『保健医療科学』 2022 第71巻 第5号 p.389-396（2022年12月）
特集：健康日本21（第二次）最終評価―都道府県等健康増進計画のためのメッセージ― ＜解説＞
健康日本 21(第二次)最終評価
―都道府県・市区町村の取組状況の評価のための調査―
寺井愛
厚生労働省健康局健康課
Final evaluation of Health Japan 21 (the second term): Survey on health promotion measures of local governments
TERAI Ai
Health Service Division, Health Service Bureau, Ministry of Health, Labour and Welfare
抄録
健康日本21(第二次)最終評価の一環として，計画期間中の取組状況を評価するため都道府県・市 区町村に対する調査を行った.
本調査の結果から，健康増進計画の評価を行う体制や，部局横断的な組織体制等，健康づくりのための体制整備は健康日本21の最終評価時点と比較して進んできたと考えられる. 教育部門や介護保険 部門等，健康づくり部門以外の部門との連携に関しても多くの自治体で行われている一方，まちづくり部門との連携は都道府県・市区町村ともに少なく今後の課題と考えられた.
健康格差については，全ての都道府県及び約半数の市区町村で把握されていたが，所得や教育，職 業等の社会経済的要因による格差を把握している都道府県・市区町村は 1 割程度にとどまった.
計画期間中に取組が進んだ領域や，今後重点的に取り組みたい領域としては，がん，循環器疾患，糖尿病領域や，栄養・食生活，身体活動・運動領域等を選んだ都道府県・市区町村が多く，休養，飲酒領域を選んだ都道府県・市区町村は少なかった. 今後，休養，飲酒領域等，取組が進んでいない領域に関しては，目標達成のための具体的な取組を示していく必要があると考えられた.
厚生労働省では，現在，最終評価の結果も踏まえて次期プランの検討を行っており令和5年春を目途に公開予定である. 都道府県，市区町村におかれては，最終評価の結果や，国で作成する次期プランも踏まえ，令和6年度から開始する次期健康増進計画の策定を進めていただきたい.
キーワード : 健康日本21(第二次)，最終評価，都道府県・市区町村の健康増進施策，次期健康増進計画
Abstract
As part of the final evaluation of Health Japan 21 (the second term), a survey was conducted to evaluate the health promotion measures in prefectures and municipalities during the campaign.
The results of the survey showed that there was significant progress in development of the system for health promotion, such as the system for evaluating health promotion plans and the cross-departmental organizational framework, in comparison to the time when the Health Japan 21 final evaluation was conducted. Although many local governments have been collaborating with departments other than health promotion departments, such as education departments and nursing care departments, only a small percentage of prefectures and municipalities have been collaborating with town/city development departments, which is considered to be one of the challenges.
While all prefectures and roughly half of municipalities understood the situation regarding health disparities, only about 10% of prefectures and municipalities were able to identify disparities due to socio-economic factors such as income, education, and occupation.
The results of the survey also showed that many local governments have promoted initiatives in the areas of cancer, cardiovascular disease, diabetes, nutrition and dietary habits, and physical activity and exercise, and that they would like to continue promoting measures intensively in these areas. However, fewer prefectures and municipalities promoted efforts in the areas of rest and alcohol consumption, and it is considered to be necessary to present specific measures to achieve the goals in these areas.
The Ministry of Health, Labour and Welfare is currently preparing the next plan based on the results of this final evaluation, and plans to publish it in the spring of next year. Prefectures and municipalities are encouraged to work on the next health promotion plan, which is to be launched in 2024, based on the results of the final evaluation and the next plan that will be drawn up by the national government.
keywords : Health Japan 21(the second term), final evaluation, health promotion measures of prefectures and municipalities, next health promotion plan
