ABSTRACT
Since 2004 we have been conducting a regional epidemiological study on a remote Japanese island to clarify associations between genetic polymorphisms and lifestyle-related diseases. To facilitate this study, we established a research base with resident researchers in this study field, cooperated with the local government, and tried to build a relationship of mutual trust with the inhabitants. In this report, we describe the logistics of building a regional epidemiological study field, providing statistical analysis in the text. Furthermore, as the study advanced, researchers in other departments requested collaboration and wrote papers using our data and samples. Our results suggested that remote places such as islands are appropriate for regional epidemiological research because the area
is limited and residents move infrequently. Furthermore, useful sample sizes and clear data in such studies will positively affect young doctors and researchers, who may advance their research careers in remote places. This might also contribute to better community medicine in remote places and islands. 3.1 IntroductionTo smoothly and attentively promote a regional epidemiological study, cooperation between research institutions, such as universities, and communities is important, and it is desirable to establish a research base with resident research staff in the community. The Nagasaki University Graduate School of Biomedical Sciences opened the Department of Island and Community Medicine in May 2004 and simultaneously established the Island Medical Research Institute as an activity base of the department in an isolated island (Goto City) in the Nagasaki prefecture. This department was founded in Nagasaki University by donation from the local government, aiming to improve remote island medical care in the Nagasaki prefecture comprised of many islands, including the largest number of inhabited islands in Japan. The objectives of the department are community health care education, studies on regional epidemiology, sharing of community health care information, and medical care support for islands and remote rural areas. The staff of our group has been stationed in the institute since the opening, in 2004, and started and promoted regional epidemiological studies through coordination with related institutions in the community in cooperation with experts of epidemiological research. If young researchers starting studies refer to our methods, activate regional epidemiological studies, and contribute to improvement of community health care, nothing could give us more pleasure. 3.2 Community Investigation and Setting of the
We considered that it is desirable to firstly know the regions in which an epidemiological study is to be performed, including the
ethnic, cultural, and historical aspects, in addition to the medical aspect, through which the characteristics and problems of the region are clarified. We named this procedure community diagnosis. There is no specific mode or text for community diagnosis. Thus, we analyzed various survey reports published by the government, such as surveys of population and age composition, causes of death and requirement of long-term nursing, and industrial composition. According to the 2009 survey document published by the hydrographic and oceanographic department, Japan is comprised of 6852 islands inhabited by about 1.2 hundred million people. As of 2010, the mean life expectancies of Japanese women and men are 86.30 and 79.55 years, respectively [1], being the world’s longevity country. In the population composition in 2010, the percentage of the young population below 15 years was 13.2%, that of the working-age population between 15 and 64 years was 63.8%, and that of the elderly population aged 65 years or older was 23.0%, showing a higher rate of aging than in other countries. In the estimation for the future, the percentage of the elderly population is predicted to rise to 31.6% in 2030 and 38.8% in 2050, showing a high rate of aging (Table 3.1) [12]. Table 3.1 Annual changes in the percentage (%) of the elderly population in Japan and other countries
was reported to be 33.4%, and this is similar to the predicted mean percentage for the nation after 20 years. Thus, the demographics of Goto City go ahead of nationwide aging. We considered that by selecting this region for the research field, we can investigate health problems of an aging society that Japan will face in the future.
