Community-level social capital and participation in health checkups among older adults in Japan: a cross-sectional study

Background: Community-level social capital has been suggested as a contextual factor influencing preventive health behaviors among older adults, yet empirical evidence from micro-scale subcommunity settings remains limited. This study examined whether community-level social capital is associated with participation in specific medical checkups among older adults living in a typical regional city in Japan. Methods: A cross-sectional survey was conducted among 13,558 adults aged 65-74 years in Uwajima City. Community-level cognitive social capital was assessed using three subscales: civic participation, social cohesion, and reciprocity. Multilevel logistic regression analysis was performed across 65 voting districts, adjusting for individual lifestyle factors, socioeconomic status, and individual-level social capital. Results: After adjusting for covariates, including individual-level social capital, a one-standard deviation increase in community-level social cohesion was significantly associated with higher odds of participation in specific medical checkups (odds ratio per standard deviation increase: 1.11; 95% confidence interval: 1.03-1.19). Conclusion: Community-level social cohesion independently contributes to increased participation in preventive health checkups among older adults. These findings highlight the potential value of subcommunity-level strategies to promote preventive health behaviors in aging populations.