Abstract
BACKGROUND: Disability-free life expectancy (DFLE) data for 47 prefectures in Japan were reported in 1999; however, few studies have identified the factors associated with the length of the DFLE. The objective of this study was to elucidate the primary factors that explain differences in DFLEs in Japan.METHODS: In our ecological study, 47 prefectures in Japan were used as units of analysis. The DFLEs for men and women at 65 years of age (DFLE65), calculated by Hashimoto et al using Sullivan’s method, were set as dependent variables. From various national surveys, 181 factors associated with demographics, socioeconomic status, health status and health behaviors, medical environment, social relationships, climate, and other areas were gathered as independent variables. Pearson’s or Spearman’s correlation coefficients were calculated to screen independent variables potentially associated with the DFLE65s. Then, multivariate linear regression analyses were conducted for the selected 24 independent variables after adjusting for the proportion of older people (65 years or more) and population density.RESULTS: Multivariate linear regression analyses revealed that the large number of public health nurses per 100,000 population, a good self-reported health status, and a high proportion of older workers were significantly associated with long DFLE65s for both genders.CONCLUSIONS: These three factors could potentially explain the differences in DFLE of the older population in Japan.
Highlights
Disability-free life expectancy (DFLE) data for 47 prefectures in Japan were reported in 1999; few studies have identified the factors associated with the length of the disability-free life expectancy (DFLE)
In SES variables, the proportion of older workers was strongly correlated with DFLE65s of men and women (Pearson's correlation coefficients = 0.42 and 0.37, respectively)
Ordinary income/expenditure (I/E) balance ratio was negatively correlated with DFLE65s, while per capita income, industrial structure, and education level were not correlated with DFLE65s
Summary
The objective of this study was to elucidate the primary factors that explain differences in DFLEs in Japan. The objective of this study was to formulate hypotheses with respect to the primary factors that explain the DFLE differences found in Japan by using aggregated data from national surveys assessing various characteristics representative of Japan. Because the purpose of this study was to generate hypotheses regarding the factors that determine the differences in health expectancy in Japan as a preliminary step for further research, these limitations are insignificant
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