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Sasaki N, Tabuchi T, Fujiwara T, Nishi D. Adverse childhood experiences and living in the socially deprived areas in adulthood: a cross-sectional study of the nationwide data in Japan. BMC Public Health 2023; 23:1616. [PMID: 37620789 PMCID: PMC10463887 DOI: 10.1186/s12889-023-16557-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVES This study aimed to examine whether having adverse childhood experiences (ACEs) was associated with living in a deprived area in adulthood. METHODS The cross-sectional study was conducted by using nation-wide data in 2022 of the Japan COVID-19 and Society Internet Survey (JACSIS). Participants were community dwelling people 18 years or older. ACEs were assessed by Japanese version of 15-items ACE measurement tool (ACE-J). Living condition was measured by Area Deprived Index (ADI) and Densely Inhabited District (DID) based on zip code. Multivariable logistic regression to analyze the associations between ADI and ACE 4 + was conducted, controlling for individual-level factors, such as age, sex, marital status, and education, as an additional analysis. RESULTS The total of 27,916 participants were included in the analysis. The prevalence of emotional neglect, childhood poverty, and school bullying were 38.2%, 26.5%, 20.8%, respectively. 75% of the population had one or more ACE(s). The number of ACEs was associated with significantly higher risk of living in deprived area in the adulthood (p = 0.001). ACEs were not associated with living in density area. The association between ADI and ACEs 4 + was non-significant after controlling the individual-level factors. CONCLUSION People with higher number of ACEs tend to live in deprived areas in adulthood. Policy makers in highly deprived areas can apply the trauma-informed approach for the community care and support, which is critical to mitigating deficit perspectives and facilitating comprehensive support for those with ACEs.
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Affiliation(s)
- Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 1130033, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 1130033, Japan.
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Kataoka A, Fukui K, Sato T, Kikuchi H, Inoue S, Kondo N, Nakaya T, Ito Y. Geographical socioeconomic inequalities in healthy life expectancy in Japan, 2010-2014: An ecological study. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 14:100204. [PMID: 34527999 PMCID: PMC8355904 DOI: 10.1016/j.lanwpc.2021.100204] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/09/2021] [Accepted: 06/18/2021] [Indexed: 11/26/2022]
Abstract
Background Area differences in life expectancy (LE) and healthy life expectancy (HLE) in large geographical units have been monitored around the world. Area characteristics may be based on culture, history, socioeconomic status and discrimination in smaller geographical units, so it is important to consider these when looking at health inequality. We aimed to evaluate LE, HLE, and non-healthy life expectancy (NHLE) in 1707 municipalities using Areal Deprivation Index (ADI) in Japan for the first time. Methods We calculated the observed LE, HLE, and NHLE using death, population, and Long-term care insurance data for 2010-2014 and applied the variance weighted least squares model to estimate LE, HLE, and NHLE by 100 percentiles using the standardized ADI. Findings The estimated LE, HLE, and NHLE became lower as the deprivation index worsened: the differences between the most and least deprived areas for HLE were 2·49 years for LE and 2·32 years for HLE in males; 1·22 years for LE and 0·93 years for HLE in females. The observed LE and HLE in the most deprived areas were much lower than other areas. Interpretation Using ADI has enabled us to see the disparity within municipalities precisely. LE and HLE outlier for the 100th percentile might be linked to historical areal deprivation and marginalization. Precise monitoring of socioeconomic status-based health inequalities could help manage these inequalities by identifying the groups most in need of intervention. Funding The Ministry of Education, Science and Culture of Japan (a Grant-in-Aid for Scientific Research [A] No. 20H00040 and 18H04071).
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Affiliation(s)
- Aoi Kataoka
- Department of Medical Statistics, Research & Development Center Osaka Medical and Pharmaceutical University.,Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Keisuke Fukui
- Department of Mathematics Program, Graduate School of Advanced Science and Engineering, Hiroshima University
| | - Tomoharu Sato
- Department of Biostatistics and Data Science, Graduate School of Medicine, Osaka University
| | - Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine, Kyoto University
| | - Tomoki Nakaya
- Department of Frontier Science for Advanced Environment, Graduate School of Environmental Studies, Tohoku University
| | - Yuri Ito
- Department of Medical Statistics, Research & Development Center Osaka Medical and Pharmaceutical University
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'It is surprising how much nonsense you hear': How residents experience and react to living in a stigmatised place. A narrative synthesis of the qualitative evidence. Health Place 2021; 68:102525. [PMID: 33571896 DOI: 10.1016/j.healthplace.2021.102525] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/12/2021] [Accepted: 01/25/2021] [Indexed: 12/29/2022]
Abstract
There are significant geographical inequalities in health. Spatial stigma - negative representations of particular localities - could be an important mechanism through which place influences population health. To explore this, we undertook a narrative synthesis of studies reporting residents' perspectives of living in stigmatised localities. Qualitative research (38 studies) was reviewed to identify how spatial stigma manifested in residents' lives, their strategies to cope with stigma and the health consequences. The review found residents internalised stigma, but also resisted it differently. Although relatively few studies purposefully investigated health, living somewhere stigmatised had psychological effects and constrained life opportunities that have implications for health.
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Zaitsu M, Kaneko R, Takeuchi T, Sato Y, Kobayashi Y, Kawachi I. Occupational class and male cancer incidence: Nationwide, multicenter, hospital-based case-control study in Japan. Cancer Med 2019; 8:795-813. [PMID: 30609296 PMCID: PMC6382925 DOI: 10.1002/cam4.1945] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/04/2018] [Accepted: 12/05/2018] [Indexed: 01/12/2023] Open
Abstract
Little is known about socioeconomic inequalities in male cancer incidence in nonwestern settings. Using the nationwide clinical and occupational inpatient data (1984‐2016) in Japan, we performed a multicentered, matched case–control study with 214 123 male cancer cases and 1 026 247 inpatient controls. Based on the standardized national classifications, we grouped patients’ longest‐held occupational class (blue‐collar, service, professional, manager), cross‐classified by industrial cluster (blue‐collar, service, white‐collar). Using blue‐collar workers in blue‐collar industries as the referent group, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by conditional logistic regression with multiple imputation, matched for age, admission date, and admitting hospital. Smoking and alcohol consumption were additionally adjusted. Across all industries, a reduced risk with higher occupational class (professionals and managers) was observed for stomach and lung cancer. Even after controlling for smoking and alcohol consumption, the reduced odds persisted: OR of managers in white‐collar industries was 0.80 (95% CI 0.72‐0.90) for stomach cancer, and OR of managers in white‐collar industries was 0.66 (95% CI 0.55‐0.79) for lung cancer. In white‐collar industries, higher occupational class men tended to have lower a reduced risk for most common types of cancer, with the exception of professionals who showed an excess risk for prostate cancer. We documented socioeconomic inequalities in male cancer incidence in Japan, which could not be explained by smoking and alcohol consumption.
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Affiliation(s)
- Masayoshi Zaitsu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Rena Kaneko
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Gastroenterology, Kanto Rosai Hospital, Kawasaki, Kanagawa, Japan
| | - Takumi Takeuchi
- Department of Urology, Kanto Rosai Hospital, Kawasaki, Kanagawa, Japan
| | - Yuzuru Sato
- Department of Gastroenterology, Kanto Rosai Hospital, Kawasaki, Kanagawa, Japan
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Lee H, Son I, Yoon J, Kim SS. Lookism hurts: appearance discrimination and self-rated health in South Korea. Int J Equity Health 2017; 16:204. [PMID: 29178889 PMCID: PMC5702199 DOI: 10.1186/s12939-017-0678-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 10/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite a growing body of evidence suggesting that discrimination harms health, the association between appearance discrimination and health has been understudied. Our study investigated the association between perceived appearance discrimination and self-rated health among emerging adults using a nationally representative cohort study in South Korea. METHODS We analyzed the 2nd-10th (2005-2013) waves of cohort data from the Korean Education Employment Panel (KEEP). KEEP consists of two groups of individuals who were 15 (group I) and 18 (group II) years old at the 1st wave of the survey (2004) and were followed annually. Appearance discrimination was assessed at baseline (19 years old: 5th wave for group I, 2nd wave for group II) and at follow-up (24 years old: 10th wave for group I, 7th wave for group II). Responses of appearance discrimination at the two-time points were classified into four groups: 1) never (no discrimination at both baseline and follow-up); 2) repeated (discrimination at both baseline and follow-up); 3) incident (discrimination only at follow-up); and 4) in error (discrimination only at baseline). Multivariate logistic regression was applied to examine the association between reporting patterns of appearance discrimination and poor self-rated health, adjusting for potential confounders. RESULTS Compared to those who did not experience appearance discrimination, 'repeated' (OR: 3.70; 95% CI: 2.19-6.27) and 'incident' (OR: 3.10; 95% CI: 1.99-4.83) groups had a higher odds ratio of poor self-rated health after adjusting for potential confounders including respondents' body mass index change and baseline self-rated health. However, no significant association was observed among those who reported appearance discrimination 'in error'. CONCLUSIONS These results suggest that perceived appearance discrimination is associated with the health of Korean emerging adults considering participants' reporting patterns of appearance discrimination.
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Affiliation(s)
- Hyemin Lee
- Department of Public Health Sciences, Graduate School of Korea University, Anam-ro, Seongbuk-gu, Seoul, South Korea
| | - Inseo Son
- Asiatic Research Institute, Korea University, Anam-ro, Seongbuk-gu, Seoul, South Korea
| | - Jaehong Yoon
- Department of Public Health Sciences, Graduate School of Korea University, Anam-ro, Seongbuk-gu, Seoul, South Korea
| | - Seung-Sup Kim
- Department of Public Health Sciences, Graduate School of Korea University, Anam-ro, Seongbuk-gu, Seoul, South Korea. .,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Guarnizo-Herreño CC, Watt RG, Stafford M, Sheiham A, Tsakos G. Do welfare regimes matter for oral health? A multilevel analysis of European countries. Health Place 2017; 46:65-72. [PMID: 28500911 DOI: 10.1016/j.healthplace.2017.05.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 05/03/2017] [Accepted: 05/05/2017] [Indexed: 11/25/2022]
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Tabuchi T, Nakayama T, Fukushima W, Matsunaga I, Ohfuji S, Kondo K, Kawano E, Fukuhara H, Ito Y, Oshima A. Determinants of participation in prostate cancer screening: a simple analytical framework to account for healthy-user bias. Cancer Sci 2015; 106:108-14. [PMID: 25456306 PMCID: PMC4317786 DOI: 10.1111/cas.12561] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 10/09/2014] [Accepted: 10/18/2014] [Indexed: 01/04/2023] Open
Abstract
In Japan at present, fecal occult blood testing (FOBT) is recommended for cancer screening while routine population-based prostate-specific antigen (PSA) screening is not. In future it may be necessary to increase participation in the former and decrease it in the latter. Our objectives were to explore determinants of PSA-screening participation while simultaneously taking into account factors associated with FOBT. Data were gathered from a cross-sectional study conducted with random sampling of 6191 adults in Osaka city in 2011. Of 3244 subjects (return rate 52.4%), 936 men aged 40-64 years were analyzed using log-binomial regression to explore factors related to PSA-screening participation within 1 year. Only responders for cancer screening, defined as men who participated in either FOBT or PSA-testing, were used as main study subjects. Men who were older (prevalence ratio [PR] [95% confidence interval (CI)] = 2.17 [1.43, 3.28] for 60-64 years compared with 40-49 years), had technical or junior college education (PR [95% CI] = 1.76 [1.19, 2.59] compared with men with high school or less) and followed doctors' recommendations (PR [95% CI] = 1.50 [1.00, 2.26]) were significantly more likely to have PSA-screening after multiple variable adjustment among cancer-screening responders. Attenuation in PR of hypothesized common factors was observed among cancer-screening responders compared with the usual approach (among total subjects). Using the analytical framework to account for healthy-user bias, we found three factors related to participation in PSA-screening with attenuated association of common factors. This approach may provide a more sophisticated interpretation of participation in various screenings with different levels of recommendation.
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Affiliation(s)
- Takahiro Tabuchi
- Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular DiseasesOsaka, Japan
- Urban Research Plaza, Osaka City UniversityOsaka, Japan
| | - Tomio Nakayama
- Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular DiseasesOsaka, Japan
| | - Wakaba Fukushima
- Department of Public Health, Osaka City University Faculty of MedicineOsaka, Japan
| | - Ichiro Matsunaga
- Department of Public Health, Osaka City University Faculty of MedicineOsaka, Japan
| | - Satoko Ohfuji
- Department of Public Health, Osaka City University Faculty of MedicineOsaka, Japan
| | - Kyoko Kondo
- Department of Public Health, Osaka City University Faculty of MedicineOsaka, Japan
| | - Eiji Kawano
- Department of Sociology, Osaka City UniversityOsaka, Japan
| | | | - Yuri Ito
- Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular DiseasesOsaka, Japan
| | - Akira Oshima
- Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular DiseasesOsaka, Japan
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