Does participation in community health salons help shrink health disparity? Results of a 5-year-long intervention study by JAGES project in Taketoyo town, Japan
METHODS: We administered a questionnaire survey in 2006 to all older residents of Taketoyo town that then launched community centers for them called “salons” in May 2007 to foster healthy aging. Visitors to the salons participate in arts, crafts and cultural activities (e.g., composing haiku). All older people (over 65 year olds) can participate for 100 yen (about 1 USD). Incidence of long term care need was tracked in 2490 ADL independent respondents, comprised of 507 salon participants and 1983 non-participants, for 1796 days (May 2007 – March 2012). Cox’s proportional hazard model was conducted to estimate the hazard ratio (HR) of participating in the salons compared to non-participants, adjusting for sex, age, equivalent income, years of education, IADL, depression and frequency of attending hospitals.
RESULTS: Salon participants had a lower equivalent income (under about 19,900 USD: participants 53.2%, non-participants 46.3%) and shorter education (under 9 years: participants 56.9%, non-participants 53.7%). However, their incidence of long term care need within 5 years was lower than non-participants (participants 7.7%, non-participants 14.4%). HRs (n, 95% confidence interval, p) of participating in a salon for long term care need was 0.607 (223, 0.388-0.950, 0.029) for participating 1-3 times, 0.472 (167, 0.268-0.829, 0.009) for participating 4-30 times and 0.244 (117, 0.100-0.596, 0.002) for participating 31 times or more. The HRs of equivalent income and years of education were not significant.
CONCLUSIONS: Although salon participants had a lower SES in 2006, their risk of long-term care need was lower than non-participants. We thus provided an empirical finding for the role of social participation in shrinking the health disparity among older people.