Watanabe Jun-Ichiro, Kimura Takashi, Nakamura Takahiro, Suzuki Daisuke, Takemoto Takashi, Tamakoshi Akiko
Hitachi Ltd, Research & Development Group, Tokyo, 185-8601, Japan.
Department of Public Health, Faculty of Medicine, Hokkaido University, Sapporo, 060-8638, Japan.
SSM Popul Health. 2021 Dec 2;17:100981. doi: 10.1016/j.ssmph.2021.100981. eCollection 2022 Mar.
Maintaining physical and mental health of older people is one of the important issues to be addressed in the aging society. Social capital, defined as the resources available to members of social groups, has recently attracted attention as a factor influencing public health. Most of the previous studies targeted various communities having different aging rates or population densities at once to examine the associations of social capital and health outcomes. However, the results of those studies are not always consistent. Moreover, because few studies have targeted a particular advanced aging society, associations of social capital and health at such societies have remained unknown. This study examined how social capital associates with health at a particular city having a very high aging rate and low population density. We targeted Iwamizawa city, Hokkaido, Japan, which is one of the most advanced aging areas, with an aging rate of 36.6% and a population density of 165/km. We analyzed self-administered questionnaire data obtained from "HELLO (HEalth, Lifestyle, and LOcal community of Iwamizawa citizen) Study" in 2018. The sample comprised 1237 individuals aged 65 and older. Following previous studies, we regarded three items-social cohesion, reciprocity, and civic participation-as social capital indices, and targeted two health outcomes: self-rated health (SRH) and degree of depression. Multilevel Poisson regression analyses were used to calculate prevalence ratios (PRs). We found that at the individual-level, the PR (95% confidence interval) of having poor SRH among those with more civic participation was 0.81 (0.71-0.93), and that of being depressed among those with more social cohesion was 0.32 (0.21-0.51), even after adjusting for compositional factors. We also found that the community-level civic participation significantly correlated with aging rate. Our findings indicate that social capital positively associates with older people's health at the advanced aging city.
维护老年人的身心健康是老龄化社会需要解决的重要问题之一。社会资本被定义为社会群体成员可利用的资源，最近作为影响公众健康的一个因素而受到关注。以前的大多数研究同时针对具有不同老龄化率或人口密度的各类社区，以考察社会资本与健康结果之间的关联。然而，这些研究的结果并不总是一致的。此外，由于很少有研究针对某个特定的高度老龄化社会，此类社会中社会资本与健康之间的关联仍不为人知。本研究考察了在一个老龄化率非常高且人口密度低的特定城市中，社会资本与健康是如何关联的。我们选取了日本北海道的岩见泽市，它是老龄化程度最高的地区之一，老龄化率为36.6%，人口密度为每平方公里165人。我们分析了从2018年“岩见泽市民的健康、生活方式和当地社区（HELLO）研究”中获得的自填式问卷调查数据。样本包括1237名65岁及以上的个体。按照以前的研究，我们将社会凝聚力、互惠性和公民参与这三个项目视为社会资本指标，并将两个健康结果作为目标：自评健康（SRH）和抑郁程度。采用多水平泊松回归分析来计算患病率比（PRs）。我们发现，在个体层面，即使在调整了构成因素之后，公民参与度较高者中自评健康状况较差的PR（95%置信区间）为0.81（0.71 - 0.93），社会凝聚力较高者中抑郁的PR为0.32（0.21 - 0.51）。我们还发现，社区层面的公民参与与老龄化率显著相关。我们的研究结果表明，在高度老龄化城市中，社会资本与老年人的健康呈正相关。
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