Study on "inequality in health" by socio-economic status

本研究旨在从理论和实证两方面揭示日本的“健康不平等”，以及社会经济因素对健康的影响路径。在理论工作中，我们假设了社会经济因素与健康的复合路径，既包括生物因素或健康行为因素，也包括心理社会因素，如连贯感、抑郁和社会网络等。在实证工作中，我们通过四个被试群体的研究得出了以下结论：中青年妇女（日本消费者小组调查）：在29-39岁日本妇女的代表性样本（约1200人）中观察到“健康方面的不平等”。婚姻历史和社会网络在这一过程中发挥了重要作用。老年人：1)我们进行了一项队列研究，受试者大约有2700人。我们发现，健康不平等不能仅仅用健康行为的差异来解释，更多的是社会经济地位的差异。缺乏对他人的社会支持显示出显著的优势比，这意味着它可能是失去健康预期寿命的一个风险因素。2)在对32000名老年人的横断面分析中，重度抑郁症患者在社会经济地位最低的群体中出现的频率是社会经济地位最高群体的6.9倍。全国代表性样本（日本综合社会调查，JGSS）：受试者约4000人。在调整个体社会经济因素后，自评健康与社会资本指数在区域水平上呈显著相关。日本-韩国老年人的比较研究：我们调查了韩国金海市约200名老年人。我们发现，在韩国，宅在家里的老年人比住在日本城镇的老年人要少。这些结果表明，“健康不平等”在日本也广泛存在，而且差距的程度比一般认为的要大。其次，从社会经济因素到健康的路径可能是一个包括生物-心理-社会因素的复合过程。影响健康的社会因素可分为个体层面和区域层面。少

The purposes of this research are to reveal "Inequality in health" in Japan and the path from socio-economic factors to health from both theoretical and empirical works.In the theoretical work, we hypothesized a compound path from socio-economic factors to health including not only biological factors or health behavioral factors but also psychosocial factors, such as sense of coherence, depression and social networks etc.In the empirical works, the following findings were obtained from the researches using four subject groups.The young-middle aged women (Japanese Panel Survey of Consumers) : "Inequality in health" was observed in the representative sample of Japanese women aged 29-39 years old (about 1200 persons). Marriage history and social network played significant role as a part of the path.The older people : 1) We conducted a cohort study those subjects were about 2700 people. We found that the inequality in health could not be explained only by the difference in health behaviors … More by socio-economic status. Lacking social support to others showed a significant odds ratio, which means it could be a risk factor of the loss of the healthy life expectancy. 2) In a cross sectional analysis of about 32,000 older persons, severe depressed people was observed as much as 6.9 times in maximum among the lowest socio-economic group compared with the highest group.A national representative sample (Japanese General Social Surveys, JGSS) : Subjects were about 4000 people. The self rated health showed a significant relationship with social capital index in regional level even after adjusting individual socio-economic factors.A comparison study between Japan-Korea older people : We investigated about 200 older people in Gimhae City in South Korea. We found a fewer older people are housebound in South Korea than those living in a Japanese town.These results suggest that "Inequality in health" exists widely also in Japan, and the extent of the gap is larger than that supposed in general. Secondarily, the path from socio-economic factors to health might be a compound process including bio-psycho-social factors. Thirdly, social factors affecting health could be divided into the individual level and the regional level. Less