[Relationship between the manpower of full-time and part-time public health nurses and standardized mortality ratios: An ecological study in municipalities in Japan].

Abstract

Objectives　The purpose of this ecological study was to clarify the relationship between the manpower of full-time and part-time public health nurses (PHNs) and standardized mortality ratios (SMRs) in municipalities in Japan.Methods　We divided 1,225 municipalities with a population over 10,000 for which SMRs were officially published into two groups based on whether the municipality had established a public health center (PHC): general municipalities and PHC-established cities. A linear mixed model was used to examine the relationships among the number of full-time PHNs; cumulative total number of workdays for part-time PHNs; and other healthcare and social welfare resources for SMRs for all causes, malignant neoplasms, cerebrovascular disease, and heart disease.Results　A higher cumulative total number of workdays for part-time PHNs was significantly associated with lower SMRs in both groups for all causes (males and females), lower SMRs in the general municipalities for malignant neoplasms (males) and heart disease (males), and lower SMRs in PHC-established cities for malignant neoplasms (males and females). The number of full-time PHNs had no effect on SMRs.Conclusion　This study suggested that an increase in the manpower of municipal PHNs improves the health and wellbeing of residents.