1
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Koga C, Saito T, Hanazato M, Kondo N, Saito M, Ojima T, Kondo K. Living in public rental housing is healthier than private rental housing a 9-year cohort study from Japan Gerontological Evaluation Study. Sci Rep 2024; 14:7547. [PMID: 38555321 PMCID: PMC10981673 DOI: 10.1038/s41598-024-58244-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/27/2024] [Indexed: 04/02/2024] Open
Abstract
Housing tenure is an important aspect to determine health. However, even though renters tend to have more socioeconomic disadvantages than homeowners, mortality risk between private and public renters compared with homeowners remains unclear. Japanese public rented housing, such as the Urban Renaissance Agency, has been developed for supplying an adequate living environment since 1950s. This study aimed to examine the mortality risk among older Japanese residents living in private and public rented houses compared with those living in owner-occupied houses using 9-year follow-up data. This study drew upon a 9-year follow-up of participants in the Japan Gerontological Evaluation Study, a population-based cohort study of Japanese independent adults aged ≥ 65 years. Mortality from 2010 to 2019 was analyzed for 44,007 respondents. Housing tenure was defined by a questionnaire. Cox regression models were used for calculating the hazard ratio for mortality. Bonferroni correction was used to account for multiple testing between rental houses. Overall, 10,638 deaths occurred during the follow-up period. Compared with housing owners, all rental housing groups had a significantly higher risk of mortality. Among renters, participants who lived in public rental housing had the lowest risk of mortality even after adjusting for sociodemographic characteristics, health status, social status, and environmental status. Multiple testing among renters with Bonferroni correction showed that public renters had 0.80 times (95% CI 0.72-0.89) lower mortality risk than private renters. Although Japanese older adults living in public rental housing had a higher mortality risk than homeowners, this risk was lower than that among private renters. A positive neighborhood environment based on well-planned urban development may have contributed to this result. The results suggest that planned urban development lowers the risk of mortality in older renters in Japan.
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Grants
- 15H01972, 15H04781, 15H05059, 15K03417, 15K03982, 15K16181, 15K17232, 15K18174, 15K19241, 15K21266, 15KT0007, 15KT0097, 16H05556, 16K09122, 16K00913, 16K02025, 16K12964, 16K13443, 16K16295, 16K16595, 16K16633, 16K17256, 16K17281, 16K19247, 16K19267, 16K21461, 16K21465, 16KT0014, 17K04305, 17K04306, 25253052, 25713027, 26285138, 26460828, 26780328, 18H03018, 18H04071, 18H03047, 18H00953, 18H00955, Japan Society for the Promotion of Science
- 15H01972, 15H04781, 15H05059, 15K03417, 15K03982, 15K16181, 15K17232, 15K18174, 15K19241, 15K21266, 15KT0007, 15KT0097, 16H05556, 16K09122, 16K00913, 16K02025, 16K12964, 16K13443, 16K16295, 16K16595, 16K16633, 16K17256, 16K17281, 16K19247, 16K19267, 16K21461, 16K21465, 16KT0014, 17K04305, 17K04306, 25253052, 25713027, 26285138, 26460828, 26780328, 18H03018, 18H04071, 18H03047, 18H00953, 18H00955, Japan Society for the Promotion of Science
- 15H01972, 15H04781, 15H05059, 15K03417, 15K03982, 15K16181, 15K17232, 15K18174, 15K19241, 15K21266, 15KT0007, 15KT0097, 16H05556, 16K09122, 16K00913, 16K02025, 16K12964, 16K13443, 16K16295, 16K16595, 16K16633, 16K17256, 16K17281, 16K19247, 16K19267, 16K21461, 16K21465, 16KT0014, 17K04305, 17K04306, 25253052, 25713027, 26285138, 26460828, 26780328, 18H03018, 18H04071, 18H03047, 18H00953, 18H00955, Japan Society for the Promotion of Science
- 15H01972, 15H04781, 15H05059, 15K03417, 15K03982, 15K16181, 15K17232, 15K18174, 15K19241, 15K21266, 15KT0007, 15KT0097, 16H05556, 16K09122, 16K00913, 16K02025, 16K12964, 16K13443, 16K16295, 16K16595, 16K16633, 16K17256, 16K17281, 16K19247, 16K19267, 16K21461, 16K21465, 16KT0014, 17K04305, 17K04306, 25253052, 25713027, 26285138, 26460828, 26780328, 18H03018, 18H04071, 18H03047, 18H00953, 18H00955, Japan Society for the Promotion of Science
- 15H01972, 15H04781, 15H05059, 15K03417, 15K03982, 15K16181, 15K17232, 15K18174, 15K19241, 15K21266, 15KT0007, 15KT0097, 16H05556, 16K09122, 16K00913, 16K02025, 16K12964, 16K13443, 16K16295, 16K16595, 16K16633, 16K17256, 16K17281, 16K19247, 16K19267, 16K21461, 16K21465, 16KT0014, 17K04305, 17K04306, 25253052, 25713027, 26285138, 26460828, 26780328, 18H03018, 18H04071, 18H03047, 18H00953, 18H00955, Japan Society for the Promotion of Science
- 15H01972, 15H04781, 15H05059, 15K03417, 15K03982, 15K16181, 15K17232, 15K18174, 15K19241, 15K21266, 15KT0007, 15KT0097, 16H05556, 16K09122, 16K00913, 16K02025, 16K12964, 16K13443, 16K16295, 16K16595, 16K16633, 16K17256, 16K17281, 16K19247, 16K19267, 16K21461, 16K21465, 16KT0014, 17K04305, 17K04306, 25253052, 25713027, 26285138, 26460828, 26780328, 18H03018, 18H04071, 18H03047, 18H00953, 18H00955, Japan Society for the Promotion of Science
- 15H01972, 15H04781, 15H05059, 15K03417, 15K03982, 15K16181, 15K17232, 15K18174, 15K19241, 15K21266, 15KT0007, 15KT0097, 16H05556, 16K09122, 16K00913, 16K02025, 16K12964, 16K13443, 16K16295, 16K16595, 16K16633, 16K17256, 16K17281, 16K19247, 16K19267, 16K21461, 16K21465, 16KT0014, 17K04305, 17K04306, 25253052, 25713027, 26285138, 26460828, 26780328, 18H03018, 18H04071, 18H03047, 18H00953, 18H00955, Japan Society for the Promotion of Science
- 24-17, 24-23, 29-42, 30-30, 30-22, 20-19, 21-20 the Research Funding for Longevity Sciences from National Center for Geriatrics and Gerontology
- 24-17, 24-23, 29-42, 30-30, 30-22, 20-19, 21-20 the Research Funding for Longevity Sciences from National Center for Geriatrics and Gerontology
- JPMJOP1831 the Japan Science and Technology
- JP18dk0110027, JP18ls0110002, JP18le0110009, JP20dk0110034, JP21lk0310073, JP21dk0110037, and JP22lk0310087 the Ministry of Health, Labor and Welfare, Japan
- H26-Choju-Ippan-006, H27-Ninchisyou-Ippan-001 H28Choju-Ippan-002, H28Ninchisyou-Ippan-002, H30-Kenki-Ippan-006,H29-Chikyukibo-Ippan-001, H30-Jyunkankinado-Ippan-004, 19FA1012, 19FA2001, 21FA1012, 22FA2001, 22FA1010 Health Labor Sciences Research Grants
- H26-Choju-Ippan-006, H27-Ninchisyou-Ippan-001 H28Choju-Ippan-002, H28Ninchisyou-Ippan-002, H30-Kenki-Ippan-006,H29-Chikyukibo-Ippan-001, H30-Jyunkankinado-Ippan-004, 19FA1012, 19FA2001, 21FA1012, 22FA2001, 22FA1010 Health Labor Sciences Research Grants
- H26-Choju-Ippan-006, H27-Ninchisyou-Ippan-001 H28Choju-Ippan-002, H28Ninchisyou-Ippan-002, H30-Kenki-Ippan-006,H29-Chikyukibo-Ippan-001, H30-Jyunkankinado-Ippan-004, 19FA1012, 19FA2001, 21FA1012, 22FA2001, 22FA1010 Health Labor Sciences Research Grants
- J09KF00804 the Japan Foundation For Aging And Health
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Affiliation(s)
- Chie Koga
- Research Center for Advanced Science and Technology, The University of Tokyo, 4-6-1 Komaba, Meguro-ku, Tokyo, 153-8904, Japan.
| | - Tami Saito
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morikoka-cho, Obu-shi, Aichi, 474-8511, Japan
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, 606-8501, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Aichi, 470-3295, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu-shi, Shizuoka, 431-3192, Japan
| | - Katsunori Kondo
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morikoka-cho, Obu-shi, Aichi, 474-8511, Japan
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba-shi, Chiba, 263-8522, Japan
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Chen YR, Hanazato M, Saito M, Koga C, Matsuoka Y, Yoshida H, Kondo K. Does the neighborhood built and social environment reduce long-term care costs for Japanese older people? The JAGES2010-2019 cohort study. Health Place 2024; 86:103223. [PMID: 38479102 DOI: 10.1016/j.healthplace.2024.103223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 02/27/2024] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Abstract
Japan's population has been aging steadily, evidenced by it spending JPY 11 trillion (USD 110 billion) on annual long-term care (LTC) costs in 2021. In this context, understanding the factors influencing LTC costs has become increasingly vital. Although studies have reported positive relationships between neighborhood environment and health outcomes, the connection between LTC costs and neighborhood environment remains unclear. To address this gap in the literature, this cohort study, conducted from 2010 to 2019 across seven Japanese municipalities and involving 34,982 older people, examined the relationship between eight neighborhood environment elements and the mean monthly cumulate costs (MMCC) of LTC. The results showed that older people who reported the presence of fresh food stores nearby and dangerous places for walking alone at night in the neighborhood had lower MMCC, by JPY 1,367.6 and 1,383.3 per month, respectively, than respondents who did not report the presence of these neighborhood elements. Meanwhile, older people whose neighborhoods had easily accessible facilities had higher MMCC of JPY 739.4. This study's key findings reveal significant relationships between neighborhood environment elements and LTC costs and can be used to support developments in urban design to support healthy aging and reduced LTC costs.
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Affiliation(s)
- Yu-Ru Chen
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan.
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Design Research Institute, Chiba University, Tokyo, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Aichi, Japan
| | - Chie Koga
- Research Center for Advanced Science and Technology, Tokyo University, Tokyo, Japan
| | - Yoko Matsuoka
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Hiroaki Yoshida
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morikoka-cho, Obu-shi, Aichi, 474-8511, Japan
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3
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Tani Y, Fujiwara T, Anzai T, Kondo K. Cooking skills, living alone, and mortality: JAGES cohort study. Int J Behav Nutr Phys Act 2023; 20:131. [PMID: 37950296 PMCID: PMC10636960 DOI: 10.1186/s12966-023-01522-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 09/26/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Living alone without someone to cook meals for them can happen more frequently in aging due to bereavement, divorce, or other family changes. Health risks to older adults due to poor cooking skills may be more pronounced among those living alone. We aimed to examine whether cooking skills are associated with mortality according to cohabitation status in older Japanese people. METHODS Participants in the Japan Gerontological Evaluation Study, a population-based cohort of independent older adults, were followed for three years (n = 10,647). Cooking skill was assessed using a scale with good validity and modified for Japanese people in the baseline survey. After stratification by living alone or together, participants with high and low cooking skills were matched on demographic, socioeconomic, health-related factors, and availability of food stores using propensity score matching. All-cause mortality risks were compared between high and low cooking skills using Cox regression models. RESULTS During the follow-up, 520 of the 10,647 participants died. One hundred and seventy-one pairs of high and low cooking skills were matched among those living alone, and 2,161 pairs among those living with others were matched as well. The hazard ratio of the low level of cooking skills (vs. high) was 2.50 (95% confidence interval [CI]: 1.10-5.68) among those living alone, while 1.05 (95% CI: 0.82-1.33) among those living with others. CONCLUSION Lower cooking skills were associated with a higher risk of mortality only among those living alone. Cooking skills may be important for older adults who live alone to reduce mortality risk.
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Affiliation(s)
- Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5- 45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5- 45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Tatsuhiko Anzai
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8672, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National National Center for Geriatrics and Gerontology, 7-430 Morikoka-cho, Obu-shi, Aichi, 474-8511, Japan
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4
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Mori Y, Tsuji T, Watanabe R, Hanazato M, Chen YR, Kondo K. Built Environments and Frailty in Older Adults: The JAGES Longitudinal Study Using Mediation Analysis. J Am Med Dir Assoc 2023; 24:1677-1682. [PMID: 37541649 DOI: 10.1016/j.jamda.2023.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/15/2023] [Accepted: 06/17/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the association between subjective built environment and the onset of frailty in older adults living in the community. In addition, we examined whether daily walking time, depressive symptoms, and social support from neighbors and friends are mediating factors. DESIGN This was a longitudinal study using prospective cohort data from the 2013 Japan Gerontological Evaluation Study. SETTING AND PARTICIPANTS Participants included 38,829 older adults who were not frail recruited from 22 cities and towns. METHODS The dependent variable, frailty, was assessed using the Kihon checklist. The explanatory variables were 5 items for the subjective built environment. The mediating variables were walking time of at least 30 minutes per day, a Geriatric Depression Scale (GDS) score of at least 5 points, and social support from neighbors and friends. We performed a causal mediation analysis of mediating effects between each built environment and frailty onset. Furthermore, the proportion of mediation was estimated. RESULTS After 3 years of follow-up, frailty emerged in 2232 adults (6.7%) in 2016. Access to parks and sidewalks, access to fresh food stores, houses or facilities where people feel free to drop in, and fascinating views, or buildings reduced the onset of frailty. Mediators significantly associated with the built environment and onset of frailty were access to parks and sidewalks (walking time: 5.9%, GDS: 22.9%, social support: 5.9%), access to fresh food stores (GDS: 31.9%, social support: 4.0%), hills and steps (GDS: 20.6%), houses or facilities where people feel free to drop in (walking time: 4.0%, GDS 28.0%, social support: 10.4%), and fascinating views, or buildings (walking time: 7.8%, GDS: 42.1%, social support: 12.0%). CONCLUSIONS AND IMPLICATIONS We found that walking time, depression, and social support were mediating factors in the relationship between built environment and the onset of frailty.
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Affiliation(s)
- Yuta Mori
- Department of Rehabilitation, Hananooka Hospital, Mie, Japan; Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.
| | - Taishi Tsuji
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Institute of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan
| | - Ryota Watanabe
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Well-being and Society, Nihon Fukushi University, Aichi, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Design Research Institute, Chiba University, Tokyo, Japan
| | - Yu-Ru Chen
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
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Hong J, Yang N, Kim K. Development and Validation of a Perceived Community Food Accessibility Measurement Questionnaire for Korean Older Adults. Nutrients 2023; 15:4301. [PMID: 37836585 PMCID: PMC10574782 DOI: 10.3390/nu15194301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/22/2023] [Accepted: 10/07/2023] [Indexed: 10/15/2023] Open
Abstract
As the community food environment is known to be an important factor in healthy food choices, it needs to be measured, to increase awareness and improve healthy eating. The objective of this study was to develop a perceived community food accessibility measurement (P-CFAM) questionnaire applicable to older adults in Korea and evaluate its reliability and validity. The questionnaire was developed based on community food environment factors that were found to affect food choices in previous studies. We evaluated the internal consistency reliability, construct validity, and criterion-related validity. The subjects were 188 older adults for validity. The Cronbach's alpha value for the reliability measure was 0.9. The confirmatory factor analysis to evaluate the construct validity of the questionnaire showed values close to those of the optimal model (GFI = 0.983, AGFI = 0.948, RMR = 0.004, NFI = 0.987, CFI = 0.996). Regarding the criterion-related validity, the P-CFAM questionnaire results were significantly related to objective measurement indicators such as the number of grocery stores, the travel time to a grocery store, and the intake of vegetables and fruit. In conclusion, the developed P-CFAM questionnaire was shown to be reliable and valid, and useful for assessing older adults' perceptions of community food accessibility in Korea.
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Affiliation(s)
| | | | - Kirang Kim
- Department of Food Science and Nutrition, College of Science and Technology, Dankook University, Cheonan 31116, Republic of Korea
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6
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Li CE, Lin ZH, Hsu YY, Kuo NW. Lessons from COVID-19 pandemic: Analysis of unequal access to food stores using the Gini coefficient. CITIES (LONDON, ENGLAND) 2023; 135:104217. [PMID: 36694616 PMCID: PMC9852324 DOI: 10.1016/j.cities.2023.104217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/11/2022] [Accepted: 01/16/2023] [Indexed: 05/03/2023]
Abstract
COVID-19 has dramatically altered daily life worldwide, with some urban residents resorting to panic buying at the beginning of the pandemic. Large-scale lockdowns and restaurant closures have increased the need for grocery shopping. Such shifts in consumer patterns have altered supply-demand systems. Insufficient food store availability increases the likelihood of crowding and thus increases the probability of viral infection. People who live without easy access to food stores also face high infection risks when forced to travel long distances for grocery shopping. The COVID-19 pandemic has demonstrated the importance of the number and distribution of food stores to virus transmission. Food access is also a core factor of urban resilience during the pandemic. This study used the Gini coefficient to investigate the fairness of accessibility to food stores at the city and village levels, with Taipei City chosen as the research area. Different spatial scales were considered, and we calculated the equality of food access for older (≥65 years old) and non-older populations separately to determine whether one group faces greater inequality. At the city level, both older and non-older populations in Taipei have reasonable access (Gini coefficient between 0.3 and 0.4), with mean Gini coefficients of 0.3616 and 0.3655, respectively. This city-level analysis represents the overall degree of unequal access to food stores. At the village level, eight villages (1.8 %; total N = 456) had severe access inequality (Gini coefficient > 0.6) for older adults; they are located primarily in downtown or suburban areas. For the non-older population, only two villages (0.4 %; total N = 456) in suburban areas exhibit severe access inequality. The village-level analysis identified villages with low equality of access to food stores and revealed local problems that cannot be observed at the city level.
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Affiliation(s)
- Chong-En Li
- Department of Geography, National Taiwan Normal University, Taipei, Taiwan
- No. 162, Section 1, Heping E. Rd., Taipei City 106, Taiwan
| | - Zih-Hong Lin
- School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Yi-Ya Hsu
- School of Built Environment, University of New South Wales, Sydney, NSW 2052, Australia
| | - Nae-Wen Kuo
- Department of Geography, National Taiwan Normal University, Taipei, Taiwan
- No. 162, Section 1, Heping E. Rd., Taipei City 106, Taiwan
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7
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Hanafusa M, Ito Y, Ishibashi H, Nakaya T, Nawa N, Sobue T, Okubo K, Fujiwara T. Association between socioeconomic status and net survival after primary lung cancer surgery: a tertiary university hospital retrospective observational study in Japan. Jpn J Clin Oncol 2023; 53:287-296. [PMID: 36655308 DOI: 10.1093/jjco/hyac204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/13/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Inequalities in opportunities for primary lung cancer surgery due to socioeconomic status exist. We investigated whether socioeconomic inequalities exist in net survival after curative intent surgery at a tertiary university hospital, in Japan. METHODS Data from the hospital-based cancer registry on primary lung cancer patients who received lung resection between 2010 and 2018 were linked to the surgical dataset. An area deprivation index, calculated from small area statistics and ranked into tertiles based on Japan-wide distribution, was linked with the patient's address as a proxy measure for individual socioeconomic status. We estimated net survival of up to 5 years by deprivation tertiles. Socioeconomic inequalities in cancer survival were analyzed using an excess hazard model. RESULTS Of the 1039 patient-sample, advanced stage (Stage IIIA+) was more prevalent in the most deprived group (28.1%) than the least deprived group (18.0%). The 5-year net survival rates (95% confidence interval) from the least to the most deprived tertiles were 82.1% (76.2-86.6), 77.6% (70.8-83.0) and 71.4% (62.7-78.4), respectively. The sex- and age-adjusted excess hazard ratio of 5-year death was significantly higher in the most deprived group than the least deprived (excess hazard ratio = 1.64, 95% confidence interval: 1.09-2.47). The hazard ratio reduced toward null after additionally accounting for disease stage, suggesting that the advanced stage may explain the poor prognosis among the deprived group. CONCLUSION There was socioeconomic inequality in the net survival of patients who received curative intent surgery for primary lung cancer. The lower socioeconomic status group might be less likely to receive early curative surgery.
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Affiliation(s)
- Mariko Hanafusa
- Department of Thoracic Surgery, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuri Ito
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Hironori Ishibashi
- Department of Thoracic Surgery, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tomoki Nakaya
- Department of Frontier Science for Advanced Environment, Graduate School of Environmental Studies, Tohoku University, Miyaghi, Japan
| | - Nobutoshi Nawa
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tomotaka Sobue
- Department of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kenichi Okubo
- Department of Thoracic Surgery, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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8
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Tsunoda K, Nagata K, Jindo T, Fujii Y, Soma Y, Kitano N, Okura T. Acceptable walking and cycling distances and functional disability and mortality in older Japanese adults: An 8-year follow-up study. Health Place 2023; 79:102952. [PMID: 36535074 DOI: 10.1016/j.healthplace.2022.102952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/26/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022]
Abstract
We prospectively investigated the association between acceptable travel distances (i.e., walking and cycling) and the incidence of functional disability and mortality among older Japanese adults. A baseline survey was conducted in 2013 among 7618 individuals aged ≥65 years in Kasama City, Japan, and they were tracked through the city's database until 2021. Acceptable travel distances were assessed using a questionnaire. Outcomes (i.e., functional disability and mortality) were gathered as binary (incident or not) with survival time. A multivariable-adjusted Cox proportional-hazards model indicated that shorter acceptable walking and cycling distances were markedly linked with higher risks of functional disability and mortality. In conclusion, acceptable distances of ≤500 m for walking and ≤1 km for cycling were associated with higher risks of functional disability and mortality among older adults.
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Affiliation(s)
- Kenji Tsunoda
- Faculty of Social Welfare, Yamaguchi Prefectural University, 6-2-1 Sakurabatake, Yamaguchi, Yamaguchi, 753-0021, Japan.
| | - Koki Nagata
- Doctoral Program in Public Health, Degree Programs in Comprehensive Human Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Takashi Jindo
- Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Yuya Fujii
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, 150 Tobuki, Hachioji, Tokyo, 192-0001, Japan
| | - Yuki Soma
- Faculty of Education, Hirosaki University, 1 Bunkyo-cho, Hirosaki, Aomori, 036-8560, Japan
| | - Naruki Kitano
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, 150 Tobuki, Hachioji, Tokyo, 192-0001, Japan
| | - Tomohiro Okura
- Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
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9
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Mori Y, Tsuji T, Watanabe R, Hanazato M, Miyazawa T, Kondo K. Built environments and frailty in older adults: A three-year longitudinal JAGES study. Arch Gerontol Geriatr 2022; 103:104773. [PMID: 35849975 DOI: 10.1016/j.archger.2022.104773] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND This study investigated the relationship between built environments and the onset of frailty after 3 years. METHODS This was a longitudinal study using prospective cohort data from the 2013 Japan Gerontological Evaluation Study on 38,829 older adults nested in 562 comunnities who were not frail. The dependent variable, frailty, was assessed using the Kihon checklist. The explanatory variables were eight items for the built environment at the individual and community levels. To consider each level of built environment simultaneously, multilevel Poisson regression analysis was used to calculate risk ratios and 95% confidence intervals. RESULTS After 3 years of follow-up, the onset of frailty was 2740 (7.1%) in 2016. At the individual level, there was an increased risk of developing frailty in negative built environments, such as locations with graffiti or garbage (incidence rate ratio (IRR), 1.15; confidence interval (CI), 1.05-1.25). Positive built environments, such as areas with access to parks and sidewalks (IRR, 0.78; CI, 0.70-0.88), lowered the risk of developing frailty. At the community level, the risk of developing frailty was lower only in areas with locations difficult for walking (hills or steps) (IRR, 0.97; CI, 0.94-0.99). CONCLUSIONS At the individual level, frailty onset was associated with all built environments. However, irrespective of their answers, there was a lower risk of developing frailty among older adults living in areas where walking was difficult. It would be desirable to verify whether the risk of developing frailty can be reduced by changing the built environment.
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Affiliation(s)
- Yuta Mori
- Department of Rehabilitation, Hananooka Hospital, 707-3, Yamamurocho, Matsusaka, Mie 515-0052, Japan; Department of Public Health, Graduate School of Medicine, University of Chiba, 1-8-1, Inohana, Chuo-ku, Chiba, Chiba 260-8670, Japan.
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, 3-29-1, Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan; Center for Preventive Medical Sciences, University of Chiba, 1-33, Yayoicho, Inage-ku, Chiba, Chiba 263-8522, Japan
| | - Ryota Watanabe
- Center for Preventive Medical Sciences, University of Chiba, 1-33, Yayoicho, Inage-ku, Chiba, Chiba 263-8522, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, University of Chiba, 1-33, Yayoicho, Inage-ku, Chiba, Chiba 263-8522, Japan
| | - Takuto Miyazawa
- Chiba Rehabilitation Center, 1-45-2, Hondacho, Midori-ku, Chiba, Chiba 266-0005, Japan
| | - Katsunori Kondo
- Department of Public Health, Graduate School of Medicine, University of Chiba, 1-8-1, Inohana, Chuo-ku, Chiba, Chiba 260-8670, Japan; Center for Preventive Medical Sciences, University of Chiba, 1-33, Yayoicho, Inage-ku, Chiba, Chiba 263-8522, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan
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An assessment of implementation gaps and priority recommendations on food environment policies: the Healthy Food Environment Policy Index in Japan. Public Health Nutr 2022; 25:1720-1732. [PMID: 34924082 PMCID: PMC9991651 DOI: 10.1017/s1368980021004900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The current study aimed to evaluate policies and actions for food environments by the Japanese Government using the Healthy Food Environment Policy Index (Food-EPI). DESIGN Public health experts rated the extent of implementation of food environment-related Policy and the Infrastructure-support components, compared with international best practices. Subsequently, the experts proposed and prioritised future actions to address implementation gaps in an online workshop. SETTING Japan. PARTICIPANTS A total of sixty-six experts rated policy implementation by the Japanese Government and twenty-three participated in the workshop on future actions. RESULTS The implementations of regulations on unhealthy foods and non-alcoholic beverages were rated low in the domains of Food composition, Food labelling and Food promotion, Food prices and Food retail in the Policy component. The implementations of several domains in the Infrastructure-support component were, overall, rated at a higher level, specifically for monitoring and intelligence systems. Based on the rating, reducing health inequalities by supporting people, both economically and physically, was the highest priority for future actions in both components. CONCLUSIONS The current study found that Japan has a robust system for long-term monitoring of population health but lacks regulations on unhealthy foods and non-alcoholic beverages compared with international best practices. The current study confirmed the importance of continuous accumulation of evidence through national monitoring systems. Developing comprehensive regulations to restrict food marketing, sales and accessibility of unhealthy foods and non-alcoholic beverages is needed to improve the health of food environments in Japan.
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11
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Katsuyama Y, Kondo K, Kojima M, Kamiji K, Ide K, Iizuka G, Muto G, Uehara T, Noda K, Ikusaka M. Mortality risk in older Japanese people based on self-reported dyslipidemia treatment and socioeconomic status: The JAGES cohort study. Prev Med Rep 2022; 27:101779. [PMID: 35340272 PMCID: PMC8943431 DOI: 10.1016/j.pmedr.2022.101779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/01/2022] [Accepted: 03/20/2022] [Indexed: 11/16/2022] Open
Abstract
Older people under self-reported dyslipidemia treatment had some distinction. They had higher income and education levels than those without treatment. Their self-reported treatment status was negatively associated with mortality risk.
Few studies consider socioeconomic status when assessing mortality risk in dyslipidemia cases. This study used cohort data from the 2010 Japan Gerontological Evaluation Study (JAGES), which contains data on older Japanese people, to associate socioeconomic status with mortality risk in patients treated for dyslipidemia. In this 6-year longitudinal study, we examined 47,275 older Japanese people aged ≥ 65 years who could independently perform activities of daily living. Patients’ background characteristics were classified based on their dyslipidemia treatment status and were assessed using the chi-squared test. The mortality risk was assessed using the Cox proportional hazards model, wherein the objective and explanatory variables were total mortality and self-report of dyslipidemia treatment, respectively. The participants were stratified by sex and age into younger (aged 65–74 years) and older (aged ≥ 75 years) groups of men and women. The results were adjusted, with health condition, health behavior, and socioeconomic status as confounding factors. The adjusted hazard ratios of 5514 people who died during the follow-up who had self-reported dyslipidemia treatment were 0.49 [95% confidence interval (CI) 0.35–0.69] for younger men; 0.57 (95% CI 0.42–0.76) for older men; 0.52 (95% CI 0.34–0.80) for younger women; and 0.47 (95% CI 0.33–0.67) for older women. Older people undergoing treatment for dyslipidemia had factors beneficial for health, such as good socioeconomic status. Despite considering these factors, individuals undergoing dyslipidemia treatment had a negative association with mortality risk.
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Yamaguchi M, Praditsorn P, Purnamasari SD, Sranacharoenpong K, Arai Y, Sundermeir SM, Gittelsohn J, Hadi H, Nishi N. Measures of Perceived Neighborhood Food Environments and Dietary Habits: A Systematic Review of Methods and Associations. Nutrients 2022; 14:1788. [PMID: 35565756 PMCID: PMC9099956 DOI: 10.3390/nu14091788] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/14/2022] [Accepted: 04/21/2022] [Indexed: 02/05/2023] Open
Abstract
Access to healthy food is a necessity for all people. However, there is still a lack of reviews on the assessment of respondent-based measures of neighborhood food environments (perceived food environments). The aim of this systematic review was to evaluate the measurement tools for perceived food environments by five dimensions of food access and to obtain the overview of their associations with dietary habits among people aged 18 years and older in middle- and high-income countries. Observational studies using perceived food environment measures were identified through a systematic review based on two databases for original studies published from 2010 to 2020. A total of 19 final studies were extracted from totally 2926 studies. Pertaining to the five dimensions of food access, 12 studies dealt with accessibility, 13 with availability, 6 with affordability, 10 with acceptability, 2 with accommodation, and 8 with a combination of two or more dimensions. Perceived healthy food environments were positively associated with healthy dietary habits in 17 studies, but 8 of them indicated statistically insignificant associations. In conclusion, this review found accessibility and availability to be major dimensions of perceived food environments. The relationship between healthy food environments and healthy diets is presumably positive and weak.
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Affiliation(s)
- Miwa Yamaguchi
- International Center for Nutrition and Information, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan;
| | - Panrawee Praditsorn
- Institute of Nutrition, Mahidol University, 999 Phuttamonthon 4, Salaya, Phuttamonthon, Nakhon Pathom 73170, Thailand; (P.P.); (K.S.)
| | - Sintha Dewi Purnamasari
- Alma Ata Graduate School of Public Health, University of Alma Ata, Jl. Brawijaya 99, Tamantirto, Yogyakarta 55183, Indonesia; (S.D.P.); (H.H.)
| | - Kitti Sranacharoenpong
- Institute of Nutrition, Mahidol University, 999 Phuttamonthon 4, Salaya, Phuttamonthon, Nakhon Pathom 73170, Thailand; (P.P.); (K.S.)
| | - Yusuke Arai
- Department of Nutrition, Chiba Prefectural University of Health Sciences, 2-10-1 Wakaba, Mihama-ku, Chiba-shi 261-0014, Japan;
| | - Samantha M. Sundermeir
- Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, 615 North Wolfe St, Baltimore, MD 21205, USA; (S.M.S.); (J.G.)
| | - Joel Gittelsohn
- Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, 615 North Wolfe St, Baltimore, MD 21205, USA; (S.M.S.); (J.G.)
| | - Hamam Hadi
- Alma Ata Graduate School of Public Health, University of Alma Ata, Jl. Brawijaya 99, Tamantirto, Yogyakarta 55183, Indonesia; (S.D.P.); (H.H.)
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan;
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Sharma A. Older Adult Mortality From COVID-19: Food Access as a Determinant Within a Socio-ecological Framework. THE GERONTOLOGIST 2022; 62:452-463. [PMID: 35072729 PMCID: PMC8807209 DOI: 10.1093/geront/gnab159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Low access to food can have an adverse impact on health yet there is limited research on how it is related to coronavirus disease 2019 (COVID-19). The objective of this study was to (a) better understand how inadequate food access was associated with older adult mortality from COVID-19 and (b) determine the spatial distribution of mortality from low food access utilizing a socio-ecological framework. RESEARCH DESIGN AND METHODS This study area was the larger Midwest, a region of the United States, which included the following states: Minnesota, Wisconsin, Iowa, Illinois, Indiana, Michigan, Ohio, and Pennsylvania. Data were aggregated from multiple sources at the county-level. Because the spatial data used in this study violated several assumptions of the global regression framework, geographically weighted regression (GWR) was employed. RESULTS Results from GWR revealed low access to food was positively associated with mortality from COVID-19 for older adults but the association varied in (a) magnitude and (b) significance across the larger Midwest. More specifically, the socio-ecological framework suggested low access to food, female-headed households, and percentage Hispanic played a meaningful role in explaining older adult mortality for the western region of the larger Midwest. This was not as evident for the eastern portion. DISCUSSION AND IMPLICATIONS Such a finding calls attention to the importance of capturing the local context when devising policies to reduce mortality for older adults from COVID-19. Regional policymakers can collaborate with public health professionals when applying these results to formulate local action plans that recognize variations across geographic space.
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Affiliation(s)
- Andy Sharma
- Public Policy Studies, Northwestern University, Chicago, Illinois, USA
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14
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Tani Y, Hanazato M, Fujiwara T, Suzuki N, Kondo K. Neighborhood Sidewalk Environment and Incidence of Dementia in Older Japanese Adults. Am J Epidemiol 2021; 190:1270-1280. [PMID: 33604662 PMCID: PMC8245872 DOI: 10.1093/aje/kwab043] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 02/04/2021] [Accepted: 02/15/2021] [Indexed: 01/22/2023] Open
Abstract
Sidewalks are indispensable environmental resources for daily life in that they encourage physical activity. However, the proportion of sidewalk coverage is low even in developed countries. We examined the association between neighborhood sidewalk environment and dementia in Japan. We conducted a 3-year follow-up (2010–2013) among participants in the Japan Gerontological Evaluation Study, a population-based cohort study of community-dwelling older adults. We ascertained the incidence of dementia for 76,053 participants from the public long-term care insurance system. We calculated sidewalk coverage (sidewalk area as a percentage of road area) within 436 residential neighborhood units using geographic information systems. Multilevel survival models were used to estimate hazard ratios for the incidence of dementia. During follow-up, 5,310 dementia cases were found. In urban areas, compared with the lowest quartile of sidewalk coverage, the hazard ratio was 0.42 (95% confidence interval: 0.33, 0.54) for the highest quartile, adjusting for individual covariates. After successive adjustments for other neighborhood factors (land slope; numbers of hospitals, grocery stores, parks, railway stations, and bus stops; educational level; and unemployment rate), the hazard ratio remained statistically significant (hazard ratio = 0.71, 95% confidence interval: 0.54, 0.92). Living in a neighborhood with a high level of sidewalk installation was associated with low dementia incidence in urban areas.
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Affiliation(s)
- Yukako Tani
- Correspondence to Dr. Yukako Tani, Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan (e-mail: )
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15
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Okuyama K, Abe T, Li X, Toyama Y, Sundquist K, Nabika T. Neighborhood Environmental Factors and Physical Activity Status among Rural Older Adults in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041450. [PMID: 33557194 PMCID: PMC7913898 DOI: 10.3390/ijerph18041450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 11/23/2022]
Abstract
(1) Background: Although several neighborhood environmental factors have been identified to be associated with older adults’ physical activity, little research has been done in rural areas where the population is aging. This study aimed to investigate neighborhood environmental factors and the longitudinal change of physical activity status among rural older adults in Japan. (2) Methods: The study included 2211 older adults, aged over 60 years, residing in three municipalities in Shimane prefecture and participating at least twice in annual health checkups between 2010 and 2019. Physical activity was identified based on self-report. Hilliness, bus stop density, intersection density, residential density, and distance to a community center were calculated for each subject. Hazard ratios for the incidence of physical inactivity were estimated using Cox proportional hazards models. (3) Results: We found that 994 (45%) of the study subjects became physically inactive during the follow-up. Those living far from a community center had a lower risk of becoming physically inactive compared to those living close to a community center. When the analysis was stratified by residential municipality, this association remained in Ohnan town. Those living in hilly areas had a higher risk of becoming physically inactive in Okinoshima town. (4) Conclusions: The impact of neighborhood environmental factors on older adults’ physical activity status might differ by region possibly due to different terrain and local lifestyles.
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Affiliation(s)
- Kenta Okuyama
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms Gata 35, 20502 Malmö, Sweden; (X.L.); (K.S.)
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane 693-8501, Japan; (T.A.); (Y.T.); (T.N.)
- Correspondence: ; Tel.: +46-73-610-0086
| | - Takafumi Abe
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane 693-8501, Japan; (T.A.); (Y.T.); (T.N.)
| | - Xinjun Li
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms Gata 35, 20502 Malmö, Sweden; (X.L.); (K.S.)
| | - Yuta Toyama
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane 693-8501, Japan; (T.A.); (Y.T.); (T.N.)
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms Gata 35, 20502 Malmö, Sweden; (X.L.); (K.S.)
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane 693-8501, Japan; (T.A.); (Y.T.); (T.N.)
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029-5674, USA
| | - Toru Nabika
- Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane 693-8501, Japan; (T.A.); (Y.T.); (T.N.)
- Department of Functional Pathology, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo-shi, Shimane 693-8501, Japan
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Time Distances to Residential Food Amenities and Daily Walking Duration: A Cross-Sectional Study in Two Low Tier Chinese Cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020839. [PMID: 33478168 PMCID: PMC7844623 DOI: 10.3390/ijerph18020839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 12/17/2022]
Abstract
Recent studies indicate the accepted concept of using land-use mix (LUM) to promote physical activity is ineffective and even counteractive in the Chinese context. Before considering LUM as a whole, different amenity types need to be respectively analyzed in relation to various functions and demands. This study aims to examine the specific associations between food-related amenities and perceived daily walking duration (WD) in small Chinese cities. Two interviewer-administered questionnaire surveys (n = 354) were conducted in Yuncheng and Suihua between 2017 and 2018. Logistic regression models were used to examine the associations of WD with seven different categories of food outlet at three levels of walking distance. The associations were further explored by food environment diversity and through two age groups. With the exception of café/tea house, the other six food outlets were positively associated with WD. After adjusting for socioeconomic variables, the associations of grocery store and supermarket weakened. Higher levels of food environment diversity were associated with a longer WD. Among the age groups, food outlets were more associated with older adults’ WD. This novel quantitative study suggests that increasing the number and heterogeneity of food-related amenities (including mobile street vendors) within a neighborhood can enhance physical activity in small Chinese cities.
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Nishida M, Hanazato M, Koga C, Kondo K. Association between Proximity of the Elementary School and Depression in Japanese Older Adults: A Cross-Sectional Study from the JAGES 2016 Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020500. [PMID: 33435418 PMCID: PMC7826926 DOI: 10.3390/ijerph18020500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/25/2020] [Accepted: 01/06/2021] [Indexed: 11/16/2022]
Abstract
Depression among older adults is one of the most critical public health issues. The proximity of elementary schools has been positively associated with neighborhood social cohesion and quality of life. However, no studies have identified an association between the proximity of elementary school and older adults' mental health. Therefore, this study aimed to examine the association between the proximity of elementary schools, one of the core facilities of neighborhood communities in Japan, and depression in older adults. A total of 131,871 participants (63,430 men 73.7 ± 6.1 years, 68,441 women 73.8 ± 6.2 years) were analyzed from the Japan Gerontological Evaluation Study (JAGES) 2016 survey. Logistic regression analysis showed that there was no association between distance to elementary school and depression among males. However, among females, compared with the participants living within 400 m from the nearest elementary school, the odds ratio of depression for those living between 400 and 799 m and more than 800 m away were 1.06 (95% confidence interval (CI) 1.00-1.12) and 1.07 (95% CI 1.00-1.15), respectively. The findings may be useful when considering the design of communities around elementary schools and the planning of facilities as a population-based approach to promote mental health of older women.
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Affiliation(s)
- Megumi Nishida
- Advanced Preventive Medical Sciences, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8672, Japan
- Takenaka Corporation, 1-13, 4-chome, Hommachi, Chuo-ku, Osaka 541-0053, Japan
- Correspondence: ; Tel.: +81-80-2454-9101
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cyo, Inage-ku, Chiba-shi, Chiba 263-8522, Japan; (M.H.); (C.K.); (K.K.)
| | - Chie Koga
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cyo, Inage-ku, Chiba-shi, Chiba 263-8522, Japan; (M.H.); (C.K.); (K.K.)
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cyo, Inage-ku, Chiba-shi, Chiba 263-8522, Japan; (M.H.); (C.K.); (K.K.)
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morikoka-cho, Obu-shi, Aichi 474-8511, Japan
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18
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Kato G, Arai T, Morita Y, Fujita H. Association of Built Environments With Frequency of Going Outdoors Among Older Community-Dwelling Adults in Japan. J Aging Phys Act 2020; 28:707-713. [PMID: 32302999 DOI: 10.1123/japa.2019-0343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/10/2019] [Accepted: 01/11/2020] [Indexed: 11/18/2022]
Abstract
Built environmental factors are important for encouraging outdoor activity among community-dwelling older adults. A total of 214 participants aged 59-94 years were recruited from local cities in Japan. A mixed-effects multivariate linear regression model was conducted for the analysis. Parks that are easy to get to and car availability were positively associated with the number of days per week with any outdoor exposure. Further, the ability to conduct activities of daily living had a significant effect on the use of safe parks and walking areas and the number of days per week with outdoor time. The findings suggest that subjectively assessed neighborhood-built environments, such as readily available safe parks, walking areas, and car availability, are important for encouraging outdoor activity among older community-dwelling adults in Japan. For those with a limited ability to conduct daily activities, the safeness of parks and walking areas are most important.
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Iizaka S, Koitabashi E, Negishi T, Kawamura A, Iizuka Y. Distance from the nearest grocery stores and frequency of store-specific shopping are associated with dietary intake frequency among the community-dwelling independent elderly population. Nutr Health 2020; 26:197-207. [PMID: 32400265 DOI: 10.1177/0260106020923806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Low accessibility to grocery stores may change dietary habits and increase health problems for elderly people living in communities. AIM This study investigated whether the distance from the nearest grocery stores, including supermarkets, convenience stores, and drugstores, and the frequency of store-specific shopping were associated with dietary intake frequency among elderly people. METHODS A cross-sectional study was conducted in two towns of suburban cities. A total of 177 people aged ≥65 years were recruited (M age=76.7 years). The frequency of intake of 10 food groups and dietary variety scores (DVS) were evaluated. Distances from the districts to the nearest grocery stores and the frequency of shopping during a week at each store were evaluated using a geographic information system. RESULTS For supermarkets, people living <300 metres from the nearest supermarket showed a higher intake frequency of fruit (p=0.024) and oil/fat (p=0.045), and those shopping three or more times a week showed a higher intake frequency of meat (p=0.025). In the case of drugstores, people shopping one or more times a week showed a higher intake frequency of eggs (p=0.006) and oil/fat (p=0.048). People living <300 m from the nearest supermarkets (p=0.048) and drugstores (p=0.047) showed higher DVS than those living ≥500 m from the nearest supermarkets and drugstores. CONCLUSIONS Our findings suggest that shopping at supermarkets and drugstores is associated with dietary intake frequency and dietary quality for elderly people living in suburban cities.
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Affiliation(s)
- Shinji Iizaka
- School of Nutrition, College of Nursing and Nutrition, Shukutoku University, Japan
| | - Emiko Koitabashi
- Department of Nursing, Faculty of Health Science, Toho University, Japan
| | - Takako Negishi
- Department of Nursing, Faculty of Health Sciences, Tokyo Kasei University, Japan
| | - Aki Kawamura
- Department of Nursing, Faculty of Nursing, Wayo Women's University, Japan
| | - Yuzuru Iizuka
- School of Nutrition, College of Nursing and Nutrition, Shukutoku University, Japan
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雨洋 张, 宁睿 刘, 瀛 龙, Yuyang Z, Ningrui L, Ying L. [Research on Healthy Neighborhood Evaluation System Based on the Combined Perspectives of Urban Planning and Public Health]. FENG JING YUAN LIN = LANDSCAPE ARCHITECTURE 2020; 27:96-103. [PMID: 38420146 PMCID: PMC7615674 DOI: 10.14085/j.fjyl.2020.11.0096.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Neighborhoods are places where people spend the most time in their lives. Neighborhoods have a decisive impact on the residents' health. With several important tasks, including the transformation of old neighborhoods, the maintenance of existing neighborhoods, and the construction of new neighborhoods in the future, a scientific and reasonable evaluation standard is urgently needed to guide the development of healthy neighborhoods. To build the evaluation system, this paper first clarifies the principles for selecting evaluation indicators, which include: 1) the indicators are selected from a humanistic perspective; 2) the pathways between neighborhoods environment and health outcomes are deeply considered; 3) the indicators are selected from multiple scales. Secondly, based on the combined perspectives of urban planning and public health, it identifies the indicators that affect the residents' health in neighborhoods and searches the literature through the quality assessment to provide evidence to support the accuracy and effectiveness of the indicators. Finally, it proposes prospect to the evaluation, including 1) it is urgent to improve and utilize the healthy neighborhoods based on the Chinese condition; 2) advanced technologies need to be widely applied in neighborhoods in the future; 3) the transitions in cities should be considered in the future development of neighborhoods. It hopes that relevant researchers and government leaders to realize the importance and urgency of healthy neighborhoods to build more healthy neighborhoods in China.
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Affiliation(s)
- 张 雨洋
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- ZHANG Yuyang is a postdoctoral researcher in the School of Architecture, Tsinghua University. His research focuses on healthy city and healthy neighborhood
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- LIU Ningrui is a Ph.D. candidate in the Department of Building Science, School of Architecture, Tsinghua University. His research focuses on indoor air quality, healthy building and healthy city
- / / / / (Corresponding author Email):
- LONG Ying, Ph.D., is a research fellow in the School of Architecture, Tsinghua University. His research focuses on urban and rural planning technical science
| | - 刘 宁睿
- / / /
- ZHANG Yuyang is a postdoctoral researcher in the School of Architecture, Tsinghua University. His research focuses on healthy city and healthy neighborhood
- / / / 、
- LIU Ningrui is a Ph.D. candidate in the Department of Building Science, School of Architecture, Tsinghua University. His research focuses on indoor air quality, healthy building and healthy city
- / / / / (Corresponding author Email):
- LONG Ying, Ph.D., is a research fellow in the School of Architecture, Tsinghua University. His research focuses on urban and rural planning technical science
| | - 龙 瀛
- / / /
- ZHANG Yuyang is a postdoctoral researcher in the School of Architecture, Tsinghua University. His research focuses on healthy city and healthy neighborhood
- / / / 、
- LIU Ningrui is a Ph.D. candidate in the Department of Building Science, School of Architecture, Tsinghua University. His research focuses on indoor air quality, healthy building and healthy city
- / / / / (Corresponding author Email):
- LONG Ying, Ph.D., is a research fellow in the School of Architecture, Tsinghua University. His research focuses on urban and rural planning technical science
| | - Zhang Yuyang
- / / /
- ZHANG Yuyang is a postdoctoral researcher in the School of Architecture, Tsinghua University. His research focuses on healthy city and healthy neighborhood
- / / / 、
- LIU Ningrui is a Ph.D. candidate in the Department of Building Science, School of Architecture, Tsinghua University. His research focuses on indoor air quality, healthy building and healthy city
- / / / / (Corresponding author Email):
- LONG Ying, Ph.D., is a research fellow in the School of Architecture, Tsinghua University. His research focuses on urban and rural planning technical science
| | - Liu Ningrui
- / / /
- ZHANG Yuyang is a postdoctoral researcher in the School of Architecture, Tsinghua University. His research focuses on healthy city and healthy neighborhood
- / / / 、
- LIU Ningrui is a Ph.D. candidate in the Department of Building Science, School of Architecture, Tsinghua University. His research focuses on indoor air quality, healthy building and healthy city
- / / / / (Corresponding author Email):
- LONG Ying, Ph.D., is a research fellow in the School of Architecture, Tsinghua University. His research focuses on urban and rural planning technical science
| | - Long Ying
- / / /
- ZHANG Yuyang is a postdoctoral researcher in the School of Architecture, Tsinghua University. His research focuses on healthy city and healthy neighborhood
- / / / 、
- LIU Ningrui is a Ph.D. candidate in the Department of Building Science, School of Architecture, Tsinghua University. His research focuses on indoor air quality, healthy building and healthy city
- / / / / (Corresponding author Email):
- LONG Ying, Ph.D., is a research fellow in the School of Architecture, Tsinghua University. His research focuses on urban and rural planning technical science
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Cerin E, Nathan A, Choi WK, Ngan W, Yin S, Thornton L, Barnett A. Built and social environmental factors influencing healthy behaviours in older Chinese immigrants to Australia: a qualitative study. Int J Behav Nutr Phys Act 2019; 16:116. [PMID: 31783867 PMCID: PMC6883540 DOI: 10.1186/s12966-019-0885-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 11/14/2019] [Indexed: 11/10/2022] Open
Abstract
Background Neighbourhood environments influence older adults’ health and health-enhancing behaviours, such as physical activity, eating a healthy diet and socialising. However, little is known about the effects of the neighbourhood environment on the health of older immigrants, the number of which is rapidly increasing in developed countries. Using Nominal Group Technique (NGT) sessions, this study of older Chinese immigrants to urban Melbourne, Australia, examined built and social environmental facilitators of and barriers to regular engagement in physical activity, eating a healthy diet and regular contact with other people. Methods Participants were recruited from four types of neighbourhoods stratified by walkability and proportion of Chinese dwellers. Twelve NGTs, four specific to each of physical activity, healthy diet and social contacts were conducted in Mandarin or Cantonese (91 participants). NGT responses from groups addressing the same questions were aggregated, similar items were combined, and scores combined across groups. Inductive thematic analysis was used to categorise answers into higher-order themes of factors associated with each behaviour. Results For physical activity, 29 facilitators and 28 barriers were generated with the highest ranked facilitator and barrier being “proximity to destinations” and “poor/inadequate public transport”, respectively. For healthy diet, 25 facilitators and 25 barriers were generated, the highest ranked facilitator and barrier were “high food safety standards/regulations” and “lack of family/household members’ social support for a healthy diet”. The social contacts NGTs generated 23 facilitators and 22 barriers, with the highest ranked facilitator and barrier being “proximity to destinations and activities” and “poor public transport”, respectively. Discussion Independent living arrangements and the accessibility of destinations of daily living (e.g., bilingual health services, libraries, places of worship and grocery stores / supermarkets), recreational facilities, affordable public transport, and community centres and activities for Chinese people are key elements for promoting regular engagement in physical activity, healthy eating and socialising in older Chinese immigrants. Governments should plan for the provision of this basic infrastructure of community facilities for older immigrants.
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Affiliation(s)
- Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. .,School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China. .,Baker Heart and Diabetes Institute, Melbourne, Australia.
| | | | - Wing Ka Choi
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Winsfred Ngan
- School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - Shiyuan Yin
- School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - Lukar Thornton
- School of Exercise and Nutrition Science, Deakin University, Geelong, Australia
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
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Okabe D, Tsuji T, Hanazato M, Miyaguni Y, Asada N, Kondo K. Neighborhood Walkability in Relation to Knee and Low Back Pain in Older People: A Multilevel Cross-Sectional Study from the JAGES. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234598. [PMID: 31756959 PMCID: PMC6926577 DOI: 10.3390/ijerph16234598] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/06/2019] [Accepted: 11/15/2019] [Indexed: 12/11/2022]
Abstract
Few studies have focused on a relationship between the built environment and musculoskeletal pain. This study aimed to investigate an association between neighborhood walkability and knee and low back pain in older people. Data were derived from the Japan Gerontological Evaluation Study (JAGES) 2013, a population-based study of independently living people ≥65 years old. A cross-sectional multilevel analysis was performed, of 22,892 participants in 792 neighborhoods. Neighborhood walkability was assessed by residents' perceptions and population density. Dependent variables were knee and low back pain restricting daily activities within the past year. The prevalence of knee pain was 26.2% and of low back pain 29.3%. After adjusting for sociodemographic covariates, the prevalence ratio (PR) of knee and low back pain was significantly lower in neighborhoods with better access to parks and sidewalks, good access to fresh food stores, and higher population densities. After additionally adjusting for population density, easier walking in neighborhoods without slopes or stairs was significantly inversely correlated with knee pain (PR 0.91, 95% confidence interval 0.85-0.99). Neighborhoods with walkability enhanced by good access to parks and sidewalks and fresh food stores, easy walking without slopes or stairs, and high population densities, had lower prevalences of knee and low back pain among older people. Further studies should examine environmental determinants of pain.
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Affiliation(s)
- Daichi Okabe
- Advanced Preventive Medical Sciences, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan;
- Correspondence: ; Tel.: +81-90-4194-8521
| | - Taishi Tsuji
- Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan; (T.T.); (M.H.); (K.K.)
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan; (T.T.); (M.H.); (K.K.)
| | - Yasuhiro Miyaguni
- Institute for Health Economics and Policy, 1-5-11 Nishi-Shimbashi, Minato-ku, Tokyo 105-0003, Japan;
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi 474-8511, Japan
| | - Nao Asada
- Advanced Preventive Medical Sciences, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan;
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan; (T.T.); (M.H.); (K.K.)
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi 474-8511, Japan
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Kiuchi S, Aida J, Kusama T, Yamamoto T, Hoshi M, Yamamoto T, Kondo K, Osaka K. Does public transportation reduce inequalities in access to dental care among older adults? Japan Gerontological Evaluation Study. Community Dent Oral Epidemiol 2019; 48:109-118. [DOI: 10.1111/cdoe.12508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/02/2019] [Accepted: 10/27/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Sakura Kiuchi
- Department of International and Community Oral Health Tohoku University Graduate School of Dentistry Sendai Japan
| | - Jun Aida
- Department of International and Community Oral Health Tohoku University Graduate School of Dentistry Sendai Japan
| | - Taro Kusama
- Department of International and Community Oral Health Tohoku University Graduate School of Dentistry Sendai Japan
| | - Takafumi Yamamoto
- Department of International and Community Oral Health Tohoku University Graduate School of Dentistry Sendai Japan
| | - Manami Hoshi
- Department of International and Community Oral Health Tohoku University Graduate School of Dentistry Sendai Japan
| | - Tatsuo Yamamoto
- Department of Disaster Medicine and Dental Sociology Graduate School of Dentistry Kanagawa Dental University Yokosuka Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences Chiba University Chiba Japan
- National Center for Geriatrics and Gerontology Obu Japan
| | - Ken Osaka
- Department of International and Community Oral Health Tohoku University Graduate School of Dentistry Sendai Japan
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Association between Food Store Availability and the Incidence of Functional Disability among Community-Dwelling Older Adults: Results from the Japanese Gerontological Evaluation Cohort Study. Nutrients 2019; 11:nu11102369. [PMID: 31590318 PMCID: PMC6835243 DOI: 10.3390/nu11102369] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/24/2019] [Accepted: 09/26/2019] [Indexed: 02/05/2023] Open
Abstract
This study sought to clarify the association between food store availability and the incidence of disability in older adults. This study utilized a population-based cohort study of independent Japanese adults aged ≥65 years, which was a 6 year follow-up of participants in the Japan Gerontological Evaluation Study. A total of 31,273 respondents were extracted. Food store availability was evaluated based on the existence of food stores within 500/1000 m of the home. We utilized participant-reported subjective measurement as well as geographic information system-based objective measurement for the evaluation. The incidence of disability was determined using municipal data on eligibility for long-term care insurance benefits. There were 7643 (24.4%) community-dwelling participants with low subjective food store availability and 5673 (18.1%) with low objective food store availability. During the follow-up period of 6 years, the cumulative incidence of disability was 20.9%, with a significant association between low subjective food store availability and increased disability. Participants who reported low subjective food store availability had a significantly higher likelihood of developing disability (hazard ratio = 1.18, 95% confidence interval: 1.11-1.25) than those who reported high subjective food store availability after adjusting for age, sex, sociodemographic status, environmental status, walking and going out, dietary food intake, body mass index, and comorbidities. Low subjective food store availability was associated with early onset of disability. Accessibility of food stores might contribute to maintaining a disability-free life.
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Comparison of Objective and Perceived Access to Food Stores Associated with Intake Frequencies of Vegetables/Fruits and Meat/Fish among Community-Dwelling Older Japanese. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050772. [PMID: 30832455 PMCID: PMC6427395 DOI: 10.3390/ijerph16050772] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 02/19/2019] [Accepted: 02/21/2019] [Indexed: 11/16/2022]
Abstract
This cross-sectional study aimed to compare access to the nearest food stores with perceived access associated with intake frequencies of vegetables/fruits and meat/fish among older Japanese people. We used intake frequencies of vegetables/fruits and meat/fish from a self-administered questionnaire in the Japan Gerontological Evaluation Study among 83,384 adults aged over 65 years. We defined distance over 1 km as poor objective access in community level. We performed multilevel regression analysis to investigate the association of objective and perceived access with intake frequencies of vegetables/fruits and meat/fish, respectively. Participants who lived in poor objective access had a significantly higher intake frequency of vegetables/fruits than those who lived in good access. In contrast, residents with poor perceived access consumed lower frequent intake of vegetables/fruits (beta coefficient (standard error) 0.086 (0.021) for objective access; -0.093 (0.009) for perceived access). There was no significant association between objective access and intake frequency of meat/fish, but poor perceived access showed a significant association with lower intake frequency of meat/fish. There was inconsistency between objective and perceived measurement of access to food stores associated with dietary habits among older Japanese adults. Food access needs to be comprehensively assessed, while considering characteristics of measurements.
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Tani Y, Suzuki N, Fujiwara T, Hanazato M, Kondo K. Neighborhood Food Environment and Dementia Incidence: the Japan Gerontological Evaluation Study Cohort Survey. Am J Prev Med 2019; 56:383-392. [PMID: 30777158 PMCID: PMC6375726 DOI: 10.1016/j.amepre.2018.10.028] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Interventions targeting built environmental factors may encourage older people to engage in favorable behaviors and decrease dementia risk, but epidemiologic evidence is limited. This study investigated the association between neighborhood food environment and dementia incidence. METHODS A 3-year follow-up (2010-2013) was conducted among participants in the Japan Gerontological Evaluation Study, a population-based cohort study of older adults aged ≥65 years. Dementia incidence for 49,511 participants was assessed through the public long-term care insurance system. Availability of food stores (defined as the number of food stores selling fruits and vegetables within 500 meters or 1 kilometer of residence) was assessed for each participant using objective (GIS-based) and subjective (participant-reported) measurements. Data were analyzed from 2017 to 2018. RESULTS A total of 3,162 cases of dementia occurred during the follow-up. Compared with the highest quartile for objective availability of food stores, the hazard ratio adjusting for age and sex was 1.60 (95% CI=1.43, 1.78) for the second-lowest quartile. Compared with the highest subjective availability of food stores, the hazard ratio was 1.74 (95% CI=1.49, 2.04) for the lowest category. After successive adjustment for sociodemographic characteristics, health status, and other geographic neighborhood factors (availability of restaurants, convenience stores, and community centers), the hazard ratio remained statistically significant. CONCLUSIONS Lower food store availability was associated with increased dementia incidence. Given that food shopping is a routine activity and a main motive for going out among older adults, increasing the availability of food stores may contribute to dementia prevention.
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Affiliation(s)
- Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan; Japan Society for the Promotion of Science, Tokyo, Japan.
| | - Norimichi Suzuki
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
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