousal illness had a significant negative effect on SRH at follow-up ( P = 0.031). More serious effects of spousal illness were found in older adults whose children lived farther than 30 min away than in couples who lived with their children ( P = 0.009). However, there was no significant interaction effect between sex and spousal illness. Conclusions Serious spousal illness could cause deterioration in the health of older spouses, particularly for older parents whose children live a distance away. Geriatr Gerontol Int 2016; 16: 1332-1338. [ABSTRACT FROM AUTHOR]

Background: Encouraging older adults to continue working longer would be a realistic solution to the shrinking labor force, which is a result of the aging population. This study examined whether working longer improves the health of older adults., Methods: We used repeated cross-sectional data from 1,483,591 individuals aged 55-69 years collected from 11 waves of a nationwide population-based survey conducted in Japan from 1986 to 2016. We estimated pooled regression models to explain health outcomes by work status, controlling for potential endogeneity biases. Based on the estimation results, we conducted simulations to predict the health impact of policy measures that encourage older adults to participate in the labor force., Results: The regression analysis showed that work status had a mixed health impact. For example, work reduced the probability of poor self-rated health by 6.7 (95% confidence interval [CI], 6.2-7.2) percentage points and increased that of psychological distress by 12.2 (95% CI, 11.3-13.1) percentage points. The simulation results showed that raising both the mandatory retirement age and eligibility age for claiming public pension benefits to 70 years would increase the employment rate by 27.8 (standard deviation [SD], 4.2) percentage points among those aged 65-69 years, which would reduce their probability of poor self-rated health by 1.8 (SD, 0.4) percentage points and raise that of psychological distress by 4.1 (SD, 0.8) percentage points for that age group., Conclusion: The results suggest the need to pay attention to the health outcomes of policy measures that encourage older adults to work longer.

Background: The majority of studies on the role of psychological resources linking childhood socioeconomic status (SES) and adult health have been conducted in Western countries. Empirical evidence for mediation effects of psychological resources is currently lacking in Japan. Purpose: The purpose of this study was to investigate the mediating effect of psychological resources (mastery and sense of coherence [SOC]) on the association between childhood SES and current health. Method: Analyses were conducted on cross-sectional data (1,497 men and 1,764 women) from the Japanese Study of Stratification, Health, Income, and Neighborhood Study (J-SHINE) in Tokyo. Psychological resources (mastery and SOC), childhood SES (parents' education and perceived childhood SES), and current health of adults (psychological distress measured by K6 and self-rated health) were measured using a self-report questionnaire. Results: Mastery and SOC significantly and independently mediated the association between childhood SES and current health in the total sample after adjusting for age, gender, and respondent education, regardless of type of SES or health outcome indicators. Similar mediation effects were observed for both men and women. A few gender differences were observed; specifically, SOC significantly mediated the association between parents' education and current health only among women, and it mediated the association between perceived childhood SES and current health only among men. Conclusions: Overall, the findings underscore the importance of the mediating role of psychological resources in the association between childhood SES and current health. [ABSTRACT FROM AUTHOR]

This paper aims to clarify the association between various social capital components at the municipal level (community social capital) and two quality-of-life factors at the individual level [individual self-rated life satisfaction and self-rated health (SRH)] based on data from a nationwide social capital survey that the authors carried out in 2013 in Japan (N = 3406 in 99 municipalities). The survey covers residents in Japan between the ages of 20 and 79 years. We focus on both contextual social capital and household income inequality in terms of the Gini coefficient at the municipality level since, to the best of our knowledge, no paper has explicitly dealt with municipalities in Japan as the units of contextual social capital and the Gini. Our analyses show that the subjective life satisfaction of individuals, after controlling for socioeconomic status and health at the individual level, is associate with both an income gap and social capital at the municipal level. Every component of community social capital in this study except for generalized reciprocity, both cognitive (generalized trust, particularized trust, and particularized reciprocity), and structural (three types of group participation and daily contacts with neighbors, friends/acquaintances, and colleagues), and the Gini coefficient on earned income were associated with self-rated life satisfaction at the individual level with statistical significance. However, SRH is associated only with cognitive social capital at the community level. SRH has no significant association with structural components of community social capital or with a community income gap in terms of the Gini coefficient on personal income. Judging from the results of estimates in the study, most of the components of community social capital at the municipal level seem to play an important role in enhancing self-rated life satisfaction. Life satisfaction may be associated with the broad atmosphere of the municipal level where one resides, while SRH is associated with cognitive social capital rather than structural social capital. However, the difference in the impact of contextual social capital between the two QOL indices may indicate the importance of considering a proper contextual level that is suitable for the outcome. [ABSTRACT FROM AUTHOR]

• There is a paucity of research about the role of job participation in health and well-beings of older people. • A longitudinal study revealed increased frequency of job participation was associated with better self-rated health and happiness and reduced risk of depression. • Subgroup analyses showed the association differed based on age-groups and gender. We investigated the association between the frequency of job participation and well-being among older people in Japan, using data from a prospective nation-wide survey, the Japan Gerontological Evaluation Study (JAGES). The frequency of work was classified into "not working," "sometimes or less" (≤3 times/week), and "often or more" (≥4 times/week), and we conducted binary and continuous outcome analyses using logistic or Poisson regression and linear regression. After adjusting for covariates, we have found that participants who worked "often or more" and "sometimes or less" were less likely to display poor subjective health (often or more = odds ratio (OR): 0.55, 95% confidence interval (CI): 0.48 to 0.62; sometimes or less = OR: 0.57, 95% CI: 0.49 to 0.67) and depression (often or more = OR: 0.62, 95% CI: 0.53 to 0.73; sometimes or less = OR: 0.58, 95% CI: 0.47 to 0.71), and more likely to be happy (often or more = prevalence ratio (PR): 1.05, 95% CI: 1.03 to 1.07; sometimes or less = PR: 1.03, 95% CI: 1.00 to 1.05). Linear regression analysis of ordinal discrete outcomes showed similar trends, and furthermore suggested that more work conferred more benefits. The participants who worked "often or more" were less likely to have poor subjective health and were happier than those who worked "sometimes or less" (linear coefficients of −0.04 and 0.15 respectively). Further research is required to investigate possible explanations for the association between frequent job participation and health and well-being at older ages. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to determine whether frailty is an important and independent predictor of incident depressive symptoms in elderly people without depressive symptoms at baseline. Design Fifteen-month prospective study. Setting General community in Japan. Participants A total of 3025 community-dwelling elderly people aged 65 years or over without depressive symptoms at baseline. Measurements The self-rated 15-item Geriatric Depression Scale was used to assess symptoms of depression with a score of 6 or more at baseline and 15-month follow-up. Participants underwent a structural interview designed to obtain demographic factors and frailty status, and completed cognitive testing with the Mini-Mental State Examination and physical performance testing with the Short Physical Performance Battery as potential predictors. Results At a 15-month follow-up survey, 226 participants (7.5%) reported the development of depressive symptoms. We found that frailty and poor self-rated general health (adjusted odds ratio 1.86, 95% confidence interval 1.30–2.66, P < .01) were independent predictors of incident depressive symptoms. The odds ratio for depressive symptoms in participants with frailty compared with robust participants was 1.86 (95% confidence interval 1.05–3.28, P = .03) after adjusting for demographic factors, self-rated general health, behavior, living arrangements, Mini-Mental State Examination, Short Physical Performance Battery, and Geriatric Depression Scale scores at baseline. Conclusions Our findings suggested that frailty and poor self-rated general health were independent predictors of depressive symptoms in community-dwelling elderly people. [ABSTRACT FROM AUTHOR]

Introduction It is well known that lower income is associated with poorer health, but poverty has several dimensions other than income. In the current study, we investigated the associations between multidimensional poverty and health variables. Methods Using micro data obtained from a nationwide population survey in Japan (N = 24,905), we focused on four dimensions of poverty (income, education, social protection, and housing conditions) and three health variables (self-rated health (SRH), psychological distress, and current smoking). We examined how health variables were associated with multidimensional poverty measures, based on descriptive and multivariable logistic regression analyses. Results Unions as composite measures of multiple poverty dimensions were more useful for identifying individuals in poor SRH or psychological distress than a single dimension such as income. In comparison, intersections of poverty dimensions reduced the coverage of individuals considered to be in poverty and tend to be difficult to justify without any explicit policy objective. Meanwhile, education as a unidimensional poverty indicator could be useful for predicting current smoking. Conclusions Results obtained from the current study confirmed the practical relevance of multidimensional poverty for health. [ABSTRACT FROM AUTHOR]

Social capital is positively associated with self-rated health; however, this association among workers is still unclear. Thus, this study examined the relationship between social capital and self-rated health with special attention to the employment type. A cross-sectional survey was conducted with 6160 workers aged 20-64 years from two towns in Mie Prefecture in January-March 2013. Social capital was assessed using five items in 4816 income-earning workers. The social capital scores were summed and then divided into three groups. The self-rated health responses were dichotomised into 'poor' and 'good'. The association was examined using a stepwise binomial logistic regression stratified by employment type and adjusted for potential confounders. Regular employees with low social capital had a higher significant odds ratio of poor self-rated health than medium (OR 0.58 95% CIs 0.39-0.87) and high (OR 0.39; 95% CIs 0.26-0.59) social capital levels after controlling for all potential confounders. Similar patterns were observed for non-regular employees with medium and high social capital. There was a significant relationship between some indicators of social capital and poor self-rated health among self-employees. These results highlight that social capital acts as an unequal health resource for different types of workers.

Previous studies have shown that income inequality in society is negatively associated with individuals subjective well-being (SWB), such as their perceived happiness and self-rated health (SRH). However, it is not realistic to assume that individuals have precise information about actual income distribution measured by the Gini coefficient or other statistical measures. In the current study, we examined how perceived income inequality, rather than actual inequality, was associated with SWB, using cross-sectional data collected from a nationwide, Internet survey conducted in Japan ( N = 10,432). We also examined how this association was confounded by individuals' objective and subjective income status, considering the possibility that individuals with lower income status are more inclined to both perceive income inequality and feel unhappy/unhealthy. In our analysis, we focused on the perception of widening income inequality (as perceived income inequality), perceived happiness and SRH (as SWB), and household income and living standards compared with 1 year ago and compared with others (as income status). We also controlled for personality traits. We obtained three key findings: (1) perceived income inequality was negatively associated with SWB; (2) both perceived income inequality and SWB were associated with income status; and (3) the association between perceived income inequality and SWB was attenuated after controlling for income status, but not fully for perceived happiness. These findings suggest that perceived income inequality, which links actual income inequality to SWB, should be further studied. [ABSTRACT FROM AUTHOR]

Abstract: The extent that risk factors, identified in Western countries, account for health inequalities in Japan remains unclear. We analysed a nationally representative sample (Comprehensive Survey of Living Conditions surveyed in 2001 (n = 40,243)). The cross-sectional association between self-rated fair or poor health and household income and a theory-based occupational social class was summarised using the relative index of inequality [RII]. The percentage attenuation in RII accounted for by candidate contributory factors – material, psychosocial, social relational and behavioural – was computed. The results showed that the RII for household income based on self-rated fair or poor health was reduced after including the four candidate contributory factors in the model by 20% (95% CI 2.1, 43.6) and 44% (95% CI 18.2, 92.5) in men and women, respectively. The RII for the Japanese Socioeconomic Classification [J-SEC] was reduced, not significantly, by 22% (95% CI −6.3, 100.0) in men in the corresponding model, while J-SEC was not associated with self-rated health in women. Material factors produced the most consistent and strong attenuation in RII for both socioeconomic indicators, while the contributions attributable to behaviour alone were modest. Social relational factors consistently attenuated the RII for both socioeconomic indicators in men whereas they did not make an independent contribution in women. The influence of perceived stress was inconsistent and depended on the socioeconomic indicator used. In summary, social inequalities in self-rated fair or poor health were reduced to a degree by the factors included. The results indicate that the levelling of health across the socioeconomic hierarchy needs to consider a wide range of factors, including material and psychosocial factors, in addition to the behavioural factors upon which the current public health policies in Japan focus. The analyses in this study need to be replicated using a longitudinal study design to confirm the roles of different factors in health inequalities. [Copyright &y& Elsevier]

Abstract: Little is known regarding the longitudinal effects of bonding and bridging social capital on health. This study examined the longitudinal associations of bonding and bridging social capital with self-rated health, depressive mood, and cognitive decline in community-dwelling older Japanese. Data analyzed in this study were from the 2010 (baseline) and 2012 (follow-up) Hatoyama Cohort Study. Bonding social capital was assessed by individual perception of homogeneity of the neighborhood (the level of homogeneity among neighbors) and of networks (the amount of homogeneous personal networks) in relation to age, gender, and socioeconomic status. Bridging social capital was assessed by individual perception of heterogeneity of networks (the amount of heterogeneous personal networks) in relation to age, gender, and socioeconomic status. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the effects of baseline social capital on poor health outcome at follow-up by logistic regression analysis. In total, 681 people completed baseline and follow-up surveys. The mean age of participants was 71.8 ± 5.1 years, and 57.9% were male. After adjusting for sociodemographics, lifestyle factors, comorbidity, functional capacity, baseline score of each outcome, and other bonding/bridging social capital, stronger perceived neighborhood homogeneity was inversely associated with poor self-rated health (OR = 0.55, 95% CI = 0.30–1.00) and depressive mood assessed by the Geriatric Depression Scale (OR = 0.58, 95% CI = 0.34–0.99). When participants who reported a depressive mood at baseline were excluded, stronger perceived heterogeneous network was inversely associated with depressive mood (OR = 0.40, 95% CI = 0.19–0.87). Neither bonding nor bridging social capital was significantly associated with cognitive decline assessed by the Mini-Mental State Examination. In conclusion, bonding and bridging social capital affect health in different ways, but they both have beneficial effects on the health of older Japanese. Our findings suggest that intervention focusing on bonding and bridging social capital may improve various health outcomes in old age. [Copyright &y& Elsevier]

Background: Enhanced female labor force participation is raising the importance of grandparents' caring for their grandchildren. However, previous studies have reported mixed results of the association between grandchild care and grandparents' health., Methods: Longitudinal data of 33,204 individuals born between 1946 and 1955 were collected from a 14-wave nationwide panel survey conducted from 2005 to 2018. We examined how caring for at least one co-residing grandchild aged <6 years was associated with grandparents' psychological distress (defined by five or higher Kessler 6 score) and poor self-rated health in pooled cross-sectional, fixed-effects, and 3-year follow-up logistic models., Results: While pooled cross-sectional models showed a positive association between grandchild care and grandparents' health, the fixed-effects or follow-up logistic models did not find any significant association between them. In the case of grandmothers, the odds ratio of reporting psychological distress in response to caring for grandchildren was 0.98 (95% confidence interval [CI], 0.89-1.08) and 1.04 (95% CI, 0.85-1.27) observed from fixed-effects and 3-year follow-up models, respectively, compared to 0.86 (95% CI, 0.81-0.91) in the pooled cross-sectional model. Similar patterns were observed for self-rated health for grandmothers, while grandfathers' health outcomes were not sensitive to grandchild care. These results contrasted with those of caring for parents, which had almost consistently a negative association with grandparents' health., Conclusion: The results suggest that caring for grandchildren does not have a beneficial or detrimental effect on grandparents' health.

Background: Cross-cultural studies studying work-family conflicts (W&#95;F&#95;Cs) are scarce. We compared the prevalence of W&#95;F&#95;Cs, factors correlated with them, and their association with self-rated health between Japan and Egypt., Methods: Among 4862 Japanese and 3111 Egyptian civil workers recruited by a convenience sample in 2018/2019 and reported self-rated health status, we assessed the W&#95;F&#95;Cs by the Midlife Development in the US (MIDUS) and attributed them to sociodemographic, family, and work variables. We also evaluated the W&#95;F&#95;Cs' gender- and country-specific associations with self-rated health by logistic regression analyses., Results: W&#95;F&#95;Cs were more prevalent in Egyptian than in Japanese women (23.7% vs. 18.2%) and men (19.1% vs. 10.5%), while poor self-rated health was more prevalent in Japanese than Egyptians (19.3% and 17.3% vs. 16.9% and 5.5%). Longer working hours, shift work, and overtime work were positively associated with stronger work-to-family conflict (WFC). Whereas being single was inversely associated with stronger family-to-work conflict (FWC). Living with children, fathers, or alone in Japan while education in Egypt was associated with these conflicts. The OR (95% CI) for poor self-reported health among those with the strong, in reference to weak total W&#95;F&#95;Cs, was 4.28 (2.91-6.30) and 6.01 (4.50-8.01) in Japanese women and men and was 2.46 (1.75-3.47) and 3.11 (1.67-5.80) in Egyptian women and men., Conclusions: Japanese and Egyptian civil workers have different prevalence and correlated factors of W&#95;F&#95;Cs and self-rated health. W&#95;F&#95;Cs were associated in a dose-response pattern with poor-self-rated health of civil workers in both countries., (© 2022. The Author(s).)

Several studies have reported the adverse impacts of the COVID-19 pandemic on health outcomes. However, little is known about which area of COVID-19 infection matters most for an individual's subjective health outcomes. We addressed this issue in the present study. We used the longitudinal data of 2260 individuals obtained from a two-wave internet-based nationwide survey conducted in Japan. We estimated the multilevel regression models, which controlled for fixed effects at the individual and prefecture levels, to explain an individual's self-rated health (SRH) based on the reported number of new COVID-19 infection cases at different area levels: prefecture, group of neighboring prefectures, and regional bloc. We found that SRH was highly associated with the average and maximum number of new infection cases among neighboring prefectures or in the regional bloc, but not with those at the prefecture level, if used jointly as explanatory variables. The results suggest that inter-prefectural coordination is needed not only to contain COVID-19 but also to reduce its adverse impact on the subjective health outcomes of residents.

Objective: To compare self-rated health and its determinants between Japanese and South Koreans. Study design: A cross-sectional study was conducted on 2496 and 1576 adults (aged ≥20 years) in Japan and Korea, respectively, who completed the 2010 East Asian Social Survey. Methods: Ordinal logistic regression was conducted to identify significant factors for self-rated health in the two nations. Results: Japan has a lower level, and a smaller variance, of self-rated health than Korea. This study confirmed traditional results by finding that socio-economic status, daily activity and physical exercise had positive effects on self-rated health; and chronic disease, overweight/obesity and smoking had negative effects on self-rated health. In addition, this study found that: middle-aged (40s/50s) Japanese have lower self-rated health than younger (20s/30s) Japanese; living with a spouse has a negative impact on self-related health in both Japanese and Koreans in their 20s/30s; and mental factors (i.e. happiness, hopelessness and mental health problems) have a greater impact on self-rated health in Japanese than in Koreans, whereas the reverse is true for physical health problems. Discussion: This study found that many health dynamics depend on the unique context of each nation. Moreover, this study may help to inform the direction of future research on self-rated health and its determinants in other Asian nations. [ABSTRACT FROM AUTHOR]

Abstract: Despite accumulating evidence of associations between social capital and health in public health research, a criticism of the field has been that researchers have exclusively focused on concepts of social cohesion to the exclusion of individual-level approaches. In the present study, we evaluated the association between social capital measured by the Resource Generator (an individual-level assessment of access to social capital) and self-rated health among Japanese population in a cross-sectional study. A postal survey of 4000 randomly selected residents in Okayama City (western Japan) was conducted in February 2009. We divided the overall scores from the Resource Generator Japan scale into quartiles. Odds ratios (ORs) and 95% confidence intervals (CIs) for self-rated health were calculated separately by sex. Individuals with the highest quartile of scores had significantly lower odds of poor health compared to the lowest group after covariate adjustment among both men and women (men; OR: 0.45, 95% CI: 0.24–0.86, women; OR: 0.44, 95% CI: 0.25–0.79, respectively) and there were also significant dose–response relationships. In the sub-domains of Resource Generator Japan scale, a differential pattern was observed by sex. Women showed a clear dose–response relationship with health across all four sub-scales (domestic resources, expert advice, personal skills, and problem solving resources). In contrast, only the domain of expert advice exhibited a strong association with men''s health. Among both men and women individual-level social capital measured by the Resource Generator was related to reduced odds of poor health even after taking into account individual confounders. Although we cannot exclude reverse causation due to the cross-sectional design, our study adds to the accumulating evidence of the potential utility of the Resource Generator for evaluating the relationship between individual-level access to social capital and health. [Copyright &y& Elsevier]

Abstract: This study aimed to quantify the contributions of the factors that have influenced changes in income-related health inequalities. We used data from a nationally representative sample of Japanese men and women aged 20–59 years who participated in eight repeated cross-sectional surveys between 1986 and 2007. A concentration index (CI) was used to measure income-related inequalities in self-rated health (SRH) and decomposed into contributing factors. We then examined temporal changes in CIs and their contributing factors. Results showed that income-related inequalities in SRH, unfavourable to low-income groups, persisted throughout the study period. Despite widening income inequalities, inequalities in SRH narrowed during the period of economic stagnation since the late 1990s because of the profound deterioration in SRH among middle- to high-income groups. Decomposition analysis showed that income itself and unemployment or economic inactivity were the most important contributors to inequalities in SRH for both sexes at almost all time points. However, from 1986 to 2007, the relative contribution of income to these inequalities decreased from 78% to 14% in men and from 85% to 38% in women. By contrast, the relative contribution of unemployment or economic inactivity increased from 18% to 77% in men and from 10% to 31% in women. Our results suggest that a reduction in avoidable health inequalities could be achieved by reducing the influence of unemployment or economic inactivity on health. [Copyright &y& Elsevier]

Our study aimed to investigate the physical performance and quality of life (QOL) as associated factors with self-rated health (SRH). Japanese community-dwelling women aged 65 years or more ( n = 51; mean age = 75.3 ± 6.0) answered a questionnaire regarding socio-demographic information, SRH, QOL by the Short Form-8, and performed the physical tests, such as Timed Up and Go, Functional Reach (FR), One Leg Stand (OLS), Five Chair Stands (CS), and hand grip strength (HGS). Smoking ( p = 0.04), more medical consultations ( p = 0.03), and more number of medications ( p = 0.001) were significantly associated with poor self-assessment of their health. Moreover, those who assessed their health condition as not so good to bad condition had lower performance in FR ( p = 0.02), HGS ( p = 0.04), OLS ( p = 0.05), and CS ( p = 0.02), and poorer QOL condition in general health ( p < 0.01), bodily pain ( p = 0.02), and vitality ( p = 0.03) in comparison with the other SRH groups (good and/or normal). Therefore, we encouraged the use of the SRH assessment and the interpretation of its results based on the present findings such as associating the SRH of older women with their physical performance and QOL. [ABSTRACT FROM AUTHOR]

Background To date, only a small amount of research on bonding/bridging social capital has separately examined their effects on health though they have been thought to have differential effects on health outcomes. By using a large population-based sample of elderly Japanese people, we sought to investigate the association between bonding and bridging social capital and self-rated health for men and women separately. Methods In August 2010, questionnaires were sent to all residents aged ≥65 years in three municipalities in Okayama prefecture (n = 21232), and 13929 questionnaires were returned (response rate: 65.6%). Social capital was measured from survey responses to questions on participation in six different types of groups: a) the elderly club or sports/hobby/culture circle; b) alumni association; c) political campaign club; d) citizen's group or environmental preservation activity; e) community association; and f) religious organization. Participant perception of group homogeneity (gender, age, and previous occupation) was used to divide social capital into bonding or bridging. Odds ratios (ORs) and 95% confidence intervals (CIs) for poor self-rated health were calculated. Results A total of 11146 subjects (4441 men and 6705 women) were available for the analysis. Among men, bonding and bridging social capital were inversely associated with poor self-rated health (high bonding social capital; OR: 0.55, 95% CI: 0.31−0.99; high bridging social capital; OR: 0.62, 95% CI: 0.48−0.81) after adjusting for age, educational attainment, smoking status, frequency of alcohol consumption, overweight, living arrangements, and type-D personality. The beneficial effect among women was more likely limited to bonding social capital (high bonding social capital; OR: 0.34, 95% CI: 0.12−1.00), and the association between bridging social capital and self-rated health was less clear (high bridging social capital; OR: 0.69, 95% CI: 0.44−1.07). Conclusions Bonding/bridging social capital could have differential associations with self-rated health among the Japanese elderly depending on the individual's sex. Considering the lack of consensus on how to measure bonding and bridging social capital, however, we need to carefully assess the generalizability of our findings. Further research is warranted to identify health-relevant dimensions of social capital in different cultural or economic settings. [ABSTRACT FROM AUTHOR]

Aim: To examine the effects of a once-weekly laughter and exercise program on physical and psychological health among elderly people living in the community. As a regular exercise program can be difficult to maintain, we provided a more enjoyable program to enhance adherence to exercise. Methods: A total of 27 individuals aged 60 years or older, without disabilities, were randomly assigned to either an immediate treatment group ( n = 14) or a delayed treatment group ( n = 13). The intervention was a 120-min session consisting of laughter and exercise, carried out once a week for 10 consecutive weeks. Measurements taken at baseline, 3 and 6 months included bodyweight, height, body fat, lean mass, bone mineral density, hemoglobin A1c (HbA1c), glucose, high-density lipoprotein and low-density lipoprotein cholesterol, and triglycerides, as well as self-rated health and psychological factors. Results: All participants completed the 3-month program. Bone mineral density increased significantly in the immediate treatment group compared with the delayed treatment group during the first 3 months ( P < 0.001). In addition, HbA1c decreased significantly ( P = 0.001), and self-rated health increased significantly ( P = 0.012). Conclusions: The combination of a laughter and exercise program might have physiological and psychological health benefits for the elderly. Laughter might be an effective strategy to motivate the elderly to participate in physical activity. Geriatr Gerontol Int 2013; 13: 152-160. [ABSTRACT FROM AUTHOR]

Background: The number of people providing informal caregiving, including dual care, which is the combination of child and nursing care, is increasing. Due to the burden of multiple responsibility, dual care could negatively affect the health of informal caregivers. Previous research has not studied the effects of combining different types of informal caregiving. Therefore, we examined, among Japanese women, 1) the association between types of informal caregiving and self-rated health (SRH), and 2) difference in this association according to caregivers' socio-economic conditions., Methods: We analyzed the nationally representative 2013 Comprehensive Survey of Living Conditions data of 104,171 women aged 20-59 years. The odds ratios (ORs) for poor SRH by type of informal caregiving (no care, childcare, nursing care, and dual care) were estimated using logistic regression. We also conducted sub-group analyses by socio-economic conditions (equivalent monthly household expenditure and educational attainment)., Results: Compared to the no care group, the adjusted ORs for poor SRH of the childcare, nursing-care, and dual care groups were 0.92 (95% confidence interval [CI], 0.88-0.97), 1.33 (95% CI, 1.21-1.47), and 1.42 (95% CI, 1.23-1.64), respectively. There was no extra risk arisen from combining childcare and nursing care. The sub-group analyses indicated that neither household expenditure nor educational attainment affected the association between caregiving type and poor SRH., Conclusion: Our study found that informal nursing care and dual care impose a health burden on female caregivers, regardless of their socio-economic conditions. This highlights the importance of addressing the effects of informal caregiving on the health of women.

Background: Coronavirus disease 2019 (COVID-19) has disproportionately affected the most vulnerable populations. We assessed the prevalence and disparities of economic hardships and their impact on health deterioration in Japan., Methods: Data were obtained from a nation-wide, cross-sectional, internet-based, self-reported survey conducted during August-September, 2020 with individuals aged 15-79 years in Japan (n = 25,482). Economic hardships and changes in various physical and mental health status were measured using sample-weighted data. Adjusted prevalence ratios (APRs) were estimated to investigate the associations between economic hardships and health outcomes., Results: During April-September, 2020 in Japan, 25.0%, 9.6%, 7.9%, and 3.1% of the respondents experienced income loss, money shortage, financial anxiety and financial exploitation, respectively, with higher prevalence among workers (vs non-workers). Stratifying by sex and working status, income loss was associated with physical health deterioration (APRs ranged from 1.45-1.95), mental health deterioration (APRs ranged from 1.47-1.68), and having serious psychological distress (APRs ranged from 1.41-2.01) across all strata. Shortage of money and financial anxiety were also associated with increased likelihood of all adverse health outcomes assessed, regardless of whether the hardships were pre-existing or experienced first time. Among non-working individuals, financial exploitation was associated with physical health deterioration among males (APR 1.88) and mental health deterioration among both males (APR 1.80) and females (APR 2.23), while such associations were not observed among working individuals., Conclusions: During the early phase of the COVID-19 epidemic, COVID-19-related economic hardships were associated with physical and mental health deterioration in Japan, particularly among the vulnerable populations. Timely and prompt responses are warranted to mitigate both economic and health burdens.

Abstract: Although earlier studies have demonstrated an association between neighbourhood perceptions and self-rated health, further study is needed regarding how this association is related to an individual''s psychological attributes. Hence, we examined how self-rated health is associated with neighbourhood satisfaction after controlling for personality traits as well as other individual- and area-level covariates. We employed multilevel analysis using microdata collected from a nationwide Internet survey in Japan in 2011 (N = 8139). When controlling for personality traits, we observed that the odds for reporting poor health in response to neighbourhood dissatisfaction declined but remained highly significant. We obtained similar results when additionally controlling for sense of coherence (SOC) or replacing personality traits with it. We also found virtually no significant effect of personality traits or SOC on the sensitivity of self-rated health with neighbourhood dissatisfaction. Overall, this study indicated that the observed association between neighbourhood satisfaction and self-rated health tends to be overestimated, but cannot be fully explained by personality traits or SOC. [Copyright &y& Elsevier]

The pathways between parenting behaviours, personality and physical health have all been separately studied. Prior research has paid little attention to the indirect effects of personality in the path between parenting behaviours and better health. The purpose of this study was to explore the mediational effects of conscientiousness on the relationships between parental socialisation of responsibility and self‐rated health, and to examine potential age differences in this mediational pathway. In total, 736 female and 749 male members across Japan participated in this study. They were divided into three groups by age category: younger‐, middle‐aged and older‐aged. Conscientiousness and health were concurrently rated, while parental socialisation of responsibility was retrospectively assessed. Our analyses revealed that parental socialisation of responsibility is positively associated with conscientiousness and self‐rated health, that conscientiousness is positively associated with self‐rated health, and that conscientiousness fully mediated the effect of parental socialisation of responsibility on self‐rated health. The mediational links were consistent across younger, middle‐aged and older‐aged cohorts. Our findings suggest that greater parental socialisation of responsibility relates to higher conscientiousness, and consequently healthier adults. These findings imply that parental behaviours could be a plausible target for intervention to foster the development of conscientiousness and better health. [ABSTRACT FROM PUBLISHER]

The article focuses on a study which analyses effects of unstable employment contracts on the health of workers of Japan. It discusses the applied methodology of health status comparison of workers with part-time employment contracts with that of permanent workers through a survey conducted at the national level. It reports poor self-rated health, psychological distress and tobacco use prevalent among part-time employment contract workers.

Abstract: The erosion of social capital in more unequal societies is one mechanism for the association between income inequality and health. However, there are relatively few multi-level studies on the relation between income inequality, social capital and health outcomes. Existing studies have not used different types of health outcomes, such as dental status, a life-course measure of dental disease reflecting physical function in older adults, and self-rated health, which reflects current health status. The objective of this study was to assess whether individual and community social capital attenuated the associations between income inequality and two disparate health outcomes, self-rated health and dental status in Japan. Self-administered questionnaires were mailed to subjects in an ongoing Japanese prospective cohort study, the Aichi Gerontological Evaluation Study Project in 2003. Responses in Aichi, Japan, obtained from 5715 subjects and 3451 were included in the final analysis. The Gini coefficient was used as a measure of income inequality. Trust and volunteering were used as cognitive and structural individual-level social capital measures. Rates of subjects reporting mistrust and non-volunteering in each local district were used as cognitive and structural community-level social capital variables respectively. The covariates were sex, age, marital status, education, individual- and community-level equivalent income and smoking status. Dichotomized responses of self-rated health and number of remaining teeth were used as outcomes in multi-level logistic regression models. Income inequality was significantly associated with poor dental status and marginally significantly associated with poor self-rated health. Community-level structural social capital attenuated the covariate-adjusted odds ratio of income inequality for self-rated health by 16% whereas the association between income inequality and dental status was not substantially changed by any social capital variables. Social capital partially accounted for the association between income inequality and self-rated health but did not affect the strong association of income inequality and dental status. [Copyright &y& Elsevier]

Poor self-rated health is considered to be a predictor of short survival, and self-rated health is associated with several lifestyle and sociodemographic factors. To determine whether marital status is an independent risk factor for poor self-rated health among inhabitants in rural areas, we conducted a cross-sectional survey of inhabitants in Japan. Complete responses were obtained from 10,268 individuals. Self-ratings of mental health, demographics, and symptoms were used to predict self-rated health. Being male; having disease, questionnaire-based physical complaints, and depressive state; having lower levels of education; and being divorced resulted in higher odds (95% confidence interval) for poor self-rated health, presenting 1.41 (1.18-1.69), 10.8 (8.62-13.7), 1.11 (1.09-1.12), 1.11 (1.08-1.13), 1.22 (1.02-1.46), and 1.53 (1.01-2.31), respectively. In contrast, age, friendship, and other marital status such as single or bereaved showed no significant relationship with poor self-rated health. To improve self-rated health among rural inhabitants, attention should be focused on divorced inhabitants, especially men. [ABSTRACT FROM AUTHOR]

We attempt to examine the extent to which poverty in childhood adversely affects success in adulthood, using micro data from nationwide surveys in Japan and taking into account the recursive structure of life outcomes. We use retrospective assessments of income class at the age of 15, because longitudinal data on household income are not available. After controlling for its endogeneity, we confirm that children from poor families tend to have lower educational attainment, face higher poverty risks, and assess themselves as being less happy and as suffering from poorer health. [ABSTRACT FROM AUTHOR]