title: Socioeconomic status and self-reported health among middle-aged Japanese men: results from a nationwide longitudinal study.
abstract: OBJECTIVE
  To examine potential associations between socioeconomic factors and self-rated health among a national sample of Japanese men aged 50-59 years between 2005 and 2010, including the 2008 global financial crisis.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Randomly selected 2515 census areas from a total of 1.8 million census areas in Japan.
  
  
  METHODS
  This study utilised data from a national, longitudinal survey conducted by the Ministry of Health, Labour and Welfare. Starting in 2005, 16,738 Japanese men aged 50-59 years were recruited and sent a questionnaire each year. We analysed data for the 6-year period (2005-2010) from participants who had worked for over 20 years in the same industry (n=9727).
  
  
  METHODS
  We focused on worsening self-rated health status by occupation, education and employment contract.
  
  
  RESULTS
  Working in the manufacturing industry was associated with worsening self-rated health scores when compared to those working in management (HR=1.19; 95% CI 1.04 to 1.37). A relationship between education level and worsening self-rated health was also identified as follows: junior high school (HR=1.49; 95% CI 1.31 to 1.69), high school (HR=1.29; 95% CI 1.17 to 1.42), and vocational college (HR=1.25; 95% CI 1.07 to 1.46), when compared with those holding university-level qualifications. Precarious employment (HR=1.17; 95% CI 1.00 to 1.37) was also associated with worsening self-rated health status in the current study.
  
  
  CONCLUSIONS
  This study suggests that working in manufacturing for more than 20 years and having lower education levels may have a significant impact on the self-rated health of middle-aged Japanese men. This may reflect a progressive decline in Japanese working conditions following the global financial crisis and/or the impact of lower socioeconomic status.
authors.affiliation: International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Wada
authors.affiliation: Department of Health and Physical Education, Fukuoka University of Education, Fukuoka, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Higuchi
authors.affiliation: Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Ourimbah, New South Wales, Australia.
authors.forename: Derek R
authors.initials: DR
authors.lastname: Smith
mesh_terms: D004651:Employment / Q000706:statistics & numerical data*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D066192:Manufacturing Industry / Q000706:statistics & numerical data*; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000517:prevention & control; D009790:Occupations / Q000706:statistics & numerical data*; D011446:Prospective Studies; D057566:Self Report; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: EPIDEMIOLOGY; OCCUPATIONAL & INDUSTRIAL MEDICINE; PUBLIC HEALTH