Citation

Nagata C, Moriichi A, Morisaki N, Gai-Tobe R, Ishiguro A, Mori R. Pediatr. Int. 2017; 59(7): 816-820.

Affiliation

Department of Health Policy, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 158-8535, Japan.

Copyright

(Copyright © 2017, Japan Pediatric Society, Publisher John Wiley and Sons)

DOI

10.1111/ped.13304

PMID

28544421

Abstract

BACKGROUND: Child poverty is a growing, serious issue in Japan, where various social disparities are widening. Numerous reports have focused on the relationship between social inequity and health. However, few studies have assessed how the overall magnitude of disparities in child health has changed over the course of drastic social and economic transitions from 1899 to more recent times. In this study, we assessed the trend of the under-five mortality rate (U5MR) and its inter-prefectural disparities in Japan.

METHODS: This is a secondary analysis of Japan's vital statistics data from 1899 to 2014 (115 years), which covers a core period of modern Japan. We calculated the U5MR of each prefecture and its Theil index by year to assess the trend of inter-prefectural disparities in child health from 1899 to 2014.

RESULTS: The U5MR monotonically decreased from 238 per 1,000 births in 1899 to 3 in 2014. The Theil index of the U5MR increased in the post-war period, peaked in 1962 (0.027) and gradually reduced to below 0.01 in the 1970s. However in the 2000s, even though the U5MR continued to decrease, the Theil index started to increase, and in 2014 had a value (0.013) exceeding that of 1970 and more comparable to those before World War II.

CONCLUSIONS: Our findings suggest the possibility of widening disparities in child health, and may serve as a warning to today's society that increasing socioeconomic gradients may lead to rising health inequity among children. Further investigations on causes, mechanisms, and possible interventions are needed. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

Language: en

Keywords

Theil index; child health; disparity; inequity; under-five mortality