Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
Int J Behav Med. 2010 Mar;17(1):58-66. doi: 10.1007/s12529-009-9051-7. Epub 2009 Jun 25.
There has been little research in inequalities in risk of cardiovascular disease incidence by social class in Asia.
The purpose of this study was to examine the association between socioeconomic indicators and risk of stroke and coronary heart disease in Japan.
Data from the Jichi Medical School Study, a population-based prospective cohort study of approximately 11,000 Japanese men and women, were used. The average follow-up period was 11.7 years. Age- and area-adjusted hazard ratios with 95% confidence intervals (CIs) for education level/occupation were calculated using Cox proportional hazard regression analysis.
Compared to those who completed education at age 14 or younger, the age and area-adjusted hazard ratios of intraparenchymal hemorrhage incidence for men who completed education at age 15-17 and at age 18 or older were 0.42 (95% CI, 0.21-0.84) and 0.34 (95% CI, 0.14-0.84), respectively. The age- and area-adjusted hazard ratios of intraparenchymal hemorrhage and subarachnoid hemorrhage incidence for female white-collar workers compared to female blue-collar workers were 0.28 (95% CI, 0.08-0.98) and 3.23 (95% CI, 1.29, 8.01), respectively. No associations were found between education level and risk of coronary heart disease among both men and women.
These results suggest the pattern of social inequalities in health in Japan might be different from that in Western countries.
亚洲在社会阶层与心血管疾病发病风险的不平等方面的研究较少。
本研究旨在探讨日本社会经济指标与卒中及冠心病风险之间的关联。
本研究使用了日本 Jichi 医科大学一项基于人群的前瞻性队列研究的数据,该研究纳入了约 11000 名日本男女。平均随访时间为 11.7 年。采用 Cox 比例风险回归分析计算了年龄和地区校正后,教育程度/职业与风险的比值比(HR)及其 95%置信区间(CI)。
与 14 岁及以下完成学业者相比,15-17 岁和 18 岁及以上完成学业者的男性脑实质内出血发病年龄和地区校正 HR 分别为 0.42(95%CI,0.21-0.84)和 0.34(95%CI,0.14-0.84)。与蓝领女性相比,白领女性的脑实质内出血和蛛网膜下腔出血发病年龄和地区校正 HR 分别为 0.28(95%CI,0.08-0.98)和 3.23(95%CI,1.29,8.01)。本研究未发现教育程度与男性和女性冠心病风险之间存在关联。
这些结果表明,日本健康方面的社会不平等模式可能与西方国家不同。