贅沢病は裕福な人に多いか 健康格差に関する一般意識と実態
【目的】 所得，学歴，職業等の社会経済的要因に伴う健康水準の違い，すなわち健康格差が注目されている。本研究は，主要な生活習慣病および健康関連生活習慣と所得との関係について，一般住民の意識ならびに実態を調べることを目的とした。 【方法】 一般住民の意識調査として，山口県の4つの自治体から無作為に抽出した30～59歳の男女650名を対象に，裕福な人がそうでない人に比較して健康問題になりやすいかどうかについて自記式郵送調査を行った。実態調査として，国民生活基礎調査（平成19年）を用い，所得と健康問題との関連をRelative Index of Inequality（RII）を指標に分析した。 【結果...
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| Published in | 医療と社会 Vol. 22; no. 1; pp. 31 - 39 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
公益財団法人 医療科学研究所
2012
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0916-9202 1883-4477 |
| DOI | 10.4091/iken.22.31 |
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| Abstract | 【目的】 所得，学歴，職業等の社会経済的要因に伴う健康水準の違い，すなわち健康格差が注目されている。本研究は，主要な生活習慣病および健康関連生活習慣と所得との関係について，一般住民の意識ならびに実態を調べることを目的とした。 【方法】 一般住民の意識調査として，山口県の4つの自治体から無作為に抽出した30～59歳の男女650名を対象に，裕福な人がそうでない人に比較して健康問題になりやすいかどうかについて自記式郵送調査を行った。実態調査として，国民生活基礎調査（平成19年）を用い，所得と健康問題との関連をRelative Index of Inequality（RII）を指標に分析した。 【結果】 一般住民の意識調査では，650名のうち363名より回答があり（回答率55.8％），うつ病を除く全ての疾病（糖尿病，高血圧，脳卒中など）で裕福な人ほどなりやすいと回答した者の割合が高かった。喫煙や過剰飲酒は，裕福な人ほど少ないと回答した者の割合が高かった。実態調査では，脳卒中，心臓病，うつ病，喫煙で，所得が高い人ほどその割合が有意に低かった。 【考察】 本研究から，生活習慣病やそのリスクとなる不健康な生活習慣は総じて所得の低い者に現れやすいが，一般住民には逆の意識があることがわかった。健康格差についての認識，すなわち，社会経済的に不利な状況は生活習慣病のリスクを高めることの認識を高めることが，それらのリスクを低下させることに繋がると考えられる。 |
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| AbstractList | 【目的】 所得，学歴，職業等の社会経済的要因に伴う健康水準の違い，すなわち健康格差が注目されている。本研究は，主要な生活習慣病および健康関連生活習慣と所得との関係について，一般住民の意識ならびに実態を調べることを目的とした。 【方法】 一般住民の意識調査として，山口県の4つの自治体から無作為に抽出した30～59歳の男女650名を対象に，裕福な人がそうでない人に比較して健康問題になりやすいかどうかについて自記式郵送調査を行った。実態調査として，国民生活基礎調査（平成19年）を用い，所得と健康問題との関連をRelative Index of Inequality（RII）を指標に分析した。 【結果】 一般住民の意識調査では，650名のうち363名より回答があり（回答率55.8％），うつ病を除く全ての疾病（糖尿病，高血圧，脳卒中など）で裕福な人ほどなりやすいと回答した者の割合が高かった。喫煙や過剰飲酒は，裕福な人ほど少ないと回答した者の割合が高かった。実態調査では，脳卒中，心臓病，うつ病，喫煙で，所得が高い人ほどその割合が有意に低かった。 【考察】 本研究から，生活習慣病やそのリスクとなる不健康な生活習慣は総じて所得の低い者に現れやすいが，一般住民には逆の意識があることがわかった。健康格差についての認識，すなわち，社会経済的に不利な状況は生活習慣病のリスクを高めることの認識を高めることが，それらのリスクを低下させることに繋がると考えられる。 |
| Author | 福田, 吉治 |
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| References | Marmot M and Wilkinson RG (1999) Social Determinants of Health. New York: Oxford University Press. Drewnowski A (2009) “Obesity, Diets, and Social Inequalities,” Nutrition Reviews. 67 (Suppl 1) : 36-39. Block JP, Scribner RA and DeSalvo KB (2004) “Fast Food, Race/ethnicity, and Income: A Geographic Analysis,” American Journal of Preventive Medicine. 27 (3) : 211-217. Fukuda Y, Nakamura K and Takano T (2005c) “Socioeconomic Pattern of Smoking in Japan: Income Inequality and Gender and Age Differences,” Annals of Epidemiology. 15 (5) : 365-372. Kagamimori S, Gaina A and Nasermoaddeli A (2009) “Socioeconomic Status and Health in the Japanese Population,” Social Science & Medicine. 68 (12) : 2152-2160. 福田吉治，今井博久（2007）「日本における「健康格差」研究の現状」『保健医療科学』56：56-62 Kamphuis CB, Giskes K, de Bruijn GJ et al. (2006) “Environmental Determinants of Fruit and Vegetable Consumption among Adults: A Systematic Review,” The British Journal of Nutrition. 96 (4) : 620-635. Drewnowski A and Specter SE (2004) “Poverty and Obesity: The Role of Energy Density and Energy Costs,” The American Journal of Clinical Nutrition. 79 (1) : 6-16. Riediger ND and Moghadasian MH (2008) “Patterns of Fruit and Vegetable Consumption and the Influence of Sex, Age and Socio-demographic Factors among Canadian Elderly,” Journal of American College of Nutrition. 27 (2) : 306-313. Elovainio M, Ferrie JE, Singh-Manoux A et al. (2011) “Socioeconomic Differences in Cardiometabolic Factors: Social Causation or Health-related Selection? Evidence from the Whitehall II Cohort Study, 1991-2004,” American Journal of Epidemiology. 174 (7) : 779-789. Robertson A (2001) “Social Inequalities and the Burden of Food-related Ill-health,” Public Health Nutrition. 4 (6A) 1371-1373. Karlamangla AS, Merkin SS, Crimmins EM et al. (2010) “Socioeconomic and Ethnic Disparities in Cardiovascular Risk in the United States, 2001-2006,” Annals of Epidemiology. 20 (8) : 617-628. Kunst AE and MacKenbach JP (1994) Measuring Socio-economic Inequalities in Health. Copenhagen: World Health Organization. Nishi N, Makino Y, Fukuda H et al. (2004) “Effects of Socioeconomic Indicators on Coronary Risk Factors, Self-rated Health and Psychological Well-being among Urban Japanese Civil Servants,” Social Science & Medicine. 58 (6) : 1159-1170. Fukuda Y, Nakamura K and Takano T (2005a) “Accumulation of Health Risk behaviours is Associated with Lower Socioeconomic Status and Women's Urban Residence: A Multilevel Analysis in Japan,” BMC Public Health. 5 : 53. 川上憲人，小林廉毅，橋本英樹（2006）『社会格差と健康』東京大学出版会 Murakami K, Sasaki S, Takahashi Y et al. (2009) “Monetary Cost of Dietary Energy is Negatively Associated with BMI and Waist Circumference, But not with Other Metabolic Risk Factors, in Young Japanese Women,” Public Health Nutrition. 12 (8) : 1092-1098. Darmon N and Drewnowski A (2008) “Does Social Class Predict Diet Quality?,” The American Journal of Clinical Nutrition. 87 (5) : 1107-1117. Macintyre S, McKay L and Ellaway A (2006) “Lay Concepts of the Relative Importance of Different Influences on Health ; Are There Major Socio-demographic Variations?,” Health Education Research. 21 (5) : 731-739. Deshmukh-Taskar P, Nicklas TA, Yang SJ et al. (2007) “Does Food Group Consumption Vary by Differences in Socioeconomic, Demographic, and Lifestyle Factors in Young Adults?,” The Bogalusa Heart Study. Journal of the American Dietetic Association. 107 (2) : 223-234. 近藤克則（2005）『健康格差社会』医学書院 Anzai Y, Ohkubo T, Nishino Y et al. (2000) “Relationship between Health Practices and Education Level in the Rural Japanese Population,” Journal of Epidemiology. 10 (3) : 149-156. Murakami K, Sasaki S, Okubo H et al. (2009) “Neighborhood Socioeconomic Status in Relation to Dietary Intake and Body Mass Index in Female Japanese Dietetic Students,” Nutrition. 25 (7-8) : 745-752. 嶺尾郁夫，木村武量，末原節代，他（2010）「高尿酸血症とメタボリックシンドローム」『綜合臨床』59（2）：257-262 Ezzati M, Vander Hoorn S, Lawes CM et al. (2005) “Rethinking the “Diseases of Affluence” Paradigm: Global Patterns of Nutritional Risks in Relation to Economic Development,” PLoS Medicine. 2 (5) : e133. Cummins SC, McKay L and MacIntyre S (2005) “Mc-Donald's Restaurants and Neighborhood Deprivation in Scotland and England,” American Journal of Preventive Medicine. 29 (4) : 308-310. Fukuda Y, Nakamura K and Takano T (2005b) “Reduced Likelihood of Cancer Screening among Women in Urban Areas and with Low Socio-economic Status: A Multilevel Analysis in Japan,” Public Health. 119 (10) : 875-884. Robert SA, Booske BC, Rigby E et al. (2008) “Public Views on Determinants of Health, Interventions to Improve Health, and Priorities for Government,” Wisconsin Medical Journal. 107 (3) : 124-130. Giskes K, Avendano M, Brug J et al. (2010) “A Systematic Review of Studies on Socioeconomic Inequalities in Dietary Intakes Associated with Weight Gain and Overweight/obesity Conducted among European Adults,” Obesity Reviews. 11 (6) : 413-429. Robert SA and Booske BC (2011) “US Opinions on Health Determinants and Social Policy as Health Policy,” American Journal of Public Health. 101 (9) : 1655-1663. 本庄かおり（2007）「社会疫学の発展」『保健医療科学』56：99-105 Martikainen P, Ishizaki M, Marmot MG et al. (2001) “Socioeconomic Differences in Behavioural and Biological Risk Factors: A Comparison of a Japanese and an English Cohort of Employed Men,” International Journal of Epidemiology. 30 (4) : 833-838. Frieden TR (2010) “A Framework for Public Health Action: The Health Impact Pyramid,” American Journal of Public Health. 100 (4) : 590-595. Berkman LF and Kawachi I (2000) Social Epidemiology. New York: Oxford University Press. Dubowitz T, Heron M, Bird CE et al. (2008) “Neighborhood Socioeconomic Status and Fruit and Vegetable Intake among Whites, Blacks, and Mexican Americans in the United States,” The American Journal of Clinical Nutrition. 87 (6) : 1883-1891. |
| References_xml | – reference: 近藤克則（2005）『健康格差社会』医学書院 – reference: Berkman LF and Kawachi I (2000) Social Epidemiology. New York: Oxford University Press. – reference: Anzai Y, Ohkubo T, Nishino Y et al. (2000) “Relationship between Health Practices and Education Level in the Rural Japanese Population,” Journal of Epidemiology. 10 (3) : 149-156. – reference: Fukuda Y, Nakamura K and Takano T (2005c) “Socioeconomic Pattern of Smoking in Japan: Income Inequality and Gender and Age Differences,” Annals of Epidemiology. 15 (5) : 365-372. – reference: Kunst AE and MacKenbach JP (1994) Measuring Socio-economic Inequalities in Health. Copenhagen: World Health Organization. – reference: Deshmukh-Taskar P, Nicklas TA, Yang SJ et al. (2007) “Does Food Group Consumption Vary by Differences in Socioeconomic, Demographic, and Lifestyle Factors in Young Adults?,” The Bogalusa Heart Study. Journal of the American Dietetic Association. 107 (2) : 223-234. – reference: Riediger ND and Moghadasian MH (2008) “Patterns of Fruit and Vegetable Consumption and the Influence of Sex, Age and Socio-demographic Factors among Canadian Elderly,” Journal of American College of Nutrition. 27 (2) : 306-313. – reference: Drewnowski A and Specter SE (2004) “Poverty and Obesity: The Role of Energy Density and Energy Costs,” The American Journal of Clinical Nutrition. 79 (1) : 6-16. – reference: Block JP, Scribner RA and DeSalvo KB (2004) “Fast Food, Race/ethnicity, and Income: A Geographic Analysis,” American Journal of Preventive Medicine. 27 (3) : 211-217. – reference: Elovainio M, Ferrie JE, Singh-Manoux A et al. (2011) “Socioeconomic Differences in Cardiometabolic Factors: Social Causation or Health-related Selection? Evidence from the Whitehall II Cohort Study, 1991-2004,” American Journal of Epidemiology. 174 (7) : 779-789. – reference: Giskes K, Avendano M, Brug J et al. (2010) “A Systematic Review of Studies on Socioeconomic Inequalities in Dietary Intakes Associated with Weight Gain and Overweight/obesity Conducted among European Adults,” Obesity Reviews. 11 (6) : 413-429. – reference: 福田吉治，今井博久（2007）「日本における「健康格差」研究の現状」『保健医療科学』56：56-62 – reference: Darmon N and Drewnowski A (2008) “Does Social Class Predict Diet Quality?,” The American Journal of Clinical Nutrition. 87 (5) : 1107-1117. – reference: Frieden TR (2010) “A Framework for Public Health Action: The Health Impact Pyramid,” American Journal of Public Health. 100 (4) : 590-595. – reference: Fukuda Y, Nakamura K and Takano T (2005a) “Accumulation of Health Risk behaviours is Associated with Lower Socioeconomic Status and Women's Urban Residence: A Multilevel Analysis in Japan,” BMC Public Health. 5 : 53. – reference: Ezzati M, Vander Hoorn S, Lawes CM et al. (2005) “Rethinking the “Diseases of Affluence” Paradigm: Global Patterns of Nutritional Risks in Relation to Economic Development,” PLoS Medicine. 2 (5) : e133. – reference: Macintyre S, McKay L and Ellaway A (2006) “Lay Concepts of the Relative Importance of Different Influences on Health ; Are There Major Socio-demographic Variations?,” Health Education Research. 21 (5) : 731-739. – reference: Murakami K, Sasaki S, Takahashi Y et al. (2009) “Monetary Cost of Dietary Energy is Negatively Associated with BMI and Waist Circumference, But not with Other Metabolic Risk Factors, in Young Japanese Women,” Public Health Nutrition. 12 (8) : 1092-1098. – reference: Kamphuis CB, Giskes K, de Bruijn GJ et al. (2006) “Environmental Determinants of Fruit and Vegetable Consumption among Adults: A Systematic Review,” The British Journal of Nutrition. 96 (4) : 620-635. – reference: Nishi N, Makino Y, Fukuda H et al. (2004) “Effects of Socioeconomic Indicators on Coronary Risk Factors, Self-rated Health and Psychological Well-being among Urban Japanese Civil Servants,” Social Science & Medicine. 58 (6) : 1159-1170. – reference: Robert SA and Booske BC (2011) “US Opinions on Health Determinants and Social Policy as Health Policy,” American Journal of Public Health. 101 (9) : 1655-1663. – reference: Murakami K, Sasaki S, Okubo H et al. (2009) “Neighborhood Socioeconomic Status in Relation to Dietary Intake and Body Mass Index in Female Japanese Dietetic Students,” Nutrition. 25 (7-8) : 745-752. – reference: Cummins SC, McKay L and MacIntyre S (2005) “Mc-Donald's Restaurants and Neighborhood Deprivation in Scotland and England,” American Journal of Preventive Medicine. 29 (4) : 308-310. – reference: Fukuda Y, Nakamura K and Takano T (2005b) “Reduced Likelihood of Cancer Screening among Women in Urban Areas and with Low Socio-economic Status: A Multilevel Analysis in Japan,” Public Health. 119 (10) : 875-884. – reference: Kagamimori S, Gaina A and Nasermoaddeli A (2009) “Socioeconomic Status and Health in the Japanese Population,” Social Science & Medicine. 68 (12) : 2152-2160. – reference: 本庄かおり（2007）「社会疫学の発展」『保健医療科学』56：99-105 – reference: Robertson A (2001) “Social Inequalities and the Burden of Food-related Ill-health,” Public Health Nutrition. 4 (6A) 1371-1373. – reference: 川上憲人，小林廉毅，橋本英樹（2006）『社会格差と健康』東京大学出版会 – reference: Marmot M and Wilkinson RG (1999) Social Determinants of Health. New York: Oxford University Press. – reference: Robert SA, Booske BC, Rigby E et al. (2008) “Public Views on Determinants of Health, Interventions to Improve Health, and Priorities for Government,” Wisconsin Medical Journal. 107 (3) : 124-130. – reference: Martikainen P, Ishizaki M, Marmot MG et al. (2001) “Socioeconomic Differences in Behavioural and Biological Risk Factors: A Comparison of a Japanese and an English Cohort of Employed Men,” International Journal of Epidemiology. 30 (4) : 833-838. – reference: 嶺尾郁夫，木村武量，末原節代，他（2010）「高尿酸血症とメタボリックシンドローム」『綜合臨床』59（2）：257-262 – reference: Dubowitz T, Heron M, Bird CE et al. (2008) “Neighborhood Socioeconomic Status and Fruit and Vegetable Intake among Whites, Blacks, and Mexican Americans in the United States,” The American Journal of Clinical Nutrition. 87 (6) : 1883-1891. – reference: Karlamangla AS, Merkin SS, Crimmins EM et al. (2010) “Socioeconomic and Ethnic Disparities in Cardiovascular Risk in the United States, 2001-2006,” Annals of Epidemiology. 20 (8) : 617-628. – reference: Drewnowski A (2009) “Obesity, Diets, and Social Inequalities,” Nutrition Reviews. 67 (Suppl 1) : 36-39. |
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| Snippet | 【目的】 所得，学歴，職業等の社会経済的要因に伴う健康水準の違い，すなわち健康格差が注目されている。本研究は，主要な生活習慣病および健康関連生活習慣と所得との関係について，一般住民の意識ならびに実態を調べることを目的とした。 【方法】... |
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| SubjectTerms | 健康の社会的決定要因 健康格差 意識調査 生活習慣病 贅沢病 |
| Subtitle | 健康格差に関する一般意識と実態 |
| Title | 贅沢病は裕福な人に多いか |
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