Effects of a Lifestyle-Based Physical Activity Intervention on Medical Expenditure in Japanese Adults: A Community-Based Retrospective Study

The impact of natural disasters on household debt: evidence from 2014 China family panel studies

Based on data from the 2014 China Family Panel Studies, we investigate the causal relationship between natural disasters and household debt using ordinary least squares and propensity score matching. This paper found that natural disasters can not only increase the probability of households owning debt but also have a significant positive impact on the number of household debt. The results of heterogeneity analysis show that natural disasters have a greater impact on families with large sizes and high-consumption levels. Mechanism checks suggest that household income and individual's health are shown to be the potential mechanism through which the impact of natural disasters on household debt.

Influencing Factors Related to Female Sports Participation Under the Implementation of Chinese Government Interventions: An Analysis Based on the China Family Panel Studies

Objectives

Regular sports participation is a gendered phenomenon in China. Women have reported much higher constraints than men on time, partner, psychology, knowledge, and interest. This study explores personal, family, lifestyle, and health factors associated with sports participation.

Study Design

This study is a cross-sectional study.

Methods

Data were collected from the national reprehensive China Family Panel Studies (CFPS) database (2018) to analyze personal information, family background, lifestyle, and health in relation to women's sports participation. Multiple classification logistic regression was used to quantify the association between independent variables and sports time.

Results

Women with high personal income and education, who were unmarried, in faster economic development areas have more awareness and more time for sports participation. Women who were overweight and self-rated as unattractive spent less time on sports participation. Women with a small family population and no children have more time for sports participation. Less time on the internet and moderate sleep contribute to active sports participation. Women with chronic diseases and high medical costs are less likely to participate in sports.

Conclusions

Negative body aesthetic perception, the burden of family environment, modernization of lifestyle, and the normalization of sub-health are essential factors affecting women's sports participation. The government should understand the inner and outer barriers to women's participation in sports, develop policies and regulations to protect and support women's sports participation, and guide and monitor the effective implementation of women's sports activities.

Renal Health Benefits of Rural City Planning in Japan

Progression of chronic kidney disease (CKD) is a substantial threat because it is associated with reduced healthy life expectancy and quality of life, and increase in economic burden. Research indicates people with nondialysis CKD often have lower physical functioning and that improvement of physical activity may contribute to maintaining renal health. Another issue with the current treatment of CKD is that the synergistic effects of rural depopulation due to aging and uncontrolled rural city sprawling will increase the number of under-served healthcare areas. To ensure the quality of renal health care, hospital integration is desirable, under the condition of reconstruction of the public transport system for physically and socially vulnerable people. Recently, medical and non-medical scientists advocate the challenge of city planning for population health. The links between city design and health such as cardiovascular disease, obesity, type 2 diabetes and mental disorders, have been widely studied, except for renal health. Based on our experience in a Kidney and Lifestyle-related Disease Center, we propose the idea that city planning be prioritized to improve renal health through two main streams: 1) Improve physical status by use of public and active transportation including daily walking and cycling; and 2) Equal accessibility to renal health services. Many countries, including Japan, have enacted plans and public policy initiatives that encourage increased levels of physical activity. We should focus on the impact of such movement on renal as well as general health.

Daily steps and healthcare costs in Japanese communities

Physical inactivity is a pandemic that requires intensive, usually costly efforts for risk reduction of related chronic diseases. Nevertheless, it is challenging to determine the effectiveness of physical activity in healthcare cost reduction based on existing literature. Therefore, this study aimed to investigate the impact of physical activity (daily steps) on healthcare costs utilising the data retrieved from a health promotion project (the e-wellness Project, held in three municipalities in Japan). Evaluating the effects of daily steps, measured by pedometers, on healthcare costs by a quasi-experimental approach among participants aged 40–75 years (about 4000 person-years of observation, between 2009 and 2013), we found that a one-step-increase in the annual average daily step reduced outpatient healthcare costs by 16.26 JPY (≒ 0.11 GBD) in the short run. Based on the assumption of a dynamic relationship between the health statuses in multiple years, the long-run effects of daily steps on healthcare costs were estimated at 28.24 JPY (≒ 0.20 GBD). We determined the health benefits of walking in a sample of middle-aged and older Japanese adults by our findings that an increase in step counts reduced healthcare costs.

Association between single limb standing test results and healthcare costs among community-dwelling older adults

BACKGROUND AND OBJECTIVE

Identifying risks for older adults who will require healthcare resources is critical for the government, healthcare providers, and consumers. The objective of this study was to examine the relationship between the results of the single limb standing (SLS) test and healthcare costs among community-dwelling older adults.

METHODS

We used data obtained from a population-based prospective cohort study of the residents of Tadami town in Fukushima Prefecture, Japan. The participants were above 60 years of age and had undergone annual health check-ups, and data on their healthcare costs over the two-year study period were available. A censored regression model adjusted for potential confounders was used to estimate the mean difference in total healthcare costs between participants who could remain standing on a single limb for at least 30 s and those who could not.

RESULTS

Healthcare costs of participants who passed the SLS test were significantly lower than those who did not. The mean difference between the two groups' healthcare costs was 4064 USD (95 % confidence interval: 2661-5467 USD, p < 0.05). After adjusting for potential confounders, the mean difference between the two groups was smaller (1686 USD) but remained statistically significant (95 % confidence interval: 125-3246 USD, p < 0.05).

CONCLUSIONS

Among community-dwelling older adults, limited static balance (SLS time <30 s) was found to be associated with high healthcare costs in the two years after the SLS test. The SLS test may help identify individuals at high risk of becoming frequent users of healthcare services in the future.

Sociodemographic and physical predictors of non-participation in community based physical checkup among older neighbors: a case-control study from the Kyoto-Kameoka longitudinal study, Japan

Background

It is difficult to obtain detailed information on non-participants in physical and health examination checkups in community-based epidemiological studies. We investigated the characteristics of non-participants in a physical and health examination checkup for older adults in a nested study from the Japanese Kyoto-Kameoka Longitudinal Study.

Methods

We approached a total of 4831 people aged ≥65 years in 10 randomly selected intervention regions. Participants responded to a mail-based population survey on needs in the sphere of daily life to encourage participation in a free face-to-face physical checkup examination; 1463 participants (706 men, 757 women) participated in the physical checkup. A multiple logistic regression model was performed to investigate the adjusted odds ratios (aOR) of non-participation based on sociodemographic status apart from psychological and physiological frailty as assessed by the validated Kihon Checklist.

Results

There was a significant, inverse relationship between non-participation and frequently spending time alone among individuals who lived with someone or other family structure (aOR = 0.53, standard error [SE] 0.08 in men, aOR = 0.66, SE 0.09 in women). Very elderly (over 80 years old) women, poorer health consciousness and current smoking in both sexes and poor self-rated health in men, were significantly related to higher non-participation rates. In both sexes, individuals who did not participate in community activities were significantly more likely to be non-participants than individuals who did (aOR = 1.94, SE 0.23 in men, aOR = 3.29, SE 0.39 in women). Having low IADL and physical functioning scores were also associated with higher rates of non-participation.

Conclusion

Health consciousness and lack of community activity participation were predictors of non-participation in a physical checkup examination among older adults. In addition, lower IADL and physical functioning/strength were also predictors of non-participation.

On the contrary, older inhabitants living with someone tended to participate in the physical checkup examination for social interchange when they were frequently alone in the household. This study suggests the importance of considering aging especially for women and poor sociodemographic background and physical frailty for both sexes so that older people can access health programs without difficulty.

Trial registration

UMIN000008105. Registered 26 April 2012. Retrospectively registered.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5426-5) contains supplementary material, which is available to authorized users.

Association between Meeting Physical Activity Guidelines and Mortality in Korean Adults: An 8-year Prospective Study

PURPOSE

Although previous studies have investigated the association between physical activity and various health outcomes, limited information is available on the effect of meeting new governmental guidelines for physical activity on the risk of mortality in Korean adults. This study aimed to examine the prospective association between meeting these guidelines and all-cause mortality during an 8-year follow-up using a large nationwide sample of middle-aged and older adults in Korea.

METHODS

This prospective study was conducted based on the Korean Longitudinal Study of Ageing. The study participants included 9,177 adults aged 45 years or older at baseline, and all participants were monitored in a 2-year cycle during an 8-year period (70,873 person-years). The risk of mortality was analyzed by determining physical activity levels using the Cox proportional hazard models, and the hazard ratio (HR) and 95% confidence interval (CI) were estimated using Cox models.

RESULTS

A statistically significant effect of physical activity on the reduced risk of mortality was observed in cases in which the participants met the guidelines compared to the inactive group (HR: 0.68, 95% CI: 0.58-0.81 vs. the inactive group). A strong association between meeting the recommended physical activity levels and the reduced risk of mortality was also found for non-smokers (HR: 0.62; 95% CI: 0.51-0.76 vs. the inactive group), but not for current smokers (HR: 0.93; 95% CI: 0.67-1.29 vs. the inactive group).

CONCLUSION

Meeting physical activity guidelines was associated with a decreased risk of all-cause mortality for Korean adults. Our results also suggest that smoking reduces the protective effect of physical activity on the risk of mortality.