Fujino Yoshihisa, Kubo Tatsuhiko, Matsuda Shinya
Department of Public Health, School of Medicine, University of Occupational and Environmental Health, Japan.
J UOEH. 2013 Oct;35 Suppl:177-83. doi: 10.7888/juoeh.35.177.
There has been an emergent issue of health inequalities in Japan. Tackling health inequalities has been put on the primary agenda in the revised national health promotion campaign, so called "Kenko-Nippon-21"(Healthy Japan 21), which was announced in 2012. Against the background of this social movement, the present article argues how occupational health can contribute to health inequality issue based on the knowledge of public health and social epidemiology.Firstly, we reviewed a brief sketch of health inequality at occupational settings including position, job, and employment status. Secondly, we de scribed a conceptual model of a causal pathway of occupational class and health, based on the idea of life-course approach, and models such as cumulative model, trigger model and latent effect/sensitive period model. Finally, we proposed that health impact assessment as a tool to mitigate health inequality related to occupational policy.
日本出现了健康不平等这一紧迫问题。解决健康不平等问题已被列入经修订的全国健康促进运动的首要议程，即2012年宣布的所谓“健康日本21”。在这一社会运动的背景下，本文基于公共卫生和社会流行病学知识，探讨职业健康如何能够对健康不平等问题有所贡献。首先，我们回顾了职业环境中健康不平等的简要概况，包括职位、工作和就业状况。其次，我们基于生命历程方法的理念，以及累积模型、触发模型和潜在效应/敏感期模型等，描述了职业阶层与健康之间因果路径的概念模型。最后，我们提议将健康影响评估作为一种工具，以减轻与职业政策相关的健康不平等。
