Japanese Journal of Health and Human Ecology

Objective : This paper is aiming at a contribution to the debate on how to make health-care services in China more responsive to the needs of the elderly.
Methods : We performed a health survey of elderly Chinese aged 65 years and above living in Tianjin. A questionnaire concerning physical, mental, socioeconomic factors was distributed to 191 people. Logistic regression analysis was then used to analyze the data in order to evaluate the relationship of outpatient medical care costs to lifestyle and fitness level.
Results : Multivariate analysis suggested that, dietary habits [reference : not, odds ratio=1.96 (paying attention to dietary balance) 95% confidence interval=1.02-3.76], self-perceived health [reference : not, OR=0.30 (fairly healthy) 95% CI=0.12-0.57], level of insurance [reference : uninsured, OR=3.81 (insured), 95% CI=1.22-11.9], and walking speed (OR=1.68, 95% CI=1.18-2.41) were closely related to a reduction in consultation behavior.
Conclusion : This study revealed the complexities of the situation coupled with the impact of class on the participation in medical insurance services. China needs urgent improvement in its legal system, and education strategies, prevention activities, and health delivery methods for the whole population, particularly groups that are hard to reach and stratified health message delivery.

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The purpose of this study is to ascertain the relationship between supportive environmental indicators of health promotion policy and inter-sectoral collaboration at local levels of the Kanto district, Japan. Researchers conducted a survey by mail, targeting health policy administrators in 509 municipalities in the Kanto district, Japan (60.2% of responders). Of these responses, we analyzed 142 people (27.9%) answers. Supportive environmental indicators items included ‘program and policy,’ ‘organization and group,’ and ‘providing information.’ Additionally, inter-sectoral collaboration items included the extent of consideration for other sectors’ policies, if there was planning committee, and the committee members. The number of municipalities that established a lot or some of supportive environmental indicators in health promotion policy was 55 (38.8%) for ‘program and policy,’ 37 (26.0%) for ‘organization and group,’ and 37 (36.6%) for ‘providing information.’ The logistic regression analysis showed the relationship between supportive environmental indicators and having other sections’ policies related to health, establishing the planning committee, and involving other sectional members for the committee. This study suggests that establishment targeting of supportive environmental indicators in health promotion policy was not prominently promoted in municipalities. The present findings indicate the need to enable supportive environment in health promotion policy by inter-sectoral collaboration in political, organizational and individual levels in municipalities.

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