Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet.
SSM Popul Health. 2023 Jun; 22:101356.SP

Abstract

Introduction

Human health and wellbeing may depend on economic growth, the implication being that policymakers need to choose between population health and the health of ecosystems. Over two decades of low economic growth, Japan's life expectancy grew. Here we assess the temporal changes of subjective health and health inequality during the long-term low economic growth period.

Methods

Eight triennial cross-sectional nationally representative surveys in Japan over the period of economic stagnation from 1992 to 2013 were used (n = 625,262). Health is defined positively as wellbeing, and negatively as poor health, based on self-rated health. We used Slope and Relative Indices of Inequality to model inequalities in self-rated health based on household income. Temporal changes in health and health inequalities over time were examined separately for children/adolescents, working-age adults, young-old and old-old.

Results

At the end of the period of economic stagnation (2013), compared to the beginning (1992), the overall prevalence of wellbeing declined slightly in all age groups. However, poor health was stable or declined in the young-old and old-old, respectively, and increased only in working-age adults (Prevalence ratio: 1.14, 95% CI 1.08, 1.20, <0.001). Over time, inequality in wellbeing and poor self-rated health were observed in adults but less consistently for children, but the inequalities did not widen in any age group between the start and end of the stagnation period.

Conclusions

Although this study was a case study of one country, Japan, and inference to other countries cannot be made with certainty, the findings provide evidence that low economic growth over two decades did not inevitably translate to unfavourable population health. Japanese health inequalities according to income were stable during the study period. Therefore, this study highlighted the possibility that for high-income countries, low economic growth may be compatible with good population health.

Links

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Authors+Show Affiliations

Hiyoshi A

Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. Department of Epidemiology and Public Health, University College London, London, UK. Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.

Honjo K

Department of Social and Behavioural Sciences, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.

Platts LG

Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden.

Suzuki Y

Department of Social and Behavioural Sciences, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.

Shipley MJ

Department of Epidemiology and Public Health, University College London, London, UK.

Iso H

Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. Institute for Global Health and Medicine, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.

Kondo N

Department of Social Epidemiology, Kyoto University, Kyoto, Japan.

Brunner EJ

Department of Epidemiology and Public Health, University College London, London, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

36852377

Citation

Hiyoshi, Ayako, et al. "Trends in Health and Health Inequality During the Japanese Economic Stagnation: Implications for a Healthy Planet." SSM - Population Health, vol. 22, 2023, p. 101356.

Hiyoshi A, Honjo K, Platts LG, et al. Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet. SSM Popul Health. 2023;22:101356.

Hiyoshi, A., Honjo, K., Platts, L. G., Suzuki, Y., Shipley, M. J., Iso, H., Kondo, N., & Brunner, E. J. (2023). Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet. SSM - Population Health, 22, 101356. https://doi.org/10.1016/j.ssmph.2023.101356

Hiyoshi A, et al. Trends in Health and Health Inequality During the Japanese Economic Stagnation: Implications for a Healthy Planet. SSM Popul Health. 2023;22:101356. PubMed PMID: 36852377.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet. AU - Hiyoshi,Ayako, AU - Honjo,Kaori, AU - Platts,Loretta G, AU - Suzuki,Yuka, AU - Shipley,Martin J, AU - Iso,Hiroyasu, AU - Kondo,Naoki, AU - Brunner,Eric J, Y1 - 2023/02/06/ PY - 2022/11/24/received PY - 2023/01/26/revised PY - 2023/02/04/accepted PY - 2023/2/28/entrez PY - 2023/3/1/pubmed PY - 2023/3/1/medline KW - De-growth KW - Economic stagnation KW - Epidemiology KW - GDP KW - GDP, Sustainable Development Goal KW - Health inequalities KW - Planetary health KW - Self-rated health KW - Sustainable development goals KW - UK, The United Kingdom KW - US, The United States KW - Wellbeing SP - 101356 EP - 101356 JF - SSM - population health JO - SSM Popul Health VL - 22 N2 - Introduction: Human health and wellbeing may depend on economic growth, the implication being that policymakers need to choose between population health and the health of ecosystems. Over two decades of low economic growth, Japan's life expectancy grew. Here we assess the temporal changes of subjective health and health inequality during the long-term low economic growth period. Methods: Eight triennial cross-sectional nationally representative surveys in Japan over the period of economic stagnation from 1992 to 2013 were used (n = 625,262). Health is defined positively as wellbeing, and negatively as poor health, based on self-rated health. We used Slope and Relative Indices of Inequality to model inequalities in self-rated health based on household income. Temporal changes in health and health inequalities over time were examined separately for children/adolescents, working-age adults, young-old and old-old. Results: At the end of the period of economic stagnation (2013), compared to the beginning (1992), the overall prevalence of wellbeing declined slightly in all age groups. However, poor health was stable or declined in the young-old and old-old, respectively, and increased only in working-age adults (Prevalence ratio: 1.14, 95% CI 1.08, 1.20, <0.001). Over time, inequality in wellbeing and poor self-rated health were observed in adults but less consistently for children, but the inequalities did not widen in any age group between the start and end of the stagnation period. Conclusions: Although this study was a case study of one country, Japan, and inference to other countries cannot be made with certainty, the findings provide evidence that low economic growth over two decades did not inevitably translate to unfavourable population health. Japanese health inequalities according to income were stable during the study period. Therefore, this study highlighted the possibility that for high-income countries, low economic growth may be compatible with good population health. SN - 2352-8273 UR - https://www.unboundmedicine.com/medline/citation/36852377/full_citation DB - PRIME DP - Unbound Medicine ER -

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Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet.SSM Popul Health. 2023 Jun; 22:101356.SP