Factors associated with access to health care among foreign residents living in Aichi Prefecture, Japan: secondary data analysis

Abstract

Background In Japan, foreign residents, and particularly new arrivals in the country, experience barriers to health care and show poorer health outcomes when compared to Japanese nationals. The health-care-related situation for foreign residents in Japan has been characterized by drastic changes over time; thus, there is difficulty identifying individuals who are “left behind” by the system. In this study, we aimed to identify, among foreign residents who attended informal free medical consultations, factors associated with “being advised to visit a medical facility” and “being referred to a medical facility,” which represented hypothetical proxy indicators of barriers to health care. Methods Secondary data analyses were conducted using the activity records of a non-governmental organization that provides free consultations targeting foreign residents in various locations in Aichi Prefecture, Japan. Participant characteristics, including insurance coverage, were determined. Bivariate and multi-variate analyses were performed to identify factors associated with having barriers to health care. Results Among 608 extracted cases, 164 (27.5%) cases were advised to visit a medical facility, and 72 (11.8%) were referred to a medical facility during the consultations. Those who were not covered by public insurance showed a 1.56-time (95% confidence interval [CI]: 1.19–2.05) higher prevalence of being advised to visit a medical facility when compared to those who were covered by public insurance. Unemployed people and students were more likely to be referred to a medical facility than were professional workers; the prevalence ratios were 3.28 (95% CI: 1.64–6.57) and 2.77 (95% CI: 1.18–6.46), respectively. Conclusions Although the majority were insured, almost 30% were advised to visit a medical facility, which implied that they had had limited access to the formal health-care system before availing of the free consultations. The findings highlight those uninsured, unemployed people and students, who are considered vulnerable to access to health care. It is vital to provide those who are vulnerable with the necessary support while updatinge evidence, so that no one is “left behind.”

Symptoms of depression and anxiety among Vietnamese immigrants in Japan during the COVID-19 pandemic: a cross-sectional web-based study

“…Among the most important health issues in Japan is the health disparity among immigrants living in Japan given the lack of access to medical services (Yasukawa et al, 2019). Another report on immigrants in Japan who participated in free medical checkups conducted by a Non-Governmental Organization revealed that many were not connected to medical services (Higuchi et al, 2021). Fear of COVID-19 has also generally reduced the number of people receiving medical services in Japan (Makiyama et al, 2021).…”

“…[35] Another report on immigrants in Japan who participated in free medical check-ups conducted by a Non-Governmental Organization revealed that many were not connected to medical services. [36] Fear of COVID-19 has also generally reduced the number of people receiving medical services in Japan. [37] The COVID-19 pandemic further restricted access to medical services among immigrants in Japan, including Vietnamese residents, which might contribute to increases in their anxiety.…”

Pre- and post-COVID-19 all-cause mortality of Japanese citizens versus foreign residents living in Japan, 2015–2021

“…Furthermore, immigrants may suffer from various socioeconomic disparities that predispose them to poorer health outcomes, such as low economic status, unstable employment, poor housing, and food insecurity ( Caron & Adegboye, 2021 ; Doan et al, 2021 ; Kita et al, 2015 ). Unemployed and student foreign residents have been identified as high-risk groups with respect to health care access ( Higuchi et al, 2021 ), as are those who have been residing in Japan for shorter periods of time ( Shakya et al, 2018 ). However, there is some evidence to suggest that there are no significant differences in mortality or length of stay between Japanese citizens and foreign residents at tertiary care centers in Japan, though the research is limited in scope ( Ishii et al, 2020 ).…”

Exploring the Needs of Female Afghan Migrants Living in Japan

“…In Japan, though limited research has been conducted towards wellbeing of migrants, some studies show their limited access to health care (Bhandari et al, 2021;Higuchi et al, 2021;Shakya et al, 2018). Furthermore, migrants tend to experience discrimination on the Japanese job-and housing market, and several issues have been observed when it comes to education for migrant children (Asis & Carandang, 2020;Joshi & Tabata, 2021;Korekawa, 2021).…”

“…In addition to the exclusion from the health care system associated with residency statuses, mental barrier created by language barrier may also create systemic barrier that results in limited access to health services. However, multiple previous researches show that language barriers are often at the core of difficulties experienced by migrants (Higuchi et al, 2021;Lee, 2020;Shakya et al, 2018). While Chiba prefecture provides information related to healthcare, education, labour, and housing in several languages such as English, Chinese, Korean, Spanish, Portuguese, Tagalog, and Vietnamese, no information is available in Dari, which is the language used by Afghan migrants living in the prefecture (Ogawa, 2021).…”