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To address the importance of family carers' understanding of care, encompassing their own care as well as the broader care and health social systems, this paper leverages the notion of 'care literacy'. The aim of this study is to understand the variation in care literacy and the impact of care literacy on preventive care. The empirical focus is on working family carers for older relatives in Japan, through a cross-sectional online survey that includes a novel operationalization of care literacy, an established measure of health literacy, the assessment of information used to understand care, and measures of preventive care. The participants' (n = 281) mean age was 53, with 44% women, and an average of 8.3 h per week caring for their parent(s). The measure of care literacy is shown to be correlated, as expected, but distinct to health literacy (correlation 0.60). Based on regression analysis of care literacy, significant explanatory variables are health literacy (p < 0.001), gender (p = 0.044), number of sources of information on care (p = 0.029), and care hours (p < 0.001). In contrast, proximity in living arrangements of the carer and care receiver and severity of care needs were not significant predictors. Turning to the impact of care literacy, care literacy is a significant explanatory variable for use of preventive measures (p = 0.002), in particular as related to nutrition (p < 0.001), frailty (p = 0.028), and general home renovations (p = 0.018). The pattern of results from this cross-sectional analysis indicates the importance of understanding the potential for improved care literacy as an enabler of better care. [ABSTRACT FROM AUTHOR]

Simple Summary: Lockdowns and health service disruptions during the COVID-19 pandemic led to concerns about a potential decrease in essential health screenings, even after the pandemic. It is crucial to understand how the pandemic affected women's participation in breast cancer screenings in Japan and whether getting the COVID-19 vaccine influenced their participation rates. We analyzed data from over 6110 women aged 40 to 74 years from a large online survey conducted in 2021 and 2022. Our findings showed that the number of women getting screened for breast cancer did not decrease after the pandemic. Moreover, women who were vaccinated against COVID-19 were more likely to attend their screenings compared to those who were not vaccinated. This result aligns with the observation that vaccinated individuals tend to be more proactive about their health. There is limited information on whether the COVID-19 pandemic was associated with decreased breast cancer screening uptake and if COVID-19 vaccination was associated with an increase in screening uptake. Our study explored the uptake of breast cancer screening in Japan after the COVID-19 pandemic and assessed its association with the COVID-19 vaccination. We analyzed data from the Japan COVID-19 and Society Internet Survey (JACSIS), a web-based prospective cohort survey, and we included 6110 women without cancer history who were aged 40 to 74 years that participated in the 2012 and 2022 surveys. We examined the regular breast cancer screening uptake before and after the pandemic and employed a multivariable Poisson regression model to seek any association between COVID-19 vaccination and screening uptake. Of 6110, 38.2% regularly participated in screening before the pandemic and 46.9% did so after the pandemic. Individuals unvaccinated due to health reasons (incidence rate ratio (IRR) = 0.47, 95% CI: 0.29–0.77, p = 0.003) and for other reasons (IRR = 0.73, 95% CI: 0.62–0.86, p < 0.001) were less likely to undergo screening compared to fully vaccinated individuals. There was no long-term decrease in breast cancer screening uptake after the pandemic in Japan. Vaccination was linked to increased uptake, but there was no dose relationship. [ABSTRACT FROM AUTHOR]

In Japan, suicides had consistently decreased before the COVID-19 pandemic (from 2009–2019), but conversely increased after the pandemic outbreak (from 2020–2022). To identify the features of fluctuations of suicides in Japan, the standardized suicide mortality rates per 100,000 population (SMRP) disaggregated by gender (males/females) and age (10-year cohorts) from 2009–2022 were analyzed using interrupted time-series and joinpoint regression analyses. Temporal causalities from unemployment rate (CUR) disaggregated by unemployment duration and reasons for seeking work to SMRP were analyzed using vector autoregressive modelling with Granger causality analysis. SMRP fluctuations from 2009–2022 were composed of three patterns, such as positive discontinuity (increasing) synchronized with the pandemic outbreak, attenuations of decreasing trends before the pandemic, turning from decreasing before the pandemic to increasing/unchanging after the pandemic outbreak. Dismissal CUR positively related to SMRP of working-age generations, whereas voluntary CUR negatively related to SMRP of younger population (<30 years), which turned to persistently increasing before the pandemic (approximately 2016–2017). CUR shorter than 3 months positively related to SMRP of working-age females, which displayed promptly increasing synchronization with the pandemic outbreak. CUR longer than 12 months positively related to SMRP of working-age males, which contributed to persistently increasing SMRPs during the pandemic. These results suggest that increasing SMRP during 2020–2022 in Japan has been probably at-tributed to interactions among the pandemic-related factors, continuous vulnerabilities from before the pandemic and newly developing risk factors for suicides during the pandemic. Unexpectedly, increasing SMRPs of working-age males in 2022 suggest that either prolongation of the pandemic or the ending of the pandemic might positively affect suicides in Japan. [ABSTRACT FROM AUTHOR]

Preterm birth rate depending on parental educational level in recent years has not been surveyed in Japan. In this study, we showed the trend in preterm birth rate depending on parental educational level from 2000 to 2020 by linking data from the Census regarding individuals' educational level and parents in birth data of the vital statistics. Four types of parental educational level, namely junior high school, high school, technical school or junior college, and university or graduate school, were compared. Slope and relative indexes of inequality for preterm birth by educational level were computed by binomial models. Data on 3,148,711 births and 381,129,294 people were used in the analysis, and data on 782,536 singleton births were used after data linkage. The preterm birth rate (%) for junior high school graduate mothers and fathers was 5.09 and 5.20 in 2020, respectively. Contrarily, the preterm birth rate (%) for parents who graduated from a university or graduate school was 4.24 for mothers and 4.39 for fathers, and the rate tended to increase as educational level decreased, irrespective of parental gender. Results of inequality indexes showed that a statistically significant inequality by parental educational level persisted from 2000 to 2020. [ABSTRACT FROM AUTHOR]

To the best of our knowledge, changes in mothers' dietary behaviors or perceptions of dietary intake during the COVID-19 pandemic have not been extensively discussed. Therefore, the present study aimed to clarify how the dietary behaviors of mothers living with their children changed during the pandemic in Japan. Ordered probit and interval regressions were applied to individual data for mothers living with children under 18 years of age from five independently conducted Surveys of Attitudes toward Food and Nutrition Education (Shokuiku in Japanese). The estimation results showed that although mothers were more likely to eat dinner with their families during the pandemic, attention to healthy dietary practices, frequency of eating nutritionally balanced food, and dietary practices for preventing lifestyle-related diseases were negatively affected by the pandemic. In conclusion, mothers were more likely to decrease their commitment to a healthy and well-balanced diet during the pandemic than before it. Further research based on the latest datasets with detailed information over the long-term is required. [ABSTRACT FROM AUTHOR]