[An introduction of the concept of social capital into health promotion activities].

Social factors, such as networks, institutions, trust, and social norms, are currently known as "Social Capital", the concept of which seeks to provide a basis for visualization and measurement of phenomena stemming from such factors. As a considerable amount of research has demonstrated that collective actions may be established with a greater degree of ease in communities with well-accumulated social factors, we can promote collective actions of Health Promotion activities through the concept of Social Capital and thereby establish more effective intervention. It is to be expected that theoretical research and operational experience using Social Capital may contribute to enhancing the effectiveness of Health Promotion activities, improving various health determinants through collective action.

[Changes in community health and welfare services with introduction of the long-term care insurance system in Japan].

OBJECTIVE: In Japan, a long-term care insurance system for elderly people was introduced in April, 2000. We have conducted a survey using a questionnaire in order to explore consequent changes in community health and welfare services. METHODS: We sent questionnaires to all municipal governments (671 cities, 1,991 towns, 567 villages and 23 wards) in Japan in November, 2001, and obtained replies from 441 cities (response rate: 65.7%), 800 towns (40.2%), 197 villages (34.9%), and 16 wards (69.6%). The questionnaire included questions concerning the budget and manpower for community health and welfare services, the state of the long term care insurance system, and the activities of public health nurses. RESULTS: A total of 57% of all municipal governments was found to be carrying out the long term care insurance program in collaboration with other governments. In order to clarify the changes in welfare services for elderly people from the budgetary viewpoint, we calculated the ratios of the 2000 and 2001 fiscal budgets applied for welfare services for elderly people, in comparison with the 1999 fiscal year. The budgets for elderly people declined to about 40% in 2000 and 2001 compared with 1999, since the budget for care services was transferred to the account of the long term care insurance system. The activities of public health nurses employed by municipal governments were not affected by the introduction of long term care insurance system. About 80% of all municipal governments suggested that both the amounts of care services received by each elderly people and the number of elderly people who received care services were increasing, and about 70% indicated that the quality of care services was improved with introduction of the long term care insurance system. DISCUSSION: Most municipal governments consider that introduction of the long term care insurance system has had a good influence on community health and welfare services. Moreover, our results suggest that the long term care insurance has a beneficial impact on care services themselves.

[Utility of the public health approach for the world population strategy].

OBJECTIVE: The populations of developing countries have so dramatically increased over the past two centuries that it has tended to undermine sustained economic growth and development. The population growth rate in the Philippines, in particular, remains at 2.0%, one of the highest in the other southeastern Asian countries. This has exacerbated problems of economic disparity and deterioration in development so that the Philippine Government has declared it a political priority to address the population problem and for this purpose has asked the Japan International Cooperation Agency (JICA) for assistance. METHOD: Based on past experience with the world population issue, the International Conference on Population and Development in Cairo (ICPD) declared that the population strategy should be merged into socio-economic development strategies that aim to achieve basic human needs, such as, education, public health and gender equality. JICA assistance to improve maternal and child health status and promote community health initiatives in the Philippines is based on this new paradigm; the ICPD plan. OUTPUT AND CONCLUSION: JICA has supported a diverse range of public health activities, such as the establishment of a comprehensive maternal and child health care system, advocacy of reproductive health, performance of adolescence health education and assistance for participatory community action. The efforts were generally geared towards sustainable implementation of health activities in the community. The JICA project employed the public health approach that gained a global consensus at Cairo to challenge the problem of a continuously high rate of population growth.