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This study examined the association between the 2008 economic recession and mental health distress among middle-aged Japanese people, and whether sex and socioeconomic status affected this association. Data were obtained from a nationwide longitudinal study (“Longitudinal Survey of Middle-aged and Elderly Persons”), conducted since 2005 on randomly selected Japanese adults aged 50–59 years. Of the 34,240 respondents to the 2005 baseline survey, data for 33,815 who responded at least once both before 2007 and after 2008 were analyzed. The 6-item Kessler Psychological Distress Scale (K6) was used to assess mental health distress (i.e., K6 scores of ≥ 5). A generalized estimating equation model applied to 6 years of longitudinal data (2005–2010) showed that mental health worsened among men and women after the 2008 recession (odds ratio [95% confidence interval] = 1.11 [1.07–1.15] for men; 1.14 [1.10–1.18] for women), particularly among self-employed men (1.08 [1.02–1.14]). The mental health of women who graduated from junior high school worsened less than that of women who graduated from university or graduate school (0.89 [0.80–0.98]). This study confirmed the association between the 2008 economic recession and mental health distress and identified vulnerable socioeconomic groups. These findings provide useful information for future economic crises.

Background Many local workers have been involved in rescue and reconstruction duties since the Great East Japan Earthquake (GEJE) on March 11, 2011. These workers continuously confront diverse stressors as both survivors and relief and reconstruction workers. However, little is known about the psychological sequelae among these workers. Thus, we assessed the prevalence of and personal/workplace risk factors for probable post-traumatic stress disorder (PTSD), probable depression, and high general psychological distress in this population. Methods Participants (N = 1294; overall response rate, 82.9%) were workers (firefighters, n = 327; local municipality workers, n = 610; hospital medical workers, n = 357) in coastal areas of Miyagi prefecture. The study was cross-sectional and conducted 14 months after the GEJE using a self-administered questionnaire which included the PTSD Checklist–Specific Version, the Patient Health Questionnaire-9, and the K6 scale. Significant risk factors from bivariate analysis, such as displacement, dead or missing family member(s), near-death experience, disaster related work, lack of communication, and lack of rest were considered potential factors in probable PTSD, probable depression, and high general psychological distress, and were entered into the multivariable logistic regression model. Results The prevalence of probable PTSD, probable depression, and high general psychological distress was higher among municipality (6.6%, 15.9%, and 14.9%, respectively) and medical (6.6%, 14.3%, and 14.5%, respectively) workers than among firefighters (1.6%, 3.8%, and 2.6%, respectively). Lack of rest was associated with increased risk of PTSD and depression in municipality and medical workers; lack of communication was linked to increased PTSD risk in medical workers and depression in municipality and medical workers; and involvement in disaster-related work was associated with increased PTSD and depression risk in municipality workers. Conclusions The present results indicate that at 14 months after the GEJE, mental health consequences differed between occupations. High preparedness, early mental health interventions, and the return of ordinary working conditions might have contributed to the relative mental health resilience of the firefighters. Unlike the direct effects of disasters, workplace risk factors can be modified after disasters; thus, we should develop countermeasures to improve the working conditions of local disaster relief and reconstruction workers.

Trust in messengers is essential for a public agency to ensure effective benefit-risk communication. However, there is insufficient research on the difference in trust between risk-only or benefit-and-risk messages that deal with negative topics. To clarify these differences, this study used three radiation topics to determine the best benefit-risk communication design. We conducted a randomized comparative study in November 2020 on 1100 Japanese individuals (550 men and 550 women), who were allocated either to the risk message group (risk-only) or the benefit-and-risk message group (benefit-and-risk). The questionnaire focused on the trust level in a public agency for each message. We conducted an independent sample t -test using the trust mean at the time of registration. There were significant differences in the trust level in the public agency for all three topics ( p  < 0.001). The trust level was ranked as risk-only, followed by benefit-and-risk; however, the trust level was still high enough when the trust level at baseline was high from the outset. In risk-only communication on negative topics, perceptions were consistent with the types of risk message due to confirmation bias. Hence, trust in risk-only negative health messages promoted a preferential higher information absorptivity under the mindsponge mechanism. However, effective benefit-risk communication is assured by high trust levels between a public agency and the public, so it is important to consistently build trust with all stakeholders on a regular basis.

Purpose: To evaluate dietary patterns in relation to colorectal cancer risk in Japanese. Methods: We prospectively assessed the association between dietary patterns among the Japanese and the risk of colorectal cancer. Dietary information was collected from 44,097 Japanese men and women aged 40–79 years without a history of cancer at the baseline in 1994. Results: During 11 years of follow-up, we documented 854 cases of colorectal cancer, which included 554 cases of colon cancer and 323 cases of rectal cancer. Factor analysis (principal component analysis) based on a validated food frequency questionnaire identified three dietary patterns: (1) a Japanese dietary pattern, (2) an \"animal food\" dietary pattern, and (3) a high-dairy, high-fruit-and-vegetable, low-alcohol (DFA) dietary pattern. After adjustment for potential confounders, the DFA pattern was inversely associated with the risk of colorectal cancer (hazard ratio of the highest quartile vs the lowest, 0.76; 95 % confidence interval 0.60–0.97; p for trend = 0.02). When colon and rectal cancers were separated, the inverse association between the DFA pattern and cancer risk was observed for rectal cancer (p for trend = 0.003), but not for colon cancer (p for trend = 0.43). No apparent association was observed for either the Japanese dietary pattern or the \"animal food\" dietary pattern. Conclusions: The DFA dietary pattern was found to be inversely associated with the risk of colorectal cancer. This association was observed for rectal cancer, but not for colon cancer.

Background: Large-scale cohort studies conducted in Japan do not always include psychosocial factors as exposures. In addition, such studies sometimes fail to satisfactorily evaluate disability status as an outcome. Methods: This prospective cohort study comprised 49 603 (22 438 men and 27 165 women) community-dwelling adults aged 40 years or older who were included in the Residential Registry for Ohsaki City, Miyagi Prefecture, in northeastern Japan. The baseline survey, which included psychosocial factors, was conducted in December 2006. Follow-up of death, immigration, cause of death, cancer incidence, and long-term care insurance certification was started on 1 January 2007. Results: The response rate was 64.2%. In general, lifestyle-related conditions in the study population were similar to those of the general Japanese population; however, the proportion of male current smokers was higher in the cohort. The association between age and the proportion of those reporting psychological distress showed a clear U-shaped curve, with a nadir at age 60 to 69 years in both men and women, although more women were affected by such distress than men. The proportion of those who reported a lack of social support was highest among those aged 40 to 49 years. Most men and women surveyed did not participate in community activities. Among participants aged 65 years or older, 10.9% of participants were certified beneficiaries of the long-term care insurance system at baseline. Conclusions: The Ohsaki Cohort 2006 Study is a novel population-based prospective cohort study that focuses on psychosocial factors and long-term care insurance certification.

Alcohol consumption is known to be a risk factor for breast cancer in Western countries, but few epidemiologic data have been available in Japan. This population-based prospective cohort study evaluated the associations of alcohol consumption with breast cancer risk in a Japanese population. A total of 19,227 women aged 40–64 years were followed from 1990 to 2003. During 246,703 person-years of follow-up, 241 breast cancer cases were identified. Hazard ratios (HRs) were estimated by the Cox proportional-hazard regression model. After adjustment for potential risk factors of breast cancer and nutritional factors, the HR and 95% confidence interval (CI) for current drinkers was 1.00 (0.74–1.34) compared with never drinkers. According to the amount of alcohol intake per day, a higher amount (≥15.0 g/day) had no significant relation to breast cancer risk (HR = 0.87, 95% CI: 0.40–1.91; P for trend = 0.85). Age upon starting to drink, and the frequency of drinking, were not associated with breast cancer risk. In analysis stratified according to exogenous female hormone use, a higher alcohol intake (≥15.0 g/day) was associated with an increased risk of breast cancer among hormone users (HR = 1.67, 95% CI: 0.17–16.73); however, this was not statistically significant. Stratification according to folate intake with energy adjustment (<219, ≥219 μg/day) found that breast cancer risk tended to increase with increasing alcohol consumption among women with a low intake of folate ( P for trend = 0.09). Our findings suggest that alcohol consumption has no overall effect on breast cancer risk among Japanese women, whereas nutritional factors such as folate intake may modify the alcohol-breast cancer risk relationship.

Objective The association between diabetes mellitus and the risk of prostate cancer has been tested in previous prospective cohort studies in western populations. However, no evidence from cohort studies is available for Asian populations, whose lifestyle is very different from that of westerners. Methods The authors examined the relationship between diabetes mellitus and the risk of prostate cancer in the Ohsaki cohort followed from 1995 to 2003, in which 230 new cases of prostate cancer were identified among 22,458 Japanese men. Baseline information including diabetes mellitus status was collected using a self-administered questionnaire. The Cox proportional hazards regression model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results Although a history of diabetes mellitus was not associated with the risk of total prostate cancer in this population, after stratification based on the clinical stage of prostate cancer, patients with diabetes mellitus showed a higher risk of advanced prostate cancer with a multivariate adjusted HR = 1.89 (95% CI: 1.02-3.50). The relationship remained robust when we excluded from the analysis cases arising in the first 2 years. Conclusion This population-based prospective cohort study indicates that a history of diabetes mellitus is associated with an increased incidence of advanced prostate cancer.

Objectives To investigate the association between green tea consumption and liver cancer incidence. Methods We prospectively followed 41,761 Japanese adults aged 40-79 years, without a history of cancer at the baseline or any missing data for green tea consumption frequency. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI), adjusted for age, alcohol drinking, smoking, the consumption of coffee, vegetables, dairy products, fruit, fish, and soybean. Results Over 9 years of follow-up, among 325,947 accrued person-years, the total incidence of liver cancer was 247 cases. We found that green tea consumption was inversely associated with the incidence of liver cancer. In men, the multivariate-adjusted HRs (95% CIs) for liver cancer incidence with different green tea consumption categories were 1.00 (reference) for <1 cup/day, 0.83 (0.53-1.30) for 1-2 cups/day, 1.11 (0.73-1.68) for 3-4 cups/day, and 0.63 (0.41-0.98) for ≥5 cups/day (p for trend = 0.11). The corresponding data among women were 1.00 (reference), 0.68 (0.35-1.31), 0.79 (0.44-1.44), 0.50 (0.27-0.90) (p for trend = 0.04). Conclusions Green tea consumption is associated with a reduced risk of liver cancer incidence.

Background: In Asia, there has been no population-based epidemiological study using the K6, a 6-item instrument that assesses nonspecific psychological distress. Methods: Using cross-sectional data from 2006, we studied 43 716 (20 168 men and 23 548 women) community-dwelling people aged 40 years or older living in Japan. We examined the association between psychological distress and demographic, medical, lifestyle, and social factors by using the K6, with psychological distress defined as 13 or more points out of a total of 24 points. Results: The following variables were significantly associated with psychological distress among the population: female sex, young and old age, a history of serious disease (hypertension, diabetes mellitus, stroke, myocardial infarction, or cancer), current smoking, former alcohol drinking, low body mass index, shorter daily walking time, lack of social support (4 of 5 components), and lack of participation in community activities (4 of 5 components). Among men aged 40 to 64 years, only \"lack of social support for consultation when in trouble\" and a history of diabetes mellitus remained significant on multivariate analysis. Among men aged 65 years or older, age was not significantly associated with psychological distress, and the significant association with current smoking disappeared on multivariate analysis. Among women aged 40 to 64 years, a history of stroke was not associated with psychological distress. Among women aged 65 years or older, the significant association with current smoking disappeared on multivariate analysis. Conclusions: A number of factors were significantly associated with psychological distress, as assessed by the K6. These factors differed between men and women, and also between middle-aged and elderly people. [PUBLICATION ABSTRACT]