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BMC Public Health
Published in: BMC Public Health 1/2005

Open Access 01-12-2005 | Research article

Municipal health expectancy in Japan: decreased healthy longevity of older people in socioeconomically disadvantaged areas

Authors: Yoshiharu Fukuda, Keiko Nakamura, Takehito Takano

Published in: BMC Public Health | Issue 1/2005

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Abstract

Background

Little is known about small-area variation in healthy longevity of older people and its socioeconomic correlates. This study aimed to estimate health expectancy at 65 years (HE65) at the municipal level in Japan, and to examine its relation to area socio-demographic conditions.

Methods

HE65 of municipalities (N = 3361) across Japan was estimated by a linear regression formula with life expectancy at 65 years and the prevalence of those certificated as needing nursing care. The relation between HE65 and area socio-demographic indicators was examined using correlation coefficients.

Results

The estimated HE65 (years) ranged from 13.13 to 17.39 for men and from 14.84 to 20.53 for women. HE65 was significantly positively correlated with the proportion of elderly and per capita income, and negatively correlated with the percentage of households of a single elderly person, divorce rate, and unemployment rate. These relations were stronger in large municipalities (with a population of more than 100,000) than in small and medium-size municipalities.

Conclusion

A decrease in healthy longevity of older people was associated with a higher percentage of households of a single elderly person and divorce rate, and lower socioeconomic conditions. This study suggests that older people in urban areas are susceptible to socio-demographic factors, and a social support network for older people living in socioeconomically disadvantaged conditions should be encouraged.
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Literature
1.
Health and Welfare Statistics, Association: Kokumin Eiseino Doko. 2003, Tokyo: Health and Welfare Statistics Association
2.
3.
Mathers CD, Sadana R, Salomon JA, Murray CJL, Lopes AD: Healthy life expectancy in 191 countries, 1999. Lancet. 2001, 357: 1685-1691. 10.1016/S0140-6736(00)04824-8.CrossRefPubMed
4.
Bone MR, Bebbington AC, Nicholaas G: Policy application of health life expectancy. J Aging Health. 1998, 10: 136-153.CrossRef
5.
Pamuk ER, Wagener DK, Molla MT: Achieving national health objectives: the impact on life expectancy and on healthy life expectancy. Am J Public Health. 2004, 94: 378-383.CrossRefPubMedPubMedCentral
6.
Sullivan DF: A single index of mortality and morbidity. HSMHA Health Report. 1971, 86: 347-354.CrossRef
7.
Kawahara K: Health Promotion Law and Community Health Law. 2003, Tokyo: Sunlife Kikaku
8.
Miyashita M, Hashimoto S, Ojima T, Nakamura Y, Hayashi M, Kato M, Fukudome K: Prevalence of the elderly requiring nursing care and health expectancy. Koseino Shihyo. 1999, 46: 25-29.
9.
Segami K: Indicators toward the 21st century. 2000, Tokyo: Health and Welfare Statistics Association
10.
Hasegawa T: Estimation of indicators of premature death and health expectancy for evaluation of Health Japan 21. 2001, Tokyo: Ministry of Health, Labour and Welfare
11.
Shimane Prefectural Institute of Public Health and Environmental Science: Geographical variation of healthy life expectancy in Shimane Prefecture. 2002, Matsue: Shimane Prefectural Institute of Public Health and Environmental Science
12.
Stuck AE, Walthert JM, Nikolaus T, Bula CJ, Hohmann C, Beck JC: Risk factors for functional status decline in community-living elderly people: a systematic literature review. Soc Sci Med. 1999, 48: 445-469. 10.1016/S0277-9536(98)00370-0.CrossRefPubMed
13.
Huisman M, Kunst AE, Mackenbach JP: Socioeconomic inequalities in morbidity among the elderly; a European overview. Soc Sci Med. 2003, 57: 861-873. 10.1016/S0277-9536(02)00454-9.CrossRefPubMed
14.
Bentham G, Eimermann J, Haynes R, Lovett A, Brainard J: Limiting long term illness and its associations with mortality and indicators of social deprivation. J Epidemiol Community Health. 1995, 49: S57-S64.CrossRefPubMedPubMedCentral
15.
Bassuk SB, Berkman LF, Amick BC 3rd: Socioeconomic status and mortality among the elderly: findings from four US communities. Am J Epidemiol. 2002, 155: 520-533. 10.1093/aje/155.6.520.CrossRefPubMed
16.
Katz SJ, Kabeto M, Langa KM: Gender disparities in the receipt of home care for elderly people with disability in the United States. JAMA. 2000, 284: 3022-3027. 10.1001/jama.284.23.3022.CrossRefPubMed
17.
Lin G: Regional assessment of elderly disability in the U.S. Soc Sci Med. 2000, 50: 1015-1024. 10.1016/S0277-9536(99)00351-2.CrossRefPubMed
18.
Yamaguchi F, Kakehashi M: An analysis of factors concerned with the active life expectancy and the duration in care of the elderly. J Population Problems. 2001, 57 (4): 51-67.
19.
Jordan H, Roderick P, Martin D: The index of multiple deprivation 2000 and accessibility effects on health. J Epidemiol Community Health. 2004, 58: 250-257. 10.1136/jech.2003.013011.CrossRefPubMedPubMedCentral
20.
Krieger N, Chen JT, Waterman PD, Soobader MJ, Subramanian SV, Carson R: Geocoding and monitoring of US socioeconomic inequalities in mortality and cancer incidence: does the choice of area-based measure and geographic level matter?: the Public Health Disparities Geocoding Project. Am J Epidemiol. 2002, 156: 471-482. 10.1093/aje/kwf068.CrossRefPubMed
21.
Pickett KE, Pearl M: Multilevel analysis of neighbourhood socioeconomic context and health outcomes: a critical review. J Epidemiol Community Health. 2001, 55: 111-122. 10.1136/jech.55.2.111.CrossRefPubMedPubMedCentral
22.
Ministry of Health, Labour and Welfare: Prefectural life table 2000. 2003, Tokyo: Health and Welfare Statistics Association
23.
24.
Ministry of Health, Labour and Welfare: Municipal life table 2000. 2003, Tokyo: Health and Welfare Statistics Association
25.
26.
Fukuda Y, Nakamura K, Takano T: Municipal socioeconomic status and mortality in Japan: sex and age differences, and trends in 1973–1998. Soc Sci Med. 2004, 59: 2435-2445. 10.1016/j.socscimed.2004.04.012.CrossRefPubMed
27.
28.
Rashash J, Browne W, Goldstein H, Yang M, Plewis I, Healy M, Woodhouse G, Draper D, Langford I, Lewis : A user's guide to MLwiN. 2002, London: Centre for Multilevel Modelling, Institute of Education, University of London
29.
Nakaya T: Spatial epidemiology. Health GIS. Edited by: Nakaya T, Tanimura S, Nihei N, Horikoshi Y. 2004, Tokyo: Kokon Shoin, 74-121.
30.
Wakefield JC, Best NG, Waller L: Bayesian approaches to disease mapping. Spatial Epidemiology. Edited by: Elliot JC, Wakefield NG, Best NG, Briggs DJ. 2000, New York: Oxford University Press, 104-127.
31.
Bernardinelli L, Montomoli C: Empirical Bayes versus fully Bayesian analysis of geographical variation in disease risk. Stat Med. 1992, 11: 983-1007.CrossRefPubMed
32.
Statistical Information Institute for Consulting and Analysis: Municipal data of social indicators. 2003, Tokyo: Statistical Information Institute for Consulting and Analysis
33.
Gutierrez-Fisac JL, Gispert R, Sola J: Factors explaining the geographical differences in Disability Free Life Expectancy in Spain. J Epidemiol Community Health. 2000, 54: 451-455. 10.1136/jech.54.6.451.CrossRefPubMedPubMedCentral
34.
Ministry of Health, Labour and Welfare: Vital statistics of Japan 2001. 2003, Tokyo: Health and Welfare Statistics Association
35.
Barnett S, Roderick P, Martin D, Diamond I, Wrigley H: Interactions between three proxies of health care need at the small area level: an urban/rural comparison. J Epidemiol Community Health. 2002, 56: 754-761. 10.1136/jech.56.10.754.CrossRefPubMedPubMedCentral
36.
Kishi R, Horikawa N: Role of the social support network which influences age of death and physical function of elderly people study of trends in and outside of Japan and future problems. Nippon Koshu Eisei Zasshi. 2004, 51: 79-93.PubMed
37.
Iwasaki M, Otani T, Ohta A, Sasazawa Y, Kuroiwa M, Suzuki S: Rural-urban differences in sociodemographic, social network and lifestyle factors related to mortality of middle-aged Japanese men from the Komo-Iso cohort study. J Epidemiol. 2002, 12: 93-104.CrossRefPubMed
38.
39.
Kishi R, Eguchi T, Sasatani H, Yaguchi T: Health status, social networks and support systems of elderly men and women in a large city and in former coal-mining areas – a population-based comparative study of 70-year-old residents of Sapporo and Yubari. Nippon Koshu Eisei Zasshi. 1994, 41: 474-488.PubMed
40.
Iwasaki M, Otani T, Sunaga R, Miyazaki H, Xiao L, Wang N, Sasazawa Y, Suzuki S: Social networks and mortality based on the Komo-Ise cohort study in Japan. Int J Epidemiol. 2002, 31: 1208-1218. 10.1093/ije/31.6.1208.CrossRefPubMed
41.
Sugisawa H, Fukaya T, Sugihara Y, Ishikawa H, Nakatani Y, Kim HK: Factors related to under-utilization of in-home services under the long term insurance system. Nippon Koshu Eisei Zasshi. 2002, 49: 425-436.PubMed
42.
Ikegami N: Public long-term care insurance in Japan. JAMA. 1997, 278: 1310-1314. 10.1001/jama.278.16.1310.CrossRefPubMed
43.
Best N, Richardson S, Thomson A: A comparison of Bayesian spatial models for disease mapping. Stat Methods Med Res. 2005, 14: 35-59. 10.1191/0962280205sm388oa.CrossRefPubMed
44.
Leyland AH, Davies CA: Empirical Bayes methods for disease mapping. Stat Methods Med Res. 2005, 14: 17-34. 10.1191/0962280205sm387oa.CrossRefPubMed
45.
Lawson AB, Biggeri AB, Boehning D, Lesaffre E, Viel JF, Clark A, Schlattmann P, Divino F: Disease mapping models: an empirical evaluation. Disease Mapping Collaborative Group. Stat Med. 2000, 19: 2217-2241. 10.1002/1097-0258(20000915/30)19:17/18<2217::AID-SIM565>3.0.CO;2-E.CrossRefPubMed
46.
Ghosh M, Rao JNK: Small area estimation an appraisal. Statistical Science. 1994, 9: 55-76.CrossRef
47.
Nakaya T: An information statistical evaluation of areal units for mortality mapping: toward constructing an analyzing system of disease maps on geographical information system. Theory and Applications of GIS. 1996, 4: 53-60.
48.
Hirako T, Sakeki N, Nakaya T: Application of Bayesian methods on municipal health statistics. Koseino Shihyo. 1999, 46 (10): 3-11.
Metadata
Title
Municipal health expectancy in Japan: decreased healthy longevity of older people in socioeconomically disadvantaged areas
Authors
Yoshiharu Fukuda
Keiko Nakamura
Takehito Takano
Publication date
01-12-2005
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2005
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-5-65

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