Papers

Many older adults still homebound after 2011 Great East Japan Earthquake:

http://www.eurekalert.org/pub_releases/2014-10/oup-moa101414.php

Full paper download: http://ageing.oxfordjournals.org/content/early/2014/10/13/ageing.afu146.full

Our new paper was published from the journal: Age and Ageing! The paper was free for download!

Abstract

Background: after the Great East Japan Earthquake in 2011, inactivity and the homebound status of older victims in affected areas have been a serious public health concern owing to the victims’ prolonged existence as evacuees in mountainous areas.

Objective: to evaluate the association between distances to retail stores and risks of being homebound.

Design: secondary analysis of cross-sectional interview survey data with a geographical information analysis.

Setting: Rikuzentakata, Iwate, a municipality seriously damaged by the 2011 earthquake and tsunami.

Subjects: all Rikuzentakata residents aged 65 or older except for those living in temporary housing (n = 2,327).

Methods: we calculated road distances between each residential address and retail stores, hawker sites and shopping bus stops, accounting for the extra load caused by walking on slopes. The prevalence ratio of being homebound adjusted for age, source of income and morbidity by road distance was estimated using Poisson regression with a generalised estimating equation.

Results: those living at distances of 1,200 m or more were 1.78 (95% confidence intervals, 1.03–3.08) times more likely to be homebound (going out only every 4 or more days a week) among men and 1.85 (1.13-3.02) among women, compared with those residing in places

Conclusions: access to daily needs is essential to prevent homebound status. Post-disaster community diagnosis in terms of the built environment is important for strategic community restoration.

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.