日本の県別の主な危険因子による疾病負担の研究

该项目旨在确定可归因于日本关键风险因素的疾病负担在县一级的变化，以便在老龄化社会的背景下为未来的政策提供信息。在该项目的前三个月，我们专注于计算由于吸烟而导致的人口归因率(PAF)。2010年，日本每10,000人中约有13.0个YLL可归因于吸烟。男性吸烟可归因于YLL的比例(16.8/10,000)高于女性(8.9/10,000)。这些结果与日本男性吸烟率历史上高于女性的情况一致。对于男性来说，属于吸烟导致的长寿死亡率最低五分之一的县包括：福井县、山梨县、长野县、岛根县和德岛县。另一方面，最高的五分位数由北海道、青森、茨城、户木和爱知组成。对于女性来说，吸烟导致的YLL率最低的五分之一包括茨城、崎玉、神奈川、新泻和富山。北海道、青森、京都、大阪和和歌山的归因风险最高。我们发现吸烟可归因于危险因素在男性中普遍增加，但在女性中没有。这项研究发现，在日本，可归因于吸烟的疾病负担比例存在显著差异。更有力的国家一级政策可能有助于减少各县之间吸烟可归因性负担的差异。未来的研究将把这些发现扩展到其他风险因素和疾病负担的特定原因估计。

This project aimed to identify prefecture-level variation in the burden of disease attributable to key risk factors in Japan, to inform future policy in the context of an aging society. In the first three months of the project, we focused on calculating the population attributable fraction (PAF) due to smoking.For Japan in 2010, about 13.0 YLLs per 10,000 population were attributable to smoking. There were more smoking-attributable YLLs among men (16.8 per 10,000) than among women (8.9 per 10,000). These results are consistent with historically higher smoking prevalences among Japanese men than women. For men, prefectures belonging to the lowest quintile for smoking-attributable YLL rates included: Fukui, Yamanashi, Nagano, Shimane and Tokushimaa. On the other hand, the highest quintile consisted of Hokkaido, Aomori, Ibaraki, Tochigi, and Aichi. For women, the lowest quintile for smoking-attributable YLL rates included Ibaraki, Saitama, Kanagawa, Niigata and Toyama. The highest quintiles of attributable risk were found in Hokkaido, Aomori, Kyoto, Osaka and Wakayama. We identified a broad increase in smoking-attributable risk factors with latitude in men but not women.This research identified significant variation in the proportion of the burden of disease attributable to smoking in Japan. More robust national level policies may help to reduce variation between prefectures in smoking-attributable burden. Future research will extend these findings to other risk factors and cause-specific estimate of disease burden.