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Hiromi Yonezawa, MS, Kayoko Hirano, PhD, Hatono Yoko, PhD, and Hiroko Okuda, MS. Department of Public Health Nursing, National Institute of Public Health in Japan, 2-3-6 Minami, Wako-shi, Saitama, Japan, +81.(0)48.458.6236, yonezawa@niph.go.jp

Objective: The present study aimed to clarify how programs for the prevention of housebound elderly, which are provided by public health nurses, have been carried out in municipalities in Japan while large-scale mergers of municipalities have been occurring. Methods: A questionnaire survey was mailed to 770 municipalities in Japan. The municipalities selected in the present study included 101 municipalities that had recently undergone mergers, 236 municipalities that were planning to undergo a merger in the near future, and 433 municipalities that had no merger plans. The individuals who responded to the questionnaire were primarily public health nurses. Regarding the degree of health among the surveyed elderly, the frail individuals who feel uneasy going out alone were selected exclusively. Results: Responses were obtained from 428 municipalities (recovery rate: 55.6%). (1) Characteristics of the municipalities: Approximately 90% of the municipalities had a population of less than 100,000. The elderly comprised a mean of 30.4% of the population in municipalities with fewer than 10,000 residents, which was extremely high. (2) Percentage of municipalities with programs for preventing housebound elderly: Of all municipalities, 88.1% provide seminars for preventing bone fracture due to falls, 62.7% provide seminars for functional training of community interactions, and 75.5% provide meetings for activities that encourage active living.In managing the seminars, the public health nurses remained conscious of the daily living activities area of the elderly. (3) In 90% of the municipalities, the independent activities conducted by residents included the prevention of housebound elderly. Many of these activities were provided by local governments. Discussion: The present results indicate that many local governments, regardless of their scale, provide programs for preventing housebound elderly, and similar programs are independently conducted by residents. As further large-scale mergers are scheduled to be conducted in the future, it is necessary to observe whether such programs have been developed for easy access even after the scale of the municipalities has increased.

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