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Aims: Japan is known as a country with low self-rated health despite high life expectancy. We compared socioeconomic inequalities in self-rated health in Japan with those in 32 European countries and the US using nationally representative samples. Methods: We analysed individual data from the Comprehensive Survey of Living Conditions (Japan), the European Union Statistics on Income and Living Conditions, and the Behavioral Risk Factor Surveillance System (US) in 2016. We used ordered logistic regression models with four ordinal categories of self-rated health as an outcome, and educational level or occupational class as independent variables, controlling for age. Results: In Japan, about half the population perceived their health as 'fair', which was much higher than in Europe (≈20–40%). The odds ratios of lower self-rated health among less educated men compared with more educated were 1.72 (95% confidence interval (CI) 1.61–1.85) in Japan, and ranged from 1.67 to 4.74 in Europe (pooled; 2.10 (95% CI 2.01–2.20)), and 6.65 (95% CI 6.22–7.12) in the US. The odds ratios of lower self-rated health among less educated women were 1.79 (95% CI 1.65–1.95) in Japan, and ranged from 1.89 to 5.30 in Europe (pooled; 2.43 (95% CI 2.33–2.54)), and 8.82 (95% CI 8.29–9.38) in the US. Socioeconomic inequalities were large when self-rated health was low for European countries, but Japan and the US did not follow the pattern. Conclusions: Japan has similar socioeconomic gradient patterns to European countries for self-rated health, and our findings revealed smaller socioeconomic inequalities in self-rated health in Japan compared with those in western countries. [ABSTRACT FROM AUTHOR]

Background In Japan, the number of municipalities that offer free medical care for children has increased. This policy, however, might unintentionally aggravate the overcrowded situation of pediatric ambulatory services in Japan. We investigated the relationship between parents' health-care seeking attitudes according to child symptom severity and the amount of copayment, as well as parents' socioeconomic and demographic factors. Methods We used data for 4385 people from the Japanese Study of Stratification, Health, Income and Neighborhood (J-SHINE), which consisted of stratified random sampling of those aged from 25 to 50 years who lived in Tokyo and neighboring areas. Outcome variables were respondent health-care seeking attitudes toward their children's mild and severe symptoms of cold. Logistic regression models were developed for each dependent variable. Results A total of 1606 respondents with one or more children under the age of 15 years were included in the analysis. For mild symptoms of cold, no subsidy (OR: 0.51, 95%CI: 0.38-0.69) and partial subsidy (OR, 0.71; 95%CI: 0.54-0.95) were associated with fewer 'visit on that day' answers, compared with full subsidy. Income and respondent educational level were not associated with the outcome. For severe symptoms of cold, the OR of no subsidy (0.61; 95%CI: 0.30-1.23) and that of partial subsidy (0.91; 95%CI: 0.40-2.07) were not statistically significant. Conclusion Imposing a small copayment might prevent visits to medical facilities for mild symptoms of cold, but will not prevent visits for severe symptoms of cold. [ABSTRACT FROM AUTHOR]

Abstract Informal caregiving is linked to psychological stress. However, recent studies have suggested a protective association between informal caregiving and mortality among caregivers. We sought to test the association between caregiving and survival in the Komo-Ise study, a prospective cohort of community-dwelling residents aged 44–77 years living in two areas in Gunma prefecture, Japan. Caregiving status was assessed in 2000, and 8084 individuals were followed for ten years. All-cause mortality was ascertained from official registers. Using multivariate Cox proportional hazards models, we found no statistically significant overall association between informal caregiving and all-cause mortality for either combined sexes, (HR 0.97, 95% CI 0.79, 1.19), men (HR 0.98, 95% CI 0.76, 1.27), or women (HR 0.95, 95% CI 0.68, 1.34). The propensity score matched model also showed no increased risk of all-cause mortality across all caregivers, male caregivers, and female caregivers. The association with all-cause mortality was not observed regardless of the presence of support for activities of daily living (ADLs)/instrumental activities of daily living (IADLs) or the relationships to the care recipients. In subgroup analyses, informal caregiving was not associated with increased risk of all-cause death across subgroups for combined sexes, men, or women, except for increased mortality among female caregivers in the lowest-income group (HR 1.75, 95% CI 1.03, 3.00). An increase in the risk of mortality was not observed among male caregivers. In conclusion, informal caregiving did not increase mortality as a whole, nor for most subgroups, while some sub-groups such as women in the lower socioeconomic status groups may be vulnerable to the adverse health effects of caregiving. Highlights • Informal caregiving often places a psychological and physical burden on caregivers. • But recent studies report a protective association between caregiving and survival. • We test the association between caregiving and survival in a 10 year follow-up study. • Overall, informal caregiving was not associated with increased mortality. • Increased mortality was observed only in the lowest-income female caregivers. [ABSTRACT FROM AUTHOR]