Medical Information Center, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
BMC Public Health. 2021 Dec 10;21(1):2242. doi: 10.1186/s12889-021-12368-2.
In recent years, socioeconomic differences in health statuses and behaviors have not been investigated from the nationally representative survey data in Japan. In this study, we showed differences in representative health behaviors and statuses depending on educational level using a nationally representative survey data in Japan.
Aggregated (not individual level) data from the Comprehensive Survey of Living Conditions in 2019 were used to examine the association between educational level and outcome status of psychological distress (K6 scores > = 5), self-rated health, smoking, alcohol drinking, and cancer screening participation (stomach, lung, colorectal, breast, and uterine cancers). Data of 217,179 households in Japan were aggregated by the Ministry of Health, Labour, and Welfare in the survey, and the data of the estimated number of household members and persons corresponding to each response option for the questions in all of Japan were used. Five-year age groups from 20 to 24 to 80-84 years and over 84 years were analyzed, and the prevalence or participation rate by educational level were calculated. In addition, the age-standardized prevalence or participation rate according to educational level were also calculated by sex. Moreover, a Poisson regression model was applied for evaluating an association of educational level with the outcomes.
As a result, a clear gradient by educational level was observed in almost all the age groups for the prevalence of psychological distress, poor self-rated health, and smoking and participation rates in cancer screening, and high educational level were associated with better health-related behaviors and statuses. Conversely, drinking prevalence was shown to be higher rather in highly educated people. In addition, a statistically significant association of educational level with all the outcomes was observed.
It was shown that disparities in health behaviors and statuses still persisted in recent years, and the findings suggested that further measures should be taken to tackle this disparity.
近年来，日本还没有从具有全国代表性的调查数据中研究健康状况和行为的社会经济差异。在这项研究中，我们使用具有全国代表性的日本调查数据，展示了不同教育水平人群代表性健康行为和状况的差异。
使用 2019 年综合生活状况调查的汇总（非个人层面）数据，研究了教育水平与心理困扰（K6 得分≥5）、自评健康、吸烟、饮酒和癌症筛查参与状况（胃癌、肺癌、结直肠癌、乳腺癌和子宫癌）结局之间的关系。该调查由厚生劳动省汇总了日本 217179 户家庭的数据，使用了日本所有问题的每个回答选项对应的家庭成员和人员的估计数量数据。分析了 20-24 岁到 80-84 岁及以上的 5 岁年龄组，并计算了按教育水平划分的流行率或参与率。此外，还按性别计算了按教育水平标准化的流行率或参与率。此外，还应用泊松回归模型评估了教育水平与结果之间的关联。
结果显示，在几乎所有年龄组中，心理困扰、自我报告健康状况不佳、吸烟和癌症筛查参与率都存在明显的教育水平梯度，高教育水平与更好的健康相关行为和状况相关。相反，高教育水平人群的饮酒流行率更高。此外，教育水平与所有结果之间存在统计学显著关联。
研究表明，近年来健康行为和状况的差异仍然存在，研究结果表明，应采取进一步措施解决这一差异。
