Kawachi Haruna, Nishioka Daisuke
Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.
JMA J. 2024 Jul 16;7(3):301-312. doi: 10.31662/jmaj.2024-0062. Epub 2024 Jun 28.
Promoting health and well-being is essential to ensure dignified lives of the entire population, including those living in poverty. Guaranteeing the human right to health is a critical responsibility of social security policies. To address emerging issues associated with poverty, the Japanese government has implemented a welfare program known as public assistance-. However, financial welfare programs may not fully mitigate health risks due to the complex impact of poverty on health. Although a global systematic review of the health status of public and social assistance recipients has been conducted, it did not include any studies from Japan. Furthermore, evidence for the development of health support strategies for Japanese recipients remains scarce. This scoping review aims to identify the current situation and potential issues concerning the health of recipients.
PubMed was searched for articles published before November 2023. Of the 357 articles identified, 56 were included. Among those included, 35 used the individual status of receiving public assistance as an exposure variable, 13 considered public assistance recipients as the study population, and 8 used the prefectural proportion of the population receiving public assistance as an environmental predictor.
We found that public assistance recipients tend to have more disadvantageous health and well-being statuses than the general population, as reported in the global systematic review. Health inequalities were also observed among recipients based on their sociodemographic characteristics. In Japan, public assistance recipients face several health risks and are at a disadvantage compared with the general population.
The distribution of risks is heterogeneous among recipients, despite the minimum income protection and financial benefits in health and long-term care use. Further studies to identify the effects of public assistance policy on the health of the impoverished population, evidence-based discussions, and reform of social security policies are warranted.
促进健康和福祉对于确保全体人口，包括贫困人口有尊严地生活至关重要。保障健康的人权是社会保障政策的一项关键责任。为应对与贫困相关的新出现问题，日本政府实施了一项名为公共援助的福利计划。然而，由于贫困对健康的复杂影响，财政福利计划可能无法完全减轻健康风险。尽管已经对公共和社会援助受助者的健康状况进行了全球系统评价，但其中并未包括来自日本的任何研究。此外，针对日本受助者制定健康支持策略的证据仍然匮乏。本范围综述旨在确定受助者健康方面的现状和潜在问题。
在PubMed中检索2023年11月之前发表的文章。在识别出的357篇文章中，纳入了56篇。在这些纳入的文章中，35篇将接受公共援助的个人状况作为暴露变量，13篇将公共援助受助者作为研究人群，8篇将接受公共援助人口的县比例作为环境预测因素。
正如全球系统评价所报告的那样，我们发现公共援助受助者的健康和福祉状况往往比一般人群更不利。根据社会人口学特征，在受助者中也观察到了健康不平等现象。在日本，公共援助受助者面临若干健康风险，与一般人群相比处于劣势。
尽管有最低收入保障以及在健康和长期护理使用方面的经济福利，但受助者之间的风险分布是不均一的。有必要开展进一步研究以确定公共援助政策对贫困人口健康的影响，进行基于证据的讨论，并改革社会保障政策。
