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Special Issue "Behavioural Change and Socioeconomic Disparity in Health during and after the COVID-19 Pandemic"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: 30 November 2023 | Viewed by 27578

Special Issue Editors

Dr. Takahiro Tabuchi
E-Mail Website
Guest Editor
Osaka International Cancer Institute, Osaka 541-8567, Japan
Interests: health inequality; social determinants of health; tobacco control; health service research and public health
Prof. Dr. Naoki Kondo
E-Mail Website
Guest Editor
Kyoto University Graduate School of Medicine, Kyoto 606-8501, Japan
Interests: social epidemiology; social determinants of health and aging
Dr. Kota Katanoda
E-Mail Website
Guest Editor
National Cancer Center, Division of Cancer Statistics Integration, Tokyo 104-0045, Japan
Interests: cancer epidemiology; cancer statistics; tobacco control; simulation modellling

Special Issue Information

Dear Colleagues,

Behavioural changes and socioeconomic disparity in health are a major public health issues, both during and after the COVID-19 pandemic. The COVID-19 problem will influence various aspect of human life and population health, not only through infectious disease matters, but also socioeconomic and other matters. As a result, various types of behavioural changes and socioeconomic disparity in health can be observed. For example, because smoking has been determined as a risk factor for COVID-19, smokers may intend to quit smoking during and after the COVID-19 pandemic in order to protect their life and health.

This Special Issue of International Journal of Environmental Research and Public Health (IJERPH) focuses on the current state of knowledge on behaviour change and socioeconomic disparity in health. New research papers, reviews, case reports, and conference papers are welcome to this Issue. Papers dealing with new approaches to observe behavioural changes or socioeconomic disparity in health are also welcome. Other manuscript types include methodological papers, position papers, brief reports, and commentaries.

Dr. Takahiro Tabuchi
Prof. Dr. Naoki Kondo
Dr. Kota Katanoda
Guest Editors

Keywords

  • Behavior change
  • Socioeconomic disparity in health
  • Health behavior
  • COVID-19 pandemic
  • Physical health
  • Mental health

Published Papers (12 papers)

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Research

Article
Association between Poverty and Refraining from Seeking Medical Care during the COVID-19 Pandemic in Japan: A Prospective Cohort Study
Int. J. Environ. Res. Public Health 2023, 20(3), 2682; https://doi.org/10.3390/ijerph20032682 - 02 Feb 2023
Viewed by 291
Abstract
This limited study examined how low household income affected avoidant behaviors to seek medical care during the pandemic. We investigated an association between household income below the relative poverty line and refraining from seeking medical care (RSMC) in a longitudinal study during the [...] Read more.
This limited study examined how low household income affected avoidant behaviors to seek medical care during the pandemic. We investigated an association between household income below the relative poverty line and refraining from seeking medical care (RSMC) in a longitudinal study during the COVID-19 pandemic. We conducted an analysis of a population-based internet cohort in Japan. Individuals aged 20 to 79 years old living in Japan participated in the internet surveys between 2020 and 2021. The primary outcome was the RSMC of regular visits and new symptoms in 2021. A total of 19,672 individuals were included in the analysis. Household income below the relative poverty line in 2020 was significantly associated with refraining from seeking regular medical visits for men and women (for men, odds ratio: 1.28; confidence interval: 1.19, 1.83; for women, odds ratio: 1.42; confidence interval: 1.14, 1.82) in 2021, after accounting for RSMC in 2020. Relative poverty in 2020 was also associated with the RSMC of new symptoms among men (for males, odds ratio: 1.32; confidence interval: 1.05, 1.66) in 2021 after adjusting for covariates. The study suggested the need to alleviate the financial burden of vulnerable people seeking medical care and advocate for making necessary medical visits, even in a pandemic. Full article
Article
Gender Difference in Fear and Anxiety about and Perceived Susceptibility to COVID-19 in the Third Wave of Pandemic among the Japanese General Population: A Nationwide Web-Based Cross-Sectional Survey
Int. J. Environ. Res. Public Health 2022, 19(23), 16239; https://doi.org/10.3390/ijerph192316239 - 04 Dec 2022
Cited by 1 | Viewed by 806
Abstract
Existing research suggested gender differences in fear and anxiety about and perceived susceptibility to COVID-19 and previous infectious disease pandemics. We analyzed whether women felt fear and anxiety about and perceived susceptibility to COVID-19 more frequently than men in Japan. We conducted a [...] Read more.
Existing research suggested gender differences in fear and anxiety about and perceived susceptibility to COVID-19 and previous infectious disease pandemics. We analyzed whether women felt fear and anxiety about and perceived susceptibility to COVID-19 more frequently than men in Japan. We conducted a cross-sectional analysis using internet survey data collected during the third wave of the pandemic in Japan. The subjects were enrolled from the Japanese general population: 11,957 men and 11,559 women. Fear and anxiety specifically related to COVID-19 were evaluated with the Japanese version of the Fear of COVID-19 Scale (FoCS). The question “How likely do you think you will be infected with COVID-19?” was used to assess the perceived susceptibility to COVID-19. Women had higher mean (standard deviation) FoCS scores [18.6 (5.6) vs. 17.5 (5.9), d = 0.190] and reported the median or higher FoCS score (57.4% vs. 51.4%, φ = 0.060) and perceived susceptibility (13.6% vs. 11.5%, φ = 0.032) more frequently than men. The odds ratios (95% confidence intervals) adjusted for age, having a spouse, comorbidities, watching commercial TV stations’ news programs, employment status, and household income were 1.24 (1.17–1.32) and 1.27 (1.16–1.38), respectively. We observed that women were more anxious and fearful about and perceived the susceptibility to infectious diseases more frequently than men even one year after the pandemic occurred in Japan, although the effect size was small. Full article
Article
Lifestyles during the First Wave of COVID-19: A Cross-Sectional Study of 16,811 Adults from Spanish-Speaking Countries in South America
Int. J. Environ. Res. Public Health 2022, 19(22), 15318; https://doi.org/10.3390/ijerph192215318 - 19 Nov 2022
Viewed by 1219
Abstract
The aim of this research was to analyze the lifestyles of adults from Spanish-speaking countries in South America during the COVID-19 pandemic using a cross-sectional, analytical, and multicenter study. The target population was composed of people aged 18 and older who resided in [...] Read more.
The aim of this research was to analyze the lifestyles of adults from Spanish-speaking countries in South America during the COVID-19 pandemic using a cross-sectional, analytical, and multicenter study. The target population was composed of people aged 18 and older who resided in South America during the pandemic; the final sample comprised 16,811 participants who were predominantly female, with ages ranging from 18 to 79 years. The results showed that approximately six out of ten respondents did not engage in any physical activity; only one in four respondents indicated that their diet was sufficient and balanced; and most washed their hands frequently and showered every day. Regarding the type of isolation, half reported that it was voluntary and the rest mandatory or restricted. Regarding mobility, six out of ten surveyed leave their residence on a weekly basis. Regarding the use of personal protective equipment, the majority used masks and a smaller proportion used gloves. In conclusion, the majority of respondents did not perform any physical activity; moreover, one in four reported having a sufficient balanced diet. We therefore recommend an improvement of public policies to promote better lifestyles in South America, in particular the reorientation of the health system to prevent similar situations. Full article
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Article
Association between Heated Tobacco Product Use during Pregnancy and Fetal Growth in Japan: A Nationwide Web-Based Survey
Int. J. Environ. Res. Public Health 2022, 19(18), 11826; https://doi.org/10.3390/ijerph191811826 - 19 Sep 2022
Cited by 1 | Viewed by 1471
Abstract
Combustible cigarette smoking impacts fetal growth during pregnancy. However, the risk associated with heated tobacco products (HTPs) remains unclear. This nationwide cross-sectional study investigated whether HTP use during pregnancy is associated with small for gestational age (SGA) outcomes among 5647 post-delivery women with [...] Read more.
Combustible cigarette smoking impacts fetal growth during pregnancy. However, the risk associated with heated tobacco products (HTPs) remains unclear. This nationwide cross-sectional study investigated whether HTP use during pregnancy is associated with small for gestational age (SGA) outcomes among 5647 post-delivery women with singleton pregnancies, which were divided into four groups: lifetime never-smokers, former smokers before pregnancy, and current smokers for each of the tobacco products during pregnancy (sole HTP and sole combustion smokers). Information on the prevalence of SGA, defined as birth weight and height below the 10th percentile, was retrieved from the Maternal and Child Health Handbooks of post-delivery women. Using logistic regression, the association between sole HTP smokers during pregnancy and SGA, adjusted for covariates, with lifetime never-smokers as reference, was investigated. The prevalence was: current sole HTP smokers during pregnancy, 1.8% (102/5647); and SGA, 2.9% (164/5647). Sole HTP smokers during pregnancy had a higher prevalence of SGA (5.9% [6/102] vs. 2.7% [111/4144]) with an adjusted odds ratio (OR) of 2.50 (95% confidence interval [CI], 1.03–6.05) than lifetime never-smokers. Among sole combustion smokers, the adjusted OR for SGA was 1.95 (95% CI, 0.81–4.67). In Japan, HTP smoking during pregnancy may be associated with an increased risk for SGA. Full article
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Article
Living Well as a Muslim through the Pandemic Era—A Qualitative Study in Japan
Int. J. Environ. Res. Public Health 2022, 19(10), 6020; https://doi.org/10.3390/ijerph19106020 - 15 May 2022
Viewed by 1345
Abstract
This study explored the living situations, financial conditions, religious obligations, and social distancing of Muslims during the COVID-19 pandemic. In total, 28 Muslim community members living in the Kanto region were recruited; 18 of them were included in in-depth qualitative interviews and 10 [...] Read more.
This study explored the living situations, financial conditions, religious obligations, and social distancing of Muslims during the COVID-19 pandemic. In total, 28 Muslim community members living in the Kanto region were recruited; 18 of them were included in in-depth qualitative interviews and 10 in two focus group interviews. The snowball method was used, and the questionnaires were divided into four themes. The audio/video interviews were conducted via Zoom, and NAVIO was used to analyse the data thematically. The major Muslim events were cancelled, and the recommended physical distancing was maintained even during the prayers at home and in the mosques. The Japanese government’s financial support to each person was a beneficial step towards social protection, which was highlighted and praised by every single participant. Regardless of religious obligations, the closing of all major mosques in Tokyo demonstrates to the Japanese community how Muslims are serious about adhering to the public health guidelines during the pandemic. This study highlights that the pandemic has affected the religious patterns and behaviour of Muslims from inclusive to exclusive in a community, and recounts the significance of religious commitments. Full article
Article
Did Children in Single-Parent Households Have a Higher Probability of Emotional Instability during the COVID-19 Pandemic? A Nationwide Cross-Sectional Study in Japan
Int. J. Environ. Res. Public Health 2022, 19(7), 4239; https://doi.org/10.3390/ijerph19074239 - 01 Apr 2022
Viewed by 2170
Abstract
The influence of public health measures against COVID-19 in Japan on child mental health by household type is unknown. This study aimed to investigate whether COVID-19 and the declaration of a state of emergency in Japan affected children’s mental health between single-parent and [...] Read more.
The influence of public health measures against COVID-19 in Japan on child mental health by household type is unknown. This study aimed to investigate whether COVID-19 and the declaration of a state of emergency in Japan affected children’s mental health between single-parent and two-parent households disproportionately. A large cross-sectional online survey was conducted from August to September 2020. The study included 3365 parents with children aged 0–14 years old who reported their children’s mental status during the declared state of emergency. Emotional instability was reported dichotomously by parents. As the primary result, the probability of emotional instability was higher in single-parent households compared with that in two-parent households after adjustments for potential covariates; the adjusted prevalence ratio (95% CI) was 1.26 (1.07–1.49). Our findings suggest a disproportionate impact on children’s mental health due to the pandemic. Full article
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Article
Increased Work from Home and Low Back Pain among Japanese Desk Workers during the Coronavirus Disease 2019 Pandemic: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2021, 18(23), 12363; https://doi.org/10.3390/ijerph182312363 - 24 Nov 2021
Cited by 4 | Viewed by 3701
Abstract
To prevent the spread of coronavirus disease 2019 (COVID-19), desk workers in Japan have been encouraged to work from home. Due to rapidly increased working from home, working in environments that are not properly designed and working with poor posture can affect low [...] Read more.
To prevent the spread of coronavirus disease 2019 (COVID-19), desk workers in Japan have been encouraged to work from home. Due to rapidly increased working from home, working in environments that are not properly designed and working with poor posture can affect low back pain (LBP). This study aimed to examine the relationship between increased work from home during the COVID-19 pandemic and LBP among Japanese desk workers. Using study data from the Japan COVID-19 and Society Internet Survey 2020 conducted from August to September 2020, 4227 desk workers who did not have LBP before the COVID-19 pandemic were analyzed out of 25,482 total respondents. Odds ratios (ORs) and 95% confidence intervals (CIs) for LBP were calculated by multivariable logistic regression, adjusting for covariates such as socioeconomic factors. During the COVID-19 pandemic, 31.3% of desk workers with an increased chance of working from home, and 4.1% had LBP. Desk workers with increased working from home were more likely to have LBP (OR: 2.00 (95% CI, 1.36–2.93)). In this large-scale study, increased work from home was associated with LBP among desk workers during the COVID-19 pandemic. Therefore, preparing an appropriate work environment for desk workers working from home can improve productivity, leading to positive effects. Full article
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Article
Social Capital and COVID-19 Deaths: An Ecological Analysis in Japan
Int. J. Environ. Res. Public Health 2021, 18(20), 10982; https://doi.org/10.3390/ijerph182010982 - 19 Oct 2021
Cited by 4 | Viewed by 2712
Abstract
Social contextual factors could determine mortality by the coronavirus disease 2019 (COVID-19), with social capital as a potential determinant. This study aimed to examine the association between prefecture-level social capital and COVID-19 deaths in Japan. Data on the cumulative number of COVID-19 deaths [...] Read more.
Social contextual factors could determine mortality by the coronavirus disease 2019 (COVID-19), with social capital as a potential determinant. This study aimed to examine the association between prefecture-level social capital and COVID-19 deaths in Japan. Data on the cumulative number of COVID-19 deaths per 100,000 individuals between 1 October 2020 and 30 June 2021 in 47 prefectures were obtained from the government open-access database. Prefecture-level social capital was collected from a large-scale web-based nationwide survey conducted between August and September 2020. We included trust in neighbors, norm of reciprocity in the neighborhood, and trust in the national government as cognitive social capital, and neighborhood ties and social participation as structural social capital. The cumulative COVID-19 deaths per 100,000 individuals (1 October 2020 to 30 June 2021) ranged from 0.15 to 27.98 in 47 prefectures. A multiple regression analysis after adjusting for covariates showed that a greater norm of reciprocity and government trust were associated with fewer COVID-19 deaths during the first and second 3-month periods of observation. In the third 3-month period, the association between COVID-19 deaths and government trust became nonsignificant. Trust in neighbors, neighborhood ties, and social participation were not related to COVID-19 deaths during any time period. The disparity of COVID-19 deaths by prefecture in Japan can be explained by cognitive social capital. This study suggests that the association between social capital and COVID-19 deaths may vary according to the dimension of social capital and time period. Full article
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Article
Factors Associated with the Work Engagement of Employees Working from Home during the COVID-19 Pandemic in Japan
Int. J. Environ. Res. Public Health 2021, 18(19), 10495; https://doi.org/10.3390/ijerph181910495 - 06 Oct 2021
Cited by 9 | Viewed by 3407
Abstract
This study aimed to identify factors influencing the work engagement of employees working from home during the COVID-19 pandemic in Japan. Employees’ work engagement was examined using the following survey questions: “Do you feel energized when you are at work? (yes or no)” [...] Read more.
This study aimed to identify factors influencing the work engagement of employees working from home during the COVID-19 pandemic in Japan. Employees’ work engagement was examined using the following survey questions: “Do you feel energized when you are at work? (yes or no)” and “Do you take pride in your work? (yes or no)” After adjusting for potential confounders, Poisson regression was used to examine prevalence ratio and 95% confidence intervals for employees’ work engagement. We analyzed 15,670 individuals (11,894 of whom did not work from home and 3776 of whom worked from home). Their mean age was 45.6 ± 13.8 years, and 58.3% were men. Those who worked from home were younger than those who did not (43.9 ± 13.1 vs. 46.1 ± 13.9, p < 0.001). About 44% of all employees reported high work engagement. Among the employees who worked from home, an increase in sleep hours, effective interactions with supervisors, and working hours of ≤40 h/week were associated with engagement. Sensitivity analysis showed similar results. Close communication with superiors, refraining from working long hours, and obtaining adequate sleep may boost the work engagement of employees working from home. Full article
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Article
How Important Is Behavioral Change during the Early Stages of the COVID-19 Pandemic? A Mathematical Modeling Study
Int. J. Environ. Res. Public Health 2021, 18(18), 9855; https://doi.org/10.3390/ijerph18189855 - 18 Sep 2021
Cited by 4 | Viewed by 1699
Abstract
How important is the speed and intensity of behavioral change due to government policies, such as enhanced social distancing or lockdown, when an emerging infectious disease occurs? In this study, we introduce a deterministic SEIR model considering the behavior-changed susceptible group to investigate [...] Read more.
How important is the speed and intensity of behavioral change due to government policies, such as enhanced social distancing or lockdown, when an emerging infectious disease occurs? In this study, we introduce a deterministic SEIR model considering the behavior-changed susceptible group to investigate the effect of the speed and intensity of behavioral change on the transmission dynamics of COVID-19. We used epidemiological data from South Korea and Italy for the simulation study, because South Korea and Italy were the first countries to report an outbreak of COVID-19 after China and the prevention and response policy of each government were similar during the first outbreak of COVID-19. Simulation results showed that it took approximately twenty fewer days in Korea than in Italy until 90% of susceptible individuals changed their behavior during the first outbreak. It was observed that the behavior-changed susceptible individuals reduced the COVID-19 transmission rate by up to 93% in Korea and 77% in Italy. Furthermore, if the intensity and speed of behavioral change in Italy were the same as in Korea, the expected number of cumulative confirmed cases would have been reduced by approximately 95%, from 210,700 to 10,700, until the end of the lockdown period. We assumed that behavioral change is influenced by the number of confirmed cases and does not take into account social and cultural differences, as well as the state of the healthcare system, between the two countries. Our mathematical modeling showed how important the high intensity and fast speed of behavioral change to reduce the number of confirmed cases in the early period of an epidemic are. Full article
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Article
Association of Visual Display Terminal Usage with Self-Rated Health and Psychological Distress among Japanese Office Workers during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(17), 9406; https://doi.org/10.3390/ijerph18179406 - 06 Sep 2021
Cited by 1 | Viewed by 2322
Abstract
The aim of this study was to examine the association of the duration of visual display terminal (VDT) usage for work and non-work activities with self-rated health (SRH) and psychological distress among office workers during the COVID-19 pandemic in Japan. A cross-sectional data [...] Read more.
The aim of this study was to examine the association of the duration of visual display terminal (VDT) usage for work and non-work activities with self-rated health (SRH) and psychological distress among office workers during the COVID-19 pandemic in Japan. A cross-sectional data of 7088 office workers from a web-based, self-administered survey conducted from 25 August 2020, to 30 September 2020, was used. Multiple logistic regression analysis was applied. Compared to those who used a VDT for 4–9 h for work, office workers who used a VDT for ≥10 h for work had poor SRH (odds ratio (OR): 1.65; 95% confidence interval (CI): 1.13, 2.41) and severe psychological distress (OR: 2.23; 95% CI: 1.52, 3.28). VDT usage for less than 1 h (OR: 1.37, 95% CI: 1.12, 1.67) and 1–3 h (OR: 1.42, 95% CI: 1.12, 1.80) for work were also associated with severe psychological distress. Stratification analysis by age showed a significant association of VDT usage for work with poor SRH among 30–64-year-olds, while a U-shape association was found between VDT usage for work and psychological distress with the younger age group (15–29 years old). During the COVID-19 pandemic in Japan, the prolonged usage of VDT for work can deteriorate both general and psychological health, while moderate usage of VDT for work can reduce psychological distress. Full article
Article
Increase in Social Isolation during the COVID-19 Pandemic and Its Association with Mental Health: Findings from the JACSIS 2020 Study
Int. J. Environ. Res. Public Health 2021, 18(16), 8238; https://doi.org/10.3390/ijerph18168238 - 04 Aug 2021
Cited by 24 | Viewed by 4853
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is assumed to have caused an increase in the number of socially isolated people. However, the prevalence of social isolation during the pandemic has not been well studied, particularly among Asian populations. This study investigated changes in [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic is assumed to have caused an increase in the number of socially isolated people. However, the prevalence of social isolation during the pandemic has not been well studied, particularly among Asian populations. This study investigated changes in the prevalence of social isolation caused by the COVID-19 pandemic and examined its association with mental health among the general Japanese population. Data were obtained from a large-scale, web-based nationwide survey conducted from August to September 2020 (n = 28,000; aged 15–79 years). Social isolation was defined as less frequent contact with people other than co-residing family members. We assessed the participants’ frequency of contact in January (before the pandemic) and August 2020 (during the pandemic). Mental health outcomes included psychological distress, suicidal ideation, loneliness, and fear of COVID-19. We analyzed the data of 25,482 respondents. The weighted prevalence (95% confidence interval) of social isolation was 21.2% (20.7–21.7%) and 27.9% (27.3–28.4%) before and during the pandemic, respectively. The prevalence of social isolation increased by 6.7 (6.3–7.0) percentage points during the pandemic. Older people and men had the greatest increase in the prevalence of social isolation. People who became socially isolated during the pandemic had greater loneliness and fear of COVID-19 than those who were consistently not socially isolated since before the pandemic. This study suggested that social isolation had increased during the COVID-19 pandemic in Japan. Our findings highlight the importance of developing immediate measures against social isolation to maintain good mental health. Full article
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