An analysis of health inequalities depending on educational level using nationally representative survey data in Japan, 2019

Abstract

Background In recent years, socioeconomic differences in health statuses and behaviors have not been investigated from the nationally representative survey data in Japan. In this study, we showed differences in representative health behaviors and statuses depending on educational level using a nationally representative survey data in Japan. Methods Aggregated (not individual level) data from the Comprehensive Survey of Living Conditions in 2019 were used to examine the association between educational level and outcome status of psychological distress (K6 scores > = 5), self-rated health, smoking, alcohol drinking, and cancer screening participation (stomach, lung, colorectal, breast, and uterine cancers). Data of 217,179 households in Japan were aggregated by the Ministry of Health, Labour, and Welfare in the survey, and the data of the estimated number of household members and persons corresponding to each response option for the questions in all of Japan were used. Five-year age groups from 20 to 24 to 80–84 years and over 84 years were analyzed, and the prevalence or participation rate by educational level were calculated. In addition, the age-standardized prevalence or participation rate according to educational level were also calculated by sex. Moreover, a Poisson regression model was applied for evaluating an association of educational level with the outcomes. Results As a result, a clear gradient by educational level was observed in almost all the age groups for the prevalence of psychological distress, poor self-rated health, and smoking and participation rates in cancer screening, and high educational level were associated with better health-related behaviors and statuses. Conversely, drinking prevalence was shown to be higher rather in highly educated people. In addition, a statistically significant association of educational level with all the outcomes was observed. Conclusion It was shown that disparities in health behaviors and statuses still persisted in recent years, and the findings suggested that further measures should be taken to tackle this disparity.

Online health information searching and health literacy among middle‐aged and older adults: A cross‐sectional study

“…In addition to education being associated with HL (Furuya et al, 2015; Verney et al, 2019), lower education was associated with multiple chronic diseases (Johnson‐Lawrence et al, 2017; Pathirana & Jackson, 2018), limitations in physical functioning due to disease (Zajacova & Montez, 2017), and has been identified as a barrier to health. Less educated individuals might have difficulty in obtaining effective information about health issues, which might affect healthy living and self‐care (Okui, 2021). Moreover, the results indicated that education was significantly associated with online health information searching, consistent with previous studies revealing that the more educated participants were, the more they searched for health information online (Medero et al, 2022; Weber et al, 2020).…”

Impact of Educational Background on Preoperative Disease Severity and Postoperative Outcomes Among Patients With Cervical Spondylotic Myelopathy

“…4 Among these factors, education level and health literacy play a pivotal role. 2,[5][6][7][8] Lower education levels of the patient and/or the primary caregiver have been associated with prolonged disease duration, poor follow-up and retention rates, and increased diseaserelated morbidity. 1 Surgical interventions for spinal pathologies are particularly susceptible to being impacted by poor patient educational levels and poor health literacy due to the inherent complexity of these pathologies.…”

“…These social determinants of health are composed of a multitude of factors, including sex, race, socioeconomic status (SES), employment status, and housing status 4 . Among these factors, education level and health literacy play a pivotal role 2,5–8 . Lower education levels of the patient and/or the primary caregiver have been associated with prolonged disease duration, poor follow-up and retention rates, and increased disease-related morbidity 1 .…”

Relationship between regular cervical cancer screening and social background in Japan during the COVID-19 pandemic

“…Public surveys of general companies have identi ed the time and nancial problems as reasons for CCS hesitancy. Many existing reports are questionnaire-based descriptive reports [6,7]. However, few have included the social backgrounds of those who did not take the test [8].…”

“…Public surveys of general companies have identi ed the time and nancial problems as reasons for CCS hesitancy. Many existing reports are questionnaire-based descriptive reports [6,7]. However, few have included the social backgrounds of those who did not take the test [8].In Japan, the impact of coronavirus disease (COVID-19) is signi cant, with the rst declaration of a state of emergency issued in March 2020, followed by "stay-at home restrictions" for approximately two and half years until the fourth declaration was lifted in September 2022 [9].Regarding cancer screening and the withholding of medical examinations due to the COVID-19 disaster, the U.S. National Cancer Institute reported in 2020 that the COVID-19 pandemic affected the cancer screening uptake rate [10].…”