Factors associated with failure to undergo health check-ups in Nagasaki Prefecture, Japan

Mayumi Ohnishi; Rieko Nakao; Ryoko Kawasaki; Junichi Tanaka; Satoko Kosaka; Masahiro Umezaki

doi:10.2185/jrm.2022-046

Factors associated with failure to undergo health check-ups in Nagasaki Prefecture, Japan

J Rural Med. 2023 Jan;18(1):28-35. doi: 10.2185/jrm.2022-046. Epub 2023 Jan 6.

Authors

Mayumi Ohnishi¹, Rieko Nakao¹, Ryoko Kawasaki¹, Junichi Tanaka¹, Satoko Kosaka¹, Masahiro Umezaki²

Affiliations

¹ Nagasaki University Graduate School of Biomedical Sciences, Japan.
² Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Japan.

Abstract

Objective: Municipal National Health Insurance (NHI) in Nagasaki Prefecture in Japan struggles with poor attendance of health check-ups, which was only 39.6% in 2018. This study aimed to evaluate factors that encourage healthy behaviors, including opting for health check-ups, and the characteristics of middle-aged and older individuals who did not undergo health check-ups. Materials and Methods: This cross-sectional study, using a self-administered questionnaire, was conducted in August 2020 in three municipalities of Nagasaki Prefecture. In addition to questions regarding sociodemographic information, such as sex, age, educational status, self-rated economic status, and family structure, the questionnaire included questions on daily lifestyle habits such as alcohol intake and exercise, current medical treatment, self-rated health, and information related to health check-ups. Of the 18,710 questionnaires distributed in the three municipalities, 8,756 (46.8%) were collected by the end of December 2020, of which 7,840 were valid for analysis. The compliance rate for health check-ups was obtained from the Public Health and Welfare Bureau of Nagasaki Prefecture. Statistical analyses were performed according to two age groups: 40-59 and 60-74 years. Results: Among the respondents who did not undergo health check-ups in the year prior to this study, "lack of time" and being "too bothersome" were the most popular reasons for not attending health check-ups. "Living alone" and "low self-rated economic status" were negative factors for receiving health check-ups regardless of age group. Conclusions: Vulnerable middle-aged and older persons, such as those living alone and with low economic status, were less likely to undergo health check-ups. Emphasis on home visits by public health nurses may also be needed to increase awareness of individual health conditions, especially for people living alone and those who are socioeconomically disadvantaged.

Keywords: health check-ups; healthy behaviors; nonattendees.