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dc.contributor.authorKondo, Naokien_US
dc.contributor.authorSaito, Masashigeen_US
dc.contributor.authorHikichi, Hiroyukien_US
dc.contributor.authorAida, Junen_US
dc.contributor.authorOjima, Toshiyukien_US
dc.contributor.authorKondo, Katsunorien_US
dc.contributor.authorKawachi, Ichiroen_US
dc.date.accessioned2015-08-03T13:59:31Z
dc.date.issued2015en_US
dc.identifier.citationKondo, Naoki, Masashige Saito, Hiroyuki Hikichi, Jun Aida, Toshiyuki Ojima, Katsunori Kondo, and Ichiro Kawachi. 2015. “Relative deprivation in income and mortality by leading causes among older Japanese men and women: AGES cohort study.” Journal of Epidemiology and Community Health 69 (7): 680-685. doi:10.1136/jech-2014-205103. http://dx.doi.org/10.1136/jech-2014-205103.en
dc.identifier.issn0143-005Xen
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:17820679
dc.description.abstractBackground: Relative deprivation of income is hypothesised to generate frustration and stress through upward social comparison with one's peers. If psychosocial stress is the mechanism, relative deprivation should be more strongly associated with specific health outcomes, such as cardiovascular disease (compared with other health outcomes, eg, non-tobacco-related cancer). Methods: We evaluated the association between relative income deprivation and mortality by leading causes, using a cohort of 21 031 community-dwelling adults aged 65 years or older. A baseline mail-in survey was conducted in 2003. Information on cause-specific mortality was obtained from death certificates. Our relative deprivation measure was the Yitzhaki Index, derived from the aggregate income shortfall for each person, relative to individuals with higher incomes in that person's reference group. Reference groups were defined according to gender, age group and same municipality of residence. Results: We identified 1682 deaths during the 4.5 years of follow-up. A Cox regression demonstrated that, after controlling for demographic, health and socioeconomic factors including income, the HR for death from cardiovascular diseases per SD increase in relative deprivation was 1.50 (95% CI 1.09 to 2.08) in men, whereas HRs for mortality by cancer and other diseases were close to the null value. Additional adjustment for depressive symptoms and health behaviours (eg, smoking and preventive care utilisation) attenuated the excess risks for mortality from cardiovascular disease by 9%. Relative deprivation was not associated with mortality for women. Conclusions: The results partially support our hypothesised mechanism: relative deprivation increases health risks via psychosocial stress among men.en
dc.language.isoen_USen
dc.publisherBMJ Publishing Groupen
dc.relation.isversionofdoi:10.1136/jech-2014-205103en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4483791/pdf/en
dash.licenseLAAen_US
dc.subjectAGEINGen
dc.subjectCHD/CORONORARY HEARTen
dc.subjectCancer epidemiologyen
dc.subjectSOCIO-ECONOMICen
dc.subjectPOVERTYen
dc.titleRelative deprivation in income and mortality by leading causes among older Japanese men and women: AGES cohort studyen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalJournal of Epidemiology and Community Healthen
dash.depositing.authorKawachi, Ichiroen_US
dc.date.available2015-08-03T13:59:31Z
dc.identifier.doi10.1136/jech-2014-205103*
dash.authorsorderedfalse
dash.contributor.affiliatedKawachi, Ichiro


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