BackgroundWe examined the relationship between incident functional disability and social participation from the perspective of number of types of organizations participated in and type of social participation in a prospective cohort study.MethodThe study was based on the Aichi Gerontological Evaluation Study (AGES) Cohort Study data. We followed 13,310 individuals aged 65 years or older for 4 years. Analysis was carried out on 12,951 subjects, excluding 359 people whose information on age or sex was missing. Social participation was categorized into 8 types.ResultsCompared to those that did not participate in any organizations, the hazard ratio (HR) was 0.83 (95% CI: 0.73–0.95) for participation in one, 0.72 (0.61–0.85) for participation in two, and 0.57 (0.46–0.70) for participation in three or more different types of organizations. In multivariable adjusted models, participation in the following types of organization was protective for incident disability: local community organizations (HR = 0.85, 95% CI: 0.76–0.96), hobby organizations (HR = 0.75, 95% CI: 0.64–0.87), and sports organizations (HR = 0.64, 95% CI: 0.54–0.81).ConclusionSocial participation may decrease the risk of incident functional disability in older people in Japan. This effect may be strengthened by participation in a variety of different types of organizations. Participating in a local community, hobby, or sports group or organization may be especially effective for decreasing the risk of disability.

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In the last two decades, there has been increasing application of the concept of social capital in various fields of public health, including oral health. However, social capital is a contested concept with debates on its definition, measurement, and application. This study provides an overview of the concept of social capital, highlights the various pathways linking social capital to health, and discusses the potential implication of this concept for health policy. An extensive and diverse international literature has examined the relationship between social capital and a range of general health outcomes across the life course. A more limited but expanding literature has also demonstrated the potential influence of social capital on oral health. Much of the evidence in relation to oral health is limited by methodological shortcomings mainly related to the measurement of social capital, cross-sectional study designs, and inadequate controls for confounding factors. Further research using stronger methodological designs should explore the role of social capital in oral health and assess its potential application in the development of oral health improvement interventions.

There are statistically significant effects of social context on dmft in municipalities in Japan.

In the aftermath of a disaster, the risk of posttraumatic stress disorder (PTSD) is high. We sought to examine whether the predisaster level of community social cohesion was associated with a lower risk of PTSD after the earthquake and tsunami in Tohoku, Japan, on March 11, 2011. The baseline for our natural experiment was established in a survey of older community-dwelling adults who lived 80 kilometers west of the epicenter 7 months before the earthquake and tsunami. A follow-up survey was conducted approximately 2.5 years after the disaster. We used a spatial Durbin model to examine the association of community-level social cohesion with the individual risk of PTSD. Among our analytic sample (n = 3,567), 11.4% of respondents reported severe PTSD symptoms. In the spatial Durbin model, individual- and community-level social cohesion before the disaster were significantly associated with lower risks of PTSD symptoms (odds ratio = 0.87, 95% confidence interval: 0.77, 0.98 and odds ratio = 0.75, 95% confidence interval: 0.63, 0.90, respectively), even after adjustment for depression symptoms at baseline and experiences during the disaster (including loss of loved ones, housing damage, and interruption of access to health care). Community-level social cohesion strengthens the resilience of community residents in the aftermath of a disaster.

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BackgroundThe efficacy of promoting social interactions to improve the health of older adults is not fully established due to residual confounding and selection bias.MethodsThe government of Taketoyo town, Aichi Prefecture, Japan, developed a resident-centred community intervention programme called ‘community salons’, providing opportunities for social interactions among local older residents. To evaluate the impact of the programme, we conducted questionnaire surveys for all older residents of Taketoyo. We carried out a baseline survey in July 2006 (prior to the introduction of the programme) and assessed the onset of functional disability during March 2012. We analysed the data of 2421 older people. In addition to the standard Cox proportional hazard regression, we conducted Cox regression with propensity score matching (PSM) and an instrumental variable (IV) analysis, using the number of community salons within a radius of 350 m from the participant's home as an instrument.ResultsIn the 5 years after the first salon was launched, the salon participants showed a 6.3% lower incidence of functional disability compared with non-participants. Even adjusting for sex, age, equivalent income, educational attainment, higher level activities of daily living and depression, the Cox adjusted HR for becoming disabled was 0.49 (95% CI 0.33 to 0.72). Similar results were observed using PSM (HR 0.52, 95% CI 0.33 to 0.83) and IV-Cox analysis (HR 0.50, 95% CI 0.34 to 0.74).ConclusionsA community health promotion programme focused on increasing social interactions among older adults may be effective in preventing the onset of disability.

BackgroundWe developed and validated an instrument to measure community-level social capital based on data derived from older community dwellers in Japan.MethodsWe used cross-sectional data from the Japan Gerontological Evaluation Study, a nationwide survey involving 123,760 functionally independent older people nested within 702 communities (i.e., school districts). We conducted exploratory and confirmatory factor analyses on survey items to determine the items in a multi-dimensional scale to measure community social capital. Internal consistency was checked with Cronbach's alpha. Convergent construct validity was assessed via correlating the scale with health outcomes.ResultsFrom 53 candidate variables, 11 community-level variables were extracted: participation in volunteer groups, sports groups, hobby activities, study or cultural groups, and activities for teaching specific skills; trust, norms of reciprocity, and attachment to one's community; received emotional support; provided emotional support; and received instrumental support. Using factor analysis, these variables were determined to belong to three sub-scales: civic participation (eigenvalue = 3.317, α = 0.797), social cohesion (eigenvalue = 2.633, α = 0.853), and reciprocity (eigenvalue = 1.424, α = 0.732). Confirmatory factor analysis indicated the goodness of fit of this model. Multilevel Poisson regression analysis revealed that civic participation score was robustly associated with individual subjective health (Self-Rated Health: prevalence ratio [PR] 0.96; 95% confidence interval [CI], 0.94–0.98; Geriatric Depression Scale [GDS]: PR 0.95; 95% CI, 0.93–0.97). Reciprocity score was also associated with individual GDS (PR 0.98; 95% CI, 0.96–1.00). Social cohesion score was not consistently associated with individual health indicators.ConclusionsOur scale for measuring social capital at the community level might be useful for future studies of older community dwellers.