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Municipal socioeconomic status and mortality in Japan: sex and age differences, and trends in 1973-1998

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  • Fukuda, Yoshiharu
  • Nakamura, Keiko
  • Takano, Takehito

Abstract

The purpose of this study was to examine the sex and age differences and the time trends in the association between municipal socioeconomic status (SES) and all-cause mortality across Japan from 1973 to 1998. Sex-specific mortality of municipalities (N=3319 in 1995) by age groups (total, under 75-year, and over 75-year populations) was linked to municipal SES indicators related to income, education, unemployment and living space, and two SES composite indices formulated by principle component analysis (Index 1 related to lower income and education, and Index 2 related to unemployment and overcrowding). The relation was assessed using mortality gradients by SES quintiles and Bayesian hierarchical Poisson regression. The results showed that a lower SES was related to higher mortality for all SES indicators and composite indices. The mortality gradient was steeper for the under 75-year population than the total and over 75-year populations, and the relation between mortality and income- and education-related indicators/index was stronger for males than for females. The time trend showed an increase in the relation for Index 2, while a decrease for Index 1. This study demonstrated that lower municipal SES had an adverse influence on population health, and the influence was marked for males and premature death. Although a substantial health disadvantage still remained in lower SES areas, the impact of SES factors on geographical health variation changed over time; the association with mortality has weakened for income and education, while it has strengthened for unemployment and living space.

Suggested Citation

  • Fukuda, Yoshiharu & Nakamura, Keiko & Takano, Takehito, 2004. "Municipal socioeconomic status and mortality in Japan: sex and age differences, and trends in 1973-1998," Social Science & Medicine, Elsevier, vol. 59(12), pages 2435-2445, December.
    • Handle: RePEc:eee:socmed:v:59:y:2004:i:12:p:2435-2445
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    Cited by:

    1. Anura Amarasinghe & Gerard D'Souza & Cheryl Brown & Tatiana Borisova, 2006. "A Spatial Analysis of Obesity in West Virginia," Working Papers Working Paper 2006-13, Regional Research Institute, West Virginia University.
    2. Kurimori, Sugako & Fukuda, Yoshiharu & Nakamura, Keiko & Watanabe, Masafumi & Takano, Takehito, 2006. "Calculation of prefectural disability-adjusted life expectancy (DALE) using long-term care prevalence and its socioeconomic correlates in Japan," Health Policy, Elsevier, vol. 76(3), pages 346-358, May.
    3. Etsuji Suzuki & Saori Kashima & Ichiro Kawachi & S V Subramanian, 2012. "Geographic Inequalities in All-Cause Mortality in Japan: Compositional or Contextual?," PLOS ONE, Public Library of Science, vol. 7(6), pages 1-12, June.
    4. Kagamimori, Sadanobu & Gaina, Alexandru & Nasermoaddeli, Ali, 2009. "Socioeconomic status and health in the Japanese population," Social Science & Medicine, Elsevier, vol. 68(12), pages 2152-2160, June.
    5. Duncan Gillespie & Meredith Trotter & Shripad Tuljapurkar, 2014. "Divergence in Age Patterns of Mortality Change Drives International Divergence in Lifespan Inequality," Demography, Springer;Population Association of America (PAA), vol. 51(3), pages 1003-1017, June.
    6. Zachary Zimmer & Heidi A. Hanson & Ken R. Smith, 2016. "Offspring Socioeconomic Status and Parent Mortality Within a Historical Population," Demography, Springer;Population Association of America (PAA), vol. 53(5), pages 1583-1603, October.

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