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ABSTRACT: Background
Recent research suggests that Japanese inter-prefecture inequality in the risk of death before reaching 5 years old has increased since the 2000s. Despite this, there have been no studies examining recent trends in inequality in the infant mortality rate (IMR) with associated socioeconomic characteristics. This study specifically focused on household occupation, environment, and support systems for perinatal parents.Methods
Using national vital statistics by household occupation aggregated in 47 prefectures between 1999 and 2017, we conducted multilevel negative binomial regression analysis to evaluate occupation/IMR associations and joinpoint analysis to observe temporal trends. We also created thematic maps to depict the geographical distribution of the IMR.Results
Compared to the most privileged occupations (i.e., type II regular workers; including employees in companies with over 100 employees) IMR ratios were 1.26 for type I regular workers (including employees in companies with less than 100 employees), 1.41 for the self-employed, 1.96 for those engaged in farming, and 6.48 for unemployed workers. The IMR ratio among farming households was 1.75 in the prefectures with the highest population density (vs. the lowest) and 1.41 in prefectures with the highest number of farming households per 100 households (vs. the lowest). Joinpoint regression showed a yearly monotonic increase in the differences and ratios of IMRs among farming households compared to type II regular worker households. For unemployed workers, differences in IMRs increased sharply from 2009 while ratios increased from 2012.Conclusions
Inter-occupational IMR inequality increased between 1999 and 2017 in Japan. Further studies using individual-level data are warranted to better understand the mechanisms that contributed to this increase.
SUBMITTER: Kanamori M
PROVIDER: S-EPMC7738643 | biostudies-literature | 2020 Feb
REPOSITORIES: biostudies-literature
Kanamori Mariko M Kondo Naoki N Nakamura Yasuhide Y
Journal of epidemiology 20200201 1
<h4>Background</h4>Recent research suggests that Japanese inter-prefecture inequality in the risk of death before reaching 5 years old has increased since the 2000s. Despite this, there have been no studies examining recent trends in inequality in the infant mortality rate (IMR) with associated socioeconomic characteristics. This study specifically focused on household occupation, environment, and support systems for perinatal parents.<h4>Methods</h4>Using national vital statistics by household ...[more]