Social capital and pneumococcal vaccination (PPSV23) in community-dwelling older Japanese: a JAGES multilevel cross-sectional study

ObjectiveInequalities exist between the 23-valent pneumococcal polysaccharide vaccination (PPSV23) rate in each municipality among Japanese older adults. Exploring individual-level and community-level intervenable factors is necessary to improve the vaccination rates. We examined the associations be...

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Bibliographic Details
Published in:BMJ open 2021-06, Vol.11 (6), p.e043723-e043723
Main Authors: Iwai-Saito, Kousuke, Shobugawa, Yugo, Kondo, Katsunori
Format: Article
Language:English
Subjects:
Adults
Cross-sectional studies
Epidemiology
geriatric medicine
health policy
Immunization
infection control
Long term health care
Middle schools
Older people
Participation
Pneumonia
preventive medicine
Public health
Questionnaires
Secondary schools
Social capital
Streptococcus infections
Subsidies
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Summary:ObjectiveInequalities exist between the 23-valent pneumococcal polysaccharide vaccination (PPSV23) rate in each municipality among Japanese older adults. Exploring individual-level and community-level intervenable factors is necessary to improve the vaccination rates. We examined the associations between community-level and individual-level social capital and the PPSV23 vaccination among older Japanese adults using multilevel Poisson regression analyses.DesignCross-sectional study.SettingWe used data from the Japan Gerontological Evaluation Study, conducted between 3 October 2016 and 10 January 2017 in 631 districts, 39 municipalities and 18 prefectures.ParticipantsThe target population comprised persons aged 65 years or older who are physically and cognitively independent (that is, not certified as needing long-term care). Further, 180 021 older adults from 39 Japanese municipalities were enrolled.Primary outcome measureThe primary outcome was the PPSV23 vaccination among the Japanese older adults aged 65 years or older who did not have physical or cognitive disabilities.ResultsAfter adjusting for municipality-, community-, individual-levels effects with multiple imputation, 137 075 individuals who participated in one/more of the civic participation (participation of social groups), social cohesion (social tie), or reciprocity (mutual exchange of social support) were significantly associated with more vaccinations than those without the three social capitals among the 137 075 older adults (13.0% (95% CI 11.0% to 14.9%), 5.0% (95% CI 2.4% to 7.6%) or 33.9% (95% CI23.6% to 44.2%) increase, respectively, p>0.001 for all). The rich (≥+1 SD) community-level civic participation was significantly associated with 3.4% increase [95% CI 0.02% to 6.78%, p
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2020-043723