Individual income, income distribution, and self rated health in Japan: cross sectional analysis of nationally representative sample.

OBJECTIVE

To assess the effects on self rated health of individual income and income distribution in Japan.

DESIGN

Cross sectional analysis. Data collected on household income, self rated health, and other sociodemographic characteristics at the individual level from comprehensive survey of the living conditions of people on health and welfare in a nationally representative sample from each prefecture.

SETTING

Prefectures in Japan.

PARTICIPANTS

80 899 people aged >15 years with full records in survey.

MAIN OUTCOME MEASURES

Dichotomous variable for self rated health of each respondent (0 if excellent, very good or good; 1 if fair or poor).

RESULTS

Inequality in income at the prefecture level measured by the Gini coefficient was comparable with that in other industrialised countries. Unadjusted odds ratios show a 14% increased risk (odds ratio 1.14, 95% confidence interval 1.02 to 1.27) in reporting poor or fair health for individuals living in prefectures with higher inequality in income. After adjustment, individual income was more strongly associated with self rated health than income inequality. Additional inclusion of regional effects showed that median income at the prefecture level was inversely related to self rated health.

CONCLUSIONS

Individual income, probably relative to the median prefecture income, has a stronger association with self rated health than income inequality at the prefecture level.