Purpose: This article aims to predict the future course of city administration and public health centers through clarifying the actual state and local residents' expectations of new public health centers on becoming a "Core City".
Method: Online questionnaire surveys targeting Kurume City residents were conducted in March 2008 (before becoming a Core City) and in October 2008, six months after becoming a Core City. Questions involved awareness of the Core City concept and the expectations for administration of the Core City and its new public health centers.
Result: The recognition rate for the Core City concept was 62.6% in the first questionnaire survey and 78.9% in the second survey, demonstrating a significant increase (P < 0.001). The expectations for the Core City centered on "Vitalization of the city" in both surveys. However, in the second survey results, "Nothing in particular" accounted for 81.2% of the responses for what the residents felt as a change after becoming a Core City. On the other hand, "Vitalization of the city" recorded 5.5% for the same question, showing a low rate. "Health promotion, Cancer check-ups, and Vaccination" were the most commonly chosen responses regarding expectations of the new public health centers in both surveys, accounting for approximately 30%. Nonetheless, the response to a question asking about actual utilization of the public health centers revealed a high rate of 83.4% for "Nothing in particular" in the second survey result. The recognition rate for the "Health Promotional Members" system implemented by the Kurume City public health centers from 2007 was a low 6.5%. Furthermore, the responses to the "District-Assigned Public Health Service" system to be introduced from 2009 were: In favor 52.6%, Opposed 3.0%, and Neither 44.3%.
Conclusion: Although residents' expectations of public health centers are high, the surveys revealed that the health promotional activities provided by the public health centers were not fully utilized. In the future, the recognition rate of the "District-Assigned Public Health Service" starting in 2009 should be improved as quickly as possible to enhance the support system to accommodate individual health needs.