Development of Healthy Communities in the “With Corona” Era

Katsunori Kondo

Center for Preventive Medical Sciences, Chiba University

National Center for Geriatrics and Gerontology

Japan Gerontological Evaluation Study (JAGES) Gerontological Evaluation Study JAGES Survey of Health and Living Participating ■ Participating municipalities in 2019 survey JAGES 2019 Municipalities ■ Participating municipalities in the previous surveys 64 municipalities Tomakomae Higashikawa Town Town, City, Handa City, Higashikagura City, City, Town, Biei Town Tokai City, Obu City, Chita City, Tobetsu Number of questionnaires sent: Town, Town Town 375,421 Yoichi Number of responses: 258,842 Town Response rate: 68.9%

Kuriyama JAGES 2016/17 Town Towada Number of municipalities: 40 City Rokunohe Gonohe Town Number of questionnaires sent: Town Hachinohe Approx. 300 thousand Kosaka Town Town Aichi Nanbu Number of responses: Approx. Town Prefecture Niigata Sannohe 200 thousand City Town Tokamachi Response rate: Approx. 69.5% City Hayakawa Iwanuma Town City Chuo JAGES 2013/14 Matsumoto City Katsurao Toyonaka City Village Number of municipalities: 30 City Kaga Oarai Taka City Town Number of questionnaires sent: Town Saitama Takahama City Approx. 200 thousand Tottori Town City Kashiwa Number of responses: Approx. Chizu City Town Nagara Fukuoka Matsudo Town 140 thousand City City Response rate: Approx. 70.8% Ichikawa City Mutsuzawa Town Tenri Oyama Machida Yokohama City Town City City JAGES 2010/11 Ichihara Kobe Ikoma Morimachi Hachioji City City Number of municipalities: 31 City Town City Tsukumi Yao Number of questionnaires sent: Matsuura City City City Usuki Approx. 170 thousand City Moriguchi City, Kadoma City, Number of responses: Approx. Mifune Taketa Shijonawate City Town Kokonoe City 110 thousand Town Response rate: Approx. 66.3% Katsunori Kondo

Development of Communities Featuring “Primordial Prevention,” where You can Live a Healthy Life by Simply Living there

Kadokawa Shinsho, 2018 The more people in a municipality who participate in society, the less people who report forgetfulness Social participation: More than several times a year, regardless of the type of activities, such as work, hobbies, sports, volunteer, JAGES2013 parenting support, and learning N=105 municipalities (338,659 people)

Large Largest

Percentage認知症発症の前駆症状 of those who report forgetfulness, which is a もの忘れがある人prodrome to dementia の割合

Smallest forgetful

report forgetfulness report

Percentage of those who who those of Percentage Percentage of those who are who those of Percentage Up to 5 times difference Small Large among cities and towns 50% 75％ 100％ Percentage of those who participate in society (1) Percentage of the single older people, (2) Population density of a habitable area, By municipality (3) Percentage of the junior high graduate older people, (4) Partial correlation analysis of adjusted taxable income Seungwon Jeong, Yusuke Inoue, Katsunori Kondo, Kazushige Ide, Yasuhiro Miyaguni, Eisaku Okada, Tokunori Takeda, Toshiyuki Ojima. Correlations between Forgetfulness and Social Participation: Community Diagnosing Indicators. Int. J. Environ. Res. Public Health 16(13): 2426，1-11，2019． Part of the Results of JAGES’s Study The Risk of Developing a State that Needs Long-term Care Based on Frequency of the Exercise and Participation in Sports Groups 11,581 people were tracked for 4 years * = p<.05 Doing the exercise with peers is recommended rather than doing it alone Sports group If you exercise once a week, Participation unless you participate in a sports group, you are 1.29 Non-participation times more likely to come to need long-term care than those who participate in one

Once a week or more Less than once a week Frequency of the exercise (Age, gender, income, academic history, marital status, with or without work, health state, depression, smoking, and drinking are taken into consideration)

Kanamori S, Kai Y, Kondo K, Hirai H, Ichida Y, Suzuki K, Kawachi I. Participation in sports organizations and the prevention of functional disability in older Japanese: the AGES Cohort Study. PLOS ONE 2012 http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0051061 Percentage of Those who Do not Laugh and have

a Poor Self-rated Health is 1.5 times larger rated rated health - Male

Female

poor poor self Percentage of those whohave

Almost every day Once to 5 times Once to 3 times Seldom (standard) a week a month *Number of samples 20,400 people Frequency of laughter *Significant differences are identified in all the groups for both male and female

Hayashi K, Kawachi I, Ohira T, Kondo K, Shirai K, Kondo N：Laughter and Subjective Health Among Community-Dwelling Older People in Japan: Cross-Sectional Analysis of the Japan Gerontological Evaluation Study Cohort Data. Journal of Nervous & Mental Disease 203 (12): 934-942, 2015 The Risk of Developing Depression is One-seventh among Males who Perform Roles and Participate in Society 2,728 people aged 65 or older who had no depression as of the AGES 2003 survey and also responded to the 2006 survey

Have no role Have a role Have no role Have a role

depression (%) depression depression (%) depression

Probability of developing developing of Probability developing of Probability

Group of those who barely Group of those who often Group of those who barely Group of those who often participate in society participate in society participate in society participate in society Male (n = 1541) Female (n = 1187) Respondents were asked whether they participate in groups associated with hobbies, sports, neighborhood associations, volunteer activities, clubs for the older people, industries, religions or politics and the social participation scores were calculated based on principal component analysis. Takagi, D., Kondo, K., & Kawachi, I. (2013). BMC Public Health, 13: 701, doi: 10.1186/1471-2458-13-701. Those Who Live Near Parks Exercise 1.2 Times More Frequently than Those Not

Whether a park is available close to your home or not (within 1 km) and frequency of the exercise Urban planning is a (simple tabulation) health policy as well

Do no exercise

A few times a year Hanibuchi T, Kawachi I, Nakaya Once or twice a monthT, Hirai H, Kondo K. 2011.

Around once a week Neighborhood built environment and physical Twice or three times a week activity of Japanese older adults:

Nearly every day Results from the Aichi Gerontological Evaluation Study (AGES). BMC Public Health 11: 657 (doi: Park is not available Park is available 10.1186/1471-2458-11-657). How Things Look Differs between the Macro and Micro Perspectives the wood a tree Not an aggregation of trees Animals and plants live

“power of an ecosystem” Summary • The older people are influenced by society/communities (environment). • Both interventions are needed: –1）in the older people –2）in society and communities • The healthy older people are living in healthy society and communities.

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