UNHEALTHY SEQUENCE IN THE EASTERN TOKYO.

在大城市东京研究了健康方面的不平等。分析了以下指标：年龄调整死亡率、出生时预期寿命、年龄调整PMI（比例死亡率）、按病因（恶性肿瘤、缺血性心脏病、脑血管疾病）划分的年龄调整死亡率、死亡年龄标准差、按年龄组划分的死亡率、婴儿死亡率、每10万人患病人数、限定住宅区占城市规划面积的百分比、限定住宅区占住宅区面积的百分比。林地和农田占土地总面积的百分比，市政财政状况，公共交通的可及性，宽阔道路的可及性（6米以上），空气污染，参加医疗保健检查的人数百分比-基本医疗保健检查，胃癌检查，肺癌检查-医疗保健设施数量，犯罪率，弹球机游戏厅数量，消费价格，人均年应税收入，年龄调整后的教育水平和失业率。结果表明，东京都东部地区（中央、大东、隅田、东东、荒川、安达、胜香和江户川）在大多数健康指标上明显不健康，而东京都西部地区（目黑、世田谷、中野、杉南、新岛、武藏野、三高、阜中、中阜、小金井、小分寺、国町、田西、豪屋、小前和东栗村）则不健康。从人口统计、疾病形态、卫生服务水平、卫生资源、生活环境、消费、应对行为、脆弱生活、药物滥用、细菌环境、河流水质等方面分析了不健康序列。还开发了地理信息系统（GIS）、多元一般非线性分析（MGNA）模型等新的健康评价方法。综上所述，社区健康水平是由上述各种因素决定的，应通过健康促进活动来提高社区健康水平。

Inequity in health was studied in megacity Tokyo. Following indices were analyzed : age-adjusted death rate, life expectancy at birth, age-adjusted PMI (Proportional Mortality Ratio), age-adjusted death rates by causes -malignant neoplasms, ischemic heart disease, cerebrovascular disease-, standard deviation of death age, death rates by age group, infant mortality, rates of patients per 100,000 population, limited residential-zone as a percentage of urban planning area, limited residential-zone as a percentage of residential-zone area, woodland and farmland as a percentage of total land area, municipal financial condition, access to public transportation, access to wide road (more than 6 m), air pollution, percentages of people attending examinations of health care -basic health care examination, examination for stomach cancer, examination for lung cancer-, nuber of medical care facilities, crime, number of pachinko game hall, consumer price, annual taxable income per capita, age-adjusted educational level and unemployment rate. It was indicated that the eastern part of Tokyo -Chuo, Taito, Sumida, Koto, Arakawa, Adachi, Katsushika and Edogawa-, was significantly unhealthy in the most health indicators compared to the western part of Tokyo -Meguro, Setagaya, Nakano, Suginami, Nerima, Musashino, Mitaka, Fuchu, Chofu, Koganei, Kodaira, Kokubunji, Kunitachi, Tanashi, Hoya, Komae and Higashikurume-. Unhealthy sequence was addressed from several aspects : demography, disease pattern, level of health services, health resources, living environment, consumption, coping behavior, fragile living, substance abuse, bacterial environment and quality of river water. New measures including Geographic Information System (GIS), multiple general non-linear analysis (MGNA) model were also developed to evaluate health. It is concluded that the community health level is determined by the various factors mentioned above, which should be improved by health promotion activities.