Medical Information Center, Kyushu University Hospital, Fukuoka 812-8582, Japan.
Department of Pharmaceutical Sciences, International University of Health and Welfare, Fukuoka 831-8501, Japan.
Int J Environ Res Public Health. 2021 Dec 20;18(24):13393. doi: 10.3390/ijerph182413393.
Geographical differences in chronic obstructive pulmonary disease (COPD) mortality have not been determined using municipal-specific data in Japan. This study determined the geographical differences in COPD mortality in Japan using municipal-specific data and identified associated factors. Data on COPD mortality from 2013 to 2017 for each municipality were obtained from the Vital Statistics of Japan. We calculated the standardized mortality ratio (SMR) of COPD by an empirical Bayes method for each municipality and located the SMRs on a map of Japan. In addition, an ecological study was conducted to identify factors associated with the SMR using demographic, socioeconomic, and medical characteristics of municipalities by a spatial statistics model. Geographical differences in the SMR were different in men and women, and municipalities with a low SMR tended to be more frequent in women. Spatial regression analysis identified that the total population and taxable income per capita were negatively associated with the SMR in men. In women, population density, the proportion of fatherless households, and the number of clinics per capita were positively associated with the SMR, whereas taxable income per capita was negatively associated with the SMR. There were some differences in regional characteristics associated with COPD mortality by sex.
日本尚未利用市级特定数据确定慢性阻塞性肺疾病（COPD）死亡率的地域差异。本研究利用市级特定数据确定了日本 COPD 死亡率的地域差异，并确定了相关因素。从日本《人口动态统计》中获取了 2013 年至 2017 年每个市町村 COPD 死亡率的相关数据。我们采用经验贝叶斯法计算了每个市町村的 COPD 标准化死亡率比（SMR），并将 SMR 标绘在日本地图上。此外，还通过空间统计学模型，利用市町村的人口统计学、社会经济和医疗特征，开展了一项生态学研究，以确定与 SMR 相关的因素。SMR 的地域差异在男性和女性中存在差异，且 SMR 较低的市町村在女性中更为常见。空间回归分析表明，男性的总人口和人均应纳税所得与 SMR 呈负相关。而在女性中，人口密度、无父家庭比例和每千人诊所数量与 SMR 呈正相关，而人均应纳税所得与 SMR 呈负相关。性别与 COPD 死亡率相关的区域特征存在一定差异。
