Research

Trends in cause specific mortality across occupations in Japanese men of working age during period of economic stagnation, 1980-2005: retrospective cohort study

BMJ 2012; 344 doi: 10.1136/bmj.e1191 (Published 6 March 2012)
Cite this as: BMJ 2012;344:e1191
  1. Koji Wada, junior associate professor1,
  2. Naoki Kondo, junior associate professor2,
  3. Stuart Gilmour, assistant professor3,
  4. Yukinobu Ichida, visiting researcher4,
  5. Yoshihisa Fujino, associate professor5,
  6. Toshihiko Satoh, professor6,
  7. Kenji Shibuya, professor3
  1. 1Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitasato Minami-ku Sagamihara, Kanagawa, 252-0374, Japan
  2. 2Department of Health Sciences, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi, 409-3898
  3. 3Department of Global Health Policy, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo,113-0033
  4. 4Center for Well-being and Society, Nihon Fukushi University, 5-22-35 Chiyoda, Naka-ku, Nagoya, 460-0012
  5. 5Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, 1-1-1 Iseigaoka, Yahatanishi-ku, Kitakyusyu, Fukuoka, 807-8555
  6. 6Kitasato Clinical Research Centre, Kitasato University School of Medicine, 1-15-1 Kitasato Minami-ku Sagamihara, Kanagawa, 252-0374
  1. Correspondence to: Koji Wada kwada-sgy{at}umin.ac.jp
  • Accepted 25 January 2012

Abstract

Objective To assess the temporal trends in occupation specific all causes and cause specific mortality in Japan between 1980 and 2005.

Design Longitudinal analysis of individual death certificates by last occupation before death. Data on population by age and occupation were derived from the population census.

Setting Government records, Japan.

Participants Men aged 30-59.

Main outcome measures Age standardised mortality rate for all causes, all cancers, cerebrovascular disease, ischaemic heart disease, unintentional injuries, and suicide.

Results Age standardised mortality rates for all causes and for the four leading causes of death (cancers, ischaemic heart disease, cerebrovascular disease, and unintentional injuries) steadily decreased from 1980 to 2005 among all occupations except for management and professional workers, for whom rates began to rise in the late 1990s (P<0.001). During the study period, the mortality rate was lowest in other occupations such as production/labour, clerical, and sales workers, although overall variability of the age standardised mortality rate across occupations widened. The rate for suicide rapidly increased since the late 1990s, with the greatest increase being among management and professional workers.

Conclusions Occupational patterns in cause specific mortality changed dramatically in Japan during the period of its economic stagnation and resulted in the reversal of occupational patterns in mortality that have been well established in western countries. A significant negative effect on the health of management and professional workers rather than clerks and blue collar workers could be because of increased job demands and more stressful work environments and could have eliminated or even reversed the health inequality across occupations that had existed previously.

Footnotes

  • We thank Zentaro Yamagata (University of Yamanashi) and Keika Hoshi and Guoqin Wang (Kitasato University School of Medicine) for their valuable contributions.

  • Contributors: KW and NK conceived and coordinated the project. KW, NK, SG, YI, and YF completed the analysis. KW and NK drafted the initial manuscript. KW, NK, SG, YF, TS, and KS revised the manuscript. All authors commented on drafts of the report. KW and NK contributed equally to the writing of the article and are guarantors.

  • Funding: This study was funded by the Ministry of Education, Culture, Sports, Science, and Technology (Grant-in-Aid for Scientific Research (B) No 22390130 and Grant-in-Aid for Scientific Research on Innovative Areas No 22119504) and the Ministry of Health, Labour and Welfare (H23-seisaku-shitei-033). The funders had no role in study design, data collection and analysis, and the decision to publish.

  • Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

  • Ethical approval: Not required

  • Data sharing: No additional data available.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

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