Exploring international comparison of inequalities in health and strategies for eliminating inequalities in health

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K21188
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0908:Society medicine, nursing, and related fields
• Research Institution: National Cancer Center Japan (2022-2023); Mie University (2021)
• Principal Investigator: Tanaka Hirokazu 国立研究開発法人国立がん研究センター, がん対策研究所, 研究員 (90905431)
• Project Period (FY): 2021-08-30 – 2024-03-31
• Keywords: 健康格差 / 公的統計データ / データリンケージ / 死亡率 / 社会経済的状況 / 国勢調査 / 人口動態統計 / 国民生活基礎調査

Outline of Final Research Achievements

In order to investigate methodology for monitoring health inequalities in Japan, we conducted a linkage study of the Census and Vital Statistics and analysis of the Comprehensive Survey of Living Conditions. The analysis showed that all-cause mortality rates for both men and women were approximately 1.2 times higher for ‘high school graduates’ and 1.4 times higher for ‘junior high school graduates’ compared with ‘graduates of university or higher’. The cause-specific patterns suggested that unfavorable health risk factors were more prominent among those with low educational level in Japan. Mortality inequalities were suggested to be smaller than those in European countries and the US. Health-related behaviors such as cancer screening uptake rates also differed significantly according to socioeconomic status, suggesting that these differences have increased over time in Japan.

Free Research Field

社会疫学

Academic Significance and Societal Importance of the Research Achievements

国勢調査と人口動態統計のリンケージ分析により、わが国において「中学・高校卒業者」は「大学以上卒業者」に比べて約1.2－1.4倍死亡率が高いことが男女それぞれで示された。このリンケージ研究では全人口の9.9%をサンプル人口として含めたが、詳細な死因別の分析や都道府県レベルの分析のためにはより精度の高い死亡率データベースの構築が必要である。また、わが国の健康格差は生活習慣や健康関連行動について拡大していることが示唆された。本研究の成果をきっかけに公的統計を活用した健康格差研究が推進されるとともに各地域の健康格差の大きさや要因について探索され、より多面的な健康格差対策が講じられることが期待される。