-
[show abstract]
[hide abstract]
ABSTRACT: Why are some communities more cohesive than others? The answer to the puzzle has two parts: (a) due to variations in the attributes of residents, and/or (b) due to variations in the attributes of places. However, few studies have sought to examine the community-level determinants of social capital. In the present study, we examined the associations between social capital and different area characteristics: (1) neighborhood walkability, (2) date of community settlement, and (3) degree of urbanization. We based our analysis on 9414 respondents from the Aichi Gerontological Evaluation Study (AGES), conducted in 2003. No significant positive association was found between the walkability score and any of the social capital indices. In contrast, community age and degree of urbanization were associated with many of the social capital indicators, even after controlling for characteristics of the residents. Community social capital thus appears to be more consistently linked to the broader historical and geographic contexts of neighborhoods, rather than to the proximal built environment (as measured by walkability).
Health & Place 03/2012; 18(2):229-39. · 2.67 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Studies have reported that the predictive ability of self-rated health (SRH) for mortality varies by sex/gender and socioeconomic group. The purpose of this study is to evaluate this relationship in Japan and explore the potential reasons for differences between the groups.
The analyses in the study were based on the Aichi Gerontological Evaluation Study's (AGES) 2003 Cohort Study in Chita Peninsula, Japan, which followed the four-year survival status of 14,668 community-dwelling people who were at least 65 years old at the start of the study. We first examined sex/gender and education-level differences in association with fair/poor SRH. We then estimated the sex/gender- and education-specific hazard ratios (HRs) of mortality associated with lower SRH using Cox models. Control variables, including health behaviors (smoking and drinking), symptoms of depression, and chronic co-morbid conditions, were added to sequential regression models. The results showed men and women reported a similar prevalence of lower SRH. However, lower SRH was a stronger predictor of mortality in men (HR = 2.44 [95% confidence interval (CI): 2.14-2.80]) than in women (HR = 1.88 [95% CI: 1.44-2.47]; p for sex/gender interaction = 0.018). The sex/gender difference in the predictive ability of SRH was progressively attenuated with the additional introduction of other co-morbid conditions. The predictive ability among individuals with high school education (HR = 2.39 [95% CI: 1.74-3.30]) was similar to that among individuals with less than a high school education (HR = 2.14 [95% CI: 1.83-2.50]; p for education interaction = 0.549).
The sex/gender difference in the predictive ability of SRH for mortality among this elderly Japanese population may be explained by male/female differences in what goes into an individual's assessment of their SRH, with males apparently weighting depressive symptoms more than females.
PLoS ONE 01/2012; 7(1):e30179. · 4.09 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Few prospective cohort studies have assessed the association between social capital and mortality. The studies were conducted only in Western countries and did not use the same social capital indicators. The present prospective cohort study aimed to examine the relationships between various forms of individual social capital and all-cause mortality in Japan.
Self-administered questionnaires were mailed to subjects in the Aichi Gerontological Evaluation Study (AGES) Project in 2003. Mortality data from 2003 to 2008 were analyzed for 14,668 respondents. Both cognitive and structural components of individual social capital were collected: 8 for cognitive social capital (trust, 3; social support, 3; reciprocity, 2) and 9 for structural social capital (social network). Cox proportional hazard models stratified by sex with multiple imputation were used. Age, body mass index, self-rated health, current illness, smoking history, alcohol consumption, exercise, equivalent income and education were used as covariates.
During 27,571 person-years of follow-up for men and 29,561 person-years of follow-up for women, 790 deaths in men and 424 in women were observed. In the univariate analyses for men, lower social capital was significantly related to higher mortality in one general trust variable, all generalised reciprocity variables and four social network variables. For women, lower social capital was significantly related to higher mortality in all generalised reciprocity and four social network variables. After adjusting for covariates, lower friendship network was significantly associated with higher all-cause mortality among men (meet friends rarely; HR = 1.30, 95%CI = 1.10-1.53) and women (having no friends; HR = 1.81, 95%CI = 1.02-3.23). Among women, lower general trust was significantly related to lower mortality (most people cannot be trusted; HR = 0.65, 95%CI = 0.45-0.96).
Friendship network was a good predictor for all-cause mortality among older Japanese. In contrast, mistrust was associated with lower mortality among women. Studies with social capital indices considering different culture backgrounds are needed.
BMC Public Health 06/2011; 11:499. · 2.00 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A body of research has shown that neighborhood environment may have an effect on a variety of health outcomes, including cardiovascular disease. One explanation for the mechanism of the effect of neighborhood on cardiovascular disease is psychosocial pathways. Direct evidence for an effect of neighborhood on cardiovascular disease with adjustment for perceived stress at the individual level has not been obtained, however. The Japan Collaborative Cohort Study for the Evaluation of Cancer Risk provides a unique dataset which has aggregated area-based cohorts from 45 areas throughout Japan. The purpose of the present study was to examine the contextual effect of area-level stress on ischemic heart disease using data from a large prospective cohort in Japan.
A baseline survey of 110,792 residents of 45 areas aged 40-79 years was conducted between 1988 and 1990. Analysis was restricted to subjects from the 33 of 45 areas providing information about self-rated stress (32183 men and 45896 women). Multilevel Poisson regression models were employed in a two-level structure of individuals nested within the 33 areas. Area-level stress was calculated by sex as the number of persons who rated their stress level as high divided by the total number of subjects in that area. Mortality rate ratios (MRRs) per 1 percentage point increase in area-level stress were estimated with adjustment for compositional individual factors.
During 15 years of follow-up (1,116,895 person-years), 936 deaths due to ischemic heart disease were recorded. Area-level stress varied from 6% to 22%. In the multivariable models, MRRs of area-level stress were 1.06 (95% confidence interval: 1.00-1.12, p = 0.043) in men and 1.07 (95% confidence interval: 1.00-1.14, p = 0.057) in women.
Area-level stress affects the likelihood of death due to ischemic heart disease of individuals in men. The present findings may suggest that stress should be considered not only within the individual but also within the neighborhood context.
BMC Public Health 05/2011; 11:398. · 2.00 Impact Factor
-
[Nippon kōshū eisei zasshi] Japanese journal of public health 11/2010; 57(11):1015-22.
-
[show abstract]
[hide abstract]
ABSTRACT: Perceived level of life enjoyment, a positive psychological condition that reflects the ability to engage pleasurably with the environment, may relate to risks of cardiovascular disease. This prospective cohort study attempted to examine the effects of perceived level of life enjoyment on cardiovascular disease incidence and mortality among Japanese community residents.
Subjects were 88 175 Japanese men and women 40 to 69 years of age who were free of cardiovascular disease at baseline and followed up for a median of 12.0 years and were included in the Japan Public Health Center-Based (JPHC) Study Cohort. Data about psychological conditions and other confounding variables were obtained through self-administered questionnaires. Information on incidence and mortality for cardiovascular disease was collected through registered hospitals and public health centers. The multivariable hazard ratios of cardiovascular disease incidence for men in the high versus low perceived levels of life enjoyment group were 1.22 (95% confidence interval, 1.01 to 1.47) for stroke and 1.23 (95% confidence interval, 1.05 to 1.44) for total cardiovascular disease. As for mortality, Japanese men with low perceived level of life enjoyment showed increased risk: hazard ratios of 1.75 (95% confidence interval, 1.28 to 2.38) for stroke, 1.91 (95% confidence interval, 1.30 to 2.81) for coronary heart disease and 1.61 (95% confidence interval, 1.32 to 1.96) for total cardiovascular disease. For women, however, the perceived level of life enjoyment was not associated with risks of cardiovascular disease incidence or mortality.
A lower perceived level of life enjoyment was found to be associated with higher risks of cardiovascular disease incidence and mortality among middle-aged men, suggesting a protective role of positive psychological conditions on cardiovascular disease.
Circulation 09/2009; 120(11):956-63. · 14.74 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: "Ikigai" is culturally defined in the society of Japan as a comprehensive concept describing subjective well-being. It is considered to be related to life-satisfaction, self-esteem, morale, happiness as well as evaluation towards meaning of one's life. Although previous studies examined factors associated with Ikigai with smaller samples, consistent results have not been obtained, especially from the viewpoint of gender differences. Identification of gender-specific factors related with Ikigai among the elderly, may be of value to enhance subjective well-being.
Self-administered questionnaires were distributed among 4,737 randomly selected members of the Silver Human Resources Centre (SHRC), a public temporary employment agency for seniors, in Osaka, Japan. This represents about 10% of all registered members (n = 41,593) in the 38 SHRC centres in Osaka. A total of 4,376 subjects (male: 2,913; female: 1,463) provided a satisfactory response to the questionnaire (response rate: 92%). The status whether they have "Ikigai" or not was evaluated by self-anchoring scale ranging from 0 to 5 (0 = lowest rate and 5 = highest rate of having "Ikigai"). Also, self-rated life-change score through work (-3 to 3) was evaluated by three items, i.e.) changes in (1) the number of friends through work, (2) social interests and (3) the quantity of conversation with others (1 = increase, 0 = no change, and -1 = decrease).
The factors associated with "Ikigai" for total subjects were the number of rooms in one's residence, annual income, healthy life style score (Breslow), the number of working days through SHRC, satisfaction with one's life history and life-change sore through work. The multivariable odds ratio (95% CI) of having "Ikigai" was 1.9 (1.1-3.3) for persons with no change in life thorough work compared with subjects with a score of < or = -1. Moreover, the multivariable odds ratios were 3.5 (1.9-6.6) for a life-change score = 1, 3.1 (1.7-5.7) for a score = 2 and 7.8 (4.0-15.2) for a score = 3 compared with persons with a score of < or = -1. For male subjects, other factors associated with having "Ikigai" were the number of rooms in their residence, annual income, the number of working days through SHRC, subjective assessment of health condition, and degree of satisfaction with their life history. For female, the corresponding factors were the presence of a spouse and degree of satisfaction with their life history.
Scores for life-changes through work were associated with a higher prevalence of having "Ikigai" for both male and female. For male, "Ikigai" tended to be associated with physical condition and socioeconomic factors such as the size of their residence or annual income, while for female, family relations such as having spouse and psychological factors such as satisfaction with one's life history were significant factors. In spite of the design limitations of this study, it is possible to conclude that the recognition of life change through obtaining work may enhance "Ikigai" among people who wish to engage in productive activities in their later stages of life for both male and female. SHRC has a potential to provide resources for fulfilling one's "Ikigai" through supporting working opportunities to realize life changes for both elder male and female.
Health and Quality of Life Outcomes 02/2006; 4:12. · 2.11 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To determine whether the clustered features of the metabolic syndrome precede the 7 year incidence of cardiovascular disease (CVD) and type 2 diabetes, we examined 6182 Japanese male office workers aged 35-59 years without any history of CVD. The 5588 subjects without type 2 diabetes also constituted the nondiabetic cohort, and were re-examined over seven successive years. Components of the metabolic syndrome included glycemic disorder (type 2 diabetes for the risk of CVD and impaired fasting glucose for the risk of type 2 diabetes), systemic obesity, hypertension, dyslipidemia, proteinuria, and elevated white blood cell (WBC) count. After controlling for age, family history of diabetes, alcohol intake, and cigarette smoking, the multivariate-adjusted relative risk of incidence of CVD compared with absence of components was 3.18, 3.48, 12.55, and 14.15 (P for trend <0.001), for the presence of 1,2,3, and > or =4 components, respectively. The corresponding relative risks of incidence of type 2 diabetes were 1.92, 4.36, 6.44, and 15.08 (P for trend <0.001). In both non-smokers and current smokers, the multivariate-adjusted relative risks of incidence of CVD and type 2 diabetes increased as the number of components increased (P for trend <0.001 for all). Our findings indicate that clustered features of the metabolic syndrome are closely associated with development of CVD and type 2 diabetes in middle-aged Japanese.
Diabetes Research and Clinical Practice 05/2004; 64(1):59-70. · 2.75 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We assessed the association of white blood cell (WBC) count with different components of the metabolic syndrome (MS) in 5275 Japanese male office workers aged 23-59 years. There was a significantly crude correlation between WBC count and body mass index, systolic and diastolic blood pressures, total cholesterol, high-density lipoprotein cholesterol (negative), triglycerides, fasting plasma glucose, and uric acid (all P<0.001). After controlling for potential confounding factors, the adjusted means of WBC count were significantly higher in subjects with each feature of the MS (obesity, hypertension, hypercholesterolemia, low high-density lipoprotein cholesterol levels, hypertriglyceridemia, high fasting plasma glucose levels, and hyperuricemia) (all P<0.005). The adjusted WBC count increments in subjects with 1, 2, 3, 4, and > or = 5 features of the MS were 0.28, 0.45, 0.68, 0.76, and 1.40 x 10(9) cells/l, respectively, compared with the subjects without features of the MS (P for trend<0.001). The adjusted means of WBC count increased significantly with the increasing number of features of the MS in both non-smokers and smokers (both P<0.001). These data indicate a strong association between WBC count and a number of disorders characterizing the MS independent of cigarette smoking among Japanese men.
Industrial Health 07/2002; 40(3):273-7. · 0.94 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To investigate the association of white blood cell (WBC) count with risk of hypertension.
Cross-sectional and longitudinal studies.
A work site in Japan.
A total of 3776 Japanese male office workers aged 23-49 years were enrolled in this study; 2900 hypertension-free [systolic blood pressure (SBP) < 140 mm Hg, diastolic blood pressure (DBP) < 90 mm Hg, no medication for hypertension, and no past history of hypertension] men were followed up over a 4-year period.
Blood pressure levels and the incidence of hypertension (SBP > or = 140 mm Hg and/or DBP > or = 90 mm Hg or medication for hypertension) according to WBC count at study entry.
After controlling for potential predictors of hypertension, SBP and DBP levels increased in a dose-dependent manner among both never-smokers and ex-smokers as WBC count increased. Among current smokers, only SBP level increased progressively with WBC count level. The multivariate-adjusted relative risk for development of hypertension compared with the first WBC count quintile was 1.29, 1.21, 1.67, and 1.92 among never-smokers (P for trend = 0.002): and 1.34, 1.46, 1.84, and 1.97 among ex-smokers (P for trend = 0.030) with the second, third, fourth, and fifth quintiles, respectively. Among current smokers, the respective multivariate-adjusted relative risks for hypertension relative to the first WBC count quintile were 0.91, 0.97, 1.08, and 0.84 (P for trend = 0.999).
WBC count is an important risk factor for hypertension, and the increased risk for hypertension associated with WBC count is more pronounced in non-smokers.
Journal of Hypertension 05/2002; 20(5):851-7. · 4.02 Impact Factor
