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一项关于新冠疫情期间日本工人社会经济地位与治疗中断情况的横断面研究。

A cross-sectional study of socioeconomic status and treatment interruption among Japanese workers during the COVID-19 pandemic.

作者信息

Fujimoto Kenji, Ishimaru Tomohiro, Tateishi Seiichiro, Nagata Tomohisa, Tsuji Mayumi, Eguchi Hisashi, Ogami Akira, Matsuda Shinya, Fujino Yoshihisa

机构信息

Occupational Health Data Science Center, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.

Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.

出版信息

J Occup Health. 2021 Jan;63(1):e12232. doi: 10.1002/1348-9585.12232.

Abstract

OBJECTIVES

The COVID-19 pandemic has caused interruptions to chronic disease and non-emergency treatment. The purpose of this study is to examine which socioeconomic status groups are most at risk of treatment interruption among Japanese workers.

METHODS

This cross-sectional internet monitor study was conducted among Japanese workers on December 22-26, 2020. Out of a total of 33 302 participants in the survey, 9510 (5392 males and 4118 females) who responded that they required regular treatment or hospital visits were included in the analysis. A multilevel logistic model nested in the prefecture of residence was used to estimate the odds ratio (OR) for treatment disruption. We examined separate multivariate models for socioeconomic factors, health factors, and lifestyle factors.

RESULTS

During a period of rapid COVID-19 infection, about 11% of Japanese workers who required regular treatment experienced interruptions to their treatment. The OR of treatment interruption associated with not being married compared with being married was 1.44 (95%CI: 1.17-1.76); manual labor work compared with desk work was 1.30 (95%CI: 1.11-1.52); loss of employment when the COVID-19 pandemic started and continued unemployment compared with being employed over the entire pandemic period was 1.62 (95%CI: 1.13-2.31) and 2.57 (95%CI: 1.63-4.07), respectively; and feeling financially unstable was 2.92 (95%CI: 2.25-3.80).

CONCLUSION

Treatment interruption is a new health inequality brought about by COVID-19 with possible medium- and long-term effects, including excess mortality, morbidity, and productivity loss due to increased presenteeism. Efforts are needed to reduce treatment interruptions among workers who require regular treatment.

摘要

目的

新型冠状病毒肺炎(COVID-19)大流行导致慢性病和非紧急治疗中断。本研究旨在调查日本劳动者中哪些社会经济地位群体面临治疗中断的风险最高。

方法

本横断面网络监测研究于2020年12月22日至26日对日本劳动者进行。在调查的33302名参与者中,9510名(5392名男性和4118名女性)回答他们需要定期治疗或就医,这些人被纳入分析。采用嵌套于居住地县的多水平逻辑模型来估计治疗中断的比值比(OR)。我们分别研究了社会经济因素、健康因素和生活方式因素的多变量模型。

结果

在COVID-19快速传播期间,约11%需要定期治疗的日本劳动者经历了治疗中断。与已婚相比,未婚导致治疗中断的OR为1.44(95%置信区间:1.17-1.76);体力劳动工作与办公室工作相比为1.30(95%置信区间:1.11-1.52);COVID-19大流行开始时失业并持续失业与在整个大流行期间一直就业相比分别为1.62(95%置信区间:1.13-2.31)和2.57(95%置信区间:1.63-4.07);感觉经济不稳定为2.92(95%置信区间:2.25-3.80)。

结论

治疗中断是COVID-19带来的一种新的健康不平等现象,可能产生中长期影响,包括因出勤主义增加导致的超额死亡率、发病率和生产力损失。需要努力减少需要定期治疗的劳动者的治疗中断情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8815/8126756/ecc1c8092308/JOH2-63-e12232-g001.jpg

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