Socioeconomic Disparities in All-Cause and Cause-Specific Mortality Rates among Municipalities in Japan, 1999–2019

Abstract

Differences in all-cause and cause-specific mortality rates depending on municipal socioeconomic status (SES) in Japan have not been revealed over the last 20 years. This study exposes the difference in 1999 and 2019 using the Vital Statistics. All of the municipalities were grouped into five quintiles based on their SES, and standardized mortality ratio (SMR) of each municipal quintile compared with all of Japan was calculated for all-cause mortality and representative cause of deaths. As a result, although SMR for all-cause mortality for women tended to be lower in low SES quintiles in 1999, the reverse phenomenon was observed in 2019. Additionally, although SMR for all-cause of mortality for men was the lowest in the highest SES quintiles already in 1999, the difference in the SMR for all-cause mortality rates between the lowest and highest SES quintiles increased in 2019. The improvement of the SMR in the highest SES quintile and the deterioration in the lowest was also observed in representative types of cancer, heart disease, stroke, pneumonia, liver disease, and renal failure for men and women. Therefore, this study indicates a disparity in mortality depending on municipal SES enlarged in the last 20 years.

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

“…It is known that the age-standardized mortality rates of cancer and cardiovascular diseases, which are the largest causes of death in Japan, are continuing to decrease over recent decades [2]. However, it is known that socioeconomic disparities exist in cause-specific mortality rates or health behaviors and statuses in Japan [3][4][5][6][7]. It was demonstrated that socioeconomic disparities exist in mortality rates among municipalities for some causes of death in Japan in 2019 [7], and as a possible reason for the disparities, socioeconomic differences in health behaviors and statuses were pointed out [7].…”

“…However, it is known that socioeconomic disparities exist in cause-specific mortality rates or health behaviors and statuses in Japan [3][4][5][6][7]. It was demonstrated that socioeconomic disparities exist in mortality rates among municipalities for some causes of death in Japan in 2019 [7], and as a possible reason for the disparities, socioeconomic differences in health behaviors and statuses were pointed out [7].…”

“…In Japan, according to previous studies, the prevalence of smoking or psychological distress varied depending on income or educational levels [3,16], and a higher income or educational level was shown to be associated with lower prevalence of smoking and psychological distress. In addition, it is known that the relationship between socioeconomic status and health behaviors or cause-specific mortality varied over the years in Japan [7,16], and a possibility exists that the relationship between each type of health behavior or status changed over the years. However, socioeconomic differences in health indicators have not been revealed using the most recent nationally representative survey data.…”

Socioeconomic Predictors of Diabetes Mortality in Japan: An Ecological Study Using Municipality-specific Data

“…One possible explanation for this is that low-income municipalities are not necessarily associated with a higher prevalence of diabetes. Municipalities' taxable per-capita income and total population are known to be positively associated in Japan [35]. Urbanization has also been found to be positively associated with diabetes prevalence and mortality in many countries [8,9,14], with high rates of physical inactivity and high-sugar, high-fat diets being identified as possible factors.…”

Erratum: Okui, T. Socioeconomic Disparities in All-Cause and Cause-Specific Mortality Rates among Municipalities in Japan, 1999–2019. Int. J. Environ. Res. Public Health 2020, 17, 9213

“…The author wants to correct the values of the 95% confidence interval of the standardized mortality ratio (SMR) in Table 3 and Table 4 in the following paper [ 1 ].…”