Socioeconomic Disparities in All-Cause and Cause-Specific Mortality Rates among Municipalities in Japan, 1999-2019.

Tasuku Okui

doi:10.3390/ijerph17249213

Abstract

Differences in all-cause and cause-specific mortality rates depending on municipal socioeconomic status (SES) in Japan have not been revealed over the last 20 years. This study exposes the difference in 1999 and 2019 using the Vital Statistics. All of the municipalities were grouped into five quintiles based on their SES, and standardized mortality ratio (SMR) of each municipal quintile compared with all of Japan was calculated for all-cause mortality and representative cause of deaths. As a result, although SMR for all-cause mortality for women tended to be lower in low SES quintiles in 1999, the reverse phenomenon was observed in 2019. Additionally, although SMR for all-cause of mortality for men was the lowest in the highest SES quintiles already in 1999, the difference in the SMR for all-cause mortality rates between the lowest and highest SES quintiles increased in 2019. The improvement of the SMR in the highest SES quintile and the deterioration in the lowest was also observed in representative types of cancer, heart disease, stroke, pneumonia, liver disease, and renal failure for men and women. Therefore, this study indicates a disparity in mortality depending on municipal SES enlarged in the last 20 years.

Highlights

Japan is one of the countries with the longest longevity worldwide, and its life expectancy is continuing to increase over time
This study indicates a disparity in mortality depending on municipal socioeconomic status (SES) enlarged in the last 20 years
According to a recent report investigating the difference in the change of life expectancy among prefectures in Japan [2], differences in life expectancy among prefectures has been growing in recent years

Summary

Introduction

Japan is one of the countries with the longest longevity worldwide, and its life expectancy is continuing to increase over time. There are regional disparities in mortality rate. When we discuss regional mortality rate differences, variance in regional mortality rate depending on its SES is often of interest for public health practice. Many studies globally investigating the relationships between regional SES and all-cause or cause-specific mortality rate [3,4,5], as well as a disparity among SES, have been shown in several countries. Some studies indicate association between Japan’s individual SES and mortality rates or health in recent years [6,7], and it is meaningful to examine whether there are differences in mortality rate depending on regional SES using recent Japan Vital Statistics data

Methods

Results

Discussion

Conclusion