Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet.
Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet.
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DOI：
10.1016/j.ssmph.2023.101356
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发表时间：
2023-06
影响因子：
4.7
通讯作者：
Brunner, Eric J.
中科院分区：
文献类型：
--
作者：
Hiyoshi, Ayako;Honjo, Kaori;Platts, Loretta G.;Suzuki, Yuka;Shipley, Martin J.;Iso, Hiroyasu;Kondo, Naoki;Brunner, Eric J.
关键词：
人类健康和福祉可能取决于经济增长，这意味着决策者需要在人口健康和生态系统健康之间做出选择。在经历了20年的低经济增长后，日本人的预期寿命有所增长。在此，我们评估了长期低经济增长时期主观健康和健康不平等的时间变化。本研究采用了1992年至2013年经济停滞期间在日本进行的八次三年一次的全国代表性横断面调查（n = 625,262）。健康被积极定义为幸福，消极定义为健康状况不佳，这是基于自我评估的健康状况。我们使用斜率和相对不平等指数来模拟基于家庭收入的自评健康不平等。对儿童/青少年、处于工作年龄的成年人、年轻人和老年人的健康和健康不平等的时间变化分别进行了研究。在经济停滞期结束时（2013年），与经济停滞期开始时（1992年）相比，所有年龄组的总体幸福感都略有下降。然而，健康状况不佳的情况在年轻老年人和老年老年人中分别保持稳定或下降，仅在工作年龄的成年人中增加（患病率：1.14,95% CI 1.08, 1.20, <0.001）。随着时间的推移，在成年人中观察到福利不平等和自我评价较差的健康状况，但在儿童中不太一致，但在停滞期开始和结束之间的任何年龄组中，不平等都没有扩大。虽然这项研究是对一个国家，即日本的个案研究，并且不能肯定地推断到其他国家，但研究结果提供了证据，表明二十年来的低经济增长并不必然转化为不利的人口健康。在研究期间，日本按收入划分的健康不平等保持稳定。因此，这项研究强调了这样一种可能性，即对于高收入国家来说，低经济增长可能与良好的人口健康相适应。低经济增长可能使死亡率和预期寿命趋势恶化。我们使用了日本基于人口的调查系列，包括低增长时期。长期的低经济增长并不必然使人口健康恶化。低经济增长和人口健康并不是一种取舍。
Human health and wellbeing may depend on economic growth, the implication being that policymakers need to choose between population health and the health of ecosystems. Over two decades of low economic growth, Japan's life expectancy grew. Here we assess the temporal changes of subjective health and health inequality during the long-term low economic growth period. Eight triennial cross-sectional nationally representative surveys in Japan over the period of economic stagnation from 1992 to 2013 were used (n = 625,262). Health is defined positively as wellbeing, and negatively as poor health, based on self-rated health. We used Slope and Relative Indices of Inequality to model inequalities in self-rated health based on household income. Temporal changes in health and health inequalities over time were examined separately for children/adolescents, working-age adults, young-old and old-old. At the end of the period of economic stagnation (2013), compared to the beginning (1992), the overall prevalence of wellbeing declined slightly in all age groups. However, poor health was stable or declined in the young-old and old-old, respectively, and increased only in working-age adults (Prevalence ratio: 1.14, 95% CI 1.08, 1.20, <0.001). Over time, inequality in wellbeing and poor self-rated health were observed in adults but less consistently for children, but the inequalities did not widen in any age group between the start and end of the stagnation period. Although this study was a case study of one country, Japan, and inference to other countries cannot be made with certainty, the findings provide evidence that low economic growth over two decades did not inevitably translate to unfavourable population health. Japanese health inequalities according to income were stable during the study period. Therefore, this study highlighted the possibility that for high-income countries, low economic growth may be compatible with good population health. Low economic growth may worsen mortality and life expectancy trends. We used a Japanese population-based survey series encompassing low growth period. A long period of low economic growth did not inevitably worsen population health. Low economic growth and population health are not a trade-off.
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