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Epidemiol Health > Volume 44; 2022 > Article
Epidemiology and Health 2022;44: e2022059-0.
DOI: https://doi.org/10.4178/epih.e2022059    Published online Jul 14, 2022.
The association between the socioeconomic deprivation level and ischemic heart disease mortality in Japan: an analysis using municipality-specific data
Tasuku Okui1  , Tetsuya Matoba2  , Naoki Nakashima1 
1Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
2Department of Cardiovascular Medicine, Kyushu University, Fukuoka, Japan
Correspondence  Tasuku Okui ,Email: task10300@gmail.com
Received: May 13, 2022  Accepted after revision: Jul 14, 2022
Geographical variation in the standardized mortality ratio (SMR) for ischemic heart disease (IHD) among municipalities has not been assessed in Japan. Additionally, associations between area-level socioeconomic deprivation indices and IHD mortality have not been identified in Japan. The present study investigated this association.
Information on IHD mortality was extracted from Vital Statistics data from 2018 to 2020 for each municipality in Japan. The socioeconomic deprivation level was derived from multiple socioeconomic characteristics. We classified municipalities into quintiles based on the deprivation level and investigated the association between the deprivation level and the SMR of IHD. Additionally, a Bayesian spatial regression model was used to investigate this association, adjusting for other municipal characteristics.
Geographical variation in the SMR of IHD was revealed, and municipalities with high SMRs were spatially clustered. There was a weak negative correlation between the socioeconomic deprivation level and the SMRs (correlation coefficient, -0.057 for men and -0.091 for women). In contrast, the regression analysis showed a statistically significant positive association between deprived areas and the IHD mortality rate, and the relative risks for the most deprived municipalities compared with the least deprived municipalities were 1.184 (95% credible interval [CrI], 1.110 to 1.277) and 1.138 (95% CrI, 1.048 to 1.249) for men and women, respectively.
A weak negative correlation between the socioeconomic deprivation level and the SMR was observed in the descriptive analysis, while the regression analysis showed that living in deprived areas was statistically positively associated with the IHD mortality rate.
Keywords: Coronary artery disease, Mortality, Japan
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