Health inequalities in Japan: The role of material, psychosocial, social relational and behavioural factors
The extent that risk factors, identified in Western countries, account for health inequalities in Japan remains unclear. We analysed a nationally representative sample (Comprehensive Survey of Living Conditions surveyed in 2001 (n = 40,243)). The cross-sectional association between self-rated fair or poor health and household income and a theory-based occupational social class was summarised using the relative index of inequality [RII]. The percentage attenuation in RII accounted for by candidate contributory factors – material, psychosocial, social relational and behavioural – was computed. The results showed that the RII for household income based on self-rated fair or poor health was reduced after including the four candidate contributory factors in the model by 20% (95% CI 2.1, 43.6) and 44% (95% CI 18.2, 92.5) in men and women, respectively. The RII for the Japanese Socioeconomic Classification [J-SEC] was reduced, not significantly, by 22% (95% CI −6.3, 100.0) in men in the corresponding model, while J-SEC was not associated with self-rated health in women. Material factors produced the most consistent and strong attenuation in RII for both socioeconomic indicators, while the contributions attributable to behaviour alone were modest. Social relational factors consistently attenuated the RII for both socioeconomic indicators in men whereas they did not make an independent contribution in women. The influence of perceived stress was inconsistent and depended on the socioeconomic indicator used. In summary, social inequalities in self-rated fair or poor health were reduced to a degree by the factors included. The results indicate that the levelling of health across the socioeconomic hierarchy needs to consider a wide range of factors, including material and psychosocial factors, in addition to the behavioural factors upon which the current public health policies in Japan focus. The analyses in this study need to be replicated using a longitudinal study design to confirm the roles of different factors in health inequalities.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 104 (2014)
Issue (Month): C ()
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Hiyoshi, Ayako & Fukuda, Yoshiharu & Shipley, Martin J. & Bartley, Mel & Brunner, Eric J., 2013. "A new theory-based social classification in Japan and its validation using historically collected information," Social Science & Medicine, Elsevier, vol. 87(C), pages 84-92.
- Mackenbach, Johan P. & Kunst, Anton E., 1997. "Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe," Social Science & Medicine, Elsevier, vol. 44(6), pages 757-771, March.
- Aida, Jun & Kondo, Katsunori & Kondo, Naoki & Watt, Richard G. & Sheiham, Aubrey & Tsakos, Georgios, 2011. "Income inequality, social capital and self-rated health and dental status in older Japanese," Social Science & Medicine, Elsevier, vol. 73(10), pages 1561-1568.
- Huijts, Tim & Eikemo, Terje Andreas & Skalická, Vera, 2010. "Income-related health inequalities in the Nordic countries: Examining the role of education, occupational class, and age," Social Science & Medicine, Elsevier, vol. 71(11), pages 1964-1972, December.
- Sekine, Michikazu & Chandola, Tarani & Martikainen, Pekka & Marmot, Michael & Kagamimori, Sadanobu, 2006. "Socioeconomic inequalities in physical and mental functioning of Japanese civil servants: Explanations from work and family characteristics," Social Science & Medicine, Elsevier, vol. 63(2), pages 430-445, July.
- Sekine, Michikazu & Chandola, Tarani & Martikainen, Pekka & Marmot, Michael & Kagamimori, Sadanobu, 2009. "Socioeconomic inequalities in physical and mental functioning of British, Finnish, and Japanese civil servants: Role of job demand, control, and work hours," Social Science & Medicine, Elsevier, vol. 69(10), pages 1417-1425, November.
- Kunz-Ebrecht, Sabine R. & Kirschbaum, Clemens & Steptoe, Andrew, 2004. "Work stress, socioeconomic status and neuroendocrine activation over the working day," Social Science & Medicine, Elsevier, vol. 58(8), pages 1523-1530, April.
- Oshio, Takashi & Kobayashi, Miki, 2009. "Income inequality, area-level poverty, perceived aversion to inequality, and self-rated health in Japan," Social Science & Medicine, Elsevier, vol. 69(3), pages 317-326, August.
- Chun, Heeran & Khang, Young-Ho & Kim, Il-Ho & Cho, Sung-Il, 2008. "Explaining gender differences in ill-health in South Korea: The roles of socio-structural, psychosocial, and behavioral factors," Social Science & Medicine, Elsevier, vol. 67(6), pages 988-1001, September.
- Wen, Ming & Hawkley, Louise C. & Cacioppo, John T., 2006. "Objective and perceived neighborhood environment, individual SES and psychosocial factors, and self-rated health: An analysis of older adults in Cook County, Illinois," Social Science & Medicine, Elsevier, vol. 63(10), pages 2575-2590, November.
- Chandola, Tarani, 2000. "Social class differences in mortality using the new UK National Statistics Socio-Economic Classification," Social Science & Medicine, Elsevier, vol. 50(5), pages 641-649, March.
- Sekine, Michikazu & Tatsuse, Takashi & Kagamimori, Sadanobu & Chandola, Tarani & Cable, Noriko & Marmot, Michael & Martikainen, Pekka & Lallukka, Tea & Rahkonen, Ossi & Lahelma, Eero, 2011. "Sex inequalities in physical and mental functioning of British, Finnish, and Japanese civil servants: Role of job demand, control and work hours," Social Science & Medicine, Elsevier, vol. 73(4), pages 595-603, August.
- Sacker, Amanda & Bartley, Mel & Firth, David & Fitzpatrick, Ray, 2001. "Dimensions of social inequality in the health of women in England: occupational, material and behavioural pathways," Social Science & Medicine, Elsevier, vol. 52(5), pages 763-781, March.
- Ichida, Yukinobu & Kondo, Katsunori & Hirai, Hiroshi & Hanibuchi, Tomoya & Yoshikawa, Goshu & Murata, Chiyoe, 2009. "Social capital, income inequality and self-rated health in Chita peninsula, Japan: a multilevel analysis of older people in 25 communities," Social Science & Medicine, Elsevier, vol. 69(4), pages 489-499, August.
- Fujisawa, Yoshikazu & Hamano, Tsuyoshi & Takegawa, Shogo, 2009. "Social capital and perceived health in Japan: An ecological and multilevel analysis," Social Science & Medicine, Elsevier, vol. 69(4), pages 500-505, August.
- Kagamimori, Sadanobu & Gaina, Alexandru & Nasermoaddeli, Ali, 2009. "Socioeconomic status and health in the Japanese population," Social Science & Medicine, Elsevier, vol. 68(12), pages 2152-2160, June.
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:104:y:2014:i:c:p:201-209. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu)
If references are entirely missing, you can add them using this form.