Okui Tasuku, Park Jinsang
Medical Information Center, Kyushu University Hospital, Maidashi 3-1-1, Higashi-ku, Fukuoka City, Fukuoka Prefecture, 812-8582, Japan.
Department of Pharmaceutical Sciences, International University of Health and Welfare, Fukuoka, Japan.
Inj Epidemiol. 2021 Oct 28;8(1):60. doi: 10.1186/s40621-021-00356-4.
Regional differences in road traffic (RT) mortality among municipalities have not been revealed in Japan. Further, the association between RT mortality and regional socioeconomic characteristics has not been investigated. We analyzed geographic differences in RT mortality and its associated factors using the Vital Statistics in Japan.
We used data on RT mortality by sex and municipality in Japan from 2013 to 2017. We calculated the standardized mortality ratio (SMR) of RT for each municipality by sex using an Empirical Bayes method. The SMRs were mapped onto a map of Japan to show the geographic differences. In addition, an ecological study investigated the municipal characteristics associated with the SMR using demographic socioeconomic, medical, weather, and vehicular characteristics as explanatory variables. The ecological study used a spatial statistical model.
The mapping revealed that the number of municipalities with a high SMR of RT (SMR > 2) was larger in men than in women. In addition, SMRs of capital areas (Kanagawa and Tokyo prefectures) tended to be low in men and women. The regression analysis revealed that population density was negatively associated with the SMR in men and women, and the degree of the association was the largest among explanatory variables. In contrast, there was a positive association between the proportion of non-Japanese persons and SMR. The proportions of lower educational level (elementary school or junior high school graduates), agriculture, forestry, and fisheries workers, service workers, and blue-collar workers were positively associated with the SMR in men. The proportion of unemployed persons was negatively associated with the SMR in men.
Socioeconomic characteristics are associated with geographic differences in RT mortality particularly in men. The results suggested preventive measures targeted at men of low socioeconomic status and non-Japanese persons are needed to decrease RT mortality further.
日本尚未揭示各市镇道路交通（RT）死亡率的地区差异。此外，尚未对RT死亡率与地区社会经济特征之间的关联进行调查。我们使用日本的生命统计数据，分析了RT死亡率的地理差异及其相关因素。
我们使用了2013年至2017年日本按性别和市镇划分的RT死亡率数据。我们采用经验贝叶斯方法，按性别计算了每个市镇RT的标准化死亡率（SMR）。将SMR映射到日本地图上，以显示地理差异。此外，一项生态研究使用人口社会经济、医疗、天气和车辆特征作为解释变量，调查了与SMR相关的市镇特征。该生态研究使用了空间统计模型。
地图显示，RT的SMR较高（SMR＞2）的市镇数量男性多于女性。此外，首都地区（神奈川县和东京都）的男性和女性SMR往往较低。回归分析显示，人口密度与男性和女性的SMR呈负相关，且在解释变量中这种关联程度最大。相比之下，非日本人比例与SMR呈正相关。较低教育水平（小学或初中毕业生）、农业、林业和渔业工人、服务业工人以及蓝领工人的比例与男性的SMR呈正相关。失业人员比例与男性的SMR呈负相关。
社会经济特征与RT死亡率的地理差异相关，尤其是在男性中。结果表明，需要针对社会经济地位较低的男性和非日本人采取预防措施，以进一步降低RT死亡率。
