Increased excess deaths in urban areas: quantification of geographical variation in mortality in Japan, 1973-1998

Geographical variations in elderly disability in Taiwan

Inequality in health has long been a topic of discussion. The purpose of this research was to provide estimates of the proportions of elderly who had difficulties in activities of daily living in each of the 23 administrative areas of Taiwan, and to assess if there was geographical disparity in disability across areas. A nationally representative sample of 303,545 subjects was selected for interview. Among the subjects selected for interview, 239,861 completed the survey, a completion rate of about 80%. For the purpose of this research, only those aged 65 years or older were included (N = 114,873) in the analyses. Non-standardized and standardized prevalences of disability were presented for each of the 23 administrative areas in Taiwan, and geographical distribution of elderly disability was plotted. Results show that significant difference in disability prevalence exists among administrative districts, even after adjusting for age and sex structure of the population. Moreover, the extent of gender disparity also varied from one area to another. The western region, in general, had lower disability prevalence than the eastern region. Findings imply that since disability prevalence varied significantly across administrative areas, funding for long-term care should not be allocated based on the number of elderly population in an administrative area. Areas with high prevalence should identify reasons for their high prevalence rates and implement proper interventions.

Socioeconomic status and cancer screening in Japanese males: Large inequlaity in middle-aged and urban residents

OBJECTIVES

Cancer screening has become common in Japan. However, little is known about the socioeconomic factors affecting cancer screening participation. This study was performed to examine the association between socioeconomic status and cancer screening participation in Japanese males.

METHODS

Using the data of 23,394 males sampled from across Japan, the associations between self-reported participation in screenings for three types of cancer (i.e., stomach, lung and colon) and socioeconomic variables, including marital status, types of residential area (metropolitan/nonmetropolitan), household income, and employment status, were examined using multilevel logistic regression by age group (40 to 64 and ≥65 years).

RESULTS

The cancer screening participation rates were 34.5% (stomach), 21.3% (lung), and 24.8% (colon) for the total population studied. Being married, living in a nonmetropolitan area, having a higher income and being employed in a large-scale company showed independent associations with a higher rate of cancer screening participation for all three types of cancer. Income-related differences in cancer screening were more pronounced in the middle-aged population than in the elderly population, and in metropolitan areas than in nonmetropolitan areas.

CONCLUSIONS

There are notable socioeconomic differences in cancer screening participation in Japan. To promote cancer screening, socioeconomic factors should be considered, particularly for middle-aged and urban residents.