Top

Population Health Metrics

Published in:

Open Access 01-12-2016 | Research

Socioeconomic status and self-rated health of Japanese people, based on age, cohort, and period

Authors: Hidehiro Sugisawa, Ken Harada, Yoko Sugihara, Shizuko Yanagisawa, Masaya Shinmei

Published in: Population Health Metrics | Issue 1/2016

Abstract

Background

Differences in health resulting from differences in socioeconomic status (SES) have been identified around the world. Age, period, and cohort (A-P-C) differences in health are vital factors which are associated with disparities in SES. However, few studies have examined these differences simultaneously. Moreover, although self-rated health (SRH) has been frequently used as an indicator of health, biases in reporting SRH that depend on the socioeconomic characteristics of respondents have been scarcely adjusted in the previous studies. To overcome these limitations, we investigated the associations between disparities in SES and adjusted SRH based on A-P-C, by using a repeated, cross-sectional survey of a nationally representative sample of Japanese people. In addition, we further investigated how exogenous (macroeconomic) conditions unique to a period or cohort would explain trends across successive periods and cohorts.

Methods

Data were obtained from a sample of 653,132 Japanese people that responded to the Comprehensive Survey of Living Conditions (CSLC), which is a cross-sectional survey that had been conducted every three years from 1986 to 2013, on over 10 occasions. In the CSLC, SES has been assessed by household income. We simultaneously controlled for each A-P-C dimension by using the model for cross-classification of random effects, and adjusting SRH data for reporting biases caused by differences in income and A-P-C.

Results

Differences in adjusted SRH associated with income differences decreased with age and reversed after 76 years of age. Period differences indicated that income differences peaked in 1992 and 2007. Moreover, differences in adjusted SRH associated with income differences decreased in periods with high unemployment across all periods. Furthermore, there were no cohort differences in adjusted SRH that were associated with income differences.

Conclusion

In Japan, there are age and period variations associated with adjusted differences in SRH as assessed by income. Moreover, exogenous conditions in each period could help explain periodic trends across successive periods.

Adler NE, Ostrove JM. Socioeconomic status and health: What we know and what we don’t. Ann N Y Acad Sci. 1999. doi:10.1111/j.1749-6632.1999.tb08101.x.

Lund C, Breen A, Flisher AJ, Kakuma R, Corrigall J, Joska JA, et al. Poverty and common metal disorders in low and middle income countries: A systematic review. Soc Sci Med. 2010. doi:10.1016/j.socscimed.2010.04.027.PubMed

Ibrahim MM, Damasceno A. Hypertension in developing countries. Lancet. 2012. doi:10.1016/S0140-6736(12)60861-7.PubMedCentral

Hayasaka Y. Inequality in Health in Japan and Some Western Countries, and the Formative factors. Bulletin Tohoku Fukushi University. 1998;23:187–205 [in Japanese].

Kagamimori S, Gaina A, Nasermoaddeli A. Socioeconomic status and health in the Japanese population. Soc Sci Med. 2009. doi:10.1016/j.socscimed.2009.03.030.PubMedCentral

Kim J, Durden E. Socioeconomic status and age trajectories of health. Soc Sci Med. 2007. doi:10.1016/j.socscimed.2007.07.022.

Fukuda Y, Nakamura K, Takano T. Municipal socioeconomic status and mortality in Japan: sex and age differences, and trends of 1973–1998. Soc Sci Med. 2004. doi:10.1016/j.socscimed.2004.04.012.

Fukuda Y, Nakamura K, Takano T, Nakao H, Imai H. Socioeconomic status and cancer screening in Japanese males; large inequalities in middle-aged and urban residents. Environ Health Prev Med. 2007. doi:10.1265/ehpm.12.90.PubMedPubMedCentral

Honjo K, Kawakami N, Tateshima T, Tachimori H, Ono Y, Uda H, et al. Social class inequalities in self-rated health and their gender and age group differences in Japan. J Epidemiol. 2006. doi:10.2188/jea.16.223.PubMed

10.

Zheng H, George LK. Rising U.S. income inequality and the changing gradient of socioeconomic status on physical functioning and activity limitations, 1984–2007. Soc Sci Med. 2012. doi:10.1016/j.socscimed.2012.08.014.

11.

Mackenbach JP. The persistence of health inequalities in modern welfare states: the explanation of a paradox. Soc Sci Med. 2012. doi:10.1016/j.socscimed.2012.02.031.

12.

Takano T, Nakamura K. The national financial adjustment policy and the equalization of health levels among prefectures. J Epidemiol Community Health. 2001. doi:10.1136/jech.55.10.748.

13.

Asada Y, Ohtsuka Y. Analysis of health-related quality of life (HRQOL), its distribution, and its distribution by income in Japan, 1989 and 1998. Soc Sci Med. 2004. doi:10.1016/j.socscimed.2004.01.025.PubMed

14.

Kondo N, Subramanian SV, Kawachi I, Takeda Y, Yamagawa Z. Economic recession and health inequalities in Japan: analysis with a national sample, 1986–2001. J Epidemiol Community Health. 2008. doi:10.1136/jech.2007.070334.PubMedPubMedCentral

15.

Hiyoshi A, Fukuda Y, Shipley MJ, Brunner EJ. Inequalities in self-rated health in Japan 1986–2007 according to household income and a novel occupational classification: national sampling survey series. J Epidemiol Commuinty Health. 2013. doi:10.1136/jech.2013.202608.

16.

Wada K, Kondo N, Gilmour S, Ichida Y, Fujino Y, Satoh T, et al. Trends in cause specific mortality across occupations in Japanese men of working age during period of economic stagnation, 1980–2005: retrospective cohort study. BMJ. 2012. doi:10.1136/bmj.e1191.PubMedPubMedCentral

17.

Ueda P, Kondo N, Fujiwara T. The global economic crisis, household income and pre-adolescent overweight and underweight: a nationwide birth cohort study in Japan. Int J Obes (Lond). 2015. doi:10.1038/ijo.2015.90.

18.

Fukuda Y, Nakamura K, Takano K. Cause-specific mortality differences across socioeconomic position of municipalities in Japan, 1973–1977 and 1993–1998: increased importance of injury and suicide in inequality for ages under 75. Int J Epidemiol. 2005. doi:10.1093/ije/dyh283.PubMed

19.

Lynch SM. Explaining life course and cohort variation in the relationship between education and health: The role of income. J Health Soc Behav. 2006. doi:10.1177/002214650604700402.PubMed

20.

Chen F, Yang Y, Liu G. Social change and socioeconomic disparities in health over the life course in China: A cohort analysis. Am Sociol Rev. 2010. doi:10.1177/0003122409359165.PubMedPubMedCentral

21.

Beck AN, Finch BK, Lin SF, Hummer RA, Masters RK. Racial disparities in self-rated health: trends, explanatory factors, and the changing role of socio-demographics. Soc Sci Med. 2014. doi:10.1016/j.socscimed.2013.11.021.

22.

Lin S, Beck AN, Finch BK. Black-white disparities in disability among U.S. older adults: age, period, and cohort trends. J Gerontol B Psychol Sci Soc Sci. 2014. doi:10.1093/geronb/gbu010.

23.

Yang Y. Age, cohorts, and methods. In: Binstock RH, George LK, editors. Handbook of aging and the social sciences. 7th ed. London: Academic; 2011. p. 17–30.CrossRef

24.

Fujii M, Oshio T, Shimizutani S. Self-rated health status of Japanese and Europeans in later life: Evidence from JSTAR and SHARE. Jpn Econ Rev. 2014. doi:10.1111/jere.12029.

25.

Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997;38(1):21–37.CrossRefPubMed

26.

Di Tella R, MacCulloch RJ, Oswald AJ. The macroeconomics of happiness. Rev Econ Stat. 2003. doi:10.1162/003465303772815745.

27.

Yang Y, Land KC. Age-period-cohort analysis; New models, methods, and empirical applications. Boca Raton: CRC Press; 2013.CrossRef

28.

Cabinet Office, Annual Report on National Accounts. http://www.esri.cao.go.jp/jp/sna/data/data_list/kakuhou/files/h25/h25_kaku_top.html. Accessed 21 Aug 2015.

29.

Statistics Bureau, Ministry of Internal Affairs and Communications. Labour Force Survey, Historical data. http://www.stat.go.jp/data/roudou/longtime/03roudou.htm. Accessed 21 August 2015.

30.

Jürges H. True health vs response styles: exploring cross-country differences in self-reported health. Health Econ. 2007. doi:10.1002/hec.1134.PubMed

31.

Enders CK, Tofighi D. Centering predictor variables in cross-sectional multilevel models: a new look at an old issues. Psychol Methods. 2007. doi:10.1037/1082-989X.12.2.121.PubMed

32.

Benzeval M, Green MJ, Leyland AH. Do social inequalities in health widen or converge with age? Longitudinal evidence from three cohorts in the west of Scotland. BMC Public Health. 2011. doi:10.1186/1471-2458-11-947.

33.

Johnson NE. The racial crossover in comorbidity, disability, and mortality. Demography. 2000;37(3):267–83.CrossRefPubMed

34.

Liang J, Bennett J, Krause N, Kobayashi E, Kim H, Brown JW, et al. Old age mortality in Japan: Does socioeconomic gradient interact with gender and age. J Gerontol B Psycho Sci Soc Sci. 2002. doi:10.1093/geronb/57.5.S294.

35.

Edwards R. Who is hurt by pro-cyclical mortality? Soc Sci Med. 2008. doi:10.1016/j.socscimed.2008.09.032.

36.

Khang YH, Lynch JW, Yun S, Lee SI. Trends in socioeconomic health inequalities in Korea: use of mortality and morbidity measures. J Epidemiol Community Health. 2004. doi:10.1136/jech.2003.012989.PubMedPubMedCentral

37.

Valkonen T, Martikainen P, Jalovaara M, Koskinen S, Martelin T, Mäkelä P. Changes in socioeconomic inequalities in mortality during an economic boom and recession among middle-aged men and women in Finland. Euro J Public Health. 2000. doi:10.1093/eurpub/10.4.274.

38.

Easterlin RA. Birth and fortune: The impact of numbers on personal welfare. Chicago: University of Chicago Press; 1987.

Title: Socioeconomic status and self-rated health of Japanese people, based on age, cohort, and period
Authors: Hidehiro Sugisawa
Ken Harada
Yoko Sugihara
Shizuko Yanagisawa
Masaya Shinmei
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Population Health Metrics / Issue 1/2016
Electronic ISSN: 1478-7954
DOI: https://doi.org/10.1186/s12963-016-0095-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Socioeconomic status and self-rated health of Japanese people, based on age, cohort, and period

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2016

A new parametric model to assess delay and compression of mortality

Future healthy life expectancy among older adults in the US: a forecast based on cohort smoking and obesity history

Summarizing health-related quality of life (HRQOL): development and testing of a one-factor model

The impact of individual-level heterogeneity on estimated infectious disease burden: a simulation study

Measuring and tracking obesity inequality in the United States: evidence from NHANES, 1971-2014

Mortality and life expectancy in Kiribati based on analysis of reported deaths