A nationwide cohort study of educational background and major causes of death among the elderly population in Japan
A nationwide cohort study of educational background and major causes of death among the elderly population in Japan
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DOI：
10.1016/j.ypmed.2004.07.002
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发表时间：
2005-04-01
影响因子：
5.1
通讯作者：
Yoshimura, T
中科院分区：
文献类型：
--
作者：
Fujino, Y;Tamakoshi, A;Yoshimura, T
背景这项前瞻性队列研究探讨了日本教育水平与主要死亡原因之间的关系。1988年至1990年期间，对45个地区110，792名40-79岁的居民进行了基线调查。每年进行后续调查，并从死亡证明中查明死亡原因。该分析仅限于16，715名男性和23，284名女性。在随访期间（377，139人-年），记录了6628例死亡。受教育程度低的个体总体死亡风险增加[男性相对危险度（RR）= 1.16，95%置信区间（CI）：1.08，1.25;女性RR = 1.26，95% CI：1.14，1.39]，癌症（RR = 1. 26，95% CI：1.14，1.39）。17，95% CI：1.04，1.32，男性; RR = 1.10，95% CI：0.93，1.30，女性）和外部原因死亡（RR = 1.81，95% CI：1.29。男性2.54;女性RR = 1.78，95%CI：1.18，2.70）。受教育程度低的男性患缺血性心脏病的风险略有降低（RR = 0.77，95%CI：0.58，1.01）。这些结果表明，虽然日本的财富不平等程度较低，但健康不平等依然存在。需要采取社会和政治举措来纠正不同社会经济地位之间的不平等。(C)2004年癌症预防研究所和爱思唯尔公司。All rights reserved.
Background. This prospective cohort study examined the association between educational level and major causes of death in Japan.Method. A baseline survey was conducted between 1988 and 1990 among 110,792 inhabitants of 45 areas aged 40-79 years. Follow-up surveys were conducted annually and causes of death were identified from death certificates. The analysis was restricted to 16,715 men and 23,284 women.Results. During the follow-up period (377,139 person-years), 6628 deaths were recorded. Individuals with low levels of education had an increased overall risk of death [relative risk (RR) = 1.16, 95% confidence interval (Cl): 1.08, 1.25, in men; RR = 1.26, 95% CI: 1.14, 1.39, in women], cancers (RR = 1. 17, 95% CI: 1.04, 1.32, in men; RR = 1.10, 95% CI: 0.93, 1.30, in women), and death from external causes (RR = 1.81, 95% CI: 1.29. 2.54, in men; RR = 1.78, 95% CI: 1.18, 2.70, in women). Ischemic heart disease risk was marginally reduced in men with low levels of education (RR = 0.77, 95% CI: 0.58, 1.01).Conclusions. These results show that health inequalities exist in Japan, even though wealth inequalities are relatively low. Social and political initiatives will be needed to correct these inequities between different socioeconomic statuses. (C) 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.