Hanibuchi Tomoya, Nakaya Tomoki
School of International Liberal Studies, Chukyo University, 101-2 Yagoto-honmachi, Showa-ku, Nagoya 466-8666, Japan.
Department of Geography, Portland State University, Portland, OR, USA.
Prev Med Rep. 2020 Mar 4;18:101075. doi: 10.1016/j.pmedr.2020.101075. eCollection 2020 Jun.
Although associations between neighborhood socioeconomic conditions and health have been well established, their geographical scope is mostly limited to Western societies, while multilevel studies in the non-Western context (e.g., Japan) are limited to specific cities/regions within countries. This consequently limits the external validity of the findings. To fill the gap, this study examined the associations between neighborhood socioeconomic conditions and health-related indicators by using nationwide cross-sectional data in Japan. Individual data was collected from a nationwide online survey conducted in 2015 (n = 4593). Self-rated health, mental distress (Kessler Psychological Distress Scale: K6), smoking, and physical activity were analyzed in relation to neighborhood conditions. Analyses of multilevel logistic regression models were done using the Areal Deprivation Index (ADI) with population density as the neighborhood-level independent variable. After adjusting for individual covariates, ADI showed significant positive associations with poor self-rated health (odds ratio for one standard deviation increase and 95% confidence interval: 1.09, 1.00-1.19), mental distress (1.09, 1.02-1.16), current smoking (1.11, 1.03-1.19), and physical inactivity (1.11, 1.04-1.18). Population density was not associated with the four dependent variables. Analyses of the nationwide survey data in Japan showed that neighborhood socioeconomic conditions were independently associated with multiple health statuses and behaviors. These analyses may contribute to generalizing existing findings. Lastly, the results indicate the importance of neighborhood socioeconomic conditions in reducing health disparities in Japan.
尽管邻里社会经济状况与健康之间的关联已得到充分证实，但其地理范围大多局限于西方社会，而非西方背景下（如日本）的多层次研究则局限于各国特定的城市/地区。这进而限制了研究结果的外部有效性。为填补这一空白，本研究利用日本全国性的横断面数据，考察了邻里社会经济状况与健康相关指标之间的关联。个体数据来自于2015年进行的一项全国性在线调查（n = 4593）。分析了自评健康、心理困扰（凯斯勒心理困扰量表：K6）、吸烟和身体活动与邻里状况的关系。使用以人口密度为邻里层面自变量的区域剥夺指数（ADI）进行多层次逻辑回归模型分析。在调整个体协变量后，ADI与自评健康状况差（标准差每增加一个单位的比值比及95%置信区间：1.09，1.00 - 1.19）、心理困扰（1.09，1.02 - 1.16）、当前吸烟（1.11，1.03 - 1.19）和身体活动不足（1.11，1.04 - 1.18）呈显著正相关。人口密度与这四个因变量无关。对日本全国性调查数据的分析表明，邻里社会经济状况与多种健康状况和行为独立相关。这些分析可能有助于推广现有研究结果。最后，结果表明邻里社会经济状况在减少日本健康差距方面的重要性。
