Impacts of health checkup programs standardization on working-age self-employed and unemployed: Insights from Japan’s local government response to national policy

Masato Oikawa (), Takamasa Yamaguchi, Awatani Toshihide, Haruko Noguchi () and Akira Kawamura ()
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Masato Oikawa: Waseda Institute for Advanced Study, Waseda University
Takamasa Yamaguchi: Waseda Institute of Social & Human Capital Studies (WISH)
Awatani Toshihide: Department of Family Medicine, Kochi Medical School, Kochi, Japan
Haruko Noguchi: Faculty of Political Science and Economics, Waseda University
Akira Kawamura: Faculty of Human Sciences, Waseda University

No 2406, Working Papers from Waseda University, Faculty of Political Science and Economics

Abstract: This study analyzes the effects of the expansion of municipal per capita expenses on health checkup programs, following the introduction of the Specific Health Checkups and Specific Health Guidance (SHC-SHG), on the health outcomes and behaviors of self-employed and unemployed populations, which have been largely overlooked by previous research. To address this, we applied a dosing difference-in-differences (DID) estimation method, exploiting variation in treatment intensity across municipalities. The DID estimation reveals that the SHC-SHG introduction led to a reduction in the proportion of people diagnosed with lifestyle-related diseases in the municipalities that required significant increases in per-capita health checkup program expenses to comply with the new program, with a more pronounced impact on those with multiple diagnoses compared to those with a single diagnosis. A subgroup analysis indicates that health improvements following the SHC-SHG introduction were observed among self-employed workers and homeowners, whereas such improvements were not evident among the unemployed and renters. Moreover, we identify significant behavioral changes among the population in the high-expansion municipalities following the policy introduction. A back-of-the-envelope calculation demonstrates the municipal response to the SHC-SHG introduction is cost-effective.

Keywords: health checkup; lifestyle-related diseases; health outcomes; health behaviors; costeffectiveness (search for similar items in EconPapers)
Pages: 64 pages
Date: 2024-11
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