RT Journal Article
SR Electronic
T1 Mortality inequalities by occupational class among men in Japan, South Korea and eight European countries: a national register-based study, 1990–2015
JF Journal of Epidemiology and Community Health
JO J Epidemiol Community Health
FD BMJ Publishing Group Ltd
SP 750
OP 758
DO 10.1136/jech-2018-211715
VO 73
IS 8
A1 Hirokazu Tanaka
A1 Wilma J Nusselder
A1 Matthias Bopp
A1 Henrik Brønnum-Hansen
A1 Ramune Kalediene
A1 Jung Su Lee
A1 Mall Leinsalu
A1 Pekka Martikainen
A1 Gwenn Menvielle
A1 Yasuki Kobayashi
A1 Johan P Mackenbach
YR 2019
UL http://jech.bmj.com/content/73/8/750.abstract
AB Background We compared mortality inequalities by occupational class in Japan and South Korea with those in European countries, in order to determine whether patterns are similar.Methods National register-based data from Japan, South Korea and eight European countries (Finland, Denmark, England/Wales, France, Switzerland, Italy (Turin), Estonia, Lithuania) covering the period between 1990 and 2015 were collected and harmonised. We calculated age-standardised all-cause and cause-specific mortality among men aged 35–64 by occupational class and measured the magnitude of inequality with rate differences, rate ratios and the average inter-group difference.Results Clear gradients in mortality were found in all European countries throughout the study period: manual workers had 1.6–2.5 times higher mortality than upper non-manual workers. However, in the most recent time-period, upper non-manual workers had higher mortality than manual workers in Japan and South Korea. This pattern emerged as a result of a rise in mortality among the upper non-manual group in Japan during the late 1990s, and in South Korea during the late 2000s, due to rising mortality from cancer and external causes (including suicide), in addition to strong mortality declines among lower non-manual and manual workers.Conclusion Patterns of mortality by occupational class are remarkably different between European countries and Japan and South Korea. The recently observed patterns in the latter two countries may be related to a larger impact on the higher occupational classes of the economic crisis of the late 1990s and the late 2000s, respectively, and show that a high socioeconomic position does not guarantee better health.