Along with the socio-economic development and human empowerment, the Japanese disease pattern has been changed to the lifestyle-related diseases. Japanese life expectancy progressed from the lowest to the highest among industrialized countries. Rank of Tokyo's life expectancy at birth by prefectures is 20/47 for men 33/47 for women in 1995. A population-based cohort study for the urban elderly dwellers was conducted in 2001. 13,066 self-rated questionnaires were analyzed by using Cox proportional hazards model. Elderly dwellers were followed up from 2001 to 2004 survey, and analyzed by using Structural equation model. Results show that having some of disease is not associated with survival probability. On the contrary, self-rated health, social network and ADL are strong determinants of mortality risk. Physical health may be affected by both self-rated health and social network health. Greater attention should be given to the self rated health for the elderly dwellers in the urban city. It is a future research issue to make clear the external validity by using random sampling survey. Greater attention should be given to the supportive environment for health by the point of health promotion.

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The purpose of this study is to clarify the process of community formation through group activities in urban area endeavors to promote health in middle-aged and elderly individuals, and to assess the state of community empowerment therein. 11 activity participants were interviewed. As a result, this process was "allow participants to take part in activities with a 'sense of unity with the surrounding community'." Middle-aged and elderly individuals who started interacting with the community because of moving into the area, etc. indicated a change in self-identification that produced feelings of identifying themselves as members of the surrounding community as well as a change in self-identification even to the point of being able to participate in activities with a sense of belonging to the community. Also, it was suggested that community empowerment strengthens social support by forging bonds of "mutual concern" among people in community areas.

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The problem concern in this article is how residents become a subject in a community. That theme was discussed from two viewpoints of empowerment and new public responsibility. This article examined the empowerment process of volunteer members and community in community based organization activities. Then, we discussed the possibility of the public responsibility formation by the community improvement activities which moreover promote empowerment. Further, this article reported study about support skills used in order to promote community empowerment in the community activity in public health nursing.

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In Japan, Health care crisis deepened in 2008. On the other hand, a glimmer of hope for improvement in health care policy appeared in the same year, after the devastating defeat of the ruling Liberal Democratic Party at an election of the members of the Diet (Sangi-In) on July 2007 and the starting of Fukuda administration that followed the collapse of Abe administration on September 2007. This article consists of three parts. In the first part, I show three kinds of hope that occurred in recent 12 months. The first is small but positive health care reforms as well as self-reform of medical professional organization. The second is the change in the stance of the influential nationwide newspapers against the health care cost containment policy. The third is the partial revision of harsh cost containment policy in health care that was introduced in 2006 under Koizumi administration. In the second part, I analyze the resent cabinet decision "Basic policies of economic and fiscal reform 2008" by Fukuda administration on June 27 and show further growing of hope such as the revision of traditional policy to contain numbers of physicians. In the third part, I show three competing options for financing the increase in public health care cost. They are increasing consumer consumption tax rate, slashing wastes in government budget and raising health insurance premiums. In Japan, the first and second options are rather popular, but I think only the revised third option is viable and practical. That is a combination of health insurance premium hike as main source and several tax increase as supplementary fund.

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In this paper, I have given my views on salutogenesis and the concept of sense of coherence (SOC) that were suggested by Dr. Antonovsky, professed a health sociologist, about thirty years ago. First, the salutogenic model of health and SOC has made a strong impact like a paradigm shift on the field of health and human services. Second, it has also broken new ground for health and medical sociology, stress research, patient study and so on. Third, SOC as the concept of a stress coping ability is a sociological and cultural anthropological concept in the sense that it relies on a lot of generalized resistance resources (GRRs), especially human and social relations. Forth, SOC scale development marked an epoch in SOC study. Experiential studies on SOC have been increasing in number and will become more and more expected.

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The purpose of this study is to analyze conversation between care worker and elderly person in nursing care home for elderly, and to find features of interactional procedure in it. Especially, I focused on "offer" that was addressed from care worker to elderly person. Then, I used conversation analytic perspectives and Goffman's examination of "face work" to describe it. In order to describe it, I videotaped in nursing care home for elderly and made a corpus. As a result, careworker's utterances of "offer" to elderly that is placed as a pre-doing care was characteristic forms of talk-in-interaction in nursing care home for elderly. And, "request" constituted a proposal of other-obligation and be accepted/rejected by recipient, whereas "offer" constituted a proposal of self-obligation and be accepted/rejected by recipient. These features caused "dilemma settings" between care worker and elderly person.

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In this article, using an analysis of audio-visual recordings, I examine the relationship between the use of medical technology and the form of communication that occur when medical technology is introduced into an OB/GYN consultation. I argue as follows: When the ultrasound scanner is brought into the interaction in the OB/GYN consultation room, the participants' bodies orientations and gaze directions are coordinated with each other to facilitate their interaction and the medical professional is expected to give the pregnant women instructions on how she should look at the shadowy image on the monitor. Whereas there is an interactional asymmetry between them involving the technological equipment, the medical professional also finds that she or he cannot avoid explaining to the pregnant women the fetus's image displayed on the monitor.

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This study was conducted on 306 new medical students, and its purpose was to survey associations between sense of coherence (SOC), which is though to be associated with stress coping ability and to affect mental health, and the degree of preference for the school, the residential environment, and mental and physical health status, and to identify factors that have an impact on SOC. A multiple regression analysis with SOC score as the dependent variable identified degree of preference for the school, CMI, depressed feeling, suicidal tendency, and obsessive thoughts as factors that had an impact on SOC. These findings suggested that determining the degree of preference for the school and physical and mental health status of students at the stage when they enter school is important in terms of supporting the subsequent mental health of students.

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I examined which workplaces, hospitals or clinics, female physicians are likely to select compared to male physicians. Employing panel data models with the age-stratified prefecture-based data of Survey of Physicians, Dentists and Pharmacists for 1998, 2000, 2002, and 2004, I find first that female physicians under fifty years are more likely to move from hospitals to clinics than male and second that there are little cases of move from clinics to hospitals both for male and female physicians. It is alleged that managers of hospitals feel shortage of physicians and that the reason is well-experienced physicians tend to fly away to clinics because of hard work and insufficient reward to the job. The results of this paper suggest that increasing number of female physicians in recent years also contributes to the shortage.

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