Research on social capital and health in Japan. A commentary on Ichida and on Fujisawa

Associations between social fragmentation, socioeconomic deprivation and suicide risk across 1887 municipalities in Japan, 2009-2017: a spatial analysis using the Bayesian hierarchical model

OBJECTIVE

Previous studies have indicated that spatial variation in suicide mortality is associated with area-specific socioeconomic characteristics, such as socioeconomic deprivation and social fragmentation. However, most of these studies have been conducted in the West and findings from Asian countries are limited. This study aims to investigate associations between socioeconomic characteristics and suicide mortality rates across 1887 municipalities in Japan between 2009 and 2017. We also assessed these associations by gender and age group.

METHODS

Suicide data were obtained from the suicide statistics of the Ministry of Health, Labour and Welfare in Japan and included information on the number of suicides by gender, age and municipality location. Social fragmentation, socioeconomic deprivation and urbanicity were used as socioeconomic characteristics in this study and were created from survey data obtained from the 2010 census. Bayesian hierarchical models were used to examine associations between socioeconomic characteristics and suicide risk.

RESULTS

Suicide rates were significantly higher in municipalities with higher levels of deprivation, with a rate ratio of 1.13 (95% credible interval: 1.10 to 1.17) in the highest quartile compared with the lowest. Higher levels of urbanicity had significantly lower suicide rates, with a rate ratio of 0.79 (95% credible interval: 0.77 to 0.82) in the highest quartile compared with the lowest. However, associations between exposures and suicide varied considerably by gender and age. Among both men and women aged 0-39 years, fragmentation was significantly associated with suicide, with rate ratios of 1.07 and 1.15 for men and women, respectively, in the highest quartile compared with the lowest.

CONCLUSION

Suicide prevention in Japan should particularly focus on areas with high levels of deprivation or low levels of urbanicity. Furthermore, young Japanese people residing in the most fragmented municipalities were also at high risk of suicide, and appropriate measures need to be taken.

Community-level social capital, parental psychological distress, and child physical abuse: a multilevel mediation analysis

PURPOSE

The purpose of this study was to investigate the association between community-level social capital and physical abuse towards children, and the mediating effect of parental psychological distress by multilevel mediation analyses.

METHODS

We analyzed data from a population-based study of first-grade elementary school children (6-7 years old) in Adachi City, Tokyo, Japan. The caregivers of first-grade students from all elementary schools in Adachi City (N = 5355) were asked to respond to a questionnaire assessing parents' self-reported physical abuse (beating and hitting) and neighborhood social capital. Among them, 4291 parents returned valid responses (response rate 80.1%). We performed multilevel analyses to determine the relationships between community-level parental social capital and physical abuse, and further multilevel mediation analyses were performed to determine whether parental psychological distress mediated the association.

RESULTS

Low community-level social capital was positively associated with physical abuse (both beating and hitting) after adjustment for other individual covariates (beating: middle, OR = 1.54, 95% CI 1.11-2.13; low, OR = 1.33, 95% CI 0.94-1.88; and hitting: middle, OR = 1.35, 95% CI 1.02-1.80; low, OR = 1.16, 95% CI 0.86-1.57). Multilevel mediation analyses revealed that community-level parental psychological distress did not mediate the association (indirect effect ß = 0.10, 95% CI - 0.10 to 0.29, p = 0.34 for beating; ß = 0.03, 95% CI - 0.16 to 0.23, p = 0.74 for hitting).

CONCLUSIONS

Fostering community-level social capital might be important for developing a strategy to prevent child maltreatment, which may have a direct impact on abusive behavior towards children.

Social cohesion and mortality: a survival analysis of older adults in Japan

OBJECTIVES

We examined the association between social cohesion and mortality in a sample of older adults in Japan.

METHODS

Data were derived from a cohort study of elderly individuals (65-84 years) in Shizuoka Prefecture; 14 001 participants were enrolled at baseline (1999) and followed up in 2002, 2006, and 2009. Among the 11 092 participants for whom we had complete data, 1427 had died during follow-up. We examined the association between social cohesion (assessed at both the community and individual levels) and subsequent mortality after control for baseline and time-varying covariates. We used clustered proportional hazard regression models to estimate hazard ratios (HRs) and confidence intervals (CIs).

RESULTS

After control for individual characteristics, individual perceptions of community cohesion were associated with a reduced risk of all-cause mortality (HR = 0.78; 95% CI = 0.73, 0.84) as well as mortality from cardiovascular disease (HR = 0.75; 95% CI = 0.67, 0.84), pulmonary disease (HR = 0.66; 95% CI = 0.58, 0.75), and all other causes (HR = 0.76; 95% CI = 0.66, 0.89). However, no statistically significant relationship was found between community cohesion and mortality risk.

CONCLUSIONS

Among the elderly in Japan, more positive individual perceptions of community cohesion are associated with reduced risks of all-cause and cause-specific mortality.

Reciprocity and depressive symptoms in Belgian workers: a cross-sectional multilevel analysis

OBJECTIVE

This study examines the multidimensional association between reciprocity at work and depressive symptoms.

METHODS

Data from the Belgian BELSTRESS survey (32 companies; N = 24,402) were analyzed. Multilevel statistical procedures were used to account for company-level associations while controlling for individual-level associations.

RESULTS

Different dimensions of individual reciprocity were negatively associated with depressive symptoms. On the company level, only vertical emotional reciprocity was negatively associated (β = -4.660; SE = 1.117) independently from individual reciprocity (β = -0.557; SE = 0.042). Complex interactions were found such that workplace reciprocity (1) may not uniformly benefit individuals and (2) related differently to depressive symptoms, depending on occupational group.

CONCLUSIONS

This study extends the existing literature with evidence on the multidimensional, contextual, and cross-level interaction associations of reciprocity as a key aspect of social capital on depressive symptoms.

Multi-level, cross-sectional study of workplace social capital and smoking among Japanese employees

Background

Social capital is hypothesized to be relevant to health promotion, and the association between community social capital and cigarette smoking has been examined. Individual-level social capital has been found to be associated with smoking cessation, but evidence remains sparse on the contextual effect of social capital and smoking. Further, evidence remains sparse on the association between smoking and social capital in the workplace, where people are spending an increasing portion of their daily lives. We examined the association between workplace social capital and smoking status among Japanese private sector employees.

Methods

We employed a two-stage stratified random sampling procedure. Of the total of 1,800 subjects in 60 companies, 1,171 (men/women; 834/337) employees (65.1%) were identified from 46 companies in Okayama in 2007. Workplace social capital was assessed in two dimensions; trust and reciprocity. Company-level social capital was based on inquiring about employee perceptions of trust and reciprocity among co-workers, and then aggregating their responses in order to calculate the proportion of workers reporting mistrust and lack of reciprocity. Multilevel logistic regression analysis was conducted using Markov Chain Monte Carlo methods to explore whether individual- and company-level social capital was associated with smoking. Odds ratios (ORs) and 95% credible intervals (CIs) for current smoking were obtained.

Results

Overall, 33.3% of the subjects smoked currently. There was no relationship between individual-level mistrust of others and smoking status. By contrast, one-standard deviation change in company-level mistrust was associated with higher odds of smoking (OR: 1.25, 95% CI: 1.06-1.46) even after controlling for individual-level mistrust, sex, age, occupation, educational attainment, alcohol use, physical activity, body mass index, and chronic diseases. No clear associations were found between lack of reciprocity and smoking both at the individual- and company-level.

Conclusions

Company-level mistrust is associated with higher likelihood of smoking among Japanese employees, while individual perceptions of mistrust were not associated. The link between lack of reciprocity and smoking was not supported either at the individual- or company-level. Further studies are warranted to examine the possible link between company-level trust and smoking cessation in the Japanese workplace.