Socioeconomic disparities in self-rated health in two East Asian countries: Comparative study between Japan and Korea

Kino, Shiho; Takahashi, Shuko; Ebner, Daniel K.; Kawachi, Ichiro

doi:10.1016/j.socscimed.2020.112945

Cited by 13 publications

(17 citation statements)

References 23 publications

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“…Regarding self-rated poor health, results were relatively similar to psychological distress. Although it was known that the degree of the disparity in self-rated health depending on educational level was relatively low in Japan [22], disparities were observed in all the age groups for both genders in this study. Given that the previous study was based on the data in 2013 [22], a possibility exists that the tendency changed over the years.…”

Section: Discussioncontrasting

confidence: 64%

“…Although it was known that the degree of the disparity in self-rated health depending on educational level was relatively low in Japan [22], disparities were observed in all the age groups for both genders in this study. Given that the previous study was based on the data in 2013 [22], a possibility exists that the tendency changed over the years. Health literacy is shown to be one factor affecting the self-rated health of Japanese people [31], and it possibly mediates the association between self-rated health and educational level.…”

Section: Discussioncontrasting

confidence: 64%

“…The Comprehensive Survey of Living Conditions is a national survey conducted by the Ministry of Health, Labour and Welfare in Japan, and its data have been used for many previous studies for revealing the relationship between each type of health behavior or status and socioeconomic status [3,4,16,[20][21][22]. The most recent Comprehensive Survey of Living Conditions was conducted in 2019, whereas only one study analyzed the data [23].…”

Section: Introductionmentioning

confidence: 99%

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

Okui

2021

BMC Public Health

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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.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussioncontrasting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

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

Okui

2021

BMC Public Health

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“…In addition, the unique Japanese trends in self-rated health can be contrasted to neighbouring Asian countries (e.g. South Korea) that have both cultural similarities and differences [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Trends and socioeconomic inequalities in self-rated health in Japan, 1986–2016

2021

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Introduction Despite having very high life expectancy, Japan has relatively poor self-rated health, compared to other high-income countries. We studied trends and socioeconomic inequalities in self-rated health in Japan using nationally representative data. Methods The Comprehensive Survey of Living Conditions was analyzed, every 3 years (n ≈ 0.6–0.8 million/year) from 1986 to 2016. Whereas previous studies dichotomized self-rated health as an outcome, we used four categories: very good, good, fair, and bad/very bad. Proportional odds ordinal logistic regression models are used, with ordinal scale self-rated health as an outcome, and age category, survey year and occupational class or educational level as independent variables. Results In 2016, the age-adjusted percentages for self-rated health categorized as very good, good, fair, and bad/very bad, were 24.0, 17.1, 48.7, and 10.2% among working-age men, and 21.6, 17.5, 49.4, and 11.5% among working-age women, respectively. With 1986 as the reference year, the odds ratios (ORs) of less good self-rated health were lowest in 1995 (0.69; 95% Confidence Interval [95% CI]: 0.66–0.71 of working-age men), and highest in 2010 (1.23 [95% CI: 1.19–1.27]). The ORs of male, lower non-manual workers (compared to upper non-manual) increased from 1.12 (95% CI: 1.07–1.17) in 2010 to 1.20 (95% CI: 1.15–1.26) in 2016. Between 2010 and 2016, the ORs of working-age men with middle and low levels of education (compared to a high level of education) increased from 1.22 (95% CI: 1.18–1.27) to 1.34 (95% CI: 1.29–1.38), and from 1.47 (95% CI: 1.39–1.56) to 1.75 (95% CI: 1.63–1.88), respectively. The ORs of working-age women with middle and low levels of education also increased from 1.22 (95% CI: 1.17–1.28) to 1.32 (95% CI: 1.26–1.37), and from 1.74 (95% CI: 1.61–1.88) to 2.03 (95% CI: 1.87–2.21) during the same period. Conclusion Japan has the unique feature that approximately 50% of the survey respondents rated their self-rated health as fair, but with important variations over time and between socioeconomic groups. In-depth studies of the role of socioeconomic conditions may shed light on the reasons for the high prevalence of poor self-rated health in Japan.

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“…Data analysis employed a probit model. The factors that influence health or health/preventive care utilization differ between men and women [ 33 – 38 ]. We divided respondents into two groups: men and women, and these two groups were separately analyzed in 2005 and 2009.…”

Section: Methodsmentioning

confidence: 99%

Decomposition of income-related inequality in health check-ups services participation among elderly individuals across the 2008 financial crisis in Taiwan

Chu

Lawana

2021

PLoS ONE

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Encouraging citizens to use health checkup services is a health promotion strategy. In nations with aging populations, ensuring equitable use of health check-ups by senior citizens is a public health concern. The objective of this research was to quantify income-related inequality and its effect on the use of health checkup services in Taiwan during the 2007–2008 global financial crisis. We used the 2005 and 2009 datasets of the Taiwan National Health Interview Surveys to assess how income-related inequality influenced health check-up use among older adults in Taiwan during the 2007–2008 financial crisis. Corrected concentration indices (CCIs) were calculated and decomposed to determine the influences of explanatory variables. The dependent variable was whether participants had used free senior health check-ups in the past year, and the determinant factors were health behavior, health situation, socioeconomic and demographic factors, and area health care resources accessibility factors. The study assessed 2,460 older adults from the 2005 dataset and 2,514 such individuals from the 2009 dataset. The utilization of health check-ups increased from 21.6% in 2005 to 34.0% in 2009. Income-related inequality in the use of health check-up services was generally tilted toward the higher income individuals among both women and men in 2005 and 2009, and income-related inequality decreased among women group and increased among men group with non significantly from 2005 to 2009 (women: CCI decreased from.0738 in 2005 to.0658 in 2009; men: CCI increased from.1068 in 2005 to.1256 in 2009). We analyzed the effect of explanatory factors on men’s and women’s intention to use health check-ups by using a probit model. After controlling for other factors, we determined that income significantly influenced women’s health check-up service use in 2005 and men’s in 2005 and 2009. Positive health behavior significantly increased health check-up services use among men and women group after the financial crisis, and negative health behavior significantly reduced health check-ups use among men across financial crisis. The 2008 global financial crisis strengthened the effect on health check-ups use of income-related inequality of elderly men, especially in older adults with negative health behaviors. Elderly men with negative health behaviors tended to contribute more income-related inequality in use health check-up services after the financial crisis. Health promotion initiatives should focus their efforts on elderly men with negative health behaviors.

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Socioeconomic disparities in self-rated health in two East Asian countries: Comparative study between Japan and Korea

Cited by 13 publications

References 23 publications

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

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

Trends and socioeconomic inequalities in self-rated health in Japan, 1986–2016

Decomposition of income-related inequality in health check-ups services participation among elderly individuals across the 2008 financial crisis in Taiwan

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