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- Hiyoshi, Ayako, 1972-, et al.
(författare)
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Low economic growth and health inequalities in a rich country : 27-year Japanese time series
- 2020
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Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 30:Suppl. 5
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Tidskriftsartikel (refereegranskat)abstract
- This presentation extends the public health theme in relation to Sustainable Development Goal #8, focusing on the health inequality trend in Japan. It is important to understand whether low economic growth is compatible with a low level of health inequalities. Unlike the UK and USA, life expectancy in Japan continued to improve despite a stagnant economy.Ten triennial waves of a nationally representative survey in Japan, 1986-2013 (n = 731,647) were used. Slope and Relative Indices of Inequality (SII and RII respectively) in relation to net household income and self-rated good health were calculated. Analyses were stratified by sex and age, for children, working-age adults, younger old and older old, given age differences in relation to labour market. Time trends of SII and RII were tested during the period of economic stagnation 1992-2013.In all age groups, prevalence of good health declined slightly from its peak in 1995 but increased after 2007. In 1992 among children, working-age adults and younger old, health in equal-ity based on SII was small, about 10% lower prevalence of good health in those with lowest compared to highest income. Among working-age adults, time trends of health inequalities based on SII narrowed from 1992 and then widened after 2002 (quadratic trends in men and women p < 0.05), resulting in the magnitude of health inequality returning to its level at the beginning of economic stagnation in 1992 but not exceeding it. Time trends in relative inequality (RII) were qualitatively similar to those in absolute inequality (SII).The long-term low-growth Japanese economy appears compatible with maintaining and improving population health and holding health inequalities at current levels. This evidence is of great significance for sustainable development and the health of current and future generations.
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- Hiyoshi, Ayako, 1972-, et al.
(författare)
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Low economic growth, health, health inequalities and sustainable development goals in a rich country : 27-year Japanese time series
- 2020
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ Publishing Group Ltd. - 0143-005X .- 1470-2738. ; 74:Suppl. 1, s. A40-A41
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Sustainable Development Goal #8 refers to decent work and economic growth. In the context of climate change and global resource depletion, it is important to understand whether low economic growth is compatible with positive population health in rich countries, particularly because the past decade of austerity in the UK and USA is associated with stagnating life expectancy. Japan provides a natural experiment in that it has experienced low economic growth since 1992, and life expectancy continued to improve. However, the trend in health inequality in good self-rated health is unknown.Methods: We examined trends in health and health inequalities using ten triennial waves of a nationally representative survey in Japan, 1986–2013 (n=731,647). Change in age-standardized self-rated good health was calculated, and health inequalities and their time trends were calculated using Slope and Relative Indices of Inequality (SII and RII respectively) in relation to net household income. Analyses were stratified by sex and age, for children (6–18 years), working-age adults (20–59 years), younger old (60–69 years) and older old (70–79 years), given age differences in relation to the economy and labour market. Time trends of SII and RII were tested during the period of economic stagnation 1992–2013.Results: Overall, age-standardised self-rated good health was high among children (70%) and low among the older old (30%). In all age groups, prevalence of good health declined slightly from its peak in 1995 but increased after 2007. In 1992 among children, working-age adults and younger old, health inequality based on SII for net household income was small (approximately 10% lower prevalence of good health in those with lowest compared to highest income). Among working-age adults, time trends of health inequalities between 1992 and 2013 were curvilinear. The SII narrowed and then widened after 2002 (quadratic trends in men and women p<0.05), resulting in the magnitude of health inequality returning to its level at the beginning of economic stagnation in 1992 but not exceeding it. Time trends in relative inequality (RII) were qualitatively similar to those in absolute inequality (SII). Health inequality narrowed and then widened, and the RIIs in 2013 was no larger than those in 1992.Conclusion: The long-term low-growth Japanese economy appears compatible with maintaining and improving population health and holding health inequalities at current levels. This evidence is of great significance for sustainable development and the health of current and future generations.
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- Hiyoshi, Ayako, 1972-, et al.
(författare)
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Myopia in late adolescence and subsequent multiple sclerosis among men
- 2023
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Ingår i: Multiple Sclerosis and Related Disorders. - : Elsevier. - 2211-0348 .- 2211-0356. ; 71
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Risk factors such as low vitamin D level has been implicated in the etiology of multiple sclerosis (MS) and may be relevant to myopia, such that there may be an association between myopia and MS.METHODS: Using linked Swedish national register data, we conducted a cohort study of men who were born in Sweden between 1950 and 1992, lived in Sweden between 1990 and 2018, and enrolled in military conscription assessment (n = 1,847,754). Myopia was defined based on the spherical equivalent refraction measured at conscription assessment, around age 18 years. Multiple sclerosis was identified using the Patient Register. Cox regression produced hazard ratios (HR) with 95% confidence intervals (95% CI), with adjustment for demographic and childhood socioeconomic characteristics and residential region. Due to changes in the assessment of refractive error, the analysis was stratified into two groups by the year of conscription assessment: 1969-1997 and 1997-2010.RESULTS: Among 1,559,859 individuals during a maximum of 48 years of follow-up from age 20 to 68 years (44,715,603 person-years), there were 3,134 MS events, and the incidence rate 7.0 (95% CI [6.8, 7.3] per 100,000 person-years). Among individuals with conscription assessments during 1997-2010, there were 380 MS events. There was no evidence of an association between myopia and MS, with HR 1.09 (95% CI 0.83, 1.43). Among individuals who underwent conscription assessment in 1969-1997, there were 2754 MS events. After adjusting for all covariates, there was no evidence of an association between myopia and MS (HR 0.99 [95% CI 0.91, 1.09]).CONCLUSION: Myopia in late adolescence is not associated with a subsequent raised risk of MS and thus there does not appear to be important shared risk factors.
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