Hanibuchi Tomoya, Nakaya Tomoki, Honjo Kaori
School of International Liberal Studies, Chukyo University, 101-2 Yagoto Honmachi, Showa-ku, Nagoya, Aichi 466-8666, Japan.
Department of Geography and Research Institute for Disaster Mitigation of Urban Cultural Heritage, Ritsumeikan University, 58 Komatsubara Kitamachi, Kita-ku, Kyoto 603-8341, Japan.
SSM Popul Health. 2016 Sep 9;2:662-673. doi: 10.1016/j.ssmph.2016.09.002. eCollection 2016 Dec.
Health disparities in Japan are attracting increasing attention. Temporal trends in health disparities should be continuously monitored using multiple indices of socioeconomic status (SES) and health-related outcomes. We explored changes in socioeconomic differences in the health of Japanese adults during 2000-2010. The data was taken from the Japanese General Social Surveys, the cross-sectional surveys for nationally representative samples of Japanese adults. We used 14,193 samples (individuals of 20-64 years of age) in our analysis. We estimated age-adjusted prevalence ratios of the lowest SES group in comparison with the highest SES group using Poisson regression models with robust error variance. Relative index of inequality (RII) and slope index of inequality (SII) were also calculated. We examined the changes in the association between health-related outcomes (self-rated health (SRH), smoking, and physical activity) and SES indices (income, education, occupation, and subjective social class identification). The results showed temporally expanding trends for the associations of current smoking with SES, especially among women, in both relative and absolute measures. In contrast, no expanding trends were seen for SRH and physical activity. Although the smoking rates declined through the first decade of the 21st century, the socioeconomic disparities in smoking prevalence among Japanese adults expanded, especially among women. Researchers and policymakers should continuously monitor the trends that may cause future disparities in smoking-related morbidity and mortality.
日本的健康差距正受到越来越多的关注。应使用社会经济地位(SES)和健康相关结果的多个指标持续监测健康差距的时间趋势。我们探讨了2000 - 2010年期间日本成年人健康方面社会经济差异的变化。数据取自日本综合社会调查,这是针对具有全国代表性的日本成年人样本的横断面调查。我们在分析中使用了14193个样本(年龄在20 - 64岁之间的个体)。我们使用具有稳健误差方差的泊松回归模型估计最低SES组与最高SES组相比的年龄调整患病率比。还计算了不平等相对指数(RII)和不平等斜率指数(SII)。我们研究了健康相关结果(自评健康(SRH)、吸烟和身体活动)与SES指标(收入、教育、职业和主观社会阶层认同)之间关联的变化。结果显示,在相对和绝对衡量方面,当前吸烟与SES的关联呈现出随时间扩大的趋势,尤其是在女性中。相比之下,自评健康和身体活动方面未见扩大趋势。尽管在21世纪的第一个十年吸烟率有所下降,但日本成年人吸烟患病率的社会经济差距却在扩大,尤其是在女性中。研究人员和政策制定者应持续监测可能导致未来与吸烟相关的发病率和死亡率差距的趋势。