Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet
Introduction: Human health and wellbeing may depend on economic growth, the implication being that policymakers need to choose between population health and the health of ecosystems. Over two decades of low economic growth, Japan's life expectancy grew. Here we assess the temporal changes of su...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | SSM: Population Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352827323000216 |
| _version_ | 1797823682915074048 |
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| author | Ayako Hiyoshi Kaori Honjo Loretta G. Platts Yuka Suzuki Martin J. Shipley Hiroyasu Iso Naoki Kondo Eric J. Brunner |
| author_facet | Ayako Hiyoshi Kaori Honjo Loretta G. Platts Yuka Suzuki Martin J. Shipley Hiroyasu Iso Naoki Kondo Eric J. Brunner |
| author_sort | Ayako Hiyoshi |
| collection | DOAJ |
| description | Introduction: Human health and wellbeing may depend on economic growth, the implication being that policymakers need to choose between population health and the health of ecosystems. Over two decades of low economic growth, Japan's life expectancy grew. Here we assess the temporal changes of subjective health and health inequality during the long-term low economic growth period. Methods: Eight triennial cross-sectional nationally representative surveys in Japan over the period of economic stagnation from 1992 to 2013 were used (n = 625,262). Health is defined positively as wellbeing, and negatively as poor health, based on self-rated health. We used Slope and Relative Indices of Inequality to model inequalities in self-rated health based on household income. Temporal changes in health and health inequalities over time were examined separately for children/adolescents, working-age adults, young-old and old-old. Results: At the end of the period of economic stagnation (2013), compared to the beginning (1992), the overall prevalence of wellbeing declined slightly in all age groups. However, poor health was stable or declined in the young-old and old-old, respectively, and increased only in working-age adults (Prevalence ratio: 1.14, 95% CI 1.08, 1.20, <0.001). Over time, inequality in wellbeing and poor self-rated health were observed in adults but less consistently for children, but the inequalities did not widen in any age group between the start and end of the stagnation period. Conclusions: Although this study was a case study of one country, Japan, and inference to other countries cannot be made with certainty, the findings provide evidence that low economic growth over two decades did not inevitably translate to unfavourable population health. Japanese health inequalities according to income were stable during the study period. Therefore, this study highlighted the possibility that for high-income countries, low economic growth may be compatible with good population health. |
| first_indexed | 2024-03-13T10:27:36Z |
| format | Article |
| id | doaj.art-1d98824d172345f6bed3fc3f8bfd9536 |
| institution | Directory Open Access Journal |
| issn | 2352-8273 |
| language | English |
| last_indexed | 2024-03-13T10:27:36Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Population Health |
| spelling | doaj.art-1d98824d172345f6bed3fc3f8bfd95362023-05-19T04:45:42ZengElsevierSSM: Population Health2352-82732023-06-0122101356Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planetAyako Hiyoshi0Kaori Honjo1Loretta G. Platts2Yuka Suzuki3Martin J. Shipley4Hiroyasu Iso5Naoki Kondo6Eric J. Brunner7Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Epidemiology and Public Health, University College London, London, UK; Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Corresponding author. . Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.Department of Social and Behavioural Sciences, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Osaka, JapanStress Research Institute, Department of Psychology, Stockholm University, Stockholm, SwedenDepartment of Social and Behavioural Sciences, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Osaka, JapanDepartment of Epidemiology and Public Health, University College London, London, UKPublic Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Institute for Global Health and Medicine, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, JapanDepartment of Social Epidemiology, Kyoto University, Kyoto, JapanDepartment of Epidemiology and Public Health, University College London, London, UKIntroduction: Human health and wellbeing may depend on economic growth, the implication being that policymakers need to choose between population health and the health of ecosystems. Over two decades of low economic growth, Japan's life expectancy grew. Here we assess the temporal changes of subjective health and health inequality during the long-term low economic growth period. Methods: Eight triennial cross-sectional nationally representative surveys in Japan over the period of economic stagnation from 1992 to 2013 were used (n = 625,262). Health is defined positively as wellbeing, and negatively as poor health, based on self-rated health. We used Slope and Relative Indices of Inequality to model inequalities in self-rated health based on household income. Temporal changes in health and health inequalities over time were examined separately for children/adolescents, working-age adults, young-old and old-old. Results: At the end of the period of economic stagnation (2013), compared to the beginning (1992), the overall prevalence of wellbeing declined slightly in all age groups. However, poor health was stable or declined in the young-old and old-old, respectively, and increased only in working-age adults (Prevalence ratio: 1.14, 95% CI 1.08, 1.20, <0.001). Over time, inequality in wellbeing and poor self-rated health were observed in adults but less consistently for children, but the inequalities did not widen in any age group between the start and end of the stagnation period. Conclusions: Although this study was a case study of one country, Japan, and inference to other countries cannot be made with certainty, the findings provide evidence that low economic growth over two decades did not inevitably translate to unfavourable population health. Japanese health inequalities according to income were stable during the study period. Therefore, this study highlighted the possibility that for high-income countries, low economic growth may be compatible with good population health.http://www.sciencedirect.com/science/article/pii/S2352827323000216WellbeingSelf-rated healthHealth inequalitiesPlanetary healthSustainable development goalsGDP |
| spellingShingle | Ayako Hiyoshi Kaori Honjo Loretta G. Platts Yuka Suzuki Martin J. Shipley Hiroyasu Iso Naoki Kondo Eric J. Brunner Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet SSM: Population Health Wellbeing Self-rated health Health inequalities Planetary health Sustainable development goals GDP |
| title | Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet |
| title_full | Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet |
| title_fullStr | Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet |
| title_full_unstemmed | Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet |
| title_short | Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet |
| title_sort | trends in health and health inequality during the japanese economic stagnation implications for a healthy planet |
| topic | Wellbeing Self-rated health Health inequalities Planetary health Sustainable development goals GDP |
| url | http://www.sciencedirect.com/science/article/pii/S2352827323000216 |
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