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In this study, 109 municipalities cooperated among the 246 municipalities (44.3% of the surveyed subjects). In the 2013 survey, 246 municipalities (cities, towns, villages) of about 1700 municipalities nationwide participated. The Survey of Needs examined a random sample of adults aged 65 or older who had not been certified for LTC for each sub-region for the spheres of daily life set for each municipality once every three years. The Survey of Needs is a survey in which the MHLW presented models that were then implemented by numerous municipalities to obtain basic information for creating plans for LTC insurance programs. The analysis subjects included 109 municipalities that agreed to provide data for 2013 for the JAGES (Japan Gerontological Evaluation Study) HEART program or the Survey of Needs in Spheres of Daily Life for the elderly (The Survey of Needs). However, which aspects of the social environment should be developed to reduce health inequalities, or which indicators should be used from among the community diagnosing indicators that measure the social environment remain unclear. In Japan, the Ministry of Health, Labour and Welfare (MHLW) proposed reducing health inequalities by developing social environments as part of its Health Japan 21 (the second term) program in 2013. To promote social environment improvement in local regions, the WHO introduced an Urban Health Equity Assessment and Response Tool (Urban-HEART) and age-friendly city indicators as tools for evaluating the social environment and health inequalities in cities. The Declaration of Alma-Ata (1978) states that health inequalities are unacceptable, and the WHO committee on the social determinants of health recommended improving the living environment in its final report in 2008. Municipalities could encourage their inhabitants to participate by developing and providing engaging social activities.Īccording to the World Health Organization (WHO), social factors, such as social support, social networks, and social environment, are some determinants of human health. The results of the present study suggest that it is appropriate to use forgetfulness and social participation at least a few times a year in any social activity as community diagnosing indicators.
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Higher levels of social participation, social contact, and social support were associated with lower levels of forgetfulness, even after adjusting for age and regional variables. The ratio of people responding that they experienced forgetfulness differed among municipalities, with a mean of 19.0% (7.1–35.6%). The variables of social environment factors were (1) social participation, (2) social contact, and (3) social support. Forgetfulness as a risk factor for dementia was used as the dependent variable. The analysis subjects included 105 municipalities that agreed to provide data for the 2013 Survey of Needs in Spheres of Daily Life in Japan ( n = 338,659 people). We analyzed the relationships between forgetfulness and social participation, social contact, and social support by municipality to develop community diagnosing indicators.