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Trends and socioeconomic inequities in insomnia-related symptoms among Japanese adults from 1995 to 2013. J Affect Disord 2023; 323:540-546. [PMID: 36462611 DOI: 10.1016/j.jad.2022.11.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/24/2022] [Accepted: 11/20/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Although insomnia prevalence is increasing in developed countries, little is known about trends in sleep problems among Japanese adults according to socioeconomic status. Therefore, we aimed to determine trends and socioeconomic inequalities in insomnia-related symptom (IRS) in Japan using nationally representative data. METHODS The IRSs were based on past subjective sleeping difficulty. Using data from the Comprehensive Survey of Living Conditions for every 3 years from 1995 to 2013, we built multivariable Poisson regression models, with IRS as an outcome and survey year and socioeconomic status variables as explanatory variables. RESULTS Data from 513,223 Japanese adults were analyzed. Age- and sex-adjusted IRS prevalence was the lowest in 1995, highest in 2007, and decreased from 2007 to 2013. The IRSs were more frequently reported in unemployed or self-employed individuals aged 20-64 years; those with the lowest household expenditure level, except among women aged ≥65 years; and those divorced, separated, or single, especially among women aged 20-64 years. LIMITATIONS First, the repeated cross-sectional study design prevented the exclusion of the possibility of reversal of causality between factors. Second, data on insomnia-related lifestyle behaviors were unavailable. Third, the IRSs examined did not meet established clinical criteria for clinical insomnia. Fourth and fifth, information and selection biases could exist because of self-reported data and a small sample size, respectively. CONCLUSIONS These results could aid in developing more effective prevention strategies for sleep problems and provide benchmarks for monitoring sleep health trends in Japan and other East Asian countries.
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Li L, Ouyang F, He J, Qiu D, Luo D, Xiao S. Associations of Socioeconomic Status and Healthy Lifestyle With Incidence of Dyslipidemia: A Prospective Chinese Governmental Employee Cohort Study. Front Public Health 2022; 10:878126. [PMID: 35757615 PMCID: PMC9218108 DOI: 10.3389/fpubh.2022.878126] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 05/10/2022] [Indexed: 11/18/2022] Open
Abstract
Objective The purpose of the study was to test whether primary lifestyles mediate associations of SES with incidence of dyslipidemia and to explore interaction relations of lifestyles and SES with incidence of dyslipidemia. Methods We included 9,901 individuals at baseline from January 2018 to November 2019, and incidence data were updated to 31 December 2020. Dyslipidemia was defined as total cholesterol (TC) 6.2 mmol/L TC ≥ or triglycerides (TG) ≥2.3 mmol/L or low-density lipoprotein cholesterol (LDL-C) ≥4.1 mmol/L or high-density lipoprotein cholesterol (HDL-C) <1.0 mmol/L; or physician diagnosed dyslipidemia or lipid-lowering drugs use. Lifestyles, socioeconomic factors, and personal characteristics were collected by a questionnaire. A latent class analysis based on education, family income, and occupational position was used to assess the SES. Lifestyle score was calculated using cigarette smoking, alcohol consumption, physical activity, and diet. Cox proportional hazard models and multivariate analyses were used to explore the associations. The mediation effect was evaluated using bootstrap method. Results Participant mean age was 36.5 years (SD = 0.11). The cumulative incidence of dyslipidemia was 11.0% over a mean follow-up of 13.4 months. Compared with participants of high SES, those with low SES had higher risk of incidence of dyslipidemia [hazard ratio 1.32, 95% confidence interval (CI): 1.01–1.73], after adjusting for lifestyle scores and other covariates. The proportion mediated by lifestyles was 5.41% (95%CI: 4.17–7.11). A significant additive interaction was found between lifestyles and SES, whereas association between lifestyle and incidence of dyslipidemia was stronger among those of high SES. Additionally, individuals with low SES and no or one healthy lifestyle behavior had a higher risk of developing dyslipidemia than those with high SES and 3 or 4 healthy lifestyles. Conclusion Unhealthy lifestyles play a small moderating role in socioeconomic inequity in incidence of dyslipidemia among Chinese governmental employees, suggesting that promoting healthy lifestyles alone may not significantly reduce socioeconomic inequalities in health, and measures to address other social determinants of health should also be considered alongside.
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Affiliation(s)
- Ling Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Feiyun Ouyang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jun He
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Dan Qiu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Dan Luo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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A genetic sum score of effect alleles associated with serum lipid concentrations interacts with educational attainment. Sci Rep 2021; 11:16541. [PMID: 34400708 PMCID: PMC8368036 DOI: 10.1038/s41598-021-95970-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 08/02/2021] [Indexed: 11/16/2022] Open
Abstract
High-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC) levels are influenced by both genes and the environment. The aim was to investigate whether education and income as indicators of socioeconomic position (SEP) interact with lipid-increasing genetic effect allele scores (GES) in a population-based cohort. Using baseline data of 4516 study participants, age- and sex-adjusted linear regression models were fitted to investigate associations between GES and lipids stratified by SEP as well as including GES×SEP interaction terms. In the highest education group compared to the lowest stronger effects per GES standard deviation were observed for HDL-C (2.96 mg/dl [95%-CI: 2.19, 3.83] vs. 2.45 mg/dl [95%-CI: 1.12, 3.72]), LDL-C (6.57 mg/dl [95%-CI: 4.73, 8.37] vs. 2.66 mg/dl [95%-CI: −0.50, 5.76]) and TC (8.06 mg/dl [95%-CI: 6.14, 9.98] vs. 4.37 mg/dl [95%-CI: 0.94, 7.80]). Using the highest education group as reference, interaction terms showed indication of GES by low education interaction for LDL-C (ßGES×Education: −3.87; 95%-CI: −7.47, −0.32), which was slightly attenuated after controlling for GESLDL-C×Diabetes interaction (ßGES×Education: −3.42; 95%-CI: −6.98, 0.18). The present study showed stronger genetic effects on LDL-C in higher SEP groups and gave indication for a GESLDL-C×Education interaction, demonstrating the relevance of SEP for the expression of genetic health risks.
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Suzuki Y, Honjo K. The association between informal caregiving and poor self-rated health among ever-married women in Japan: A nationally representative survey. J Epidemiol 2020; 32:174-179. [PMID: 33281151 PMCID: PMC8918620 DOI: 10.2188/jea.je20200320] [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] [Indexed: 11/25/2022] Open
Abstract
Background The number of people providing informal caregiving, including dual care, which is the combination of child and nursing care, is increasing. Due to the burden of multiple responsibility, dual care could negatively affect the health of informal caregivers. Previous research has not studied the effects of combining different types of informal caregiving. Therefore, we examined, among Japanese women, 1) the association between types of informal caregiving and self-rated health (SRH), and 2) difference in this association according to caregivers’ socio-economic conditions. Methods We analyzed the nationally representative 2013 Comprehensive Survey of Living Conditions data of 104,171 women aged 20–59 years. The odds ratios (ORs) for poor SRH by type of informal caregiving (no care, childcare, nursing care, and dual care) were estimated using logistic regression. We also conducted sub-group analyses by socio-economic conditions (equivalent monthly household expenditure and educational attainment). Results Compared to the no care group, the adjusted ORs for poor SRH of the childcare, nursing-care, and dual care groups were 0.92 (95% confidence interval [CI], 0.88–0.97), 1.33 (95% CI, 1.21–1.47), and 1.42 (95% CI, 1.23–1.64), respectively. There was no extra risk arisen from combining childcare and nursing care. The sub-group analyses indicated that neither household expenditure nor educational attainment affected the association between caregiving type and poor SRH. Conclusion Our study found that informal nursing care and dual care impose a health burden on female caregivers, regardless of their socio-economic conditions. This highlights the importance of addressing the effects of informal caregiving on the health of women.
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Affiliation(s)
- Yuka Suzuki
- Social and Behavioral Sciences, Faculty of Medicine, Osaka Medical College
| | - Kaori Honjo
- Social and Behavioral Sciences, Faculty of Medicine, Osaka Medical College
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Asahara SI, Miura H, Ogawa W, Tamori Y. Sex difference in the association of obesity with personal or social background among urban residents in Japan. PLoS One 2020; 15:e0242105. [PMID: 33237961 PMCID: PMC7688126 DOI: 10.1371/journal.pone.0242105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/26/2020] [Indexed: 11/29/2022] Open
Abstract
The development of obesity is influenced by genetic and environmental factors and is associated with a variety of health problems. To gain insight into environmental factors that contribute to obesity, we analyzed the relation of personal or social background to obesity in men and women separately with the use of data from a community-based questionnaire survey of 5425 residents aged 20 to 64 years of Kobe, a representative large city in Japan. Obesity and normal weight were defined as a body mass index (BMI) of ≥25 and of ≥ 18.5 and < 25 kg/m2, respectively, according to the diagnostic criteria of the Japan Society for the Study of Obesity. The personal or social background factors examined included marital status, family structure, employment, household income, residence type, welfare enrollment, economic conditions of current life, educational level, extracurricular activity in school, living conditions at 15 years of age, and childhood adversity. We found that the prevalence of obesity was 27.2% and 10.6% in men and women, respectively. Among women, unmarried status, a low household income, welfare enrollment, difficult current economic conditions, a low educational level, and childhood adversity were associated with obesity, whereas none of the personal or social background factors examined were associated with obesity in men. Our results suggest that the development of obesity in women is strongly influenced by personal or social background, and such factors should be taken into consideration in the management of this condition in women.
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Affiliation(s)
- Shun-ichiro Asahara
- Division of Creative Health Promotion, Department of Social/Community Medicine and Health Science, Kobe University Graduate School of Medicine, Kobe, Japan
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Miura
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Wataru Ogawa
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshikazu Tamori
- Division of Creative Health Promotion, Department of Social/Community Medicine and Health Science, Kobe University Graduate School of Medicine, Kobe, Japan
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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Takaku R. Reversal pattern of health inequality: New evidence from a large-scale national survey in Japan. Health Policy 2020; 124:1254-1262. [DOI: 10.1016/j.healthpol.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 08/10/2020] [Accepted: 08/17/2020] [Indexed: 01/11/2023]
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Dutheil F, Baker JS, Mermillod M, De Cesare M, Vidal A, Moustafa F, Pereira B, Navel V. Shift work, and particularly permanent night shifts, promote dyslipidaemia: A systematic review and meta-analysis. Atherosclerosis 2020; 313:156-169. [PMID: 33069952 DOI: 10.1016/j.atherosclerosis.2020.08.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/15/2020] [Accepted: 08/26/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Shift work is common worldwide and linked to deleterious cardiovascular effects that might be underlined by dyslipidemia. The aim of this systematic review and meta-analysis is to determine the impact of shiftwork on dyslipidemia. METHODS Searching in PubMed, Cochrane Library, Science Direct and Embase databases without language restriction on 15 February 2020, included studies that describe blood lipids levels or a risk measure in shift workers compared with fixed-day workers (controls). Differences by study-level characteristics were estimated using stratified meta-analysis by type of shift work, and meta-regression to examine relations between dyslipidemia and demographic, lifestyle and work characteristics. Estimates were pooled using random-effect meta-analysis. RESULTS We included a total of 66 articles, representing 197,063 workers. Shift work globally increased the levels of triglycerides (overall SMD = 0.09; 95CI 0.05 to 0.13; p < 0.001), and globally decreased the levels of c-HDL (-0.08; 95CI -0.12 to -0.03; p = 0.001). Permanent night shift workers were an at-risk type of shift for dyslipidemia with significantly higher blood levels of total cholesterol (0.22; 95CI 0.01 to 0.42; p = 0.043) and triglycerides (0.18; 0.03 to 0.33; p = 0.017), and significantly lower blood levels of c-HDL (-0.16; 95CI -0.32 to 0.00; p = 0.05). Permanent night shift workers were more at-risk for total cholesterol than rotating 3 × 8 shift workers (Coefficient 0.22; 95CI 0.01 to 0.42; p = 0.038) and rotating 2 × 12 shift workers (0.24; 0.02 to 0.46; p = 0.037), and more at-risk for triglycerides than rotating day shift workers (0.21; 95CI 0.03 to 0.38; p = 0.023). Results were non-significant for c-LDL, nor depending on type of shifts. CONCLUSIONS Shift work, and particularly permanent night shift, is associated with dyslipidaemia via elevated total cholesterol and triglycerides, and reduced HDL-cholesterol. Our current study provides a practical and valuable strengthening of the evidence-base required for preventive health initiatives and workplace reform.
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Affiliation(s)
- Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, F-63000, Clermont-Ferrand, France.
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Martial Mermillod
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, LPNC, Grenoble, France; Institut Universitaire de France, Paris, France
| | - Mélanie De Cesare
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, F-63000, Clermont-Ferrand, France
| | - Alexia Vidal
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, F-63000, Clermont-Ferrand, France
| | - Fares Moustafa
- CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Emergency Unit, F-63000, Clermont-Ferrand, France
| | - Bruno Pereira
- University Hospital of Clermont-Ferrand (CHU), Clinical Research and Innovation Direction, Clermont-Ferrand, France
| | - Valentin Navel
- Université Clermont Auvergne, CNRS, INSERM, GReD, Translational Approach to Epithelial Injury and Repair, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Ophthalmology, F-63000, Clermont-Ferrand, France
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Watanabe T, Sugiyama T, Takahashi H, Noguchi H, Tamiya N. Concordance of hypertension, diabetes and dyslipidaemia in married couples: cross-sectional study using nationwide survey data in Japan. BMJ Open 2020; 10:e036281. [PMID: 32723739 PMCID: PMC7389765 DOI: 10.1136/bmjopen-2019-036281] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Because married couples have many environmental influences in common, spouses may develop similar diseases. This study aimed to determine the concordance of hypertension, diabetes and dyslipidaemia, which are major risk factors for cardiovascular disease, among married couples in Japan. RESEARCH DESIGN AND METHODS We conducted a cross-sectional study of married couples who were both aged ≥40 years using the 2016 Comprehensive Survey of Living Conditions, which is a Japanese national survey. We first determined the proportions of wives and husbands who were receiving therapy for each of the diseases of interest. We then conducted logistic regression analyses using the wives undergoing therapy for each disease as outcomes and the husbands undergoing therapy for the same disease as the principal exposure, adjusting for covariates. RESULTS The subjects of the analyses were 86 941 married couples. The wives of male patients were significantly more likely to be receiving therapy for the same disease. Logistic regression revealed that when husbands were undergoing therapy for these diseases their wives had ORs (95% CIs) of 1.79 (1.72-1.86) for hypertension, 1.45 (1.34-1.58) for diabetes, 2.58 (2.41-2.75) for dyslipidaemia and 1.87 (1.80-1.93) for any of these diseases. CONCLUSIONS If men have hypertension, diabetes or dyslipidaemia, their wives were also more susceptible to the same disease. Medical professionals and couples may need to recognise these results and consider couple-based interventions to help the prevention, early detection and treatment of these diseases.
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Affiliation(s)
- Taeko Watanabe
- Department of Health Services Research, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Takehiro Sugiyama
- Department of Health Services Research, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Hideto Takahashi
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
- National Institute of Public Health, Wako, Saitama, Japan
| | - Haruko Noguchi
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Faculty of Political Science and Economics, Waseda University, Shinjuku-ku, Tokyo, Japan
| | - Nanako Tamiya
- Department of Health Services Research, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Zaitsu M, Kato S, Kim Y, Takeuchi T, Sato Y, Kobayashi Y, Kawachi I. Occupational Class and Risk of Cardiovascular Disease Incidence in Japan: Nationwide, Multicenter, Hospital-Based Case-Control Study. J Am Heart Assoc 2020; 8:e011350. [PMID: 30845875 PMCID: PMC6475056 DOI: 10.1161/jaha.118.011350] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background In contemporary Western settings, higher occupational class is associated with lower risk for cardiovascular disease (CVD) incidence, including coronary heart disease (CHD) and stroke. However, in non‐Western settings (including Japan), the occupational class gradient for cardiovascular disease risk has not been characterized. Methods and Results Using a nationwide, multicenter hospital inpatient data set (1984–2016) in Japan, we conducted a matched hospital case‐control study with ≈1.1 million study subjects. Based on a standard national classification, we coded patients according to their longest‐held occupational class (blue‐collar, service, professional, manager) within each industrial sector (blue‐collar, service, white‐collar). Using blue‐collar workers in blue‐collar industries as the referent group, odds ratios and 95% CIs were estimated by conditional logistic regression with multiple imputation, matched for sex, age, admission date, and admitting hospital. Smoking and drinking were additionally controlled. Higher occupational class (professionals and managers) was associated with excess risk for CHD. Even after controlling for smoking and drinking, the excess odds across all industries remained significantly associated with CHD, being most pronounced among managers employed in service industries (odds ratio, 1.19; 95% CI, 1.08–1.31). On the other hand, the excess CHD risk in higher occupational class was offset by their lower risk for stroke (eg, odds ratio for professionals in blue‐collar industries, 0.77; 95% CI, 0.70–0.85). Conclusions The occupational “gradient” in cardiovascular disease (with lower risk observed in higher status occupations) may not be a universal phenomenon. In contemporary Japanese society, managers and professionals may experience higher risk for CHD.
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Affiliation(s)
- Masayoshi Zaitsu
- 1 Department of Social and Behavioral Sciences Harvard T.H. Chan School of Public Health Boston MA.,2 Department of Public Health Graduate School of Medicine The University of Tokyo Japan
| | - Soichiro Kato
- 1 Department of Social and Behavioral Sciences Harvard T.H. Chan School of Public Health Boston MA.,3 Department of Trauma and Critical Care Medicine Kyorin University School of Medicine Tokyo Japan
| | - Yongjoo Kim
- 1 Department of Social and Behavioral Sciences Harvard T.H. Chan School of Public Health Boston MA
| | | | - Yuzuru Sato
- 5 Department of Gastroenterology Kanto Rosai Hospital Kanagawa Japan
| | - Yasuki Kobayashi
- 2 Department of Public Health Graduate School of Medicine The University of Tokyo Japan
| | - Ichiro Kawachi
- 1 Department of Social and Behavioral Sciences Harvard T.H. Chan School of Public Health Boston MA
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Narisada A, Suzuki K. Association between procrastination, white-collar work and obesity in Japanese male workers: a cross-sectional study. BMJ Open 2019; 9:e029931. [PMID: 31740465 PMCID: PMC6887083 DOI: 10.1136/bmjopen-2019-029931] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To investigate the associations among procrastination (time inconsistency), work environment and obesity-related factors in Japanese male workers. DESIGN Cross-sectional study. SETTING Data were collected at two work sites of Japanese electronics manufacturing company in 2015. PARTICIPANTS 795 full-time male workers in a Japanese electric company, aged 35-64 years, who underwent health checkups in 2015. MAIN OUTCOME MEASURES Body mass index (BMI), adult weight change, obesity (BMI ≥25 kg/m2), adult weight gain over 10 kg (AWG10) and metabolic syndrome (MetS). Multivariable linear and logistic regression analyses were performed to assess the associations of procrastination assessed by using a one-item questionnaire and white-collar and blue-collar work with obesity-related factors. RESULTS White-collar workers with high procrastination levels showed positive associations with BMI (B: 0.75, 95% CI 0.06 to 1.44) and adult weight change (B: 1.77, 95% CI 0.26 to 3.29), and had increased odds of AWG10 (OR: 1.85, 95% CI 1.04 to 3.29) and MetS (OR: 2.29 95% CI 1.18 to 4.44) after adjustment for age, education, work-related factors and lifestyle factors. However, such positive associations were not observed among blue-collar workers. CONCLUSIONS Procrastination and white-collar work might have a joint effect on weight gain during adulthood and consequential obesity.
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Affiliation(s)
- Akihiko Narisada
- Institute for Occupational Health Science, Aichi Medical University, Nagakute, Japan
| | - Kohta Suzuki
- Institute for Occupational Health Science, Aichi Medical University, Nagakute, Japan
- Department of Health and Psychosocial Medicine, Aichi Medical University, Nagakute, Japan
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Mbouemboue OP, Ngoufack TJO. High Blood Pressure Prevalence, Awareness, Control, and Associated Factors in a Low-Resource African Setting. Front Cardiovasc Med 2019; 6:119. [PMID: 31544107 PMCID: PMC6728810 DOI: 10.3389/fcvm.2019.00119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/05/2019] [Indexed: 01/13/2023] Open
Abstract
Background and Objectives: Recent and contextualized data are needed to improve hypertension management known as a major cardiovascular disease risk factor regardless of the geographical area. This study aimed at assessing the prevalence of hypertension, awareness of hypertensive status, treatment, and control of hypertension as well as assessing the factors associated with risk of hypertension and awareness of hypertensive status in the population of Ngaoundere. Methods: This was a community based cross sectional study carried out from February to December 2016. A three-stage sampling method was used for recruitment of participants. Demographic, clinical, and biological data were collected and analyzed using Statistical Package for Social Sciences version 20.0. Statistical significance was set at P < 0.05. Results: In total, 948 participants were included in the study. The overall prevalence of hypertension was 46.94% (n = 445). Fraction of hypertensive participants who were aware of their status was 36.85% (n = 164). Among them, 39 (23.78%) were getting treatment and the control rate of treated hypertensives was 30.56%. Age, marital status, family history of hypertension, overweight, and high serum triglyceride level were identified as independent predicting factors of hypertension, whereas female gender, age, personal history of stroke or diabetes, family history of hypertension or heart failure, overweight, and abdominal obesity were those of hypertension awareness. Conclusion: The present study revealed high prevalence, extremely low awareness, treatment, and control rates of hypertension in Ngaoundere community setting.
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Affiliation(s)
- Olivier Pancha Mbouemboue
- Department of Biomedical Sciences, Faculty of Science, University of Ngaoundere, Ngaoundere, Cameroon
- General Medicine Service, Ngaoundere Regional Hospital, Ngaoundere, Cameroon
| | - Tsougmo Jacques Olivier Ngoufack
- Department of Biomedical Sciences, Faculty of Science, University of Ngaoundere, Ngaoundere, Cameroon
- Hypertension and Diabetes Unit, Ngaoundere Regional Hospital, Ngaoundere, Cameroon
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Gao L, DU M, Li J, Zhao NJ, Yang Y, Dong C, Sun XL, Chi B, Wang Q, Chen W, Tian C, Zhang N, Li L, Niu LW, Zheng H, Bao H, Liu Y, Sun J. Effects of occupation on intracerebral hemorrhage-related deaths in Inner Mongolia. INDUSTRIAL HEALTH 2019; 57:342-350. [PMID: 30089766 PMCID: PMC6546581 DOI: 10.2486/indhealth.2018-0057] [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: 03/07/2018] [Accepted: 07/25/2018] [Indexed: 06/08/2023]
Abstract
This study assessed the relationship between occupation and Intracerebral Hemorrhage-related deaths and compared the differences in ICH-related deaths rates between the eastern and midwestern regions of Inner Mongolia. We used the case-control method. Cases included Intracerebral Hemorrhage-related deaths that occurred from 2009 to 2012 in Inner Mongolia while controls included non-circulatory system disease deaths that occurred during the same period. Odds ratios (ORs) for Intracerebral Hemorrhage-related deaths were calculated using logistic regression analysis, estimated according to occupation, and adjusted for marital status and age. The Intracerebral Hemorrhage mortality rate in the eastern regions (125.19/100000) was nearly 3 times higher than that in the midwestern regions (45.31/100000). ORs for agriculture-livestock workers, service professionals and general workers, professional workers and senior officials were in descending order. The age-adjusted OR for Intracerebral Hemorrhage-related deaths was lowest in unmarried men senior officials (OR 0.37, 95% CI 0.14-0.99). The Intracerebral Hemorrhage mortality rate in the eastern regions was much higher than that of the midwestern regions, since about 90% of Intracerebral Hemorrhage-related deaths in the eastern regions were those of agriculture-livestock workers who has the largest labor intensity of any other occupation assessed.
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Affiliation(s)
- Liqun Gao
- Inner Mongolia Medical University, China
| | - Maolin DU
- Inner Mongolia Medical University, China
| | - Jiayi Li
- Beijing Health Vocational College, China
| | - Neng Jun Zhao
- The Affiliated People's Hospital of Inner Mongolia Medical University, China
| | - Ying Yang
- Inner Mongolia Medical University, China
| | - Chao Dong
- Inner Mongolia Medical University, China
| | | | | | | | | | - Chunfang Tian
- Inner Mongolia Autonomous Region Hospital of Traditional Chinese Medicine, China
| | - Nan Zhang
- Inner Mongolia Medical University, China
| | - Lehui Li
- Inner Mongolia Medical University, China
| | - Li Wei Niu
- Inner Mongolia Medical University, China
| | | | - Han Bao
- Inner Mongolia Medical University, China
| | - Yan Liu
- Inner Mongolia Medical University, China
| | - Juan Sun
- Inner Mongolia Medical University, China
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13
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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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14
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Nagamine Y, Kondo N, Yokobayashi K, Ota A, Miyaguni Y, Sasaki Y, Tani Y, Kondo K. Socioeconomic Disparity in the Prevalence of Objectively Evaluated Diabetes Among Older Japanese Adults: JAGES Cross-Sectional Data in 2010. J Epidemiol 2018; 29:295-301. [PMID: 30449769 PMCID: PMC6614078 DOI: 10.2188/jea.je20170206] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background Studies on sex-specific socioeconomic gradients in objectively evaluated diabetes among older adults are scarce. Methods We used cross-sectional data of 9,893 adults aged 65 years and older in Aichi Prefecture without long-term care insurance from the Japan Gerontological Evaluation Study (JAGES) in 2010 (Response rate: 66.3%). We collected demographic, socioeconomic (income, years of education, and longest occupation) and behavioral information using a mail-in self-reported survey. Blood samples for the objectively evaluated diabetes and self-reported medical history were collected at annual municipal health checkups. Poisson regression analysis stratified by sex with multiple imputations was conducted to calculate prevalence ratio and 95% confidence interval. Results A clear income gradient in diabetes prevalence was observed among women, from 11.7% in the lowest income quartile (Q1) to 7.8% in the highest (Q4). Among men, the findings were 17.6% in Q1 to 15.1% in Q4. The prevalence ratios for diabetes with incomes Q1 to Q4 were 1.43 (95% confidence interval [CI], 1.07–1.90) for women and 1.16 (95% CI, 0.90–1.50) for men after adjusting for age and other socioeconomic factors. Even after adjusting for marital status, body mass index, other metabolic risk factors, and lifestyle factors, the income-based gradient remained among women. Education and occupation were not significantly associated with diabetes in the study population. Conclusions Only women showed an income-based gradient in diabetes. Monitoring income gradient in diabetes is important in public health actions, even in older populations. Future longitudinal and intervention studies should evaluate the causal link of income to diabetes onset, determine the mechanisms of the potential sex differences in the income/diabetes association, and identify ways to mitigate the income-based inequality.
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Affiliation(s)
- Yuiko Nagamine
- Department of Public Health, Graduate School of Medicine, Chiba University
| | - Naoki Kondo
- Department of Health Education and Health Sociology, School of Public Health, the University of Tokyo
| | | | - Asami Ota
- Division of Health and Nutrition, University of Niigata Prefecture
| | - Yasuhiro Miyaguni
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology
| | - Yuri Sasaki
- Department of International Health and Collaboration, National Institute of Public Health
| | - Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU).,Research Fellow of Japan Society for the Promotion of Science
| | - Katsunori Kondo
- Department of Public Health, Graduate School of Medicine, Chiba University.,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology.,Center for Well-being and Society, Nihon Fukushi University
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15
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ANDO E, KACHI Y, KAWAKAMI N, FUKUDA Y, KAWADA T. Associations of non-standard employment with cardiovascular risk factors: findings from nationwide cross-sectional studies in Japan. INDUSTRIAL HEALTH 2018; 56:336-345. [PMID: 29657240 PMCID: PMC6066431 DOI: 10.2486/indhealth.2017-0079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 03/22/2018] [Indexed: 05/04/2023]
Abstract
This study aimed to examine the cross-sectional association of non-standard employment with cardiovascular disease risk factors. Five yr of data from the Comprehensive Survey of Living Conditions and National Health and Nutritional Survey were combined. We used logistic regression to examine the association of employment contract (non-standard [part-time, dispatched, or contract] vs. standard [full-time and permanent]) with eight cardiovascular disease risk factors among 1,636 men and 2,067 women aged 40-60 yr. There were significant associations between non-standard employment and cardiovascular disease risk factors such as current smoking among men (odds ratio [OR] 1.39; 95% confidential interval [CI], 1.13-1.86) and diabetes among women (OR 1.83; 95% CI, 1.10-3.09). Non-standard employment was associated with a few cardiovascular disease risk factors in this middle-aged cohort in Japan.
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Affiliation(s)
- Emiko ANDO
- Department of Mental Health, Graduate School of Medicine, The
University of Tokyo, Japan
| | - Yuko KACHI
- Department of Hygiene and Public Health, Nippon Medical
School, Japan
| | - Norito KAWAKAMI
- Department of Mental Health, Graduate School of Medicine, The
University of Tokyo, Japan
| | | | - Tomoyuki KAWADA
- Department of Hygiene and Public Health, Nippon Medical
School, Japan
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16
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Fujiyoshi N, Arima H, Satoh A, Ojima T, Nishi N, Okuda N, Kadota A, Ohkubo T, Hozawa A, Nakaya N, Fujiyoshi A, Okamura T, Ueshima H, Okayama A, Miura K. Associations between Socioeconomic Status and the Prevalence and Treatment of Hypercholesterolemia in a General Japanese Population: NIPPON DATA2010. J Atheroscler Thromb 2018; 25:606-620. [PMID: 29321397 PMCID: PMC6055037 DOI: 10.5551/jat.42531] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 11/09/2017] [Indexed: 01/16/2023] Open
Abstract
AIM To investigate associations between socioeconomic status (SES) and the prevalence and treatment status of hypercholesterolemia in a general Japanese population. METHODS In 2010, we established a cohort study of 2417 adults (age 20-91 yr) from 300 randomly selected areas across Japan who participated in the National Health and Nutrition Survey of Japan. We cross-sectionally examined an association between SES and (1) prevalence of hypercholesterolemia in 2417 participants (999 men and 1418 women) and (2) not receiving medication for hypercholesterolemia in 654 participants (215 men and 439 women). SES included employment status, marital status, length of education, and household expenditures. Hypercholesterolemia was defined as a total serum cholesterol level of ≥6.21 mmol/L (240 mg/dL) or the use of lipid-lowering medications. RESULTS The overall prevalence of hypercholesterolemia was 21.5% in men and 31.0% in women. In men, the lowest quintile of household expenditures was associated with a higher prevalence of hypercholesterolemia (28.3%) compared with the upper 4 quintiles (19.9%) (multivariable-adjusted odds ratio 1.66; 95% confidence interval [CI] 1.16-2.38). Among participants with hypercholesterolemia, 55.4% of men and 55.1% of women were not receiving medication. Unmarried men were more likely to be untreated (75.0%) than married men (50.9%) (multivariable-adjusted odds ratio 2.53;95%CI 1.05-6.08). SES had no significant effects in women. CONCLUSION In a general population of Japanese men, low household expenditures were associated with a higher prevalence of hypercholesterolemia, and unmarried men with hypercholesterolemia were less likely to receive medication.
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Affiliation(s)
- Naoko Fujiyoshi
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Hisatomi Arima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Atsushi Satoh
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, 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
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Sciences, Shiga, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health Teikyo University School of Medicine, Tokyo, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Naoki Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Sciences, Shiga, Japan
| | - Akira Okayama
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Sciences, Shiga, Japan
| | - NIPPON DATA2010 Research Group
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Sciences, Shiga, Japan
- Department of Hygiene and Public Health Teikyo University School of Medicine, Tokyo, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan
- Research Institute of Strategy for Prevention, Tokyo, Japan
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17
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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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18
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Ota A, Yatsuya H, Nishi N, Okuda N, Ohkubo T, Hayakawa T, Kadota A, Okayama A, Miura K. Relationships among Socioeconomic Factors and Self-rated Health in Japanese Adults: NIPPON DATA2010. J Epidemiol 2018; 28 Suppl 3:S66-S72. [PMID: 29503389 PMCID: PMC5825690 DOI: 10.2188/jea.je20170246] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 10/18/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The distributions of socioeconomic status (SES) factors have been changing in Japan. We examined the relationships among SES and self-rated health (SRH) in Japanese adults. METHODS We analyzed 1,178 men and 1,555 women. We showed the distribution of SRH by sex and age and examined cross-sectional relationships among educational attainment, marital/living statuses, working status, household income and expenditure, and fine SRH (defined as excellent, very good, or good). We adjusted for age, subjective symptoms, visiting doctors, monthly equivalent household expenditure (EHE), and living in their own house. RESULTS The age-standardized prevalence of fine SRH was 79% and 73% among men and women, respectively. Among men, graduating from high school (adjusted odds ratio [aOR] 1.53; 95% confidence interval [CI], 1.07-2.19, relative to graduating from elementary or junior high school) and university or junior college (aOR 1.74; 95% CI, 1.15-2.62) was associated with fine SRH. Among women, graduating from university or junior college was associated with fine SRH (aOR 1.65; 95% CI, 1.12-2.46). Neither marital/living status nor working status was associated with SRH after adjustments for age in either sex. Among women, high EHE and income were associated with fine SRH (the highest expenditure group: aOR 1.80; 95% CI, 1.22-2.65; the highest income group: aOR 2.15; 95% CI, 1.34-3.46, relative to the corresponding lowest group). These simple relationships were not observed for men. CONCLUSIONS High educational attainment was associated with fine SRH. Relationships among household income, EHE, and fine SRH differed by sex.
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Affiliation(s)
- Atsuhiko Ota
- Department of Public Health, Fujita Health University School of Medicine, Aichi, Japan
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University School of Medicine, Aichi, 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
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Takehito Hayakawa
- Research Center for Social Studies of Health and Community, Ritsumeikan University, Kyoto, Japan
| | - Aya Kadota
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
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19
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Nakamura T, Nakamura Y, Saitoh S, Okamura T, Yanagita M, Yoshita K, Kita Y, Murakami Y, Yokomichi H, Nishi N, Okuda N, Kadota A, Ohkubo T, Ueshima H, Okayama A, Miura K. Relationship Between Socioeconomic Status and the Prevalence of Underweight, Overweight or Obesity in a General Japanese Population: NIPPON DATA2010. J Epidemiol 2018; 28 Suppl 3:S10-S16. [PMID: 29503379 PMCID: PMC5825685 DOI: 10.2188/jea.je20170249] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Socioeconomic status (SES) imbalances in developed and developing countries may result in individuals being overweight and obese. However, few studies have investigated this issue in Japan. We herein examined the relationship between SES and being underweight, overweight or obese according to sex and age groups (20-64 or ≥65 years) in Japan. METHODS In 2010, we established a cohort of participants in the National Health and Nutrition Survey of Japan. We divided 2,491 participants (1,081 men and 1,410 women) according to the WHO definitions of underweight, overweight or obesity and performed multinomial logistic analyses using BMI <18.5 kg/m2 (underweight), BMI 25.0-29.9 kg/m2 (overweight), and BMI ≥30.0 kg/m2 (obese) versus BMI 18.5-24.9 kg/m2 (normal) as the outcome, with SES groups as the main explanatory variables. RESULTS In adult men, a lower education level relative to a higher education level was inversely associated with obesity after adjustments for other SESs (odds ratio [OR] 0.41; 95% confidence interval [CI], 0.18-0.96). However, in adult women, lower education level was positively associated with being overweight and obese (OR 1.67; 95% CI, 1.07-2.49 for overweight and OR 2.66; 95% CI, 1.01-7.01 for obese). In adult women, a lower household income was positively associated with being overweight and obese (obese: OR 4.84; 95% CI, 1.36-17.18 for those with a household income <2 million JPY relative to those with ≥6 million JPY). CONCLUSIONS In adult women, a lower education level and lower household income were positively associated with being overweight or obese. In contrast, in adult men, a lower education level was inversely associated with obesity. Gender and age differences in SESs affect the prevalence of being overweight or obese.
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Affiliation(s)
- Tomiyo Nakamura
- Department of Food Science and Human Nutrition, Ryukoku University, Shiga, Japan
| | - Yasuyuki Nakamura
- Department of Food Science and Human Nutrition, Ryukoku University, Shiga, Japan
| | - Shigeyuki Saitoh
- School of Health Sciences, Sapporo Medical University, Hokkaido, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Masahiko Yanagita
- Faculty of Health and Sports Science, Doshisha University, Kyoto, Japan
| | - Katsushi Yoshita
- Department of Food and Human Health Science, Osaka City University Graduate School of Human Life Science, Osaka, Japan
| | - Yoshikuni Kita
- Faculty of Nursing Science, Tsuruga Nursing University, Fukui, Japan
| | - Yoshitaka Murakami
- Department of Medical Statistics, School of Medicine, Toho University, Tokyo, Japan
| | - Hiroshi Yokomichi
- Department of Health Sciences, University of Yamanashi, Yamanashi, 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
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Aya Kadota
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Hirotsugu Ueshima
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
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20
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Tsuji M, Arima H, Ohkubo T, Nakamura K, Takezaki T, Sakata K, Okuda N, Nishi N, Kadota A, Okamura T, Ueshima H, Okayama A, Miura K. Socioeconomic Status and Knowledge of Cardiovascular Risk Factors: NIPPON DATA2010. J Epidemiol 2018; 28 Suppl 3:S46-S52. [PMID: 29503386 PMCID: PMC5825694 DOI: 10.2188/jea.je20170255] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 10/10/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The relationship between socioeconomic status (SES) and knowledge of cardiovascular risk factors remains unknown in a general Japanese population. METHODS Of 8,815 participants from 300 randomly selected areas throughout Japan, 2,467 participants who were free of cardiovascular disease and who provided information on SES in the National Health and Nutrition Survey of Japan 2010 were enrolled in this cross-sectional analysis. SES was classified according to the employment status, length of education, marital and living statuses, and equivalent household expenditure (EHE). Outcomes were ignorance of each cardiovascular risk factor (hypertension, diabetes, hypercholesterolemia, low high-density lipoprotein [HDL] cholesterol, arrhythmia, and smoking) and insufficient knowledge (number of correct answers <4 out of 6). RESULTS A short education and low EHE were significantly associated with a greater ignorance of most cardiovascular risk factors. A short education (<10 years) was also associated with insufficient knowledge of overall cardiovascular risk factors: age- and sex-adjusted odds ratios (OR) were 1.92 (95% confidence interval [CI], 1.51-2.45) relative to participants with ≥13 years of education. Low EHE was also associated with insufficient knowledge (age- and sex-adjusted OR 1.24; 95% CI, 1.01-1.51 for the lowest quintile vs the upper 4 quintiles). These relationships remained significant, even after further adjustments for regular exercise, smoking, weekly alcohol consumption, body mass index, hypertension, diabetes mellitus, hypercholesterolemia, and low HDL cholesterol. CONCLUSION Participants with a short education and low EHE were more likely to have less knowledge of cardiovascular risk factors.
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Affiliation(s)
- Masayoshi Tsuji
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Koshi Nakamura
- Department of Public Health, Hokkaido University, Hokkaido, Japan
| | - Toshiro Takezaki
- Department of International Island and Community Medicine, Kagoshima University, Kagoshima, Japan
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Iwate, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, 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
| | - 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
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, 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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Miyamoto K, Iwakuma M, Nakayama T. Effect of Genetic Information Regarding Salt-Sensitive Hypertension on the Intent to Maintain a Reduced Salt Diet: Implications for Health Communication in Japan. J Clin Hypertens (Greenwich) 2017; 19:270-279. [PMID: 27572673 PMCID: PMC8030761 DOI: 10.1111/jch.12897] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 07/07/2016] [Accepted: 07/21/2016] [Indexed: 12/29/2022]
Abstract
The authors investigated the relationship between the awareness of dietary salt and genetics and the intent to maintain a low-salt diet. In particular, they assessed whether hypothetical genetic information regarding salt-sensitive hypertension motivates the intent to reduce dietary salt for communicating the health benefits of lower salt consumption to citizens. A self-administered questionnaire survey was conducted with 2500 randomly sampled residents aged 30 to 69 years living in Nagahama, Japan. Genetic information regarding higher salt sensitivity increased motivation to reduce salt intake for both those who agreed that genes cause hypertension and those who did not. Less than 50% of those who agreed that genes cause hypertension lost their intention to lower their salt consumption when they found they did not possess the susceptibility gene. Communicating genetic information positively affected motivation to reduce salt intake. The present study clarifies the difficulty in changing the behavioral intent of those who have significantly less incentive to reduce salt intake. Therefore, a multidimensional approach is crucial to reduce salt consumption.
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Affiliation(s)
- Keiko Miyamoto
- Department of Medical CommunicationKyoto University School of Public HealthJapan
| | - Miho Iwakuma
- Department of Medical CommunicationKyoto University School of Public HealthJapan
| | - Takeo Nakayama
- Department of Health InformaticsKyoto University School of Public HealthJapan
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Associations of socioeconomic status with prevalence, awareness, treatment, and control of hypertension in a general Japanese population. J Hypertens 2017; 35:401-408. [DOI: 10.1097/hjh.0000000000001169] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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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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Ikeda N. Secondary Data Analysis of National Surveys in Japan Toward Improving Population Health. J Epidemiol 2016; 26:106-14. [PMID: 26902170 PMCID: PMC4773486 DOI: 10.2188/jea.je20150319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Secondary data analysis of national health surveys of the general population is a standard methodology for health metrics and evaluation; it is used to monitor trends in population health over time and benchmark the performance of health systems. In Japan, the government has established electronic databases of individual records from national surveys of the population’s health. However, the number of publications based on these datasets is small considering the scale and coverage of the surveys. There appear to be two major obstacles to the secondary use of Japanese national health survey data: strict data access control under the Statistics Act and an inadequate interdisciplinary research environment for resolving methodological difficulties encountered when dealing with secondary data. The usefulness of secondary analysis of survey data is evident with examples from the author’s previous studies based on vital records and the National Health and Nutrition Surveys, which showed that (i) tobacco smoking and high blood pressure are the major risk factors for adult mortality from non-communicable diseases in Japan; (ii) the decrease in mean blood pressure in Japan from the late 1980s to the early 2000s was partly attributable to the increased use of antihypertensive medication and reduced dietary salt intake; and (iii) progress in treatment coverage and control of high blood pressure is slower in Japan than in the United States and Britain. National health surveys in Japan are an invaluable asset, and findings from secondary analyses of these surveys would provide important suggestions for improving health in people around the world.
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Affiliation(s)
- Nayu Ikeda
- Center for International Collaboration and Partnership, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition
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25
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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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Tabuchi T, Nakamura M, Nakayama T, Miyashiro I, Mori JI, Tsukuma H. Tobacco Price Increase and Smoking Cessation in Japan, a Developed Country With Affordable Tobacco: A National Population-Based Observational Study. J Epidemiol 2015; 26:14-21. [PMID: 26277880 PMCID: PMC4690736 DOI: 10.2188/jea.je20140183] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Longitudinal assessment of the impact of tobacco price on smoking cessation is scarce. Our objective was to investigate the effect of a price increase in October 2010 on cessation rates according to gender, age, socioeconomic status, and level of tobacco dependence in Japan. Methods We used longitudinal data linkage of two nationally representative studies and followed 2702 smokers for assessment of their cessation status. The odds ratios (ORs) for cessation were calculated using logistic regression. To estimate the impact of the 2010 tobacco price increase on cessation, data from 2007 were used as a reference category. Results Overall cessation rates significantly increased from 2007 to 2010, from 3.7% to 10.7% for men and from 9.9% to 16.3% for women. Cessation rates were 9.3% for men who smoked 1–10 cigarettes per day, 2.7% for men who smoked 11–20 cigarettes per day, and 2.0% for men who smoked more than 20 cigarettes per day in 2007. These rates increased to 15.5%, 10.0%, and 8.0%, respectively, in 2010. The impact was stronger among subjects who smoked more than 11 cigarettes per day than those who smoked 1–10 cigarettes per day in both sexes: ORs for 2010 were 4.04 for those smoking 11–20 cigarettes per day, 4.26 for those smoking more than 20 cigarettes per day, and 1.80 for those smoking 1–10 cigarettes per day in the main model in men. There were no obvious differences in the relationship between tobacco price increase and smoking cessation across age and household expenditure groups. Conclusions The tobacco price increase in Japan had a significant impact on smoking cessation in both sexes, especially among heavy smokers, with no clear difference in effect by socio-demographic status.
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Affiliation(s)
- Takahiro Tabuchi
- Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases
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Kachi Y, Otsuka T, Kawada T. Socioeconomic Status and Overweight: A Population-Based Cross-Sectional Study of Japanese Children and Adolescents. J Epidemiol 2015; 25:463-9. [PMID: 26005066 PMCID: PMC4483371 DOI: 10.2188/jea.je20140108] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 12/14/2014] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Socioeconomic status (SES) as a determinant of obesity has received scant attention in Japan. This study examined the association between SES and overweight among Japanese children and adolescents. METHODS Cross-sectional analyses of a representative sample of Japanese children (6-11 years: n = 397) and adolescents (12-18 years: n = 397) were performed, with measured heights and weights from the 2010 National Health and Nutrition Examination Survey and the 2010 Comprehensive Survey of Living Conditions. Overweight, including obesity, was defined by International Obesity Task Force cut-offs. SES indicators included household income, equivalent household expenditure, parental educational attainment, and parental occupational class. RESULTS Overweight prevalence was 12.3% in children and 9.1% in adolescents. Adolescents living in middle-income households were more likely to be overweight than those living in high-income households (OR 2.26, 95% CI, 1.01-5.67) after adjustment for age, sex, and parental weight status. Similarly, adolescents living in households with low expenditure levels were more likely to be overweight than those living in households with high expenditure levels (OR 3.40, 95% CI, 1.20-9.60). In contrast, no significant association was observed among children. CONCLUSIONS Our results indicated that low household economic status was associated with being overweight, independent of parental weight status, among Japanese adolescents.
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Affiliation(s)
- Yuko Kachi
- Department of Hygiene and Public Health, Nippon Medical School
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Ito K, Aida J, Yamamoto T, Ohtsuka R, Nakade M, Suzuki K, Kondo K, Osaka K. Individual- and community-level social gradients of edentulousness. BMC Oral Health 2015; 15:34. [PMID: 25884467 PMCID: PMC4460930 DOI: 10.1186/s12903-015-0020-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 02/20/2015] [Indexed: 11/24/2022] Open
Abstract
Background Community-level factors as well as individual-level factors affect individual health. To date, no studies have examined the association between community-level social gradient and edentulousness. The aim of this study was to investigate individual- and community-level social inequalities in edentulousness and to determine any explanatory factors in this association. Methods We analyzed the data from the Japan Gerontological Evaluation Study (JAGES). In 2010-2012, 112,123 subjects aged 65 or older responded to the questionnaire survey (response rate = 66.3%). Multilevel logistic regression analysis was applied to determine the association between community-level income and edentulousness after accounting for individual-level income and demographic covariates. Then, we estimated the probability of edentulousness by individual- and community-level incomes after adjusted for covariates. Results Of 79,563 valid participants, the prevalence of edentulousness among 39,550 men (49.7%) and 40,013 women (50.3%) were both 13.8%. Living in communities with higher mean incomes and having higher individual-level incomes were significantly associated with a lower risk of edentulousness (odds ratios [ORs] by 10,000 USD increments were 0.37 (95% confidence interval [CI] [0.22-0.63]) for community-level and 0.85 (95% CI [0.84-0.86]) for individual-level income). Individual- and community-level social factors, including density of dental clinics, partially explained the social gradients. However, in the fully adjusted model, both community- and individual-level social gradients of edentulousness remained significant (ORs = 0.43 (95% CI [0.27-0.67]) and 0.90 (95% CI [0.88-0.91]), respectively). One standard deviation changes in community- and individual-level incomes were associated with 0.78 and 0.84 times lower odds of edentulousness, respectively. In addition, compared to men, women living in communities with higher average incomes had a significantly lower risk of edentulousness (p-value for interaction < 0.001). Conclusions Individual- and community-level social inequalities in dental health were observed. Public health policies should account for social determinants of oral health when reducing oral health inequalities.
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Affiliation(s)
- Kanade Ito
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai City, Miyagi, Japan. .,Division of Oral Health Sciences, Department of Health Sciences, School of Health and Social Services, Saitama Prefectural University, Koshigaya City, Saitama, Japan.
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai City, Miyagi, Japan.
| | - Tatsuo Yamamoto
- Department of Dental Sociology, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka City, Kanagawa, Japan.
| | - Rika Ohtsuka
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Itabashi Ward, Tokyo, Japan.
| | - Miyo Nakade
- Department of Nutrition, Faculty of Health and Nutrition, Tokaigakuen University, Nagoya City, Aichi, Japan.
| | - Kayo Suzuki
- Center for Well-being and Society, Nihon Fukushi University, Nagoya City, Aichi, Japan. .,Department of Policy Studies, Aichi Gakuin University, Nisshin City, Aichi, Japan.
| | - Katsunori Kondo
- Center for Well-being and Society, Nihon Fukushi University, Nagoya City, Aichi, Japan. .,Center for Preventive Medical Sciences, Chiba University, Chiba City, Chiba, Japan.
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai City, Miyagi, Japan.
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Murayama H, Liang J, Bennett JM, Shaw BA, Botoseneanu A, Kobayashi E, Fukaya T, Shinkai S. Socioeconomic Status and the Trajectory of Body Mass Index Among Older Japanese: A Nationwide Cohort Study of 1987-2006. J Gerontol B Psychol Sci Soc Sci 2015; 71:378-88. [PMID: 25577567 DOI: 10.1093/geronb/gbu183] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 12/03/2014] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES This research analyzed the body mass index (BMI) level and rate of change, and their association with socioeconomic status among older Japanese adults. METHODS Data came from a national sample of over 4,800 Japanese adults aged 60 and older at baseline, with up to 7 repeated observations over a period of 19 years (1987-2006). Hierarchical linear modeling was used to analyze the intrapersonal and interpersonal differences in BMI. RESULTS Average BMI among older Japanese was 22.26 at baseline and decreased with an accelerating rate over time. Relative to those with less education, BMI among older Japanese with more education was lower and it declined linearly at a faster rate over time. In contrast, higher household income at baseline was associated with a higher level of BMI but similar rates of decline over time. Furthermore, we found no evidence for age variations in the SES-BMI linkage as predicted by prior investigators. DISCUSSION These findings provide new insights into the complex relationship between socioeconomic factors and BMI, and help to inform the design of health policies and interventions related to weight control among older adults with diverse socioeconomic backgrounds.
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Affiliation(s)
- Hiroshi Murayama
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan. Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan.
| | - Jersey Liang
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Joan M Bennett
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Benjamin A Shaw
- Department of Health Policy, Management and Behavior, School of Public Health, State University of New York at Albany, Rensselaer
| | - Anda Botoseneanu
- Department of Behavioral Sciences, University of Michigan-Dearborn, Dearborn, Michigan. Department of Internal Medicine/Geriatrics, Yale University, New Haven, Connecticut
| | - Erika Kobayashi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Taro Fukaya
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
| | - Shoji Shinkai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan
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Gordon-Strachan G, Cunningham-Myrie C, Fox K, Kirton C, Fraser R, McLeod G, Forrester T. Richer but fatter: the unintended consequences of microcredit financing on household health and expenditure in Jamaica. Trop Med Int Health 2014; 20:67-76. [PMID: 25329229 DOI: 10.1111/tmi.12403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Kristin Fox
- Sir Arthur Lewis Institute of Social and Economic Studies; University of the West Indies; Mona Jamaica
| | - Claremont Kirton
- Department of Economics; University of the West Indies; Mona Jamaica
| | - Raphael Fraser
- Department of Statistics; Florida State University; Tallahassee FL USA
| | - Georgia McLeod
- Department of Economics; University of the West Indies; Mona Jamaica
| | - Terrence Forrester
- UWI Solutions for Developing Countries; University of the West Indies; Mona Jamaica
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Kimura S, Endo Y, Minamimae K, Kanzaki S, Hanaki K. Gender differences in childhood food preference: evaluation using a subjective picture choice method. Pediatr Int 2014; 56:389-94. [PMID: 24920454 DOI: 10.1111/ped.12276] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/14/2013] [Accepted: 11/25/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND A preference for calorie-dense food in men seems to be closely linked with a considerably higher incidence of obesity in adulthood for men than women, but it is not clear in which life stage the gender differences in food preference begin to appear. In order to clarify this, a picture choice method has been developed that is designed to evaluate food preferences or interests in children based on their subjective choices. METHODS In total, 486 children aged 6-12 years were enrolled. To evaluate food interest, children were instructed to choose any 10 from 36 pictures in the panel showing 10 different foods and 26 other things. The number of foods chosen was set as the food interest score. For food preference, they were also instructed to choose any 10 from 36 pictures in the other panel depicting 36 different foods. For the 10 foods chosen, Japanese food score, energy density, fat energy content, and saturated fatty acid score were calculated. These indices were compared for sex, age group and body mass index. RESULTS Indices reflecting food interest or fat preference were significantly higher in boys than girls both in the 7-9- and 10-12-year-old age groups. Positive correlations were found between food interest score and energy density, fat energy content, and saturated fatty acid score. CONCLUSIONS Using the picture choice method, definite gender differences in food preference were identified in early elementary school children. This information could be useful for dietary therapy in childhood obesity.
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Affiliation(s)
- Shinji Kimura
- Division of Women's and Children's Family Nursing, School of Health Sciences, Faculty of Medicine, Tottori University, Yonago, Japan; Department of Clinical Nursing, Faculty of Medicine, Shimane University, Izumo, Japan
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Socioeconomic status and dyslipidemia in Korean adults: the 2008-2010 Korea National Health and Nutrition Examination Survey. Prev Med 2013; 57:304-9. [PMID: 23769897 DOI: 10.1016/j.ypmed.2013.06.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 05/28/2013] [Accepted: 06/02/2013] [Indexed: 01/27/2023]
Abstract
OBJECTIVE This study investigated the relationship between socioeconomic status (SES) and dyslipidemia and various parameters of dyslipidemia among Korean adults. METHODS Data from the 2008-2010 Korea National Health and Nutrition Examination Survey were used in this study. A total of 19,041 Korean adults greater than 19years old participated in the study. The SES was assessed by monthly household income and education level. The relationship of SES to the risk of dyslipidemia was assessed with multivariate logistic regression analysis after adjusting for potential confounders. RESULTS The prevalence of dyslipidemia was 37.4% among Korean adults. In men, household income level was positively associated with prevalence and risks of several parameters of dyslipidemia, and education level had positive associations with the risks of dyslipidemia and parameters of dyslipidemia. However, low SES was linked to increased prevalence and risks of dyslipidemia (P for trend<0.05) and parameters of dyslipidemia in women. CONCLUSIONS Socioeconomic disparities in dyslipidemia were found in the Korean population. Also, there were gender differences in the relationship between SES and dyslipidemia. These disparities should be considered when performing risk calculations and screening for dyslipidemia, which will ultimately help prevent cardiovascular disease.
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