LATEBREAKER
Health Disparities
Excess death and population attributable risk fraction of major cause of death due to area-level socioeconomic inequalities in Japan from 2015 to 2020 Yuri Ito* Yuri Ito Aoi Kataoka Tomoki Nakaya Manami Inoue Tomotaka Sobue Naoki Kondo
Background
Socioeconomic inequalities in health have long been a global issue. Health Japan 21, Japan’s health promotion plan, has focused on reducing health inequalities by bottoming up the health of subpopulations with low socioeconomic status (SES). To prioritize subpopulations for the plan’s target, we estimated excess deaths and population attributable risk fractions due to socioeconomic inequalities (EDSI and PAFSI) for major causes of death by sex and age group.
Method
The areal deprivation index (ADI) was used to establish area-based SES. We categorized municipalities into the ADI quintile weighted by population size; Q1 is the least deprived, and Q5 is the most deprived group. EDSI was calculated as the difference between the observed number of deaths and expected deaths of the Q2–Q5 groups, with Q1 as the standard population, and PAFSI was the proportion of EDSI in the observed death. We calculated the mortality of the six major causes of death (Cancer, Heart disease, Cerebrovascular disease, Pneumonia, Accidents, and Suicides) obtained from vital statistics from 2015 to 2020.
Results
For all ages, the largest EDSI was Cancer in men (12,118) and Heart disease in women (9,066). The largest PAFSI was Accidents in men (23.1%) and women (20.6%) of all ages. For the less than 75 years old group, the largest EDSI was Cancer in both men and women, and the largest PAFSI was Accidents. By age group, the largest EDSI showed in the 0-39 years was Suicides in men and Cancer in women, the 40-64 years were Cancer for both sexes, the 65-74 years were Cancer in men and Heart Disease in women, and 75 years and older were Cerebrovascular disease in men and Heart disease in women. Cancer, Heart disease, Cerebrovascular disease, and Accidents had the largest PAFSI in those aged 0-39 years, Pneumonia in those aged 40-64 years and Suicide in those aged ≥ 75 years.
Conclusion
EDSI and PAFSI differed by sex and age. We need to consider the priority of intervention to reduce the deprivation gap based on the figures for both EDSI and PAFSI.