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  • 1.
    Fukuda, Yoshiharu
    et al.
    Department of Community Health and Medicine, Yamaguchi University School of Medicine, Ube, Japan.
    Hiyoshi, Ayako
    Department of Epidemiology and Public Health, University College London, London, UK.
    Association of income with symptoms, morbidities, and healthcare usage among Japanese adults2011In: Environmental Health and Preventive Medicine, ISSN 1342-078X, E-ISSN 1347-4715, Vol. 17, no 4, p. 299-306Article in journal (Refereed)
    Abstract [en]

    Objectives: Socioeconomic inequalities in healthcare services are major public health and healthcare concerns. We have examined the association of income with symptoms, morbidities and healthcare usage in a national sample of the Japanese population.

    Methods: For this study, data compiled on 21,929 men and 24,620 women from the Comprehensive Survey of the Living Conditions of People on Health and Welfare in 2007 were assessed. Among the survey respondents with symptoms, we compared the prevalences of symptoms and treatments and the number of respondents who received treatments for 16 groups of symptoms and disorders according to household income, from the highest to the lowest, using the relative index of inequalities (RII). The RIIs were computed by age groups [25–59 years (young group) and 60+ years (senior group)].

    Results: People with lower incomes had higher prevalences of symptoms and treatments for most of the disorders examined. The RIIs of symptoms and treatments were 1.19 [95% confidence interval (CI) 1.09–1.31] and 1.04 (95% CI 0.93–1.16) for the young group and 1.69 (1.53–1.87) and 1.51 (1.36–1.67) for the senior group, respectively. In terms of treatment prevalence among those with symptoms, the RII was not significantly lower than 1.0 except for a few disorders in the young group.

    Conclusions: Our results indicate that income inequalities can be related to the prevalences of various symptoms and morbidities in our Japanese sample population and that these inequalities were greater in the senior group than in the young group. Our results also suggest that lower income is not a substantial barrier to the use of healthcare services by older Japanese individuals, while it is related to lower healthcare usage by individuals of working age.

  • 2.
    Fukuda, Yoshiharu
    et al.
    Department of Community Health and Medicine, Yamaguchi University School of Medicine, Ube, Japan.
    Hiyoshi, Ayako
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Influences of income and employment on psychological distress and depression treatment in Japanese adults2011In: Environmental Health and Preventive Medicine, ISSN 1342-078X, E-ISSN 1347-4715, Vol. 17, no 1, p. 10-17Article in journal (Refereed)
    Abstract [en]

    Objectives: Psychological distress is a health issue of critical importance, especially in people of working age in developed countries, including Japan. This study examined the relationships of income and employment arrangement with psychological distress and treatment of depression in a national sample of Japanese adults.

    Methods: Data for 10,959 men and 11,655 women 25–59 years of age, obtained from the Comprehensive Survey of the Living Conditions of People on Health and Welfare in 2007, were examined. Health outcomes were psychological distress measured by the Japanese version of the K6, subjective complaints and medical treatment of depression. Explanatory variables included marital status, employment arrangement, and household income. The relationships between health outcomes and explanatory variables were examined using multiple logistic regression analyses.

    Results: Lower income and unemployment were associated with a higher prevalence of psychological distress and treatment of depression. The association between psychological distress and income showed a threshold: the lowest income quintile had an especially high prevalence, while other quintiles had similar prevalences. The prevalence of depression treatment in those with psychological distress was significantly lower in the highest income quintile than in all the other income groups, and the prevalence was also significantly lower in employed than in unemployed respondents.

    Conclusions: This study showed clear relationships of lower income and unemployment with psychological distress and depression treatment. It has been suggested that people with higher socioeconomic status and full-time work may be reluctant to consult professionals and receive medical treatment, despite their psychological distress. Comprehensive mental health interventions are required to prevent psychological distress in all socioeconomic strata of the population.

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