Socioeconomic Predictors of Diabetes Mortality in Japan: An Ecological Study Using Municipality-specific Data
Objectives The aim of this study was to examine the geographic distribution of diabetes mortality in Japan and identify socioeconomic factors affecting differences in municipality-specific diabetes mortality. Methods Diabetes mortality data by year and municipality from 2013 to 2017 were extracted f...
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| Format: | Article |
| Language: | English |
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Korean Society for Preventive Medicine
2021-09-01
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| Series: | Journal of Preventive Medicine and Public Health |
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| Online Access: | http://www.jpmph.org/upload/pdf/jpmph-21-215.pdf |
| _version_ | 1819114196183285760 |
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| author | Tasuku Okui |
| author_facet | Tasuku Okui |
| author_sort | Tasuku Okui |
| collection | DOAJ |
| description | Objectives The aim of this study was to examine the geographic distribution of diabetes mortality in Japan and identify socioeconomic factors affecting differences in municipality-specific diabetes mortality. Methods Diabetes mortality data by year and municipality from 2013 to 2017 were extracted from Japanese Vital Statistics, and the socioeconomic characteristics of municipalities were obtained from government statistics. We calculated the standardized mortality ratio (SMR) of diabetes for each municipality using the empirical Bayes method and represented geographic differences in SMRs in a map of Japan. Multiple linear regression was conducted to identify the socioeconomic factors affecting differences in SMR. Statistically significant socioeconomic factors were further assessed by calculating the relative risk of mortality of quintiles of municipalities classified according to the degree of each socioeconomic factor using Poisson regression analysis. Results The geographic distribution of diabetes mortality differed by gender. Of the municipality-specific socioeconomic factors, high rates of single-person households and unemployment and a high number of hospital beds were associated with a high SMR for men. High rates of fatherless households and blue-collar workers were associated with a high SMR for women, while high taxable income per-capita income and total population were associated with low SMR for women. Quintile analysis revealed a complex relationship between taxable income and mortality for women. The mortality risk of quintiles with the highest and lowest taxable per-capita income was significantly lower than that of the middle-income quintile. Conclusions Socioeconomic factors of municipalities in Japan were found to affect geographic differences in diabetes mortality. |
| first_indexed | 2024-12-22T04:41:27Z |
| format | Article |
| id | doaj.art-675efafadbef4b9e9e779cf1aeffdba3 |
| institution | Directory Open Access Journal |
| issn | 1975-8375 2233-4521 |
| language | English |
| last_indexed | 2024-12-22T04:41:27Z |
| publishDate | 2021-09-01 |
| publisher | Korean Society for Preventive Medicine |
| record_format | Article |
| series | Journal of Preventive Medicine and Public Health |
| spelling | doaj.art-675efafadbef4b9e9e779cf1aeffdba32022-12-21T18:38:44ZengKorean Society for Preventive MedicineJournal of Preventive Medicine and Public Health1975-83752233-45212021-09-0154535235910.3961/jpmph.21.2152162Socioeconomic Predictors of Diabetes Mortality in Japan: An Ecological Study Using Municipality-specific DataTasuku Okui0 Medical Information Center, Kyushu University Hospital, Fukuoka, JapanObjectives The aim of this study was to examine the geographic distribution of diabetes mortality in Japan and identify socioeconomic factors affecting differences in municipality-specific diabetes mortality. Methods Diabetes mortality data by year and municipality from 2013 to 2017 were extracted from Japanese Vital Statistics, and the socioeconomic characteristics of municipalities were obtained from government statistics. We calculated the standardized mortality ratio (SMR) of diabetes for each municipality using the empirical Bayes method and represented geographic differences in SMRs in a map of Japan. Multiple linear regression was conducted to identify the socioeconomic factors affecting differences in SMR. Statistically significant socioeconomic factors were further assessed by calculating the relative risk of mortality of quintiles of municipalities classified according to the degree of each socioeconomic factor using Poisson regression analysis. Results The geographic distribution of diabetes mortality differed by gender. Of the municipality-specific socioeconomic factors, high rates of single-person households and unemployment and a high number of hospital beds were associated with a high SMR for men. High rates of fatherless households and blue-collar workers were associated with a high SMR for women, while high taxable income per-capita income and total population were associated with low SMR for women. Quintile analysis revealed a complex relationship between taxable income and mortality for women. The mortality risk of quintiles with the highest and lowest taxable per-capita income was significantly lower than that of the middle-income quintile. Conclusions Socioeconomic factors of municipalities in Japan were found to affect geographic differences in diabetes mortality.http://www.jpmph.org/upload/pdf/jpmph-21-215.pdfmortalityvital statisticsjapandiabetesgeographic differencesocioeconomic factors |
| spellingShingle | Tasuku Okui Socioeconomic Predictors of Diabetes Mortality in Japan: An Ecological Study Using Municipality-specific Data Journal of Preventive Medicine and Public Health mortality vital statistics japan diabetes geographic difference socioeconomic factors |
| title | Socioeconomic Predictors of Diabetes Mortality in Japan: An Ecological Study Using Municipality-specific Data |
| title_full | Socioeconomic Predictors of Diabetes Mortality in Japan: An Ecological Study Using Municipality-specific Data |
| title_fullStr | Socioeconomic Predictors of Diabetes Mortality in Japan: An Ecological Study Using Municipality-specific Data |
| title_full_unstemmed | Socioeconomic Predictors of Diabetes Mortality in Japan: An Ecological Study Using Municipality-specific Data |
| title_short | Socioeconomic Predictors of Diabetes Mortality in Japan: An Ecological Study Using Municipality-specific Data |
| title_sort | socioeconomic predictors of diabetes mortality in japan an ecological study using municipality specific data |
| topic | mortality vital statistics japan diabetes geographic difference socioeconomic factors |
| url | http://www.jpmph.org/upload/pdf/jpmph-21-215.pdf |
| work_keys_str_mv | AT tasukuokui socioeconomicpredictorsofdiabetesmortalityinjapananecologicalstudyusingmunicipalityspecificdata |