Health issues of risk populations associated with decay of megacities.

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1. A model of the association between health levels and various indicators of urban conditions such as health resources, infrastructures, economy, education, and employment was established. The validity of the model of the model for megatities in foreign countries was shown by using age-adjusted mortality and published databases of urban indicators of Shanghai.2. Present illness, past history, drug resistance, complications, and socioeconomic conditions of homeless tuberculosis patients admitted to a hospital in Tokyo were examined. Analysis showed higher fatality, lower compliance, and difficulty of follow-up in the treatment.3. By the use of geographical information system (GIS), risks of respiratory disorders for the elderly in Tokyo in relation to the living in rented wooden houses were examined. .4. Case studies of child abuse were conducted ; the questionnaire formats for a field survey were developed.5' (1) A health survey for randomly sampled population living in a city of Shizuoka prefecture and a ward of Tokyo was conducted to compare the health issues related to stress, food intake and lifestyle-related disease between local cities and megacities.(2) The influence of job-stress and life events to health-related behaviors and health status in middle-aged men was analyzed.(3) The evaluation of a community-leaders program showed the effectiveness of the program to promotion of health related behaviors and improvement of health literacy.6 (1) Community health needs assessment GIS was developed ; it was applied to a secondary medical area in Tokyo.(2) A method to estimate relative excess deaths as a measurement of regional differences in health levels was developed.(3) A study of the association between national financial adjustment and health levels among prefectures showed that the policy helped to reduce disparity in health levels and resulted in relative decline of Tokyo's health level.