Ikeda Nayu
Center for International Collaboration and Partnership, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition.
J Epidemiol. 2016;26(3):106-14. doi: 10.2188/jea.JE20150319. Epub 2016 Feb 20.
Secondary data analysis of national health surveys of the general population is a standard methodology for health metrics and evaluation; it is used to monitor trends in population health over time and benchmark the performance of health systems. In Japan, the government has established electronic databases of individual records from national surveys of the population's health. However, the number of publications based on these datasets is small considering the scale and coverage of the surveys. There appear to be two major obstacles to the secondary use of Japanese national health survey data: strict data access control under the Statistics Act and an inadequate interdisciplinary research environment for resolving methodological difficulties encountered when dealing with secondary data. The usefulness of secondary analysis of survey data is evident with examples from the author's previous studies based on vital records and the National Health and Nutrition Surveys, which showed that (i) tobacco smoking and high blood pressure are the major risk factors for adult mortality from non-communicable diseases in Japan; (ii) the decrease in mean blood pressure in Japan from the late 1980s to the early 2000s was partly attributable to the increased use of antihypertensive medication and reduced dietary salt intake; and (iii) progress in treatment coverage and control of high blood pressure is slower in Japan than in the United States and Britain. National health surveys in Japan are an invaluable asset, and findings from secondary analyses of these surveys would provide important suggestions for improving health in people around the world.
对普通人群进行的全国性健康调查进行二次数据分析，是健康指标和评估的标准方法；它用于监测一段时间内人群健康趋势，并对卫生系统的绩效进行基准评估。在日本，政府已建立了基于全国人口健康调查的个人记录电子数据库。然而，考虑到调查的规模和覆盖范围，基于这些数据集的出版物数量较少。日本全国健康调查数据的二次使用似乎存在两个主要障碍：《统计法》规定的严格数据访问控制，以及解决处理二次数据时遇到的方法学难题的跨学科研究环境不足。作者此前基于生命记录和国民健康与营养调查的研究实例表明，调查数据二次分析的实用性显而易见，这些实例表明：（i）吸烟和高血压是日本成年人非传染性疾病死亡的主要危险因素；（ii）从20世纪80年代末到21世纪初，日本平均血压的下降部分归因于抗高血压药物使用的增加和饮食中盐摄入量的减少；（iii）日本高血压治疗覆盖率和控制方面的进展比美国和英国要慢。日本的全国性健康调查是一项宝贵资产，对这些调查进行二次分析得出的结果将为改善全球人民的健康提供重要建议。
