155731 Income, occupation, and self-rated health in Japan: Pooled analysis with national representative sample in 1998 and 2001

Sunday, November 4, 2007

Naoki Kondo, MD, PhD , Department of Population and International Health, Harvard School of Public Health, Boston, MA
S.V. Subramanian, PhD , Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA
Ichiro Kawachi, MD, PhD , Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA
Yasuhisa Takeda, MD, PhD , Ministry of Health, Labour and Welfare, Tokyo, Japan
Zentaro Yamagata, MD, PhD , Department of Health Sciences, School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
Backgrounds:

The effect of socioeconomic status (SES) on health varies across societies. Japan is a more egalitarian society than the United States, and we hypothesized that the SES gradient in self-rated health is shallower compared to the U.S.

Methods:

Random probability samples from the Japanese population were collected by the 1998 and 2001 Comprehensive Survey of Living Conditions on Health and Welfare. Data were collected by face-to-face interview on household income, occupational status, and self-rated health. The response rate was 80.0%. Pooled data from the two waves of the survey included 96,691 individuals aged 20-60 years. Logistic regression was used to calculate the odds ratio (OR) and 95% confidence intervals (CI) of self-reported poor health by SES indicators, adjusted for potential confounding factors.

Results:

The OR (95%CI) of poor health in the lowest income quintile was 1.30 (1.21-1.40) compared with the highest. The ORs of professional, non-manual, and manual workers were 1.19 (1.06-1.35), 1.15 (1.02-1.29), and 1.09 (0.97-1.23), respectively, compared with managerial/administrative workers. Unemployed persons and homemakers were more likely to report poor health. The ORs were 2.08 (1.81-2.39) and 1.43 (1.26-1.63), respectively. These associations were stronger in men than women.

Discussion:

Compared to recent evidence obtained from Finland, the UK, and the US, these data demonstrated that the SES gradient in self-rated health is shallower in Japan. Lower income Japanese have a lower prevalence of poor health compared to the West. However, the absolute prevalence of poor health appears higher among higher-income Japanese men and women.

Learning Objectives:
The participants of the session will be able to:(1) recognize updated evidence of the SES-health association in Japan based on a national representative sample; (2) discuss with the presenters why Japan shows shallower association between SES and health than the West.

Keywords: Social Class, Social Inequalities

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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