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Nemoto Y, Sakurai R, Matsunaga H, Hasebe M, Fujiwara Y. Examining health risk behaviors of self-employed and employed workers in Japan: a cross-sectional study. Public Health 2022; 211:149-156. [PMID: 36115138 DOI: 10.1016/j.puhe.2022.07.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/14/2022] [Accepted: 07/22/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Self-employed workers have a higher risk for adverse health outcomes than employed workers. However, the differences in health risk behaviors by employment status are largely unknown. This study examined differences in health risk behaviors between self-employed and employed (permanent/non-permanent) workers by sex and age (20-59 years, 60-79 years). STUDY DESIGN This was a cross-sectional study involving community-dwelling adults living in urban cities in Japan. METHODS In 2019, we conducted a mail survey in Wako city, Saitama, and Fuchu city, Tokyo. In total, 30,315 adults aged ≥18 years were randomly selected, and 14,185 completed the survey (response rate: 46.8%). The participants for analysis were 8538 workers. Health risk behaviors included physical inactivity (<150 min/wk of moderate-to-vigorous physical activity), prolonged sitting (>480 min/d), high-frequency drinking (≥3 d/wk), tobacco use (current smoker), and overweight (body mass index ≥ 25 kg/m2). We also calculated the total number of health risk behaviors. RESULTS Self-employed workers had more health risk behaviors than permanent and non-permanent employees, with this difference more significant among younger males. In younger males, compared with self-employment, permanent employment was associated with less tobacco use, and non-permanent employment was associated with less physical inactivity, prolonged sitting, high-frequency drinking, and overweight. In younger females, non-permanent employment was associated with less prolonged sitting and overweight than self-employment. In older males and females, the prevalence of physical inactivity was lower in non-permanent employed than in self-employed workers. CONCLUSIONS Promoting health behaviors among self-employed may be beneficial for reducing health inequalities between self-employed and employed workers.
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Affiliation(s)
- Yuta Nemoto
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi, Tokyo 173-0015, Japan; Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku, Tokyo 160-8402, Japan.
| | - Ryota Sakurai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi, Tokyo 173-0015, Japan
| | - Hiroko Matsunaga
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi, Tokyo 173-0015, Japan
| | - Masami Hasebe
- Department of Human Welfare, Seigakuin University, 1-1 Tosaki, Ageo, Saitama 362-8585, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi, Tokyo 173-0015, Japan
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Lim D, Kong KA, Park H, Jung-Choi K. Employment status and mortality among Korean men over a 13-year period. Epidemiol Health 2021; 43:e2021055. [PMID: 34412445 PMCID: PMC8510830 DOI: 10.4178/epih.e2021055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/18/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES This study explored the effect of employment status on mortality over a 13-year period in Korean men. METHODS Data were used from the Korean Labor and Income Panel Study from 1999 to 2012. This study started with 2,737 subjects and included employed men in good health, aged 30-69 years. Deaths were tracked for 13 years from 2000 to 2012. Employment status classifications were: (1) regular employees, (2) precarious employees, (3) petty bourgeoisie, and (4) employers. Hazard ratios (HRs) were calculated using a Cox proportional hazards model, and were adjusted for age, education, income, and occupation, with regular employees as the reference category. To examine the effect of employment status and include employment history, the risk ratios of mortality were measured using the Poisson regression model, considering the duration of each employment and using 0 years as the reference category. RESULTS Over the course of the 13-year study, being a precarious employee (HR, 1.84) or petty bourgeoisie (HR, 1.87) at a particular point in time had a negative effect on mortality when compared with regular employees. Furthermore, working as precarious employees or petty bourgeoisie had no positive effect on mortality. A positive effect was observed, however, on the overall mortality risk for regular employees. CONCLUSIONS These results suggest that a healthy social policy is needed for precarious employees and petty bourgeoisie to avoid disadvantages in the workplace and the social safety net.
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Affiliation(s)
- Dohee Lim
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Kyoung Ae Kong
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea.,Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Kyunghee Jung-Choi
- Department of Occupational and Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Korea
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Krittanawong C, Kumar A, Wang Z, Baber U, Bhatt DL. Self-employment and cardiovascular risk in the US general population. INTERNATIONAL JOURNAL CARDIOLOGY HYPERTENSION 2021; 6:100035. [PMID: 33442670 PMCID: PMC7287446 DOI: 10.1016/j.ijchy.2020.100035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/24/2020] [Accepted: 05/29/2020] [Indexed: 11/18/2022]
Abstract
Background Studies on self-employment and cardiovascular risk are very limited. We examined the relationship between self-employment and cardiovascular risk among the general population in the United States from 1999 to 2016. Methods Using the National Health and Nutrition Examination Survey (NHANES), we identified all patients with hypertension (HTN), hyperlipidemia (HLD), diabetes mellitus (DM), stroke, heart failure (HF), and coronary artery disease (CAD) between 1999 and 2016. Type of job was defined based on the participant's response to the survey question as “an employee of a private company, business, or individual for wages, salary, or commission” or “self-employed in own business, professional practice or farm”. Multivariable logistic regression analyses were performed to adjust for confounders. Results Of 30,103 patients, 2835 (9.4%) were self-employed in their own business, professional practice, or farm and 27,268 (90.6%) were employed by a private company, business, or government. After adjusting for age, race, sex, BMI, marital status, educational level, health insurance status, smoking status, sleep duration and lipid profiles, self-employed individuals had a higher prevalence of HTN (OR: 1.12; 95% confidence interval [CI] 1.05–1.20), HLD (OR: 1.10; 95% CI 1.07–1.31), stroke (OR: 1.45; 95% CI 1.27–1.67), HF (OR: 1.17; 95% CI 1.03–1.32), and CAD (OR: 1.26; 95% CI 1.13–1.35) (all P v< 0.05). Conclusions Self-employment may be associated with greater cardiovascular risk in the US general population. Further prospective studies are urgently needed to establish the optimal preventive strategy to reduce cardiovascular risk in self-employed individuals. Self-employment may be associated with cardiovascular risk in the US general population Self-employed individuals may encounter work-related adversity, leading to cardiovascular risk Further prospective studies and clinical trials are urgently needed to establish the optimal preventive strategy for reducing cardiovascular risk associated with self-employment
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Affiliation(s)
- Chayakrit Krittanawong
- Section of Cardiology, Baylor School of Medicine and the Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Department of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, New York, NY, USA
| | - Anirudh Kumar
- Heart and Vascular Institute, Cleveland Clinic, OH, USA
| | - Zhen Wang
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
- Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Usman Baber
- Department of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, New York, NY, USA
| | - Deepak L. Bhatt
- Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA, USA
- Corresponding author. Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
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Maeda M, Filomeno R, Kawata Y, Sato T, Maruyama K, Wada H, Ikeda A, Tanigawa T. Association Between Employment Status and Short Sleep Duration Among Middle-Aged Japanese: the Survey on Time Use and Leisure Activities. Int J Behav Med 2019; 27:21-29. [PMID: 31346965 DOI: 10.1007/s12529-019-09807-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Short sleep duration (SSD) is reported to be highly associated with socio-economic status. There are few studies on the relationship between employment status and SSD in Japan. METHOD The authors used the 2006 Survey on Time Use and Leisure Activities conducted by the Ministry of Internal Affairs and Communications Japan, which provides representative samples of Japanese people. The anonymous data of 120,783 people aged 30-59 years were analyzed. Authors defined five categories of employment status: "unemployed," "regularly employed," "non-regularly employed," "self-employed," and "other." Authors also defined a sleep duration shorter than 5 h per night as SSD. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of SSD using regular employment as the reference group were calculated using the logistic regression model, adjusting for potential confounding factors, i.e., age, marital status, education level, communication device use, and the amount of time spent on various daily activities. RESULTS The prevalence of SSD was 2.8% (1639/58,308) in men and 3.2% (1976/62,475) in women. The multivariable-adjusted OR (95% CI) of SSD for the self-employed was 0.78 (0.65-0.92) in men and 1.78 (1.43-2.21) in women after adjustment for potential confounding factors, i.e., age, marital status, education level, and communication device use. Further adjustment for the time spent on daily activities revealed that the OR (95% CI) of SSD for the self-employed was 0.78 (0.65-0.92) in men and 1.89 (1.52-2.36) in women. CONCLUSION Self-employed women had a higher prevalence of SSD. By contrast, self-employed men had a lower prevalence of SSD.
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Affiliation(s)
- Mitsuya Maeda
- Department of Public Health, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Ronald Filomeno
- Department of Public Health, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yumi Kawata
- Department of Public Health, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Tomoyo Sato
- Department of Public Health, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Koutatsu Maruyama
- Department of Public Health, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Laboratory of Community Health and Nutrition, Special Course of Food and Health Science, Department of Bioscience, Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime, 790-8566, Japan
| | - Hiroo Wada
- Department of Public Health, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Ai Ikeda
- Department of Public Health, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
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Toivanen S, Griep RH, Mellner C, Vinberg S, Eloranta S. Mortality differences between self-employed and paid employees: a 5-year follow-up study of the working population in Sweden. Occup Environ Med 2016; 73:627-36. [PMID: 27443155 PMCID: PMC5013135 DOI: 10.1136/oemed-2015-103472] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 07/01/2016] [Indexed: 01/13/2023]
Abstract
Objectives Analyse mortality differences between self-employed and paid employees with a focus on industrial sector, educational level and gender using Swedish register data. Methods A cohort of the total working population (4 776 135 individuals; 7.2% self-employed; 18–100 years of age at baseline 2003) in Sweden with a 5-year follow-up (2004–2008) for all-cause and cause-specific mortality (57 743 deaths). Self-employed individuals were categorised as sole proprietors or limited liability company (LLC) owners according to their enterprise's legal form. Cox proportional hazards models were applied to compare mortality rates between sole proprietors, LLC owners and paid employees, adjusted for sociodemographic confounders. Results Mortality from cardiovascular diseases was 16% lower and from suicide 26% lower among LLC owners than among paid employees, adjusted for confounders. Within the industrial category, all-cause mortality was 13–15% lower among sole proprietors and LLC owners compared with employees in manufacturing and mining (MM) as well as personal and cultural services (PCS), and 11–20% higher in sole proprietors in trade, transport and communication and the welfare industry (W). A significant three-way interaction indicated 17–23% lower all-cause mortality among male LLC owners in MM and female sole proprietors in PCS, and 50% higher mortality in female sole proprietors in W than in employees in the same industries. Conclusions Mortality differences between self-employed individuals and paid employees vary by the legal form of self-employment, across industries, and by gender. Differences in work environment exposures and working conditions, varying market competition across industries and gender segregation in the labour market are potential mechanisms underlying these findings.
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Affiliation(s)
- Susanna Toivanen
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Rosane Härter Griep
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Christin Mellner
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Stig Vinberg
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
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Ota A, Kondo N, Murayama N, Tanabe N, Shobugawa Y, Kondo K. Serum Albumin Levels and Economic Status in Japanese Older Adults. PLoS One 2016; 11:e0155022. [PMID: 27276092 PMCID: PMC4898757 DOI: 10.1371/journal.pone.0155022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 04/22/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Low serum albumin levels are associated with aging and medical conditions such as cancer, liver dysfunction, inflammation, and malnutrition and might be an independent predictor of long-term mortality in healthy older populations. We tested the hypothesis that economic status is associated with serum albumin levels and explained by nutritional and health status in Japanese older adults. DESIGN We performed a cross-sectional analysis using data from the Japan Gerontological Evaluation study (JAGES). The study participants were 6528 functionally independent residents (3189 men and 3339 women) aged ≥65 years living in four municipalities in Aichi prefecture. We used household income as an indicator of economic status. Multiple linear regression was used to compare serum albumin levels in relation to household income, which was classified as low, middle, and high. Additionally, mediation by nutritional and health-related factors was analyzed in multivariable models. RESULTS With the middle-income group as reference, participants with low incomes had a significantly lower serum albumin level, even after adjustment for sex, age, residential area, education, marital status, and household structure. The estimated mean difference was -0.17 g/L (95% confidence interval, -0.33 to -0.01 g/L). The relation between serum albumin level and low income became statistically insignificant when "body mass index", "consumption of meat or fish", "self-rated health", "presence of medical conditions", "hyperlipidemia", or "respiratory disease "was included in the model. CONCLUSION Serum albumin levels were lower in Japanese older adults with low economic status. The decrease in albumin levels appears to be mediated by nutrition and health-related factors with low household incomes. Future studies are needed to reveal the existence of other pathways.
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Affiliation(s)
- Asami Ota
- Division of Health and Nutrition, University of Niigata Prefecture, Niigata, Japan
- * E-mail:
| | - Naoki Kondo
- Department of Health and Social Behavior/Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Nobuko Murayama
- Division of Health and Nutrition, University of Niigata Prefecture, Niigata, Japan
| | - Naohito Tanabe
- Division of Health and Nutrition, University of Niigata Prefecture, Niigata, Japan
| | - Yugo Shobugawa
- Division of International Health, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Science, Chiba University, Chiba, Japan
- Center for Well-being and Society, Nihon Fukushi University, Aichi, Japan
- National Center for Geriatrics and Gerontology, Obu City, Aichi, Japan
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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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Employment situation and risk of death among middle-aged Japanese women. J Epidemiol Community Health 2015; 69:1012-7. [DOI: 10.1136/jech-2015-205499] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 05/21/2015] [Indexed: 11/03/2022]
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Self-employment in joinery: an occupational risk facor? Int J Occup Med Environ Health 2014; 27:355-63. [PMID: 24763900 DOI: 10.2478/s13382-014-0261-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 02/05/2014] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Only a few studies have analyzed the health of self-employed workers. This cross-sectional study is the first to compare health status among craftsmen joiners and paid joiners. MATERIAL AND METHODS Clinical and paraclinical data for self-employed craftsmen and employees were collected by occupational health doctors according to a standardized protocol and compared. Health data and professional status relationships were analyzed by logistic regression. RESULTS A total of 171 craftsmen and 196 paid workers were included. Craftsmen had more dermatologic pathologies (odds ratio (OR) = 2.67, p < 0.05), ear/nose/throat symptoms (OR = 3.38, p < 0.001), pulmonary symptoms (OR = 2.46, p < 0.05), musculoskeletal symptoms (OR = 3.09, p < 0.001), and abnormal audiogram (OR = 3.50, p < 0.001). The FEV1 was significantly lower among craftsmen (p < 0.01), independently of tobacco smoke exposure. CONCLUSIONS This survey high-lights a high morbidity rate among self-employed craftsmen, suggesting that among woodworkers, professional status can be a risk factor for health. The preventive medical system for craftsmen has to be rethought to guarantee better safety for this population.
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Hiyoshi A, Fukuda Y, Shipley MJ, Brunner EJ. Health inequalities in Japan: the role of material, psychosocial, social relational and behavioural factors. Soc Sci Med 2014; 104:201-9. [PMID: 24581079 DOI: 10.1016/j.socscimed.2013.12.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 11/18/2013] [Accepted: 12/27/2013] [Indexed: 10/25/2022]
Abstract
The extent that risk factors, identified in Western countries, account for health inequalities in Japan remains unclear. We analysed a nationally representative sample (Comprehensive Survey of Living Conditions surveyed in 2001 (n = 40,243)). The cross-sectional association between self-rated fair or poor health and household income and a theory-based occupational social class was summarised using the relative index of inequality [RII]. The percentage attenuation in RII accounted for by candidate contributory factors - material, psychosocial, social relational and behavioural - was computed. The results showed that the RII for household income based on self-rated fair or poor health was reduced after including the four candidate contributory factors in the model by 20% (95% CI 2.1, 43.6) and 44% (95% CI 18.2, 92.5) in men and women, respectively. The RII for the Japanese Socioeconomic Classification [J-SEC] was reduced, not significantly, by 22% (95% CI -6.3, 100.0) in men in the corresponding model, while J-SEC was not associated with self-rated health in women. Material factors produced the most consistent and strong attenuation in RII for both socioeconomic indicators, while the contributions attributable to behaviour alone were modest. Social relational factors consistently attenuated the RII for both socioeconomic indicators in men whereas they did not make an independent contribution in women. The influence of perceived stress was inconsistent and depended on the socioeconomic indicator used. In summary, social inequalities in self-rated fair or poor health were reduced to a degree by the factors included. The results indicate that the levelling of health across the socioeconomic hierarchy needs to consider a wide range of factors, including material and psychosocial factors, in addition to the behavioural factors upon which the current public health policies in Japan focus. The analyses in this study need to be replicated using a longitudinal study design to confirm the roles of different factors in health inequalities.
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Affiliation(s)
- Ayako Hiyoshi
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom; Clinical Epidemiology and Biostatistics, Örebro University Hospital, Örebro, Sweden; School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
| | - Yoshiharu Fukuda
- Department of Community Health and Medicine, Yamaguchi University School of Medicine, Ube, Japan
| | - Martin J Shipley
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Eric J Brunner
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
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The relationship between job type and development of cerebral stroke in a large, longitudinal cohort study of workers in a railway company in Japan. Atherosclerosis 2013; 229:217-21. [DOI: 10.1016/j.atherosclerosis.2013.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 04/03/2013] [Accepted: 04/07/2013] [Indexed: 11/20/2022]
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Sposato LA, Ioli P, Povedano G, Esnaola y Rojas MM, Saposnik G. Unemployment: A Social Risk Factor Associated with Early Ischemic Stroke Mortality? Results from the Argentinean National Stroke Registry (ReNACer). J Stroke Cerebrovasc Dis 2012; 21:679-83. [DOI: 10.1016/j.jstrokecerebrovasdis.2011.02.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 02/26/2011] [Accepted: 02/27/2011] [Indexed: 10/18/2022] Open
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Li Q, Morikawa Y, Sakurai M, Nakamura K, Miura K, Ishizaki M, Kido T, Naruse Y, Suwazono Y, Nakagawa H. Occupational class and incidence rates of cardiovascular events in middle aged men in Japan. INDUSTRIAL HEALTH 2010; 48:324-330. [PMID: 20562508 DOI: 10.2486/indhealth.48.324] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We investigated whether occupational class affects the incidence of cardiovascular events in Japanese factory workers. We prospectively evaluated 1,794 male workers aged 40-59, including 632 non-manual and 1,162 manual workers, employed in a metal products factory in Japan. The hazard ratios of stroke, myocardial infarction (MI) and cardiovascular events (combined stroke, MI and sudden cardiac death) for manual workers were compared with non-manual workers as estimated by the Cox proportional hazards regression model. Among the 1,794 workers, there were 60 cardiovascular events (32 cases of stroke, 23 cases of MI and 5 cases of sudden cardiac death) with an incidence rate of 3.14 per 1,000 person-years for cardiovascular events; 1.68 for stroke and 1.20 for MI. Blood pressure and HbA1c significantly increased the risk of stroke. Body mass index and total cholesterol significantly increased the risk of MI. However, occupational class was determined not to be a risk factor for cardiovascular events. The hazard ratios of stroke, MI and cardiovascular events for manual workers compared with non-manual workers were 0.97 (95%CI, 0.45-2.08), 0.73 (95%CI, 0.30-1.79) and 0.92 (95%CI, 0.53-1.61), respectively. Our study did not reveal significant occupational class inequalities in the rate of cardiovascular events. These findings are not in accordance with studies from other industrialized countries.
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Affiliation(s)
- Qian Li
- Department of Social Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
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Kagamimori S, Gaina A, Nasermoaddeli A. Socioeconomic status and health in the Japanese population. Soc Sci Med 2009; 68:2152-60. [DOI: 10.1016/j.socscimed.2009.03.030] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2007] [Indexed: 10/20/2022]
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Ito S, Takachi R, Inoue M, Kurahashi N, Iwasaki M, Sasazuki S, Iso H, Tsubono Y, Tsugane S. Education in relation to incidence of and mortality from cancer and cardiovascular disease in Japan. Eur J Public Health 2008; 18:466-72. [DOI: 10.1093/eurpub/ckn052] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mirabelli MC, Zock JP, Plana E, Benke G, Kromhout H, Norbäck D, Olivieri M, Radon K, Villani S, Kogevinas M. Employment status and use of respiratory protection among metalworkers, solderers and welders. Occup Environ Med 2007; 64:548-52. [PMID: 17387135 PMCID: PMC2078493 DOI: 10.1136/oem.2006.031195] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Reported associations of self-employment with occupational injury and cerebrovascular disease suggest that worker safety and health precautions may vary by occupational status. The authors assessed the extent to which use of respiratory protection and ventilation equipment is associated with self-employed versus employee status among adults in an international study. METHODS The European Community Respiratory Health Survey II (ECRHS II) is a follow-up study conducted in a population-based random sample of adult ECRHS I participants. Men and women enrolled in the ECRHS II completed interviewer-administered questionnaires to provide information about their occupational status and job history during the 9-year ECRHS follow-up period. Respondents in selected occupational groups completed supplemental questionnaires about their jobs and use of respiratory protection and ventilation equipment on-the-job. The authors assessed self-reported use of respiratory and ventilation equipment among 72 self-employed and 371 employed adults in metalworking, soldering and welding occupations. RESULTS Local exhaust ventilation (fixed extraction: OR 0.37, 95% CI 0.17 to 0.80; mobile extraction: OR 0.23, 95% CI 0.09 to 0.60; on-tool extraction: OR 0.39, 95% CI 0.18 to 0.88) was reported less frequently among self-employed respondents than among employed respondents. The magnitude of the negative association between self-employment status and any of the three types of local exhaust ventilation was not attenuated by adjustment for duration of work per day or week or asthma and/or wheezing symptoms. Respiratory protection was not associated with employment status in these data. CONCLUSIONS More limited use of local exhaust ventilation among self-employed workers compared to employees suggests the need to promote occupational safety among self-employed workers.
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Affiliation(s)
- Maria C Mirabelli
- Centre for Research in Environmental Epidemiology, Municipal Institute of Medical Research, Barcelona, Spain.
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