An analysis of factors related to disability-free life expectancy at 65 years of age across Japanese prefectures in 2010
An analysis of factors related to disability-free life expectancy at 65 years of age across Japanese prefectures in 2010
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DOI：
10.1007/s10433-017-0433-4
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发表时间：
2018-03-01
影响因子：
3.8
通讯作者：
Saito, Yasuhiko
中科院分区：
文献类型：
--
作者：
Minagawa, Yuka;Saito, Yasuhiko
与大量关注日本国内死亡率差异的研究相比，人们对健康预期的区域差异（尤其是老年人）知之甚少。本文有两个相互关联的目标。第一个目标是估算 2010 年各都道府县 65 岁的无残疾预期寿命 (DFLE)。按性别和县分列的 65 岁 DFLE 是使用沙利文方法计算的，该方法适用于 2010 年国民生活条件综合调查 (Kokumin Seikatsu Kiso Chosa) 中的都道府县特定生命表和残疾发生率。第二个目标是调查与 DFLE 相关的宏观层面因素。日本 47 个都道府县的 65 个。我们的结果表明，老年人 DFLE 存在地区差异。重要的是，我们注意到都道府县的财富、劳动力和福利特征与 65 岁的 DFLE 之间存在密切关系。人均收入、65 岁以上工人的比例以及福利支出与 DFLE 呈正相关，而人均失业和长期护理保险支出与男女的 DFLE 呈负相关。依赖公共援助的老年人比例仅与女性的 DFLE 负相关。这些结果表明，缩小社会经济差距可能有助于日本老年人的健康。因此，缩小地区健康差距需要政策制定者考虑每个地区更广泛的社会经济条件。
Compared to the large volume of research focused on mortality differentials within Japan, relatively little is known about regional variations in health expectancy, particularly among older people. This article has two interrelated objectives. The first objective is to estimate prefecture-specific disability-free life expectancy (DFLE) at 65 years of age in 2010. DFLE at 65 by gender and prefecture was computed using the Sullivan method, which was applied to prefecture-specific life tables and prevalence of disability from Kokumin Seikatsu Kiso Chosa (Comprehensive Survey of Living Conditions) of 2010. The second objective is to investigate macro-level factors associated with DFLE at 65 across 47 Japanese prefectures. Our results indicate regional disparities in DFLE at older ages. Importantly, we note close relationships between a prefecture's wealth, labor, and welfare characteristics and DFLE at 65. Income per capita, the proportion of workers older than 65, and welfare expenditures are positively related to DFLE, whereas unemployment and long-term care insurance expenditures per-capita are inversely associated with DFLE for both genders. The proportion of older adults relying on public assistance is negatively related only to women's DFLE. These results suggest that narrowing socioeconomic disparities may contribute to the health of Japanese elders. Reducing regional health disparities therefore requires policy makers to take into account the broader socioeconomic conditions of each prefecture.