BMJ 2002;324:16 ( 5 January )

Papers

Individual income, income distribution, and self rated health in Japan: cross sectional analysis of nationally representative sample

Kenji Shibuya, assistant professor,  Hideki Hashimoto, assistant professor,  Eiji Yano, professor and chairman. 

Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan

Correspondence to: H Hashimoto hhashimo{at}med.teikyo-u.ac.jp

Objective: To assess the effects on self rated health of individual income and income distribution in Japan.
Design: Cross sectional analysis. Data collected on household income, self rated health, and other sociodemographic characteristics at the individual level from comprehensive survey of the living conditions of people on health and welfare in a nationally representative sample from each prefecture.
Setting: Prefectures in Japan.
Participants: 80 899 people aged >15 years with full records in survey.
Main outcome measures: Dichotomous variable for self rated health of each respondent (0 if excellent, very good or good; 1 if fair or poor).
Results: Inequality in income at the prefecture level measured by the Gini coefficient was comparable with that in other industrialised countries. Unadjusted odds ratios show a 14% increased risk (odds ratio 1.14, 95% confidence interval 1.02 to 1.27) in reporting poor or fair health for individuals living in prefectures with higher inequality in income. After adjustment, individual income was more strongly associated with self rated health than income inequality. Additional inclusion of regional effects showed that median income at the prefecture level was inversely related to self rated health.
Conclusions: Individual income, probably relative to the median prefecture income, has a stronger association with self rated health than income inequality at the prefecture level.

What is already known on this topic Contrary to the common perception of an egalitarian society, income inequality in Japan has increased rapidly since the late 1980s, though life expectancy continues to increase Individual level studies, exclusively carried out in the United States to assess the independent effects of income inequality on health, have had mixed results What this study adds Individual income levels, probably relative to regional median income, may have more influence on an individual's perceived health than regional income inequality in Japan

---

© BMJ 2002
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Income distribution affects health in Japan
BMJ 2002 324: 0. [Full Text]

Income inequality and population health

Johan P Mackenbach
BMJ 2002 324: 1-2. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Jaeger, M. M. (2009). United But Divided: Welfare Regimes and the Level and Variance in Public Support for Redistribution. Eur Sociol Rev 0: jcn079v1-jcn079 [Abstract] [Full text]  
• Kondo, N, Subramanian, S V, Kawachi, I, Takeda, Y, Yamagata, Z (2008). Economic recession and health inequalities in Japan: analysis with a national sample, 1986-2001. J. Epidemiol. Community Health 62: 869-875 [Abstract] [Full text]  
• Shooshtari, S., Menec, V., Tate, R. (2007). Comparing Predictors of Positive and Negative Self-Rated Health Between Younger (25-54) and Older (55+) Canadian Adults: A Longitudinal Study of Well-Being. Research on Aging 29: 512-554 [Abstract]  
• Andersen, F. K., Christensen, K., Frederiksen, H. (2007). Self-rated health and age: A cross-sectional and longitudinal study of 11,000 Danes aged 45 102. Scand J Public Health 35: 164-171 [Abstract]  
• Kawachi, I. (2006). Commentary: Social capital and health: making the connections one step at a time. Int J Epidemiol 35: 989-993 [Full text]  
• Materia, E., Cacciani, L., Bugarini, G., Cesaroni, G., Davoli, M., Mirale, M. P., Vergine, L., Baglio, G., Simeone, G., Perucci, C. A. (2005). Income inequality and mortality in Italy. Eur J Public Health 15: 411-417 [Abstract] [Full text]  
• Huynh, M., Parker, J. D, Harper, S., Pamuk, E., Schoendorf, K. C (2005). Contextual effect of income inequality on birth outcomes. Int J Epidemiol 34: 888-895 [Abstract] [Full text]  
• Carlson, P. (2005). Relatively poor, absolutely ill? A study of regional income inequality in Russia and its possible health consequences. J. Epidemiol. Community Health 59: 389-394 [Abstract] [Full text]  
• Fukuda, Y., Nakamura, K., Takano, T. (2005). Cause-specific mortality differences across socioeconomic position of municipalities in Japan, 1973-1977 and 1993-1998: increased importance of injury and suicide in inequality for ages under 75. Int J Epidemiol 34: 100-109 [Abstract] [Full text]  
• Tay, J. B, Kelleher, C. C, Hope, A., Barry, M., Gabhainn, S. N., Sixsmith, J. (2004). Influence of sociodemographic and neighbourhood factors on self rated health and quality of life in rural communities: findings from the Agriproject in the Republic of Ireland. J. Epidemiol. Community Health 58: 904-911 [Abstract] [Full text]  
• Brown, A. F., Ettner, S. L., Piette, J., Weinberger, M., Gregg, E., Shapiro, M. F., Karter, A. J., Safford, M., Waitzfelder, B., Prata, P. A., Beckles, G. L. (2004). Socioeconomic Position and Health among Persons with Diabetes Mellitus: A Conceptual Framework and Review of the Literature. Epidemiol Rev 26: 63-77 [Full text]  
• Subramanian, S. V., Kawachi, I. (2004). Income Inequality and Health: What Have We Learned So Far?. Epidemiol Rev 26: 78-91 [Full text]  
• Salomon, J. A, Tandon, A., Murray, C. J L (2004). Comparability of self rated health: cross sectional multi-country survey using anchoring vignettes. BMJ 328: 258- [Abstract] [Full text]  
• Subramanian, S., Kawachi, I. (2003). The association between state income inequality and worse health is not confounded by race. Int J Epidemiol 32: 1022-1028 [Abstract] [Full text]  
• Subramanian, S V, Delgado, I, Jadue, L, Vega, J, Kawachi, I (2003). Income inequality and health: multilevel analysis of Chilean communities. J. Epidemiol. Community Health 57: 844-848 [Abstract] [Full text]  
• Healy, J D (2003). Excess winter mortality in Europe: a cross country analysis identifying key risk factors. J. Epidemiol. Community Health 57: 784-789 [Abstract] [Full text]  
• McLeod, C. B., Lavis, J. N., Mustard, C. A., Stoddart, G. L. (2003). Income Inequality, Household Income, and Health Status in Canada: A Prospective Cohort Study. AJPH 93: 1287-1293 [Abstract] [Full text]  
• Messias, E. (2003). Income Inequality, Illiteracy Rate, and Life Expectancy in Brazil. AJPH 93: 1294-1296 [Abstract] [Full text]  
• Osler, M., Christensen, U., Due, P., Lund, R., Andersen, I., Diderichsen, F., Prescott, E. (2003). Income inequality and ischaemic heart disease in Danish men and women. Int J Epidemiol 32: 375-380 [Abstract] [Full text]  
• Blakely, T, Atkinson, J, O'Dea, D (2003). No association of income inequality with adult mortality within New Zealand: a multi-level study of 1.4 million 25-64 year olds. J. Epidemiol. Community Health 57: 279-284 [Abstract] [Full text]  
• Pearce, N., Davey Smith, G. (2003). Is Social Capital the Key to Inequalities in Health?. AJPH 93: 122-129 [Abstract] [Full text]  
• Lynch, J., Smith, G. D. (2002). Commentary: Income inequality and health: The end of the story?. Int J Epidemiol 31: 549-551 [Full text]  
• (2002). Income Inequality and Health Around the World. JWatch Psychiatry 2002: 13-13 [Full text]  
• (2002). Income Inequality and Health Around the World. JWatch General 2002: 7-7 [Full text]  
• Mackenbach, J. P (2002). Income inequality and population health. BMJ 324: 1-2 [Full text]  

Rapid Responses:

Read all Rapid Responses

Local government should be a key stakeholder in disseminating Healthy Japan 21

Kimiko Ueda, et al.
bmj.com, 24 Feb 2002 [Full text]

Online poll

Find out more >>