OBJECTIVE: To assess the effects on self rated health of individual income and income distribution in Japan. DESIGN: Cross sectional analysis. Data collected on household income, self rated health, and other sociodemographic characteristics at the individual level from comprehensive survey of the living conditions of people on health and welfare in a nationally representative sample from each prefecture. SETTING: Prefectures in Japan. PARTICIPANTS: 80 899 people aged >15 years with full records in survey. MAIN OUTCOME MEASURES: Dichotomous variable for self rated health of each respondent (0 if excellent, very good or good; 1 if fair or poor). RESULTS: Inequality in income at the prefecture level measured by the Gini coefficient was comparable with that in other industrialised countries. Unadjusted odds ratios show a 14% increased risk (odds ratio 1.14, 95% confidence interval 1.02 to 1.27) in reporting poor or fair health for individuals living in prefectures with higher inequality in income. After adjustment, individual income was more strongly associated with self rated health than income inequality. Additional inclusion of regional effects showed that median income at the prefecture level was inversely related to self rated health. CONCLUSIONS: Individual income, probably relative to the median prefecture income, has a stronger association with self rated health than income inequality at the prefecture level.
OBJECTIVE: To assess the effects on self rated health of individual income and income distribution in Japan. DESIGN: Cross sectional analysis. Data collected on household income, self rated health, and other sociodemographic characteristics at the individual level from comprehensive survey of the living conditions of people on health and welfare in a nationally representative sample from each prefecture. SETTING: Prefectures in Japan. PARTICIPANTS: 80 899 people aged >15 years with full records in survey. MAIN OUTCOME MEASURES: Dichotomous variable for self rated health of each respondent (0 if excellent, very good or good; 1 if fair or poor). RESULTS: Inequality in income at the prefecture level measured by the Gini coefficient was comparable with that in other industrialised countries. Unadjusted odds ratios show a 14% increased risk (odds ratio 1.14, 95% confidence interval 1.02 to 1.27) in reporting poor or fair health for individuals living in prefectures with higher inequality in income. After adjustment, individual income was more strongly associated with self rated health than income inequality. Additional inclusion of regional effects showed that median income at the prefecture level was inversely related to self rated health. CONCLUSIONS: Individual income, probably relative to the median prefecture income, has a stronger association with self rated health than income inequality at the prefecture level.
Authors: John Lynch; George Davey Smith; Sam Harper; Marianne Hillemeier; Nancy Ross; George A Kaplan; Michael Wolfson Journal: Milbank Q Date: 2004 Impact factor: 4.911
Authors: Joseph B Tay; Cecily C Kelleher; Ann Hope; Margaret Barry; Saoirse Nic Gabhainn; Jane Sixsmith Journal: J Epidemiol Community Health Date: 2004-11 Impact factor: 3.710
Authors: D O'Reilly; K J Thompson; A W Murphy; G Bury; A Gilliland; A Kelly; T O'Dowd; K Steele Journal: Ir J Med Sci Date: 2006 Jul-Sep Impact factor: 1.568