Pre- and post-COVID-19 all-cause mortality of Japanese citizens versus foreign residents living in Japan, 2015–2021

Immigrants in Japan face multiple health care challenges. There is limited research addressing how all-cause mortality differs between foreign residents and Japanese citizens, including the impact of the COVID-19 pandemic. We assessed whether all-cause mortality rates between Japanese citizens and f...

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Main Authors: Cyrus Ghaznavi, Akifumi Eguchi, Yuta Tanoue, Daisuke Yoneoka, Takayuki Kawashima, Motoi Suzuki, Masahiro Hashizume, Shuhei Nomura
Format: Article
Language:English
Published: Elsevier 2022-06-01
Series:SSM: Population Health
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352827322000933
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author Cyrus Ghaznavi
Akifumi Eguchi
Yuta Tanoue
Daisuke Yoneoka
Takayuki Kawashima
Motoi Suzuki
Masahiro Hashizume
Shuhei Nomura
author_facet Cyrus Ghaznavi
Akifumi Eguchi
Yuta Tanoue
Daisuke Yoneoka
Takayuki Kawashima
Motoi Suzuki
Masahiro Hashizume
Shuhei Nomura
author_sort Cyrus Ghaznavi
collection DOAJ
description Immigrants in Japan face multiple health care challenges. There is limited research addressing how all-cause mortality differs between foreign residents and Japanese citizens, including the impact of the COVID-19 pandemic. We assessed whether all-cause mortality rates between Japanese citizens and foreign residents living in Japan differ, and whether these differentials changed after the start of the COVID-19 pandemic. We conducted a cross-sectional analysis using vital statistical data of all deaths among citizens and foreign residents that occurred within Japanese borders aggregated every 6 months between January 1, 2015 and June 30, 2021. Data were used to calculate sex-, region-, and 20-year age group-specific standardized mortality rates using the direct method based on the population distribution of Japanese citizens in 2021 by sex, region, and 20-year age groups. Chi-squared tests and linear regression were used to assess whether the pandemic was associated with changes in mortality rates among groups and changes in the mortality differentials between citizens and non-citizens, respectively. All-cause mortality increased monotonically with age for men and women. Men had higher mortality than women, regardless of age or nationality. All-cause mortality is lower among immigrants than Japanese citizens between the ages of 20–59, but higher under the age of 20 and over the age of 59. The pandemic was associated with significant changes in mortality in most groups, but no statistically significant changes in the mortality differentials between immigrants and Japanese citizens were detected. Young immigrants are generally healthier than their Japanese counterparts, in line with the healthy migrant hypothesis. Younger migrants are at higher risk of mortality, possibly due to increased vulnerability to psychologic stress. Older migrant mortality converged with citizen mortality, consistent with acculturation that occurs with longer duration of residence. The pandemic did not exacerbate health inequities for foreign residents with respect to mortality.
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spelling doaj.art-37bad228e5a0415f8f23bfba5ce4d3c02022-12-22T02:29:31ZengElsevierSSM: Population Health2352-82732022-06-0118101114Pre- and post-COVID-19 all-cause mortality of Japanese citizens versus foreign residents living in Japan, 2015–2021Cyrus Ghaznavi0Akifumi Eguchi1Yuta Tanoue2Daisuke Yoneoka3Takayuki Kawashima4Motoi Suzuki5Masahiro Hashizume6Shuhei Nomura7Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Medical Education Program, Washington University School of Medicine in St Louis, Saint Louis, USADepartment of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Center for Preventive Medical Sciences, Chiba University, Chiba, JapanDepartment of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Institute for Business and Finance, Waseda University, Tokyo, JapanDepartment of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, JapanDepartment of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Mathematical and Computing Science, Tokyo Institute of Technology, Tokyo, JapanCenter for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, JapanDepartment of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan; Corresponding author. Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.Immigrants in Japan face multiple health care challenges. There is limited research addressing how all-cause mortality differs between foreign residents and Japanese citizens, including the impact of the COVID-19 pandemic. We assessed whether all-cause mortality rates between Japanese citizens and foreign residents living in Japan differ, and whether these differentials changed after the start of the COVID-19 pandemic. We conducted a cross-sectional analysis using vital statistical data of all deaths among citizens and foreign residents that occurred within Japanese borders aggregated every 6 months between January 1, 2015 and June 30, 2021. Data were used to calculate sex-, region-, and 20-year age group-specific standardized mortality rates using the direct method based on the population distribution of Japanese citizens in 2021 by sex, region, and 20-year age groups. Chi-squared tests and linear regression were used to assess whether the pandemic was associated with changes in mortality rates among groups and changes in the mortality differentials between citizens and non-citizens, respectively. All-cause mortality increased monotonically with age for men and women. Men had higher mortality than women, regardless of age or nationality. All-cause mortality is lower among immigrants than Japanese citizens between the ages of 20–59, but higher under the age of 20 and over the age of 59. The pandemic was associated with significant changes in mortality in most groups, but no statistically significant changes in the mortality differentials between immigrants and Japanese citizens were detected. Young immigrants are generally healthier than their Japanese counterparts, in line with the healthy migrant hypothesis. Younger migrants are at higher risk of mortality, possibly due to increased vulnerability to psychologic stress. Older migrant mortality converged with citizen mortality, consistent with acculturation that occurs with longer duration of residence. The pandemic did not exacerbate health inequities for foreign residents with respect to mortality.http://www.sciencedirect.com/science/article/pii/S2352827322000933JapanCOVID-19Foreign residentsImmigrantsAll-cause mortality
spellingShingle Cyrus Ghaznavi
Akifumi Eguchi
Yuta Tanoue
Daisuke Yoneoka
Takayuki Kawashima
Motoi Suzuki
Masahiro Hashizume
Shuhei Nomura
Pre- and post-COVID-19 all-cause mortality of Japanese citizens versus foreign residents living in Japan, 2015–2021
SSM: Population Health
Japan
COVID-19
Foreign residents
Immigrants
All-cause mortality
title Pre- and post-COVID-19 all-cause mortality of Japanese citizens versus foreign residents living in Japan, 2015–2021
title_full Pre- and post-COVID-19 all-cause mortality of Japanese citizens versus foreign residents living in Japan, 2015–2021
title_fullStr Pre- and post-COVID-19 all-cause mortality of Japanese citizens versus foreign residents living in Japan, 2015–2021
title_full_unstemmed Pre- and post-COVID-19 all-cause mortality of Japanese citizens versus foreign residents living in Japan, 2015–2021
title_short Pre- and post-COVID-19 all-cause mortality of Japanese citizens versus foreign residents living in Japan, 2015–2021
title_sort pre and post covid 19 all cause mortality of japanese citizens versus foreign residents living in japan 2015 2021
topic Japan
COVID-19
Foreign residents
Immigrants
All-cause mortality
url http://www.sciencedirect.com/science/article/pii/S2352827322000933
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