Geographical Differences and Their Associated Factors in Chronic Obstructive Pulmonary Disease Mortality in Japan: An Ecological Study Using Nationwide Data.

Tasuku Okui,Jinsang Park

doi:10.3390/ijerph182413393

Abstract

Geographical differences in chronic obstructive pulmonary disease (COPD) mortality have not been determined using municipal-specific data in Japan. This study determined the geographical differences in COPD mortality in Japan using municipal-specific data and identified associated factors. Data on COPD mortality from 2013 to 2017 for each municipality were obtained from the Vital Statistics of Japan. We calculated the standardized mortality ratio (SMR) of COPD by an empirical Bayes method for each municipality and located the SMRs on a map of Japan. In addition, an ecological study was conducted to identify factors associated with the SMR using demographic, socioeconomic, and medical characteristics of municipalities by a spatial statistics model. Geographical differences in the SMR were different in men and women, and municipalities with a low SMR tended to be more frequent in women. Spatial regression analysis identified that the total population and taxable income per capita were negatively associated with the SMR in men. In women, population density, the proportion of fatherless households, and the number of clinics per capita were positively associated with the SMR, whereas taxable income per capita was negatively associated with the SMR. There were some differences in regional characteristics associated with COPD mortality by sex.

Highlights

The geographical differences in standardized mortality ratio (SMR) of Chronic obstructive pulmonary disease (COPD) for men and women in Japan are shown in Figure 1, and the SMRs of all the municipalities in Japan are shown
Population density, the proportion of fatherless households, and the number of clinics per capita were positively associated with the SMR, whereas taxable income per capita was negatively associated with the SMR
We identified geographical differences in COPD mortality in Japan using municipalspecific data and identified factors associated with COPD mortality

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is a leading cause of death, and more than 3.2 million people died from the disease worldwide in 2015 [1]. The COPD mortality rate in Japan is relatively low [2], but more than 15,000 people die each year [3]. COPD prevalence in Japan is not different from other countries [4], and the economic cost associated with COPD is high due to circumstances such as inpatient hospitalization costs or work disability [5,6]. COPD is considered a preventable chronic lung disease, as long-term exposure to cigarette smoke is the major cause of COPD in Japan [2,4]

Methods

Results

Discussion

Conclusion