Medical Information Center, Kyushu University Hospital, Fukuoka City 812-8582, Japan.
Int J Environ Res Public Health. 2020 Dec 9;17(24):9213. doi: 10.3390/ijerph17249213.
Differences in all-cause and cause-specific mortality rates depending on municipal socioeconomic status (SES) in Japan have not been revealed over the last 20 years. This study exposes the difference in 1999 and 2019 using the Vital Statistics. All of the municipalities were grouped into five quintiles based on their SES, and standardized mortality ratio (SMR) of each municipal quintile compared with all of Japan was calculated for all-cause mortality and representative cause of deaths. As a result, although SMR for all-cause mortality for women tended to be lower in low SES quintiles in 1999, the reverse phenomenon was observed in 2019. Additionally, although SMR for all-cause of mortality for men was the lowest in the highest SES quintiles already in 1999, the difference in the SMR for all-cause mortality rates between the lowest and highest SES quintiles increased in 2019. The improvement of the SMR in the highest SES quintile and the deterioration in the lowest was also observed in representative types of cancer, heart disease, stroke, pneumonia, liver disease, and renal failure for men and women. Therefore, this study indicates a disparity in mortality depending on municipal SES enlarged in the last 20 years.
在过去的 20 年中，日本的全因死亡率和特定原因死亡率因城市社会经济地位（SES）的不同而有所差异，但这一点尚未得到揭示。本研究利用人口动态统计数据揭示了 1999 年和 2019 年的差异。根据 SES 将所有市町村分为五组，并计算了每个市町村组与全日本的标准化死亡率比（SMR），以评估全因死亡率和代表性死因。结果表明，虽然 1999 年女性的全因死亡率在低 SES 五组中较低，但在 2019 年则出现了相反的现象。此外，虽然男性的全因死亡率在 1999 年已经在 SES 最高的五组中最低，但 2019 年 SES 最低和最高五组之间的全因死亡率差异有所增加。在男性和女性的代表性癌症、心脏病、中风、肺炎、肝病和肾衰竭等类型中，也观察到 SES 最高五组的 SMR 改善和 SES 最低五组的恶化。因此，本研究表明，过去 20 年来，由于城市 SES 不同，死亡率存在差异。
