Author: Naoki

Our study on TV news: children do not complete vaccination schedule if mother cannot take parental leave after delivery

Our paper on the previous post (below) was broadcasted by NHK: Japan’s public broadcaster!

Maternal work conditions, socioeconomic and educational status, and vaccination of children: A community-based household survey in Japan

Michiko Uedaa, Naoki Kondo, Misato Takada, Hideki Hashimoto

Objective

This study examined how maternal work-related factors, including the availability of paid maternal leave, affect childhood vaccination status. Relatively little is known about the association between the employment status of mothers and the vaccination status of their children.

Method

We examined data from the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE), an ongoing epidemiologic household panel study in Japan. We used surveys taken in 2010–2011 in this study.

Results

We found that mothers who returned to work after giving birth were much less likely to follow recommended vaccine schedules for their children compared with mothers who stayed at home and those who had left the workforce by the time of childbirth. However, taking parental leave significantly reduced the risk of not being up-to-date with the vaccination schedule at 36 months of age. We also found that children whose mother was younger and less educated, and those from an economically deprived family were at a high risk of not being up-to-date with the vaccination status at 36 months of age.

Conclusion

Because vaccination is free and widely available in Japan, our findings indicate that provision of free vaccinations is not sufficient to achieve high vaccination rates.

The Journal: http://www.sciencedirect.com/science/article/pii/S0091743514001844

New paper: Rising inequality in mortality among working-age Swedes

Our new paper was published from the Journal of Epidemiology and Community Health.
The paper is Open Access: http://jech.bmj.com/content/early/2014/08/20/jech-2013-203619.full

In the past two decades, health inequality has persisted or increased in states with comprehensive welfare.

We conducted a national registry-based repeated cohort study with a 3-year follow-up between 1990 and 2007 in Sweden.

Information on all-cause mortality in all working-age Swedish men and women aged between 30 and 64 years was collected.

Among men, age-standardised mortality rate decreased by 38.3% from 234.9 to 145 (per 100 000 population) over the whole period in the highest income quintile, whereas the reduction was only 18.3% (from 774.5 to 632.5) in the lowest quintile.

Among women, mortality decreased by 40% (from 187.4 to 112.5) in the highest income group, but increased by 12.1% (from 280.2 to 314.2) in the poorest income group.

The differences in age-standardised mortality between the highest and the lowest income quintiles decreased among men by 18.85 annually between 1990 and 1994 (p trend=0.02), whereas it increased later, with a 2.88 point increase per year (p trend <0.0001).

Among women, it continuously increased by 9.26/year (p trend <0.0001). In relative terms, age-adjusted mortality rate ratios showed a continuous increase in both genders.

Income-based inequalities among working-age male and female Swedes have increased since the late 1990s, whereas in absolute terms the increase was less remarkable among men. Structural and behavioural factors explaining this trend, such as the worst-ever economic recession in the early 1990s, should be studied further.