Sex- and Age-Specific Associations of Social Status and Health-Related Behaviors with Health Check Attendance: Findings from the Cross-Sectional Kanazawa Study

Abstract

Health checks are key features of primary and secondary disease prevention. The aim of this study was to examine the sex- and age-specific association of social status and health-related behaviors with health check attendance in eligible persons. Data were derived from the Kanazawa Study 2011 (n = 12,781), a cross-sectional study which investigated all the residents in model areas of Kanazawa City, Ishikawa Prefecture, Japan. We selected participants aged 23 years or older with National Health Insurance (n = 4920). Attendance at health checks was the outcome. We used social status and health-related behaviors as predictor variables. We analyzed them by sex and applied stratified analyses by age groups for each sex. The bivariate analyses were conducted by means of cross-tabs. We calculated health check attendance rates by each variable. We used Pearson’s χ2-test to examine statistically significant differences. We fitted logistic regression models to estimate adjusted odds ratios (ORs) of attendance in the past one year. We computed ORs in a logistic regression model containing all variables described above. Workingmen and women aged 23 to 39 years and aged 40 to 64 years had significantly increased ORs for health check attendance compared with non-working persons. Men, men aged 23 to 39 years and men aged 65 years or older with more physical activity had significantly increased ORs for health check attendance. Male ex-smokers, female ex- and non-smokers, male ex-smokers aged 65 years or older, and female non-smokers aged 40 to 64 years had significantly increased ORs. The findings suggest that population groups with lower social status or increased risks of adverse health effects are less likely to attend health checks than those with higher social status or decreased risks in particular sex and age groups. It indicates that diverse approaches are required to realize the full benefit of health checks.