Changes in cause-specific mortality trends across occupations in working-age Japanese women from 1980 to 2015: a cross-sectional analysis

Abstract

Background Reducing health inequalities is an important public health challenge. Many studies have examined the widening health gap by occupational class among men, but few among women. We therefore estimated variation in absolute and relative mortality by occupational category across four leading causes of mortality—cancer, ischaemic heart disease, cerebrovascular disease, and suicide—to explore how occupational class is associated with health among working women aged 25–64 in Japan. Methods We conducted a repeated cross-sectional study using Poisson regression analysis on each five-yearly mortality data from 1980 to 2015, obtained from the National Vital Statistics and the Japanese Population Census. Results There was a decreasing trend in mortality from all cancers, ischaemic heart disease, cerebrovascular disease, and suicide among women in all occupational groups from 1980 to 2015. Agriculture workers had higher risk of mortality than professional workers for all four causes of death. The absolute difference in mortality rates for all cancers and cerebrovascular disease was higher in 2000–2015 than 1980–1995. The mortality trend among clerks and sales workers decreased after 2000, except for suicide. Conclusions Mortality rates from all four causes are higher among agriculture workers compared to professional workers, and attention is needed to reduce this mortality gap. Continuous monitoring of ongoing mortality trends is essential to ensure better health and wellbeing in Japan.

Difference in Mortality Rates by Occupation in Japanese Male Workers Aged 25 to 64 Years from 1980 to 2015

“…Japan introduced universal health insurance coverage in 1961, and under this scheme all occupations had equal opportunities for health promotion [ 6 ]. Nonetheless, large health inequalities persist across the occupational categories in Japan [ 7 , 8 ]. Construction and transportation workers work longer hours in Japan compared with other industries [ 9 ].…”

“…Mortality by occupational class in Japan does not follow a clear social gradient as with its Western counterparts [ 7 , 12 , 13 ]. Previous studies in Japan have found higher mortality rate ratios among professional and managerial workers aged 30 to 59 years compared with non-managerial workers [ 14 ].…”

Occupation- and industry-specific cancer mortality among Japanese women from 1980 to 2015

“…It is generally possible to characterize women's risks based on the results of studies conducted on men, but this is not always the case [28], and past studies of occupational risk in Japan have often focused only on men. Recent studies have focused on occupation as a means of identifying women at high risk as a proxy measurement of health inequality [29]. However, most studies to date have explored leading causes of cancer by occupation and industry among Japanese men only [7].…”