Socioeconomic status and self-reported health among middle-aged Japanese men: results from a nationwide longitudinal study

Koji Wada · Yoshiyuki Higuchi · Derek Richard SMITH

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Health disparities and outcomes Workplace Health and Well-being Employment and Welfare Studies

Abstract

OBJECTIVE: To examine potential associations between socioeconomic factors and self-rated health among a national sample of Japanese men aged 50-59 years between 2005 and 2010, including the 2008 global financial crisis. DESIGN: Prospective cohort study. SETTING: Randomly selected 2515 census areas from a total of 1.8 million census areas in Japan. PARTICIPANTS: This study utilised data from a national, longitudinal survey conducted by the Ministry of Health, Labour and Welfare. Starting in 2005, 16,738 Japanese men aged 50-59 years were recruited and sent a questionnaire each year. We analysed data for the 6-year period (2005-2010) from participants who had worked for over 20 years in the same industry (n=9727). MAIN OUTCOME MEASURES: We focused on worsening self-rated health status by occupation, education and employment contract. RESULTS: Working in the manufacturing industry was associated with worsening self-rated health scores when compared to those working in management (HR=1.19; 95% CI 1.04 to 1.37). A relationship between education level and worsening self-rated health was also identified as follows: junior high school (HR=1.49; 95% CI 1.31 to 1.69), high school (HR=1.29; 95% CI 1.17 to 1.42), and vocational college (HR=1.25; 95% CI 1.07 to 1.46), when compared with those holding university-level qualifications. Precarious employment (HR=1.17; 95% CI 1.00 to 1.37) was also associated with worsening self-rated health status in the current study. CONCLUSIONS: This study suggests that working in manufacturing for more than 20 years and having lower education levels may have a significant impact on the self-rated health of middle-aged Japanese men. This may reflect a progressive decline in Japanese working conditions following the global financial crisis and/or the impact of lower socioeconomic status.

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References

1997Self-Rated Health and Mortality: A Review of Twenty-Seven Community Studies 2008The subprime solution: how today's global financial crisis happened, and what to do about it 2009Socioeconomic status and health in the Japanese population 2005Accumulation of health risk behaviours is associated with lower socioeconomic status and women's urban residence: a multilevel analysis in Japan 2011Self-Rated Health as a Predictor of Disability Retirement – The Contribution of Ill-Health and Working Conditions 2014The Irish health-care system and austerity: sharing the pain 2014Multidimensional poverty and health: evidence from a nationwide survey in Japan 2008Education in relation to incidence of and mortality from cancer and cardiovascular disease in Japan

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