日本の県別の主な危険因子による疾病負担の研究

该项目旨在确定日本主要风险因素导致的县一级疾病负担的差异，为老龄化社会背景下的未来政策提供信息。在项目的前三个月，我们重点计算吸烟导致的人口归因分数（PAF）。2010年，日本每1万人中约有13.0人死于吸烟。男性因吸烟导致的yll（16.8 / 10000）高于女性（8.9 / 10000）。这些结果与历史上日本男性吸烟率高于女性的情况一致。对于男性来说，属于吸烟导致的YLL发病率最低的五分之一的县包括：福井、山梨县、长野县、岛根县和德岛县。另一方面，收入最高的五分之一是北海道、青森、茨城县、枥木县和爱知县。对于女性来说，吸烟导致的青少年死亡率最低的五分之一地区包括茨城县、埼玉县、神奈川县、新泻县和富山市。可归因风险最高的五分之一是北海道、青森、京都、大阪和歌山。我们发现男性与纬度相关的吸烟归因风险因素普遍增加，但女性没有。这项研究确定了日本因吸烟造成的疾病负担比例的显著差异。更强有力的国家一级政策可能有助于减少各县在吸烟归因负担方面的差异。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病因特异性估计。

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.