Determinants of changes in income-related health inequalities among working-age adults in Japan, 1986-2007: Time-trend study
Determinants of changes in income-related health inequalities among working-age adults in Japan, 1986-2007: Time-trend study
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DOI：
10.1016/j.socscimed.2012.11.042
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发表时间：
2013-03-01
影响因子：
5.4
通讯作者：
Yano, Eiji
中科院分区：
文献类型：
--
作者：
Kachi, Yuko;Inoue, Mariko;Yano, Eiji
这项研究旨在量化影响与收入有关的健康不平等变化的因素的贡献。我们使用的数据来自1986年至2007年期间参加8次重复横断面调查的20-59岁日本男性和女性的全国代表性样本。集中指数（CI）被用来衡量收入相关的不平等自测健康（SRH）和分解成促成因素。然后，我们研究了CI的时间变化及其影响因素。结果表明，在整个研究期间，性健康和生殖健康方面与收入有关的不平等现象持续存在，对低收入群体不利。尽管收入不平等扩大，但在1990年代后期以来的经济停滞期间，由于中高收入群体的性健康和生殖健康状况严重恶化，性健康和生殖健康方面的不平等有所缩小。分解分析表明，收入本身和失业或经济不活跃是几乎在所有时间点造成两性性健康和生殖健康不平等的最重要因素。然而，从1986年到2007年，收入对这些不平等的相对贡献在男子中从78%下降到14%，在妇女中从85%下降到38%。相比之下，失业或不从事经济活动的相对比例在男子中从18%增至77%，在妇女中从10%增至31%。我们的研究结果表明，可以通过减少失业或经济不活跃对健康的影响来减少可避免的健康不平等。(C)2012爱思唯尔有限公司保留所有权利。
This study aimed to quantify the contributions of the factors that have influenced changes in income-related health inequalities. We used data from a nationally representative sample of Japanese men and women aged 20-59 years who participated in eight repeated cross-sectional surveys between 1986 and 2007. A concentration index (Cl) was used to measure income-related inequalities in self-rated health (SRH) and decomposed into contributing factors. We then examined temporal changes in CIs and their contributing factors. Results showed that income-related inequalities in SRH, unfavourable to low-income groups, persisted throughout the study period. Despite widening income inequalities, inequalities in SRH narrowed during the period of economic stagnation since the late 1990s because of the profound deterioration in SRH among middle- to high-income groups. Decomposition analysis showed that income itself and unemployment or economic inactivity were the most important contributors to inequalities in SRH for both sexes at almost all time points. However, from 1986 to 2007, the relative contribution of income to these inequalities decreased from 78% to 14% in men and from 85% to 38% in women. By contrast, the relative contribution of unemployment or economic inactivity increased from 18% to 77% in men and from 10% to 31% in women. Our results suggest that a reduction in avoidable health inequalities could be achieved by reducing the influence of unemployment or economic inactivity on health. (C) 2012 Elsevier Ltd. All rights reserved.