# A questionnaire survey of healthcare access and dietary habits in a rural Japanese community: implications for potential community pharmacy roles

## TL;DR

This study explores healthcare and food access challenges in a rural Japanese community, suggesting community pharmacies could help improve health outcomes.

## Contribution

The study provides empirical evidence on healthcare access and dietary habits in a rural Japanese community, highlighting community pharmacy roles.

## Key findings

- Only 25.2% of respondents achieved optimal macronutrient balance.
- Residents with hypertension had higher salt intake compared to non-hypertensive individuals.
- Poor chewing ability correlated with lower subjective health status.

## Abstract

Residents in rural mountainous areas face significant challenges in accessing healthcare and food resources, affecting their dietary intake, nutritional status, and overall health. However, detailed evidence on the interplay between access limitations, dietary habits, and nutritional status is limited, hindering the development of effective, equity-focused interventions. This study aimed to evaluate healthcare access, food procurement practices, and dietary intake in such a community to identify key challenges and opportunities for sustainable health support.

A cross-sectional survey was conducted targeting residents aged ≥ 20 years in a rural Japanese village. Two questionnaires were administered: a food frequency questionnaire based on food groups (FFQg) and a questionnaire we developed that assessed healthcare utilization and food procurement. Macronutrient balance was considered optimal when the intake ratios of the three macronutrients were within the recommended ranges (proteins: 13–20%, fats: 20–30%, carbohydrates: 50–65%).

Of 115 respondents (58 males, 57 females), 51.3% shopped for food weekly, with 65.5% requiring 1–2 h of one-way travel time to reach stores. While 86.0% had annual health checkups, only 56.1% received regular dental checkups. Only 25.2% achieved an optimal macronutrient balance for all three macronutrients. Among respondents with hypertension (28.3%), the mean salt intake was 11.3 g, which was higher than that of non-hypertensive residents (p < 0.05). A significant correlation was observed between poor chewing ability and lower subjective health status (p < 0.05).

Residents in this rural mountainous community face significant challenges in healthcare and food access, which are linked to suboptimal dietary intake and health issues. These findings highlight the need to develop community-based health-support systems that can provide targeted nutritional support and health counseling. In the Japanese context, the health-support functions of community pharmacies represent one potential resource that could be leveraged for this purpose, but further research is needed to determine how such services can be effectively implemented to help mitigate health disparities in underserved populations.