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Hamasaki H, Yanai H. Periodic health checkups reduce the risk of hospitalization in patients with type 2 diabetes. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2023; 4:1087303. [PMID: 36993816 PMCID: PMC10012066 DOI: 10.3389/fcdhc.2023.1087303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/05/2023] [Indexed: 01/28/2023]
Abstract
IntroductionPeriodic health checkups (PHCs) represent a unique system in Japan that is useful for the early detection of lifestyle-related diseases and cardiovascular diseases (CVDs). This study aims to investigate the association of PHCs with the hospitalization risk of patients with type 2 diabetes mellitus (T2DM).MethodsA retrospective cohort study was conducted from April 2013 to December 2015 and included participant information such as CVD history, lifestyle, and whether PHC was conducted in addition to regular medical examinations. Difference in clinical data between patients with and without PHC was examined. Furthermore, Cox regression analysis was performed to investigate the independent association of PHCs with hospitalization.ResultsHerein, 1,256 patients were selected and followed up for 2.35 ± 0.73 years. In the PHC group, body mass index, waist circumference, proportion of patients with a history of CVD, and number of hospitalizations were lower than those in the non-PHC group. Furthermore, the PHC group exhibited a significant association with lower hospitalization risk (hazard ratio = 0.825; 95% confidence interval, 0.684 to 0.997; p = 0.046) in the Cox model.ConclusionThis study revealed that PHCs minimized the risk of hospitalization in patients with T2DM. Furthermore, we discussed the effectiveness of PHCs in enhancing health outcomes and reducing health care costs in such patients.
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Affiliation(s)
- Hidetaka Hamasaki
- Hamasaki Clinic, Kagoshima, Japan
- *Correspondence: Hidetaka Hamasaki,
| | - Hidekatsu Yanai
- Department of Diabetes, Endocrinology, and Metabolism, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan
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Ji Y, Zhang Y, Yun Q, Chang C. Gender differences in social environmental changes associated with smoking: a cross-sectional study from Chinese internal migrants. BMJ Open 2022; 12:e058097. [PMID: 36414285 PMCID: PMC9685270 DOI: 10.1136/bmjopen-2021-058097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To identify clues for women's tobacco control, this study analyses the gender differences in social environmental changes associated with smoking and the interaction between the environment and individuals' social integration. DESIGN, SETTING AND PARTICIPANTS A cross-sectional design and secondary analysis were used among Chinese internal migrants. Data were from the 2012 Migrant Dynamics Monitoring Survey in China with participants aged 15-59 years old (75 416 women and 83 140 men) who resided in cities for more than 1 month. PRIMARY AND SECONDARY OUTCOME MEASURES Social environmental changes were measured by differences in smoking prevalence and women's empowerment between the migrant-receiving province (MRP) and migrant-sending province (MSP). Social participation and duration of stay (DOS) were adopted as indicators of social integration. Stratified analysis and binary logistic regression models were used to determine the dependent variable (smoking status) and environmental changes after controlling for age, education, income and happiness. RESULTS Differences in the smoking prevalence environment (lower in MRP, OR 0.70, 95% CI 0.60 to 0.83; higher rate in MRP, OR 1.79, 95% CI 1.35 to 2.37) and women's empowerment (lower rate in MRP, OR 0.80, 95% CI 0.68 to 0.97; higher rate in MRP, OR 1.15, 95% CI 1.00 to 1.33) between MRP and MSP were positively correlated with women's smoking. In men, however, migrating to an area with lower smoking prevalence could not reduce smoking risk, whereas moving to an area with higher women's empowerment could. A long DOS was an independent risk factor for smoking in women (ranged from 1.20 to 2.00 in various environmental changes scenarios) but a protective factor for men. An interaction between environmental changes and social integration could not be verified. CONCLUSIONS Tobacco control strategies should consider gender differences, especially women who are experiencing social environmental changes.
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Affiliation(s)
- Ying Ji
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Yan Zhang
- Institute of Nutrition and Food Hygiene, Beijing Centers for Diseases Control and Prevention, Beijing, China
| | - Qingping Yun
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
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Dhungel B, Murakami T, Gilmour S, Ikeda S, Wada K. Occupation- and industry-specific cancer mortality among Japanese women from 1980 to 2015. BMC Public Health 2022; 22:2003. [PMID: 36320013 PMCID: PMC9628126 DOI: 10.1186/s12889-022-14304-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/07/2022] [Accepted: 09/29/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The number of women in Japan who continue working after childbirth is on the rise. Over the past few years, Japan's cancer mortality rate has increased. About 50% of all cancer deaths among Japanese women aged 25-64 are caused by lung, gastric, pancreatic and colorectal cancers. This study aims to examine the difference in mortality risk for key cancers among women and explore the effect of the economic crisis in the mid-1990s separately for occupational and industrial categories. METHODS Data from 1980 to 2015 were gathered from the Japanese Population Census and National Vital Statistics conducted in the same year. A Poisson regression analysis was used to estimate mortality risk and mortality trends for lung, gastric, pancreatic and colorectal cancer among Japanese working women aged 25-64 years. RESULTS Across most industrial and occupational groups, the trends in age-standardised cancer mortality rate for women have declined. Workers in management, security and transportation have a higher cancer mortality risk than sales workers. The risk of death from all four cancers is higher for workers in the mining and electricity industries than for wholesale and retail workers. CONCLUSION To improve the health and well-being of employed Japanese women, it is crucial to monitor cancer mortality trends. Using these population-level quantitative risk estimates, industry- and occupation-specific prevention programmes can be developed to target women at higher cancer risk and enable the early detection and treatment of cancer.
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Affiliation(s)
- Bibha Dhungel
- grid.419588.90000 0001 0318 6320Graduate School of Public Health, St. Luke’s International University, Tsukiji, Tokyo Japan ,Department of Health Policy, National Centre for Child Health and Development, Setagaya, Tokyo Japan
| | - Tomoe Murakami
- grid.411731.10000 0004 0531 3030Graduate School of Medicine, International University of Health and Welfare, 4-1-26 Akasaka, 107-8402 Minato City, Tokyo, Japan
| | - Stuart Gilmour
- grid.419588.90000 0001 0318 6320Graduate School of Public Health, St. Luke’s International University, Tsukiji, Tokyo Japan
| | - Shunya Ikeda
- grid.411731.10000 0004 0531 3030Graduate School of Medicine, International University of Health and Welfare, 4-1-26 Akasaka, 107-8402 Minato City, Tokyo, Japan
| | - Koji Wada
- grid.411731.10000 0004 0531 3030Graduate School of Medicine, International University of Health and Welfare, 4-1-26 Akasaka, 107-8402 Minato City, Tokyo, Japan
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4
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Dhungel B, Murakami T, Wada K, Ikeda S, Gilmour S. Difference in Mortality Rates by Occupation in Japanese Male Workers Aged 25 to 64 Years from 1980 to 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11328. [PMID: 36141600 PMCID: PMC9517138 DOI: 10.3390/ijerph191811328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
This study examines the trends in mortality among Japanese working men, across various occupational categories, from 1980 to 2015. A Poisson model of trend, occupational category, and step variable was analysed for eight occupational categories separately, by cause, to explore the trends in mortality. This study found a sharp increase in mortality in the late 1990s, especially among professionals and managers. The overall trends in cancer, ischemic heart disease (IHD), cerebrovascular disease (CVD), and suicide mortality decreased across almost all occupational categories from 1980 to 2015, although there was an increasing trend in cancer of 0.5% among managers. Clerical workers had the greatest relative decrease in mortality rates from cancer (-82.9%), IHD (-81.7%), and CVD (-89.1%). Japan continues to make gains in lowering mortality and extending life expectancy, but its workplace culture must improve to ensure that those working at the heart of the Japanese corporate world can also benefit from Japan's progress in health. Mortality rates in working-aged Japanese men have been declining. However, similar declines are not evident among managers, for whom the mortality rate is remaining stable or slightly increasing. There is a need to address the needs of managers and improve workplace environments for these workers.
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Affiliation(s)
- Bibha Dhungel
- Graduate School of Public Health, St. Luke’s International University, Tsukiji, Tokyo 104-0044, Japan
- Department of Health Policy, National Centre for Child Health and Development, Setagaya, Tokyo 157-8535, Japan
| | - Tomoe Murakami
- Graduate School of Medicine, International University of Health and Welfare, Akasaka, Tokyo 107-8402, Japan
| | - Koji Wada
- Graduate School of Medicine, International University of Health and Welfare, Akasaka, Tokyo 107-8402, Japan
| | - Shunya Ikeda
- Graduate School of Medicine, International University of Health and Welfare, Akasaka, Tokyo 107-8402, Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke’s International University, Tsukiji, Tokyo 104-0044, Japan
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Okui T, Nakashima N. Analysis of differences in preterm birth rate depending on household occupation in Japan from 2007 to 2019. J Prev Med Public Health 2022; 55:371-378. [PMID: 35940192 PMCID: PMC9371782 DOI: 10.3961/jpmph.22.178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 06/03/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Naoki Nakashima
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
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Nogimura A, Noguchi T, Otani T, Kamiji K, Yasuoka M, Watanabe R, Ojima T, Kondo K, Kojima M. Chronic obstructive pulmonary disease and the mortality risk in male older adults: role of socioeconomic factors. Arch Gerontol Geriatr 2022; 102:104741. [DOI: 10.1016/j.archger.2022.104741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/23/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022]
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Nakazawa S, Fukai K, Furuya Y, Kojimahara N, Hoshi K, Toyota A, Tatemichi M. Occupations associated with diabetes complications: A nationwide-multicenter hospital-based case-control study. Diabetes Res Clin Pract 2022; 186:109809. [PMID: 35247525 DOI: 10.1016/j.diabres.2022.109809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/25/2022] [Accepted: 02/28/2022] [Indexed: 11/03/2022]
Abstract
AIM Investigating the risks of diabetes complications among inpatients with diabetes associated with longest-held and current occupations. METHOD Using a Japanese nationwide, multicenter, hospital inpatient dataset (2005-2015), a matched case-control study with 39,550 inpatients with diabetes was conducted. We considered both the longest-held and current occupations of the study subjects. RESULT Diabetes complications such as retinopathy, nephropathy, neuropathy, and peripheral vascular complications occur more often in managers, sales workers, service workers, transportation workers, construction and mining workers and carrying, cleaning and packing workers. Among these occupations, particularly the service workers indicated consistently significant increased risks (OR = 1.36 (1.23-1.51)) in developing all the considered subtypes of diabetes complications, and the performed sensitivity analysis confirmed this conclusion. Moreover, among service workers, cooks, waiters, building service staff and other service workers were identified as having the highest risks in developing diabetes complications (ORs = 1.30 (1.12-1.51), 1.63 (1.36-1.95), 1.79 (1.21-2.67), and 2.05 (1.30-3.22), respectively). CONCLUSIONS Our study's potential translational impact should lead to subsequent investigations on the causes connected to certain occupations of various diabetes complications and particularly to more carefully dealing with patients with diabetes who work in the identified occupational areas and their health risks.
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Affiliation(s)
- Shoko Nakazawa
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan143 Shimokasuya, Isehara-shi, Kanagawa 259-1193, Japan
| | - Kota Fukai
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan143 Shimokasuya, Isehara-shi, Kanagawa 259-1193, Japan.
| | - Yuko Furuya
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan143 Shimokasuya, Isehara-shi, Kanagawa 259-1193, Japan
| | - Noriko Kojimahara
- Department of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan4-27-2, Kita-ando, Aoi-ku, Shizuoka-shi 420-0881, Japan
| | - Keika Hoshi
- Center for Public Health Informatics, National Institute of Public Health, Wako, Japan2-3-6 Minami, Wako-shi, Saitama 351-0197, Japan; Department of Hygiene, School of Medicine, Kitasato University, Sagamihara, Japan1-15-1, Kitazato, Minami-ku, Sagamihara-shi, Kanagawa 252-0374, Japan
| | - Akihiro Toyota
- Chugoku Rosai Hospital Research Center for the Promotion of Health and Employment Support, Japan Organization of Occupational Health and Safety, Hiroshima, Japan1-5-1 Hirotagaya, Kure-shi, Hiroshima 737-0193, Japan
| | - Masayuki Tatemichi
- Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan143 Shimokasuya, Isehara-shi, Kanagawa 259-1193, Japan
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8
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Kyan A, Takakura M. Socioeconomic inequalities in physical activity among Japanese adults during the COVID-19 pandemic. Public Health 2022; 207:7-13. [DOI: 10.1016/j.puhe.2022.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 02/25/2022] [Accepted: 03/10/2022] [Indexed: 11/27/2022]
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Changes in cause-specific mortality trends across occupations in working-age Japanese women from 1980 to 2015: a cross-sectional analysis. BMC Womens Health 2022; 22:44. [PMID: 35193556 PMCID: PMC8861597 DOI: 10.1186/s12905-022-01621-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 02/07/2022] [Indexed: 01/28/2023] Open
Abstract
Background Reducing health inequalities is an important public health challenge. Many studies have examined the widening health gap by occupational class among men, but few among women. We therefore estimated variation in absolute and relative mortality by occupational category across four leading causes of mortality—cancer, ischaemic heart disease, cerebrovascular disease, and suicide—to explore how occupational class is associated with health among working women aged 25–64 in Japan. Methods We conducted a repeated cross-sectional study using Poisson regression analysis on each five-yearly mortality data from 1980 to 2015, obtained from the National Vital Statistics and the Japanese Population Census. Results There was a decreasing trend in mortality from all cancers, ischaemic heart disease, cerebrovascular disease, and suicide among women in all occupational groups from 1980 to 2015. Agriculture workers had higher risk of mortality than professional workers for all four causes of death. The absolute difference in mortality rates for all cancers and cerebrovascular disease was higher in 2000–2015 than 1980–1995. The mortality trend among clerks and sales workers decreased after 2000, except for suicide. Conclusions Mortality rates from all four causes are higher among agriculture workers compared to professional workers, and attention is needed to reduce this mortality gap. Continuous monitoring of ongoing mortality trends is essential to ensure better health and wellbeing in Japan. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01621-4.
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Okui T, Park J. Difference in the prevalence of hypertension and its risk factors depending on area-level deprivation in Japan. BMC Res Notes 2022; 15:37. [PMID: 35144673 PMCID: PMC8832789 DOI: 10.1186/s13104-022-05931-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/28/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives Area-level deprivation is an important factor related to mortality or health behaviors; however, a study investigating differences in hypertension prevalence depending on area-level deprivation has not been conducted in Japan. We investigated differences in the prevalence of hypertension and its risk factors, i.e. obesity, smoking, alcohol consumption, and heavy alcohol drinking depending on area-level deprivation using nationwide health checkups data in 2018. Results Area-level deprivation was derived from census data. An analysis of the data by secondary medical areas revealed that the age-standardized proportions of individuals whose systolic blood pressure was ≥ 140 mmHg, those whose diastolic blood pressure was ≥ 90 mmHg, those whose body mass index was ≥ 25 or 30 kg/m2, smokers, and heavy alcohol drinkers showed an increasing trend with an increase in the deprivation level. The relative index of inequality, which can be interpreted as the ratio of the age-standardized proportion for the most deprived area compared with that for the least deprived area, was significantly greater than 1 for all proportions, except for the proportion of drinkers in women. Overall, there was a disparity in the prevalence of hypertension and its risk factors depending on area-level deprivation. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-022-05931-6.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Maidashi3-1-1 Higashi-ku, Fukuoka, Fukuoka, 812-8582, Japan.
| | - Jinsang Park
- Department of Pharmaceutical Sciences, International University of Health and Welfare, Fukuoka, Japan
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Okui T, Park J. Geographical Differences and Their Associated Factors in Chronic Obstructive Pulmonary Disease Mortality in Japan: An Ecological Study Using Nationwide Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413393. [PMID: 34949002 PMCID: PMC8704528 DOI: 10.3390/ijerph182413393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/15/2021] [Accepted: 12/18/2021] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka 812-8582, Japan
- Correspondence:
| | - Jinsang Park
- Department of Pharmaceutical Sciences, International University of Health and Welfare, Fukuoka 831-8501, Japan;
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Okui T, Park J. Analysis of the regional difference in the number of multi-drug prescriptions and its predictors in Japan, 2015-2018. BMC Res Notes 2021; 14:367. [PMID: 34544503 PMCID: PMC8454144 DOI: 10.1186/s13104-021-05787-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/14/2021] [Indexed: 11/29/2022] Open
Abstract
Objective Polypharmacy and multi-drug prescription are major public health problems in Japan, but only a few studies have investigated the regional differences. By revealing regional differences in the multi-drug prescriptions, we can infer regions with high rates of multimorbidity or inappropriate prescribing. This study revealed regional differences in multi-drug prescriptions (the number of simultaneous prescriptions of seven or more internal medicines) and investigated the factors affecting the difference using the National Database of Health Insurance Claims and Specific Health Checkups of Japan data. Results The standardized claim ratio (SCR) of the number of multi-drug prescriptions, which corrected the difference in sex and age distribution of prefectures, varied depending on prefectures. A panel data analysis investigating the association between the SCR and explanatory variables (Medical institutions, socioeconomic factors, and physical characteristics of people in prefectures) revealed that the number of public assistance recipients per 1,000 persons was positively and significantly associated with the SCR (Standardized partial regression coefficient = 0.244, p-value = 0.038). In conclusion, regional differences in the number of the multi-drug prescriptions were revealed in Japan, suggesting that public assistance recipients tend to experience multi-drug prescriptions. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05787-2.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Maidashi 3-1-1 Higashi-ku, Fukuoka City, Fukuoka Prefecture, 812-8582, Japan.
| | - Jinsang Park
- Department of Pharmaceutical Sciences, International University of Health and Welfare, Fukuoka, Japan
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Okui T. Socioeconomic Predictors of Diabetes Mortality in Japan: An Ecological Study Using Municipality-specific Data. J Prev Med Public Health 2021; 54:352-359. [PMID: 34649397 PMCID: PMC8517364 DOI: 10.3961/jpmph.21.215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/29/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES The aim of this study was to examine the geographic distribution of diabetes mortality in Japan and identify socioeconomic factors affecting differences in municipality-specific diabetes mortality. METHODS Diabetes mortality data by year and municipality from 2013 to 2017 were extracted from Japanese Vital Statistics, and the socioeconomic characteristics of municipalities were obtained from government statistics. We calculated the standardized mortality ratio (SMR) of diabetes for each municipality using the empirical Bayes method and represented geographic differences in SMRs in a map of Japan. Multiple linear regression was conducted to identify the socioeconomic factors affecting differences in SMR. Statistically significant socioeconomic factors were further assessed by calculating the relative risk of mortality of quintiles of municipalities classified according to the degree of each socioeconomic factor using Poisson regression analysis. RESULTS The geographic distribution of diabetes mortality differed by gender. Of the municipality-specific socioeconomic factors, high rates of single-person households and unemployment and a high number of hospital beds were associated with a high SMR for men. High rates of fatherless households and blue-collar workers were associated with a high SMR for women, while high taxable income per-capita income and total population were associated with low SMR for women. Quintile analysis revealed a complex relationship between taxable income and mortality for women. The mortality risk of quintiles with the highest and lowest taxable per-capita income was significantly lower than that of the middle-income quintile. CONCLUSIONS Socioeconomic factors of municipalities in Japan were found to affect geographic differences in diabetes mortality.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
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Hirokawa K, Ohira T, Nagao M, Nagayoshi M, Kajiura M, Imano H, Kitamura A, Kiyama M, Okada T, Iso H. Associations Between Occupational Status, Support at Work, and Salivary Cortisol Levels. Int J Behav Med 2021; 29:299-307. [PMID: 34462898 DOI: 10.1007/s12529-021-10020-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The present study investigated associations between occupation, job stress, and salivary cortisol levels after psychological tasks. METHODS We examined 766 (273 men and 493 women) healthy employed Japanese participants aged 21 to 68 years (mean age = 46.4 years, standard deviation = 8.5) with three types of occupation: manager, teacher, and general worker. The Brief Job Stress Questionnaire was used to evaluate participants' job stress levels, including job demand, job control, support from supervisors, and support from coworkers. Salivary cortisol levels were measured at pre-session, post-stressful tasks, and post-relaxation. All samples were assayed using an enzyme-linked immunosorbent assay test. Natural log transformation was applied before statistical analyses. A multiple regression analysis and a repeated measures analysis of covariance were conducted to test associations between occupation and salivary cortisol levels, adjusting for confounding factors. Statistical analyses were conducted separately for men and women. RESULTS Among both men and women, general workers had higher cortisol levels than managers throughout the experimental session (men 0.6 μg/dL and 0.4 μg/dL, respectively; women 0.5 μg/dL and 0.4 μg/dL, respectively). Job control was positively associated with cortisol levels measured in all sessions, after adjusting for confounding factors (standardized beta 0.15, 0.21, and 0.18 for pre-session, post-stressful-tasks, and post-relaxation, respectively, all p < 0.05). Men with low support from coworkers had higher cortisol levels than those with high support through the sessions (0.6 μg/dL and 0.4 μg/dL, respectively). CONCLUSION Socioeconomic disparity according to occupational status was related to cortisol levels in Japanese workers. Support from coworkers may be effective for reducing cortisol secretion in men.
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Affiliation(s)
- Kumi Hirokawa
- Department of Nursing, Baika Women's University, 2-19-5 Shukunosho, Ibaraki, Osaka, 567-8578, Japan. .,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan.
| | - Tetsuya Ohira
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan. .,Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima, 960-1295, Japan.
| | - Masanori Nagao
- Radiation Medical Science Center for the Fukushima Health Management Survey Office of Epidemiology, Fukushima Medical University, 1 Hikariga-oka, Fukushima City Fukushima, Fukushima, 960-1295, Japan
| | - Mako Nagayoshi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Mitsugu Kajiura
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Akihiko Kitamura
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan
| | - Masahiko Kiyama
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan
| | - Takeo Okada
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
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Sumimoto Y, Yanagita M, Miyamatsu N, Okuda N, Nishi N, Nakamura Y, Nakamura K, Miyagawa N, Miyachi M, Kadota A, Ohkubo T, Okamura T, Ueshima H, Okayama A, Miura K. Association between socioeconomic status and physical inactivity in a general Japanese population: NIPPON DATA2010. PLoS One 2021; 16:e0254706. [PMID: 34265008 PMCID: PMC8282078 DOI: 10.1371/journal.pone.0254706] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/02/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Lower socioeconomic status (SES) may be related to inactivity lifestyle; however, the association between SES and physical inactivity has not been sufficiently investigated in Japan. METHODS The study population is the participants of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey 2010 in Japan. They were residents in 300 randomly selected areas across Japan. This study included 2,609 adults. Physical activity was assessed by physical activity index (PAI) calculated from activity intensity and time. The lowest tertile of PAI for each 10-year age class and sex was defined as physical inactivity. Multivariable logistic regression analyses were conducted to examine the association of SES (employment status, educational attainment, living status, and equivalent household expenditure (EHE)) with physical inactivity. RESULTS In the distribution of PAI by age classes and sex, the highest median PAI was aged 30-39 years among men (median 38.6), aged 40-49 years among women (38.0), and median PAI was decreased with increasing age. Multivariable-adjusted model shows that not working was significantly associated with physical inactivity after adjustment for age in all age groups and sexes. Not living with spouse for adult women and elderly men was significantly associated with physical inactivity compared to those who living with spouse. However, neither educational attainment nor EHE had any significant associations with physical inactivity. CONCLUSIONS The result indicated that physical inactivity was associated with SES in a general Japanese population. SES of individuals need to be considered in order to prevent inactivity lifestyle.
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Affiliation(s)
- Yuka Sumimoto
- Department of Health and Sports Science, Doshisha University, Kyotanabe, Kyoto, Japan
- Department of Clinical Nursing, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, Japan
| | - Masahiko Yanagita
- Department of Health and Sports Science, Doshisha University, Kyotanabe, Kyoto, Japan
| | - Naomi Miyamatsu
- Department of Clinical Nursing, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, Japan
| | - Nagako Okuda
- Department of Health Science, Kyoto Prefectural University, Sakyo-ku, Kyoto, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Shinjuku, Tokyo, Japan
| | - Yosikazu Nakamura
- Department of Public Health, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Koshi Nakamura
- Department of Public Health and Hygiene, University of the Ryukyus, Nishihara, Okinawa, Japan
| | - Naoko Miyagawa
- Department of Preventive Medicine and Public Health, Keio University, Shinjuku, Tokyo, Japan
| | - Motohiko Miyachi
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Shinjuku, Tokyo, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, Japan
- NCD Epidemiology Research Center, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University, Tokyo, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University, Shinjuku, Tokyo, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, Japan
- NCD Epidemiology Research Center, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, Japan
- NCD Epidemiology Research Center, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, Japan
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16
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Chen N, Kim CG. The Moderating Effect of Community-Level Deprivation on the Association between Individual Characteristics and Smoking Behavior among Chinese Adults: A Cross-Level Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115785. [PMID: 34072249 PMCID: PMC8199057 DOI: 10.3390/ijerph18115785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/24/2021] [Accepted: 05/24/2021] [Indexed: 11/16/2022]
Abstract
China joined the World Health Organization (WHO) Framework Convention on Tobacco Control in 2006; however, the overall Chinese smoking rate is still high. The aim of this study is to provide new evidence for the direct effects of community-level deprivation, and the effects of interactions between community-level deprivation and individual characteristics, on smoking intensity, by using cross-sectional data from the 2015 China Health and Nutrition Survey (CHNS). The results show that there is a strong association between community-level deprivation and individual smoking intensity, and that community deprivation moderates the relationship between individual perceived stress and smoking intensity. The findings imply that adequate interventions should be conducted in the context of deprived neighborhoods, and should consider differences between levels of individual perceived stress and between sexes, especially focusing on highly stressed women who live in deprived communities.
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Affiliation(s)
- Nan Chen
- Major in Chinese Studies, Department of Global Business, Kosin University, Busan 49104, Korea;
| | - Chang-Gyeong Kim
- Department of Chinese Studies, Pukyong National University, Busan 48513, Korea
- Correspondence: ; Tel.: +82-51-629-5342
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17
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An analysis of predictors for heavy alcohol drinking using nationally representative survey data in Japan. BMC Public Health 2021; 21:359. [PMID: 33593302 PMCID: PMC7885596 DOI: 10.1186/s12889-021-10382-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Predictors of heavy or moderate alcohol drinking behavior have not been investigated using recent nationally representative survey data in Japan. This study investigated the effects of the predictors of heavy and moderate alcohol drinking in Japan using nationally representative survey data. Methods Anonymous data from the 2013 Comprehensive Survey of Living Conditions in Japan were used to compare the predictors of heavy and moderate drinkers with those who abstain. Anonymized data that are resampled from all the survey data from the Ministry of Health, Labour and Welfare were obtained. Age group, marital status, living arrangements, educational level, household income, smoking status, and employment type were used as the explanatory variables. In addition, the drinking status (i.e., heavy drinker, moderate drinker, or abstainer) was used as the outcome variable. A multinomial logistic regression model was used, and an analysis comparing heavy drinkers and abstainers, as well as moderate drinkers and abstainers, was conducted. Results Moderate drinking was positively associated with high educational level or high household income for men and women, as well as married status for men. In addition, unemployment was found to be negatively associated with heavy drinking for men and women, and an unmarried status was also found to be negatively associated with heavy drinking for men. Moreover, lower educational levels and smoking prevalence were found to be associated with heavy drinking for men and women. Furthermore, living alone for men and working in a large-scale company for women were also found to be predictors of heavy drinking. Conclusions The preventive measures for heavy drinking were suggested to be particularly needed for those with lower educational levels and smokers. A call for attention among men living alone and among female employees in large-scale workplaces is also needed.
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18
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Okui T. Socioeconomic Predictors of Trends in Cancer Mortality among Municipalities in Japan, 2010-2019. Asian Pac J Cancer Prev 2021; 22:499-508. [PMID: 33639666 PMCID: PMC8190362 DOI: 10.31557/apjcp.2021.22.2.499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Indexed: 12/03/2022] Open
Abstract
Background: A study investigating associations between various socioeconomic factors and standardized mortality ratios (SMR) of each type of cancer among municipalities in Japan has not been conducted using the data of the past decade. Herein, we investigated the predictors of a recent trend of municipal SMRs of cancer using the Vital Statistics in Japan and revealed the change in the SMRs depending on the identified predictors. Methods: Data on cancer mortality for each municipality in 2010 and 2019 were used. We calculated empirical Bayes SMR (EBSMR) for each municipality by type of cancer and sex and then fitted a multiple linear regression model using possible predictors in 2010 as explanatory variables and the EBSMR in 2019 as the outcome variable. We also classified municipalities into quintiles based on the values of an identified predictor in 2010, and SMRs of each type of cancer in 2010 and 2019 were calculated for each quintile. Results: The total population was positively associated with EMSMRs of multiple cancer types, whereas educational level was negatively associated with EMSMRs of multiple cancer types. In addition, SMRs of municipalities with the lowest educational level deteriorated from 2010 to 2019 for many cancer types among men and women, and the difference between municipalities with the highest and lowest educational level for the SMR of cancer in all sites widened in 2019 for men. On the other hand, the SMR of municipalities with the highest educational level or the largest total population tended to be higher than municipalities with lower counterparts in both 2010 and 2019 for women. Conclusion: There was a difference in the trend of the SMRs of multiple types of cancer depending on municipal educational level, whereas municipalities with larger population or educational level continued to have higher SMRs of cancer in all sites for women.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka City, Japan
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19
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Okui T. Socioeconomic Disparities in All-Cause and Cause-Specific Mortality Rates among Municipalities in Japan, 1999-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9213. [PMID: 33317152 PMCID: PMC7763490 DOI: 10.3390/ijerph17249213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/30/2020] [Accepted: 12/08/2020] [Indexed: 12/12/2022]
Abstract
Differences in all-cause and cause-specific mortality rates depending on municipal socioeconomic status (SES) in Japan have not been revealed over the last 20 years. This study exposes the difference in 1999 and 2019 using the Vital Statistics. All of the municipalities were grouped into five quintiles based on their SES, and standardized mortality ratio (SMR) of each municipal quintile compared with all of Japan was calculated for all-cause mortality and representative cause of deaths. As a result, although SMR for all-cause mortality for women tended to be lower in low SES quintiles in 1999, the reverse phenomenon was observed in 2019. Additionally, although SMR for all-cause of mortality for men was the lowest in the highest SES quintiles already in 1999, the difference in the SMR for all-cause mortality rates between the lowest and highest SES quintiles increased in 2019. The improvement of the SMR in the highest SES quintile and the deterioration in the lowest was also observed in representative types of cancer, heart disease, stroke, pneumonia, liver disease, and renal failure for men and women. Therefore, this study indicates a disparity in mortality depending on municipal SES enlarged in the last 20 years.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka City 812-8582, Japan
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20
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Okui T. An age-period-cohort analysis of the difference in smoking prevalence between urban and non-urban areas in Japan (2004-2019). Epidemiol Health 2020; 42:e2020072. [PMID: 33285059 PMCID: PMC7871160 DOI: 10.4178/epih.e2020072] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/26/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This study aimed to conduct an age-period-cohort (APC) analysis of smoking prevalence trends in urban and non-urban areas in Japan. METHODS Data on smoking prevalence from 2004 to 2019 were extracted from the Comprehensive Survey of Living Conditions in Japan. Government ordinance-designated cities and special wards in Tokyo were defined as urban areas. The respondents ranged from 20 years to 79 years old, and were grouped in 5-year intervals. Cohorts were defined for each age group of each year, and those born between 1925-1929 and 1995-1999 were examined. We calculated the estimated smoking prevalence for each age, period, and cohort, as well as the smoking prevalence ratio of non-urban areas compared with urban areas from the APC analysis results. RESULTS The magnitude of the decrease in the period effect on smoking prevalence was larger in urban areas than in non-urban areas for both men and women. The smoking prevalence ratio for non-urban areas compared with that of urban areas was above 1 for men at most time points, except in the older age groups. In addition, the prevalence ratio between the areas decreased, particularly as age increased. For women, the smoking prevalence ratio in non-urban areas compared to urban areas was below 1 until cohorts born in the 1970s, but the trend reversed thereafter. CONCLUSIONS The results of this study suggest that further smoking control and cessation measures are necessary, particularly for older cohorts in urban women and for younger ages in non-urban men.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
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21
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Hirokawa K, Ohira T, Kajiura M, Imano H, Kitamura A, Kiyama M, Okada T, Iso H. Job stress factors measured by Brief Job Stress Questionnaire and sickness absence among Japanese workers: A longitudinal study. Fukushima J Med Sci 2020; 66:88-96. [PMID: 32595178 PMCID: PMC7470755 DOI: 10.5387/fms.2019-15] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study aimed to investigate associations between Brief Job Stress Questionnaire (BJSQ)-measured job stress factors and sickness absence in Japanese workers. Among 551 healthy, employed Japanese men and women (age range: 21-73 years) who underwent mental health examinations at the Osaka Medical Center for Health Science and Promotion between 2006 and 2009, 197 (67 men, 130 women) consented to participate in this study. Their sickness absences until the end of March 2010 were then followed-up via postal mail survey, with 112 participants effectively responding to the question on sickness absence (56.9%). The hazard ratio (HR) and 95% confidence interval (CI) were calculated using the Cox proportional hazards model, adjusting for age, sex, and lifestyle factors. Among the 112 respondents, 12 took sickness absence after their study entry, as found during the mean 2.3 years of follow-up (258.8 person-years). Among all sickness absences, those of eight participants were because of mental illness. Physical demands were positively associated with increased risks of all sickness absence (adjusted HR: 2.78, 95% CI: 1.01-7.64). Physical demands were predictive for all sickness absence, and should be alleviated at workplaces to prevent such absence.
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Affiliation(s)
- Kumi Hirokawa
- Department of Nursing, Baika Women's University.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Tetsuya Ohira
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.,Department of Epidemiology, Fukushima Medical University School of Medicine.,Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Mitsugu Kajiura
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Akihiko Kitamura
- Osaka Center for Cancer and Cardiovascular Disease Prevention.,Tokyo Metropolitan Institute of Gerontology
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
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22
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Hirokawa K, Ohira T, Kajiura M, Imano H, Kitamura A, Kiyama M, Okada T, Iso H. Cardiovascular reactivity to acute stress associated with sickness absence among Japanese men and women: A prospective study. Brain Behav 2020; 10:e01541. [PMID: 32077640 PMCID: PMC7177567 DOI: 10.1002/brb3.1541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 12/25/2019] [Accepted: 01/04/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE We aimed to investigate associations between cardiovascular reactivity to acute stress and sickness absence among Japanese male and female workers, in a prospective study. METHODS Among healthy employed Japanese workers who underwent mental health checks between 2006 and 2009, data of 111 participants were analyzed. Changes in blood pressure, pulse rate, peripheral blood flow (PBF), and heart rate variability (HRV) (high frequency [HF] and low frequency [LF]) were calculated using differences between the two tasks, mirror drawing stress [MDS] and a maze task, and the postperiod value. Sickness absence through March 2010 was followed up by mail survey (average follow-up 2.3 years). Logistic regression analysis was used, adjusting for lifestyle factors. RESULTS Among 12 participants who took sickness absences, eight were owing to mental problems. Changes in the LF during the MDS and maze tasks and LF-to-HF ratio during the MDS task were positively associated with all sickness absences (odds ratio [OR], 95% confidence interval [CI]: 2.09, 1.03-4.22; 2.04, 1.09-3.82; and 3.10, 1.46-6.58, respectively). Changes in PBF during the MDS task were also associated with increased risk of sickness absence (OR, 95% CI: 2.53, 1.10-5.81). CONCLUSION Cardiovascular reactivity to acute stress should be considered at workers' health checks.
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Affiliation(s)
- Kumi Hirokawa
- Department of Nursing, Baika Women's University (Hirokawa), Ibaraki, Osaka, Japan.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Tetsuya Ohira
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan.,Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Mitsugu Kajiura
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Akihiko Kitamura
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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23
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Hanibuchi T, Nakaya T. Associations of neighborhood socioeconomic conditions with self-rated health, mental distress, and health behaviors: A nationwide cross-sectional study in Japan. Prev Med Rep 2020; 18:101075. [PMID: 32181123 PMCID: PMC7063227 DOI: 10.1016/j.pmedr.2020.101075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/04/2020] [Accepted: 03/03/2020] [Indexed: 11/20/2022] Open
Abstract
Although associations between neighborhood socioeconomic conditions and health have been well established, their geographical scope is mostly limited to Western societies, while multilevel studies in the non-Western context (e.g., Japan) are limited to specific cities/regions within countries. This consequently limits the external validity of the findings. To fill the gap, this study examined the associations between neighborhood socioeconomic conditions and health-related indicators by using nationwide cross-sectional data in Japan. Individual data was collected from a nationwide online survey conducted in 2015 (n = 4593). Self-rated health, mental distress (Kessler Psychological Distress Scale: K6), smoking, and physical activity were analyzed in relation to neighborhood conditions. Analyses of multilevel logistic regression models were done using the Areal Deprivation Index (ADI) with population density as the neighborhood-level independent variable. After adjusting for individual covariates, ADI showed significant positive associations with poor self-rated health (odds ratio for one standard deviation increase and 95% confidence interval: 1.09, 1.00–1.19), mental distress (1.09, 1.02–1.16), current smoking (1.11, 1.03–1.19), and physical inactivity (1.11, 1.04–1.18). Population density was not associated with the four dependent variables. Analyses of the nationwide survey data in Japan showed that neighborhood socioeconomic conditions were independently associated with multiple health statuses and behaviors. These analyses may contribute to generalizing existing findings. Lastly, the results indicate the importance of neighborhood socioeconomic conditions in reducing health disparities in Japan.
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Affiliation(s)
- Tomoya Hanibuchi
- School of International Liberal Studies, Chukyo University, 101-2 Yagoto-honmachi, Showa-ku, Nagoya 466-8666, Japan.,Department of Geography, Portland State University, Portland, OR, USA
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Sendai, Miyagi, Japan
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24
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Tabuchi T. Cancer and Socioeconomic Status. SOCIAL DETERMINANTS OF HEALTH IN NON-COMMUNICABLE DISEASES 2020. [DOI: 10.1007/978-981-15-1831-7_4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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25
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Nagatomo W, Saito J, Kondo N. Effectiveness of a low-value financial-incentive program for increasing vegetable-rich restaurant meal selection and reducing socioeconomic inequality: a cluster crossover trial. Int J Behav Nutr Phys Act 2019; 16:81. [PMID: 31511013 PMCID: PMC6740003 DOI: 10.1186/s12966-019-0830-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 08/06/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In light of recent theories in behavioural economics, an intervention program with monetary incentives could be effective for helping patrons order healthy food, even if the incentive is small and less than one's perceived marginal value. METHODS In this single-arm cluster crossover trial at 26 local restaurants, a 1-week campaign offered a 50-yen (approximately 0.5 US dollars) cash-back payment to customers ordering vegetable-rich meals, while no pre-order incentives were offered during the control period. RESULTS In total, 511 respondents out of 7537 customers (6.8%), and 704 respondents out of 7826 customers (9.0%), ordered vegetable-rich meals during the control and intervention periods, respectively. During the intervention period, the covariate-adjusted proportion of vegetable-rich meal orders was 1.50 times higher (95% confidence interval [CI]: 1.29 to 1.75), which increased daily sales by 1.77 times (95% CI: 1.11 to 2.83), even when subtracting the cost of cash-back payments. Respondents who reported spending the least amount of money on eating out (used as a proxy measure for income) were the least likely to order vegetable-rich meals during the control period. However, these individuals increased their proportion of purchasing such meals during the intervention period (a 3.8 percentage point increase (95% CI: 2.82 to 4.76) among those spending the least vs a 2.1 percentage point increase (95% CI: 1.66 to 2.62) among those spending the most; P for interaction = 0.001). Similarly, irregular employees exhibited a larger increase (+ 5.2 percentage points, 95% CI: 4.54 to 5.76) than did regular workers (- 1.4, 95% CI: - 1.66 to - 1.05, P for interaction = 0.001). CONCLUSIONS A program with an immediate low-value monetary incentive could be a public health measure for reducing inequalities in making healthy food choices. TRIAL REGISTRATION UMIN Clinical Trials Registry, UMIN000022396 . Registered 21 May 2016.
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Affiliation(s)
- Wataru Nagatomo
- Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Junko Saito
- Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
- Division of Prevention, Centre for Public Health Sciences, National Cancer Centre, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 Japan
| | - Naoki Kondo
- Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
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26
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Fujita T, Babazono A, Harano Y, Jiang P. Influence of Occupational Background on Smoking Prevalence as a Health Inequality Among Employees of Medium- and Small-Sized Companies in Japan. Popul Health Manag 2019; 23:183-193. [PMID: 31207197 PMCID: PMC7074897 DOI: 10.1089/pop.2019.0021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Tobacco smoking is a major public health problem. In addition, the influence of socioeconomic status on health inequalities has received great attention worldwide. The authors used insurance data of beneficiaries employed in medium- and small-sized Japanese companies to investigate the influence of occupational background on smoking prevalence as a health inequality among workers in Japan. Participants were aged 35–74 years and underwent health examinations in 2015. Smoking prevalence was estimated for each occupational group according to sex, age, and income. Logistic regression analysis was used to assess the association between smoking status and occupational groups. A total of 385,945 participants were included. Overall smoking prevalence was 36.3%, higher than average in Japan. Smoking prevalence was lowest among workers in the education and learning support category; all other occupational groups had significantly high prevalence, with the highest for transport and postal services (odds ratio 2.69, 95% confidence interval 2.53–2.86). There were few differences in smoking prevalence at higher income levels among female participants, but differences were remarkably significant at lower income levels. For health inequalities related to smoking, occupational background was associated with smoking prevalence. In particular, there was high smoking prevalence in workplaces not covered by smoke-free policies. These results also demonstrated differences between the sexes; smoking prevalence among female workers with lower income levels was strongly associated with occupational background whereas there were no large differences among male workers by income. These findings suggest that the government should encourage companies to adopt smoke-free policies in the workplace.
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Affiliation(s)
- Takako Fujita
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.,Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akira Babazono
- Department of Healthcare Administration and Management, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yumi Harano
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Peng Jiang
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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27
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Associations of education and income with heavy drinking and problem drinking among men: evidence from a population-based study in Japan. BMC Public Health 2019; 19:420. [PMID: 31014312 PMCID: PMC6480518 DOI: 10.1186/s12889-019-6790-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 04/09/2019] [Indexed: 12/03/2022] Open
Abstract
Background Some studies in Western countries have suggested that education and income are differentially associated with different drinking patterns. This study aimed to examine the associations of education and income with heavy drinking and problem drinking among community-dwelling Japanese men. Methods A questionnaire survey was conducted in metropolitan areas in Japan from 2010 to 2011 among residents aged 25 to 50 years; valid responses were received from 2004 men. Drinking patterns were categorized as non-to-moderate drinking, non-problematic heavy drinking, and problem drinking. Multiple logistic regression analyses were conducted to determine whether educational attainment or income was associated with drinking patterns, after adjustment for age, marital status, working status, income/education, self-rated health, and psychological distress. Results The study population included 84.4% non-to-moderate drinkers, 8.9% non-problematic heavy drinkers, and 6.7% problem drinkers. Lower educational attainment (high school or less) was significantly associated with increased risks of both non-problematic heavy drinking (odds ratio [OR], 1.80; 95% confidence interval [CI], 1.21–2.67) and problem drinking (OR, 2.06; 95% CI, 1.34–3.16), compared with university education or higher. Lower income (lowest tertile) was significantly associated with a lower risk of non-problematic heavy drinking (OR, 0.66; 95% CI, 0.43–1.00), but not of problem drinking (OR, 0.80; 95% CI, 0.50–1.30), compared with the highest income tertile. Conclusions These findings indicate that education and income are differentially associated with alcohol drinking patterns among community-dwelling Japanese men.
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Health, psychological, social and environmental mediators between socio-economic inequalities and participation in exercise among elderly Japanese. AGEING & SOCIETY 2019. [DOI: 10.1017/s0144686x1900014x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThis study examined which of the identified health, psychological, social and environmental mediators could most effectively explain the socio-economic status (SES)-based differences in participation in exercise among elderly Japanese. The candidates for mediators were composed based on the socio-ecological model. A representative sample of people 65 years and older living in two areas with different residential SES in Tokyo, Japan produced 739 effective participants. The intensity of exercise was evaluated based on whether the participants exercise for 30 minutes or longer twice a week, or for 20 minutes or longer three times a week. SES was evaluated by education and income. Mediators were assessed through four dimensions: (a) health, (b) psychological status, (c) social relations and (d) environmental context. As a result, SES's indirect effect through the mediators was evaluated using a multiple mediator model. The influence of both education and income on exercise was mediated by self-efficacy for exercise and social support for exercise. Self-efficacy for exercise had the strongest effect, while social support for exercise explained more of the income differences affecting participation in exercise than it did regarding educational differences. Self-efficacy for exercise may have the strongest effect as a mediator, which would explain the differences in participation in exercise among elderly Japanese based on education and income.
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Tomioka K, Kurumatani N, Saeki K. The Association Between Education and Smoking Prevalence, Independent of Occupation: A Nationally Representative Survey in Japan. J Epidemiol 2019; 30:136-142. [PMID: 30828035 PMCID: PMC7025916 DOI: 10.2188/jea.je20180195] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Higher smoking prevalence in less educated persons and manual workers is well known. This study examines the independent relationship of education and occupation with tobacco use. Methods We used anonymized data from a nationwide population survey (30,617 men and 33,934 women). Education was divided into junior high school, high school, or university attainment. Occupation was grouped into upper non-manual, lower non-manual, and manual. Poisson regression models stratified by age and gender were used to estimate adjusted prevalence ratio (PR) and 95% confidence interval (CI) for current smoking. Results After adjustment for covariates, education, and occupation, education was significantly related to current smoking in both genders; compared to university graduates, PRs of junior high school graduates aged 20–39, 40–64, and ≥65 were 1.74 (95% CI, 1.53–1.98), 1.50 (95% CI, 1.36–1.65), and 1.28 (95% CI, 1.08–1.50) among men, and 3.54 (95% CI, 2.92–4.30), 2.72 (95% CI, 2.29–3.23), and 1.74 (95% CI, 1.14–2.66) among women, respectively. However, significantly higher smoking prevalence in manual than in upper non-manual was found only in men aged 20–64; compared to upper non-manual, the PRs of manual workers aged 20–39, 40–64, and ≥65 were 1.11 (95% CI, 1.02–1.22), 1.18 (95% CI, 1.10–1.27), and 1.10 (95% CI, 0.89–1.37) among men, and 0.95 (95% CI, 0.75–1.20), 0.92 (95% CI, 0.75–1.12), and 0.46 (95% CI, 0.22–0.95) among women, respectively. Conclusions Independent of occupation, educational disparities in smoking existed, regardless of age and gender. Occupation-smoking relationship varied with age and gender. Our study suggests that we should pay attention to social inequality in smoking as well as national smoking prevalence.
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Affiliation(s)
- Kimiko Tomioka
- Nara Prefectural Health Research Center, Nara Medical University
| | - Norio Kurumatani
- Nara Prefectural Health Research Center, Nara Medical University
| | - Keigo Saeki
- Nara Prefectural Health Research Center, Nara Medical University
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Abbass MMS, AbuBakr N, Radwan IA, Rady D, El Moshy S, Ramadan M, Ahmed A, Al Jawaldeh A. The potential impact of age, gender, body mass index, socioeconomic status and dietary habits on the prevalence of dental caries among Egyptian adults: a cross-sectional study. F1000Res 2019; 8:243. [PMID: 30906540 PMCID: PMC6426081 DOI: 10.12688/f1000research.17892.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Dental caries is a major public health problem and the most widespread chronic disease to affect individuals throughout their lifetime. Little information exists about the prevalence of dental caries among Egyptian adults. Therefore, this study investigated the dental caries experience among Egyptian adults in correlation with different risk factors. Methods: A total of 359 Egyptian adults (age range, 18-74 years) were examined over a period of 3 months, starting on the 15
th of November 2017 until the 13
th of January 2018. Socio-demographic data, brushing frequency, body mass index (BMI) and eating habits were recorded and collected using a questionnaire. Dental examination was performed using the Decayed, Missing and Filled tooth (DMFT) index. Results: In total, 86.63% of participants had dental caries experience. Of the participants, 60.45%, 48.47% and 55.43% had at least one decayed, missing and filled tooth, respectively. The mean number of decayed, missing, filled or DMFT for the whole sample were 2.4±3.6, 1.98±3.99, 1.79±2.45, 6.09±5.7, respectively. Decayed teeth were inversely correlated with socio-economic status (SES), education level, brushing frequency and milk consumption and positively correlated with grains, junk food and soda drinks consumption. Missing teeth were inversely correlated with SES, education level and brushing frequency, while positively correlated with age, BMI and caffeinated drink consumption. Conversely, filled teeth were positively correlated with age, BMI, SES and education level, while negatively correlated with grains and sugars in drinks. Conclusion: The present study clarifies that age, BMI, SES, education level and brushing frequency are risk factors significantly associated with dental caries prevalence amongst Egyptian adults. Egyptian adults' dietary habits might lead to obesity, which indirectly causes dental caries rather than directly as in children.
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Affiliation(s)
- Marwa M S Abbass
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nermeen AbuBakr
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Israa Ahmed Radwan
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Dina Rady
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Sara El Moshy
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mohamed Ramadan
- Specialized Dental Hospital, Armed Forces Medical Complex, Cairo, Egypt
| | - Attera Ahmed
- Independent Researcher, Research door, Limerick, County Limerick, Ireland
| | - Ayoub Al Jawaldeh
- Nutrition Unit, World Health Organization Office for Eastern Mediterranean Region, Cairo, Egypt
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Tanaka R, Tsuji M, Tsuchiya T, Kawamoto T. Association Between Work-Related Factors and Diet: A Review of the Literature. Workplace Health Saf 2019; 67:137-145. [PMID: 30602349 DOI: 10.1177/2165079918812481] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The quality of workers' dietary intake could be influenced by their working conditions. This review aimed to summarize the published literature examining the association between work-related factors, such as work hours, shift work, physical strain, mental strain, job strain, support, and diet quality. The literature search, conducted in PubMed, was limited to articles published from 2000 to 2017, written in English, available online, and among workers employed in high-income countries. The search resulted in 16 articles that met the criteria. Although there was some evidence of unhealthy diet among shift workers, data on the diet quality in association with other work-related factors, such as number of hours worked, physical, mental, and job strain, and worksite support were scarce. Further studies are need for purposes better defining the association between work-related factors and quality of workers' diet.
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Affiliation(s)
- Rie Tanaka
- 1 University of Occupational and Environmental Health Japan
| | - Mayumi Tsuji
- 1 University of Occupational and Environmental Health Japan
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Tanaka R, Tsuji M, Kusuhara K, Kawamoto T. Association between time-related work factors and dietary behaviors: results from the Japan Environment and Children's Study (JECS). Environ Health Prev Med 2018; 23:62. [PMID: 30547743 PMCID: PMC6293619 DOI: 10.1186/s12199-018-0753-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 11/29/2018] [Indexed: 11/10/2022] Open
Abstract
Background Few studies have examined the association of workhours and shift work (referred to here as “time-related work factors”) with dietary behaviors. We aimed to investigate this association, as well as the dietary behaviors among individuals with occupations characterized by time-related work factors. Methods A cross-sectional study was performed using data from the Japan Environment and Children’s Study. The study included 39,315 working men. Dietary behaviors (i.e., skipping breakfast, eating out, eating instant food, overeating, and eating fast) were assessed with a self-reported information from the Food Frequency Questionnaire. Logistic regression analysis was conducted to examine the associations of time-related work factors with dietary behaviors and dietary behavior tendencies among those in occupations characterized by long workhours and/or shift work. Results Long workhours were associated with high frequencies of skipping breakfast, eating out, eating instant food, overeating, and eating fast. The frequency of having shift work was associated with high frequencies of skipping breakfast, eating out, and eating instant food. Several occupations involving long workhours and/or shift work showed specific dietary behaviors; in some occupations, the level of significance changed after adjusting for time-related work factors in addition to other potential confounding factors. Conclusions Time-related work factors may help explain workers’ dietary behaviors. Long workhours and shift work may lead to poor dietary behaviors. Other factors influenced by occupation itself, such as food environment, may also influence workers’ dietary behaviors. Workhours and/or shift work, and these other work factors, should be given attention in workplace health promotion.
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Affiliation(s)
- Rie Tanaka
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Mayumi Tsuji
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan.
| | - Koichi Kusuhara
- Japan Environment and Children's Study, UOEH Subunit Center, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan.,Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Toshihiro Kawamoto
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
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Tanaka R, Tsuji M, Asakura K, Senju A, Shibata E, Kusuhara K, Morokuma S, Sanefuji M, Kawamoto T. Variation in Men's Dietary Intake Between Occupations, Based on Data From the Japan Environment and Children's Study. Am J Mens Health 2018; 12:1621-1634. [PMID: 29890875 PMCID: PMC6142127 DOI: 10.1177/1557988318780847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
There has been increasing interest in dietary health promotion in the workplace. Although many previous studies have focused on dietary habits in specific occupations, variation between occupational groups requires clarification. The present study aimed to examine differences in food and nutrient intake between occupational groups, using detailed classification. A cross-sectional study was conducted using data from the Japan Environment and Children’s Study. The study included 38,721 employed Japanese expectant fathers aged between 20 and 65 years. Dietary intake was assessed using a food frequency questionnaire. Occupations were categorized into 11 categories according to the Japan Standard Occupational Classification. Analysis of variance and analysis of covariance were performed to compare dietary intake of occupational groups. Logistic regression analysis was performed to examine the differences in adherence to dietary recommendations across occupations. Dietary intake differed significantly between occupations. Specific dietary intake was observed in security and agricultural workers, who tended to exhibit higher consumption levels for numerous foods and nutrients. In addition, relative to other workers, security workers showed higher intake of dairy products and calcium, and agricultural workers consumed larger amounts of pickles and salt. The study categorized occupations into detailed categories using the Japan Standard Occupational Classification, which facilitated the clarification of overall dietary trends across occupations and identification of specific dietary characteristics in individual occupations. The findings could aid in workplace health promotion.
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Affiliation(s)
- Rie Tanaka
- 1 Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Mayumi Tsuji
- 1 Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Keiko Asakura
- 2 Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo, Japan
| | - Ayako Senju
- 3 Japan Environment and Children's Study (JECS), UOEH Subunit Center, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.,4 Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Eiji Shibata
- 5 Department of Obstetrics and Gynecology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Koichi Kusuhara
- 3 Japan Environment and Children's Study (JECS), UOEH Subunit Center, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.,4 Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Seiichi Morokuma
- 6 Research Center for Environmental and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masafumi Sanefuji
- 6 Research Center for Environmental and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshihiro Kawamoto
- 1 Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
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Tanaka R, Tsuji M, Senju A, Kusuhara K, Kawamoto T. Dietary Differences in Male Workers among Smaller Occupational Groups within Large Occupational Categories: Findings from the Japan Environment and Children's Study (JECS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E961. [PMID: 29751622 PMCID: PMC5982000 DOI: 10.3390/ijerph15050961] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 04/24/2018] [Accepted: 05/04/2018] [Indexed: 02/05/2023]
Abstract
Studies examining workers' diet according to smaller occupational groups within "large occupational categories" are sparse. The aim of this study was to examine the potential differences in workers' diets based on the classification of workers into smaller occupational groups that comprise "large occupational categories". The subjects of this study were working fathers who had participated in the Japan Environment and Children's Study (N = 38,656). Energy and nutrient intake were calculated based on data collected from the Food Frequency Questionnaire. Occupations were classified according to the Japanese Standard Occupational Classification. Logistic regression analyses were performed to examine the adherence to current dietary recommendations within smaller occupational groups. In particular, significant differences were observed among the categorical groups of "professional and engineering workers", "service workers", and "agricultural, forestry, and fishery workers". In "professional and engineering workers", teachers showed higher odds of adherence to calcium intake recommendations compared with nurses (OR, 2.54; 95% CI, 2.02⁻3.14; p < 0.001). In "agricultural, forestry, and fishery workers", agriculture workers showed higher odds of adherence to calcium (OR, 2.15; 95% CI, 1.46⁻3.15; p < 0.001) and vitamin C (OR 1.90, 95% CI 1.31⁻2.74, p = 0.001) intake recommendations compared with forestry and fishery workers. These findings may be beneficial from a research perspective as well as in the development of more effective techniques to improve workers' diet and health.
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Affiliation(s)
- Rie Tanaka
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan.
| | - Mayumi Tsuji
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan.
| | - Ayako Senju
- Japan Environment and Children's Study, UOEH Subunit Center, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan.
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan.
| | - Koichi Kusuhara
- Japan Environment and Children's Study, UOEH Subunit Center, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan.
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan.
| | - Toshihiro Kawamoto
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan.
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Simon-Tuval T, Shmueli A, Harman-Boehm I. Adherence of patients with type 2 diabetes mellitus to medications: the role of risk preferences. Curr Med Res Opin 2018; 34:345-351. [PMID: 29069921 DOI: 10.1080/03007995.2017.1397506] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To examine whether risk tolerance is associated with adherence to oral hypoglycemic agents (OHAs). METHODS We performed a cross-sectional study among adult patients with type 2 diabetes mellitus (n = 308) presenting for routine out-patient visits, using validated questionnaires to estimate: risk preferences (risk-seeking, risk averse, risk neutral), motivation, self-efficacy, impulsivity, perception of the disease and of the interpersonal process of care, demographic and socioeconomic characteristics; computerized patient medical records to estimate disease severity and a computerized database for retrieval of medication adherence, 1 year before the interview. Adherence was estimated using prescription-based measures of proportion of days covered (PDC). Concurrent adherence was calculated as: PDC with ≥1 OHAs; average PDC; PDC of ≥80% for all OHAs. RESULTS Multivariable ordered logit model revealed that compared to others, risk-seeking patients had lower PDC with ≥1 OHAs (β = -0.50, p ≤ .1). Specifically, risk-seeking patients were 11.2 percentage points less likely to have ≥80% of the follow-up period covered with ≥1 OHAs available (p ≤ .1). In addition, risk-seeking patients had lower average PDC (β = -0.85, p ≤ .05). Specifically, these patients were 19.5 percentage points less likely to have an average PDC of ≥80% (p ≤ .05). Multivariable logistic model revealed that risk-seeking was associated with lower probability of having PDC ≥80% for all OHAs in the follow-up period (OR; 90% CI: 0.59; 0.35-0.97). CONCLUSIONS Risk-seeking patients are less adherent to OHA medications. Identifying these patients may enable practitioners to proactively tailor strategies to improve their adherence and health outcomes.
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Affiliation(s)
- Tzahit Simon-Tuval
- a Department of Health Systems Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences , Ben-Gurion University of the Negev , Israel
| | - Amir Shmueli
- b The Braun Hebrew University-Hadassah School of Public Health , Israel
| | - Ilana Harman-Boehm
- c Faculty of Health Sciences , Ben-Gurion University of the Negev , Israel
- d Diabetes Clinic, Department of Internal Medicine C , Soroka University Medical Center , Israel
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Kondo N, Ishikawa Y. Affective stimuli in behavioural interventions soliciting for health check-up services and the service users' socioeconomic statuses: a study at Japanese pachinko parlours. J Epidemiol Community Health 2018; 72:e1. [PMID: 29330163 PMCID: PMC5909741 DOI: 10.1136/jech-2017-209943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 12/21/2017] [Accepted: 12/29/2017] [Indexed: 11/15/2022]
Abstract
Editor’s note
The study reported in this article examines a health intervention that uses gendered stereotypes of the nursing profession and suggestive uniforms that play on women’s sexuality to encourage people to engage in health checkups. The intervention was not under the control of the authors and the study was approved by an institutional research ethics board. The Journal of Epidemiology & Community Health condemns the use of sexism, gender and professional stereotypes and other forms of discriminatory or exploitative behaviour for any purpose, including health promotion programs. In light of concerns raised about this paper (see eLetters with this paper), we are conducting an audit of our review process and will put in place measures to ensure that the material we publish condemns sexism, racism and other forms of discrimination and embodies principles of inclusion and non-discrimination.
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Affiliation(s)
- Naoki Kondo
- Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Yoshiki Ishikawa
- Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Tokyo, Japan
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Goryoda S, Nishi N, Hozawa A, Yoshita K, Arai Y, Kondo K, Miyagawa N, Hayakawa T, Fujiyoshi A, Kadota A, Ohkubo T, Okamura T, Okuda N, Ueshima H, Okayama A, Miura K. Differences in Lifestyle Improvements With the Intention to Prevent Cardiovascular Diseases by Socioeconomic Status in a Representative Japanese Population: NIPPON DATA2010. J Epidemiol 2018; 28 Suppl 3:S35-S39. [PMID: 29503384 PMCID: PMC5825687 DOI: 10.2188/jea.je20170254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 10/17/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The relationships among socioeconomic status and lifestyle improvements have not yet been examined in a representative Japanese population. METHODS We analyzed data from 2,647 participants (1,087 men and 1,560 women) who participated in NIPPON DATA2010. This survey inquired about lifestyle improvements and socioeconomic status. Education was categorized as low (≤9 years), middle (10-12 years), and high (≥13 years). Marital status was categorized as married, divorced, widowed, and never married/other. A multivariable logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of lifestyle improvements with the intention of preventing cardiovascular diseases for educational attainment and marital status, with adjustments for age and awareness of cardiovascular disease risk factors. RESULTS Overall, 1,507 (56.9%) participants practiced prevention and improvements in hypertension, diabetes, elevated cholesterol, and metabolic syndrome, and the OR of lifestyle improvements was significantly higher with a high education than with a low education in men (OR 2.86; 95% CI, 1.96-4.17) and women (OR 2.36; 95% CI, 1.67-3.33). The number of participants who practiced prevention and improvements in hypertension, diabetes, elevated cholesterol, and metabolic syndrome was significantly lower in divorced than in married men (OR 0.46; 95% CI, 0.22-0.95) and women (OR 0.53; 95% CI, 0.33-0.86). CONCLUSIONS Specific differences caused by educational attainment and marital status may exist in lifestyle improvements.
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Affiliation(s)
- Sayuri Goryoda
- The Disease Prevention Science Course, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan
| | - Katsushi Yoshita
- Department of Food and Human Health Science, Osaka City University Graduate School of Human Life Science, Osaka, Japan
| | - Yusuke Arai
- Department of Nutrition, Chiba Prefectural University of Health Sciences, Chiba, Japan
| | - Keiko Kondo
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Naoko Miyagawa
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Takehito Hayakawa
- Research Center for Social Studies of Health and Community, Ritsumeikan University, Kyoto, Japan
| | - Akira Fujiyoshi
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
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Imanishi Y, Fukuma S, Karaboyas A, Robinson BM, Pisoni RL, Nomura T, Akiba T, Akizawa T, Kurokawa K, Saito A, Fukuhara S, Inaba M. Associations of employment status and educational levels with mortality and hospitalization in the dialysis outcomes and practice patterns study in Japan. PLoS One 2017; 12:e0170731. [PMID: 28264035 PMCID: PMC5338767 DOI: 10.1371/journal.pone.0170731] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 01/10/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Socioeconomic status (SES) factors such as employment, educational attainment, income, and marital status can affect the health and well-being of the general population and have been associated with the prevalence of chronic kidney disease (CKD). However, no studies to date in Japan have reported on the prognosis of patients with CKD with respect to SES. This study aimed to investigate the influences of employment and education level on mortality and hospitalization among maintenance hemodialysis (HD) patients in Japan. METHODS Data on 7974 HD patients enrolled in Dialysis Outcomes and Practice Patterns Study phases 1-4 (1999-2011) in Japan were analysed. Employment status, education level, demographic data, and comorbidities were abstracted at entry into DOPPS from patient records. Mortality and hospitalization events were collected during follow-up. Patients on dialysis < 120 days at study entry were excluded from the analyses. Cox regression modelled the association between employment and both mortality and hospitalization among patients < 60 years old. The association between education and outcomes was also assessed. The association between patient characteristics and employment among patients < 60 years old was assessed using logistic regression. RESULTS During a median follow-up of 24.9 months (interquartile range, 18.4-32.0), 10% of patients died and 43% of patients had an inpatient hospitalization. Unemployment was associated with mortality (hazard ratio [HR] = 1.57; 95% confidence interval [CI]: 1.05-2.36) and hospitalization (HR = 1.25; 95% CI: 1.08-1.44). Compared to patients who graduated from university, patients with less than a high school (HS) education and patients who graduated HS with some college tended to have elevated mortality (HR = 1.41; 95% CI, 1.04-1.92 and HR = 1.36; 95% CI: 1.02-1.82, respectively) but were not at risk for increased hospitalizations. Factors associated with unemployment included lower level of education, older age, female gender, longer vintage, and several comorbidities. CONCLUSIONS Employment and education status were inversely associated with mortality in patients on maintenance HD in Japan. Employment but not education was also inversely associated with hospitalizations. After adjustment for comorbidities, the associations with clinical outcomes tended to be stronger for employment than education status.
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Affiliation(s)
- Yasuo Imanishi
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
- * E-mail:
| | - Shingo Fukuma
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Angelo Karaboyas
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States of America
| | - Bruce M. Robinson
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States of America
- University of Michigan, Ann Arbor, MI, United States of America
| | - Ronald L. Pisoni
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States of America
| | | | - Takashi Akiba
- Department of Blood Purification and Internal Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | - Tadao Akizawa
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | | | - Akira Saito
- Division of Nephrology and Dialysis Center, Shonantobu General Hospital, Kanagawa, Japan
| | - Shunichi Fukuhara
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan
| | - Masaaki Inaba
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
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Matsumoto M, Nakayama K. Development of the health literacy on social determinants of health questionnaire in Japanese adults. BMC Public Health 2017; 17:30. [PMID: 28056903 PMCID: PMC5217562 DOI: 10.1186/s12889-016-3971-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 12/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health inequities are increasing worldwide, with mounting evidence showing that the greatest cause of which are social determinants of health. To reduce inequities, a lot of citizens need to be able to access, understand, appraise, and apply information on the social determinants; that is, they need to improve health literacy on social determinants of health. However, only a limited number of scales focus on these considerations; hence, we developed the Health Literacy on Social Determinants of Health Questionnaire (HL-SDHQ) and examined its psychometric properties. METHODS We extracted domains of the social determinants of health from "the solid facts" and related articles, operationalizing the following ten domains: "the social gradient," "early life," "social exclusion," "work," "unemployment," "social support," "social capital," "addiction," "food," and "transport," Next, we developed the scale items in the ten extracted domains based on the literature and included four aspects of health literacy (ability to access, understand, appraise, and apply social determinants of health-related information) in the items. We also evaluated the ease of response and content validity. The self-administered questionnaire consisted of 33 items. The reliability and construct validity were verified among 831 Japanese adults in an internet survey. RESULTS The scale items had high reliability with a Cronbach's alpha of 0.92, and also adequate results were obtained for the internal consistency of the information-processing dimensions (Cronbach's alpha values were 0.82, 0.91, 0.84, and 0.92 for accessing, understanding, appraising, and applying, respectively). The goodness of fit by confirmatory factor analysis based on the four dimensions was an acceptable value (comparative fit index = 0.901; root mean square error of approximation = 0.058). Furthermore, the bivariate relationship between HL-SDHQ and the frequency of participation in citizen's activities was similar to the theoretical results. CONCLUSIONS HL-SDHQ clarifies the relationship between the ten domains of the social determinants of health and health in each domain and is able to measure whether it is possible to access, understand, appraise, and apply related information. The reliability and validity of the scale were adequate.
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Affiliation(s)
- Masayoshi Matsumoto
- Universal Business Solutions, 3-1-1 Kyoubashi TOKYO SQUARE GARDEN, Chuo-ku, Tokyo, 104-0031, Japan.
| | - Kazuhiro Nakayama
- Department of Nursing Informatics, Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
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Amano H, Fukuda Y, Kitashima C, Yokoo T, Yamaoka K. Individual Income Status Correlates with Chronic Kidney Disease in Japan beyond Metabolic Risk Factors: Cross Sectional Study. Health (London) 2017. [DOI: 10.4236/health.2017.911112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ishikawa Y, Kondo N, Kawachi I, Viswanath K. Are socioeconomic disparities in health behavior mediated by differential media use? Test of the communication inequality theory. PATIENT EDUCATION AND COUNSELING 2016; 99:1803-1807. [PMID: 27349600 DOI: 10.1016/j.pec.2016.05.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 05/07/2016] [Accepted: 05/28/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Communication inequality has been offered as one potential mechanism through which social determinants influence multiple health behaviors. The purpose of this study was to examine the underlying mechanisms between communication inequality and health behaviors. METHODS Data from a nationally representative cross-sectional survey of 18,426 people aged 18 years and above in the United States were used for secondary analysis. Measures included socio-demographic characteristics, social participation (structural social capital), health media use (TV, print, and the Internet), and five health behaviors (physical activity, cigarette smoking, alcohol use, and intake of fruit and vegetable). Path analysis was performed to examine the linkages between social determinants, health media use, social participation, and social gradients in health behaviors. RESULTS Path analysis revealed that socioeconomic gradients in health behaviors is mediated by: 1) inequalities in health media use; 2) disparities in social participation, which leads to differential media use; and 3) disparities in social participation that are not mediated by media use. CONCLUSIONS Consistent with the theory of communication inequality, socioeconomic disparities in media use partially mediate disparities in multiple health behaviors. PRACTICE IMPLICATIONS To address health inequalities, it is important to utilize health media to target populations with low socioeconomic statuses.
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Affiliation(s)
- Yoshiki Ishikawa
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Cancer Scan, Shibuya-ku, Tokyo, Japan.
| | - Naoki Kondo
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, United States
| | - Kasisomayajula Viswanath
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, United States; Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, United States
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Higashibata T, Wakai K, Okada R, Nakagawa H, Hamajima N. Associations of smoking status with other lifestyle behaviors are modified by sex and occupational category among urban civil servants in Japan. Environ Health Prev Med 2016; 21:539-546. [PMID: 27699695 DOI: 10.1007/s12199-016-0577-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 09/18/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The aim of the present study was to examine the associations of current smoking with five other unhealthy lifestyle behaviors among urban civil servants in Japan according to sex and occupational category. METHODS The study included 10,232 urban civil servants in Japan who presented for a health check-up in 2011. We analyzed data on anthropometric measurements and self-reported lifestyle factors. RESULTS Current smokers had a higher BMI than never smokers in white-collar workers, but not in blue-collar workers of both sexes. There were strong associations of current smoking with irregular breakfasting regardless of sex and occupational category. In males, current smokers were less likely to take exercise than ex-smokers in both occupational categories. CONCLUSIONS The associations of current smoking with other unhealthy behaviors were modified by sex and occupational category. These results are useful for understanding the health risks among smokers according to sex and occupational category.
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Affiliation(s)
- Takahiro Higashibata
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Rieko Okada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Hiroko Nakagawa
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Hanibuchi T, Nakaya T, Honjo K. Trends in socioeconomic inequalities in self-rated health, smoking, and physical activity of Japanese adults from 2000 to 2010. SSM Popul Health 2016; 2:662-673. [PMID: 29349178 PMCID: PMC5757786 DOI: 10.1016/j.ssmph.2016.09.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/04/2016] [Accepted: 09/06/2016] [Indexed: 11/29/2022] Open
Abstract
Health disparities in Japan are attracting increasing attention. Temporal trends in health disparities should be continuously monitored using multiple indices of socioeconomic status (SES) and health-related outcomes. We explored changes in socioeconomic differences in the health of Japanese adults during 2000–2010. The data was taken from the Japanese General Social Surveys, the cross-sectional surveys for nationally representative samples of Japanese adults. We used 14,193 samples (individuals of 20–64 years of age) in our analysis. We estimated age-adjusted prevalence ratios of the lowest SES group in comparison with the highest SES group using Poisson regression models with robust error variance. Relative index of inequality (RII) and slope index of inequality (SII) were also calculated. We examined the changes in the association between health-related outcomes (self-rated health (SRH), smoking, and physical activity) and SES indices (income, education, occupation, and subjective social class identification). The results showed temporally expanding trends for the associations of current smoking with SES, especially among women, in both relative and absolute measures. In contrast, no expanding trends were seen for SRH and physical activity. Although the smoking rates declined through the first decade of the 21st century, the socioeconomic disparities in smoking prevalence among Japanese adults expanded, especially among women. Researchers and policymakers should continuously monitor the trends that may cause future disparities in smoking-related morbidity and mortality. Associations of health indicators with socioeconomic status were observed in Japan. We identified increasing trends in smoking disparity from 2000 to 2010 in women. Increasing smoking disparities were seen in both relative and absolute measures. Expanding trends were not seen for self-rated health and physical activity.
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Affiliation(s)
- Tomoya Hanibuchi
- School of International Liberal Studies, Chukyo University, 101-2 Yagoto Honmachi, Showa-ku, Nagoya, Aichi 466-8666, Japan
| | - Tomoki Nakaya
- Department of Geography and Research Institute for Disaster Mitigation of Urban Cultural Heritage, Ritsumeikan University, 58 Komatsubara Kitamachi, Kita-ku, Kyoto 603-8341, Japan
| | - Kaori Honjo
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
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Hirokawa K, Ohira T, Nagayoshi M, Kajiura M, Imano H, Kitamura A, Kiyama M, Okada T, Iso H. Occupational status and job stress in relation to cardiovascular stress reactivity in Japanese workers. Prev Med Rep 2016; 4:61-7. [PMID: 27413662 PMCID: PMC4929058 DOI: 10.1016/j.pmedr.2016.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 04/11/2016] [Accepted: 05/16/2016] [Indexed: 12/02/2022] Open
Abstract
This study aimed to investigate the effects of occupational status and job stress factors on cardiovascular stress reactivity in Japanese workers. In this baseline assessment between 2001 and 2009 in Osaka, Japan, we examined 928 healthy Japanese employees (330 men, 598 women) from two occupational statuses: managers/professionals and general workers. A brief job stress questionnaire was used to evaluate job stress levels. Systolic and diastolic blood pressure (SBP, DBP), heart rate, heart rate variability (high-frequency [HF], low-frequency [LF], LF/HF], and peripheral blood flow were measured at rest and during two stressful tasks. Changes in stress reactivity were calculated as the difference between the measured variables during the tasks and the rest period. Men showed inverse associations between quantitative job overload and DBP, heart rate, and LF/HF, between physical demands and blood pressure (SBP, DBP), and between a poor physical environment and HF. Men also had positive associations between qualitative job overload and heart rate, and between physical demands and peripheral blood flow (all p < 0.05). Women showed inverse associations between qualitative job overload and SBP, and showed positive associations between qualitative job overload and peripheral blood flow, and between a poor physical environment and SBP (all p < 0.05). When stratified by occupational status, significant associations between job stress and changes in stress reactivity were observed in male managers/professionals and female general workers (p < 0.05). Job stress levels are associated with changes in cardiovascular stress reactivity in men and women. Occupational status may modify these associations. Job stressors are associated with changes in stress reactivity in men and women. Job stressors associated with stress reactivity in male managers/professionals. Job stressors associated with stress reactivity in female general workers. Occupational status and gender differences should be considered.
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Affiliation(s)
- Kumi Hirokawa
- Department of Nursing, Baika Women's University, 2-19-5 Shukunosho, Ibaraki, Osaka 567-8578, Japan; Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Tetsuya Ohira
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Department of Epidemiology, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Mako Nagayoshi
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science 1-12-4 Sakamoto, Nagasaki 852-8523 JAPAN
| | - Mitsugu Kajiura
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-2 Nakamich, Higashinari-ku, Osaka 537-0025, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Akihiko Kitamura
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-2 Nakamich, Higashinari-ku, Osaka 537-0025, Japan
| | - Masahiko Kiyama
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-2 Nakamich, Higashinari-ku, Osaka 537-0025, Japan
| | - Takeo Okada
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-2 Nakamich, Higashinari-ku, Osaka 537-0025, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan
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Income Related Inequality of Health Care Access in Japan: A Retrospective Cohort Study. PLoS One 2016; 11:e0151690. [PMID: 26978270 PMCID: PMC4792389 DOI: 10.1371/journal.pone.0151690] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 03/02/2016] [Indexed: 11/19/2022] Open
Abstract
The purpose of this retrospective cohort study was to analyze the association between income level and health care access in Japan. Data from a total of 222,259 subjects (age range, 0–74 years) who submitted National Health Insurance claims in Chiba City from April 2012 to March 2014 and who declared income for the tax period from January 1 to December 31, 2012 were integrated and analyzed. The generalized estimating equation, in which household was defined as a cluster, was used to evaluate the association between equivalent income and utilization and duration of hospitalization and outpatient care services. A significant positive linear association was observed between income level and outpatient visit rates among all age groups of both sexes; however, a significantly higher rate and longer period of hospitalization, and longer outpatient care, were observed among certain lower income subgroups. To control for decreased income due to hospitalization, subjects hospitalized during the previous year were excluded, and the data was then reanalyzed. Significant inverse associations remained in the hospitalization rate among 40–59-year-old men and 60–69-year-old women, and in duration of hospitalization among 40–59 and 60–69-year-olds of both sexes and 70–74-year-old women. These results suggest that low-income individuals in Japan have poorer access to outpatient care and more serious health conditions than their higher income counterparts.
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Morris LJ, D'Este C, Sargent-Cox K, Anstey KJ. Concurrent lifestyle risk factors: Clusters and determinants in an Australian sample. Prev Med 2016; 84:1-5. [PMID: 26740345 DOI: 10.1016/j.ypmed.2015.12.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 11/04/2015] [Accepted: 12/17/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine clustering among three major lifestyle risk factors for chronic disease (smoking, alcohol, and physical inactivity) and define sociodemographic subgroups with elevated risks of multiple lifestyle risk factors. METHOD Data on 6052 adults aged 28-32, 48-52, and 68-72 from wave 3 (2007-2010) of the PATH Through Life Cohort Study, Australia, were used to estimate prevalence of individual and combinations of risk factors, and multinomial regression analysis undertaken to examine demographic factors associated with number of risks. RESULTS Clustering of risks varied by age and gender, with more people than expected having none or all of the risk factors. Smoking clustered with harmful alcohol use, as well as physical inactivity. No relationship was observed between physical inactivity and alcohol use. Several sociodemographic characteristics were associated with the number of lifestyle risk factors including partner status, gender, age, education, and physical and mental health related quality of life. CONCLUSIONS The tendency for lifestyle risk factors to aggregate in different subgroups has meaningful implications for health promotion strategies. Better insight in the more vulnerable subpopulations that are at higher risk of displaying multiple lifestyle risk factors is of importance if we wish to reduce the population propensity for chronic disease.
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Affiliation(s)
- Lara J Morris
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Building 62, Eggleston Road, Canberra, ACT 2601, Australia.
| | - Catherine D'Este
- National Centre for Epidemiology & Population Health, Research School of Population Health, Australian National University, Building 62, Eggleston Road, Canberra, ACT 2601, Australia.
| | - Kerry Sargent-Cox
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Building 62, Eggleston Road, Canberra, ACT 2601, Australia.
| | - Kaarin J Anstey
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Building 62, Eggleston Road, Canberra, ACT 2601, Australia.
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Yang T, Barnett R, Jiang S, Yu L, Xian H, Ying J, Zheng W. Gender balance and its impact on male and female smoking rates in Chinese cities. Soc Sci Med 2016; 154:9-17. [PMID: 26943009 DOI: 10.1016/j.socscimed.2016.02.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 01/27/2016] [Accepted: 02/21/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Although gender differences in smoking have received much attention, few studies have explored the importance of contextual effects on male and female smoking rates. The aim of this study is to examine the association between variations in city-level sex ratios and gender differences in smoking in China. METHODS Participants included 16,866 urban residents, who were identified through multi-stage sampling conducted in 21 Chinese cities. RESULTS The study found that, independent of personal characteristics, cities with more males had higher male smoking rates and lower female rates. CONCLUSIONS Our research underscores the importance of city-level contextual effects in understanding gender differences in smoking in China.
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Affiliation(s)
- Tingzhong Yang
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China.
| | - Ross Barnett
- Department of Geography, University of Canterbury, Christchurch 8140, New Zealand
| | - Shuhan Jiang
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Lingwei Yu
- Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Hong Xian
- Department of Biostatistics, Saint Louis University, St. Louis, MO 63104-1314, USA
| | - Jun Ying
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Weijun Zheng
- Department of Preventive Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, China
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Nakamura S, Inayama T, Hata K, Matsushita M, Takahashi M, Harada K, Arao T. Association of household income and education with eating behaviors in Japanese adults: a cross-sectional study. BMC Public Health 2016; 16:61. [PMID: 26800891 PMCID: PMC4722662 DOI: 10.1186/s12889-016-2748-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 01/19/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Socioeconomic inequalities as social determinants of health are important issues in public health and health promotion. However, the association between socioeconomic status and eating behaviors has been investigated poorly in Japanese adults. To fill this gap, the present study examines the association of eating behaviors with household income and education. METHODS The sample comprised 3,137 Japanese adults (1,580 men and 1,557 women) aged 30 to 59 years who responded to an Internet-based cross-sectional survey in 2014. Data on the following eating behaviors were collected via self-report: "taking care of one's diet for health," "eating vegetables," "frequency of eating breakfast," "frequency of family breakfasts," "frequency of family dinners," "using the information on nutrition labels," and "conversations with family or friends during meals." Self-reported data on socioeconomic status (household income and education) and demographic variables (gender, age, district of residence, marital status, residence status, and employment status) were also collected. The associations between eating behaviors and household income or education were tested using binomial logistic regression analysis with eating behaviors as dependent variables and household income and education as independent variables. A trend P -value was calculated for three categories of household income (less than 3,000,000 JPY, 3,000,000-7,000,000 JPY, and over 7,000,000 JPY) and education (junior high/high school, 2-year college, and 4-year college/graduate school). RESULTS Higher household income and education were significantly associated with higher rates of eating vegetables, using the information on nutrition labels, and conversation with family or friends during meals in Japanese men and women. Higher household incomes were significantly associated with lower rates of frequency of family breakfasts in Japanese men and lower rates of frequency of family dinners in Japanese men and women. CONCLUSIONS Higher socioeconomic status as indicated by household income or education was associated with eating more vegetables and conversation with family or friends during meals in Japanese men and women. Socioeconomic status should be considered in health promotion and diet improvement.
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Affiliation(s)
- Saki Nakamura
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Hachioji, Tokyo, Japan
| | - Takayo Inayama
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Hachioji, Tokyo, Japan.
| | - Kikuko Hata
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Hachioji, Tokyo, Japan
| | | | - Masaki Takahashi
- Faculty of Science and Engineering, Waseda University, Shinjyuku, Tokyo, Japan
| | - Kazuhiro Harada
- Section of Motor Function Activation, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Takashi Arao
- School of Sports Sciences, Waseda University, Tokorozawa, Saitama, Japan
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Dynamic impact of social stratification and social influence on smoking prevalence by gender: An agent-based model. Soc Sci Med 2015; 147:280-7. [DOI: 10.1016/j.socscimed.2015.08.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 06/19/2015] [Accepted: 08/23/2015] [Indexed: 12/13/2022]
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50
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Behanova M, Katreniakova Z, Nagyova I, van Ameijden EJ, van Dijk JP, Reijneveld SA. Elderly from lower socioeconomic groups are more vulnerable to mental health problems, but area deprivation does not contribute: a comparison between Slovak and Dutch cities. Eur J Public Health 2015; 27:80-85. [DOI: 10.1093/eurpub/ckv096] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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