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Anton E Kunst, Commentary: Using geographical data to monitor socioeconomic inequalities in mortality: experiences from Japanese studies, International Journal of Epidemiology, Volume 34, Issue 1, February 2005, Pages 110–112, https://doi.org/10.1093/ije/dyi013
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Extract
Policies to reduce socioeconomic inequalities in health need detailed and accurate descriptions of health inequalities in order to define priority areas for intervention.1 Essential for the monitoring of health inequalities is the use of national data on cause-specific mortality according to socioeconomic indicators such as education and income level. Longitudinal mortality data covering large national samples are available for only a dozen countries in Europe and elsewhere in the world.2 When such data are not available, alternative data sources have to be considered, such as ‘unlinked’ cross-sectional studies, longitudinal studies among small national samples or local populations, or geographical studies comparing neighbourhoods, municipalities, or regions.
Japan is a country of special interest. The record life expectancy of Japanese women did not only set a benchmark for public health in Western countries,3 but it also raised the question whether Japan had made similar achievements with respect to socioeconomic inequalities in mortality. Health inequalities in Japan may show different patterns, and may perhaps be substantially smaller than elsewhere. In the past century, Japan's social and economic policies had a distinct outcome-oriented egalitarian ethos.4 In addition, Japan has a large middle class that is highly homogeneous in attitudes and life styles, even though its social stratification system may not be fundamentally different from Western capitalist countries.5
