Background: Although reducing socioeconomic inequalities in depression is necessary, their associated factors have rarely been studied. This study aimed to screen the potential contextual factors associated with income-based inequality in older adults’ depression.

Methods: Using data from the Japan Gerontological Evaluation Study (JAGES) of 2013, we conducted an ecological study covering 77 communities in Japan. Our measures of socioeconomic inequalities in depression were the slope index of inequalities (SII) and the relative index of inequalities (RII) of the prevalence of depressive symptoms across three income levels. We categorized available community-level factors, including socio-demographic factors, social participation, social relationships, subjective changes in the residential area, and the built environment. These indicators were aggregated from individual responses of 51,962 and 52,958 physically independent men and women, respectively, aged 65 years or more. We performed multiple linear regression analyses to explore factors with statistical significance of a two-tailed P-value less than 0.05.

Results: Factors associated with shallower gradients in depression for men included higher participation in local activities and reception or provision of social support, which did not show significant association among women. Perceived increases in unemployment and economic inequalities were positively associated with larger inequalities in both genders (P < 0.05). The built environment did not indicate any significant association.

Conclusions: A community environment fostering social activities and relationships might be associated with smaller income-based inequalities in depression. There is a need for more deterministic studies for planning of effective community interventions to address socioeconomic inequalities in depression.

Background: We aimed to investigate the association between alcohol drinking patterns and the presence of impaired fasting glucose (IFG) and diabetes mellitus (DM).

Methods: We used data from the Korean National Health and Nutrition Examination Survey, 2010–2014. The participants were aged ≥30 years and had no previous diagnosis of DM. High-risk drinking was defined as alcohol consumption of ≥7 glasses at a sitting for men, and ≥5 glasses for women. After adjusting for confounding factors, a polychotomous logistic regression analysis was performed to assess the association of drinking patterns with IFG and DM.

Results: For men, high-risk drinking was associated with higher odds ratios (ORs) of IFG (2–4/month, OR 1.51; 95% confidence interval [CI], 1.13–2.04; 2–3/week, OR 1.79; 95% CI, 1.38–2.33; and ≥4/week, OR 2.24; 95% CI, 1.65–3.03) and of DM (2–4/month, OR 2.12; 95% CI, 1.20–3.77; 2–3/week, OR 1.78; 95% CI, 1.05–3.03; and ≥4/week, OR 2.98; 95% CI, 1.72–5.17). For women, high-risk drinking was associated with higher risk of IFG (2–4/month, OR 1.51; 95% CI, 1.04–2.21; 2–3/week, OR 3.19; 95% CI, 2.20–4.64; and ≥4/week, OR 2.23; 95% CI, 1.23–4.06), but not of DM, compared with non-high-risk drinkers who consumed alcohol ≤1 day/month. Non-high-risk drinkers who consumed alcohol ≥4 days/week had higher ORs of DM in men, but lower ORs of DM in women compared with non-high risk drinkers who consumed alcohol ≤1 day/month.

Conclusions: Compared with non-high-risk alcohol drinking, even occasional high-risk alcohol drinking was associated with a higher risk of IFG in men and women, and DM in men. Nearly daily non-high-risk alcohol drinking was associated with a higher risk of DM in men and lower risk of DM in women.

Background: Prevalence rates of all anomalies classified as birth defects, including those identified before the 22nd gestational week, are limited in published reports, including those from the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR). In our birth cohort study, we collected the data for all birth defects after 12 weeks of gestation.

Methods: Subjects in this study comprised 19,244 pregnant women who visited one of 37 associated hospitals in the Hokkaido Prefecture from 2003 through 2012, and completed follow-up. All birth defects after 12 weeks of gestation, including 55 marker anomalies associated with environmental chemical exposures, were recorded. We examined parental risk factors for birth defects and the association between birth defects and risk of growth retardation.

Results: Prevalence of all birth defects was 18.9/1,000 births. The proportion of patients with birth defects delivered between 12 and 21 weeks of gestation was approximately one-tenth of all patients with birth defects. Among those with congenital malformation of the nerve system, 39% were delivered before 22 weeks of gestation. All patients with anencephaly and encephalocele were delivered before 22 weeks of gestation. We observed different patterns of parental risk factors between birth defect cases included in ISBDSR and cases not included. Cases included in ISBDSR were associated with an increased risk of preterm birth. Cases not included in ISBDSR were associated with an increased risk of being small for gestational age at term.

Conclusions: Data from our study complemented the data from ICBDSR. We recommend that birth defects not included in ICBDSR also be analyzed to elucidate the etiology of birth defects.

Background: Secondhand smoke (SHS) causes many deaths. Inequalities in SHS have been reported in several countries; however, the evidence in Asian countries is scarce. We aimed to investigate the association between socioeconomic status (SES) and SHS at home and the workplace/school among non-smoking Japanese adults.

Methods: Cross-sectional data from the Miyagi Prefectural Health Survey 2014 were analyzed. Self-reported questionnaires were randomly distributed to residents ≥20 years of age and 2,443 (92.8%) responded. The data of the 1,738 and 1,003 respondents were included to the analyses for SHS in the past month at home and at the workplace/school, respectively. Ordered logistic regression models considering possible confounders, including knowledge of the adverse health effects of tobacco, were applied.

Results: The prevalence of SHS at home and the workplace/school was 19.0% and 39.0%, respectively. Compared with ≥13 years of education, odds ratios (ORs) and 95% confidence intervals (CIs) for SHS at home were 1.94 (95% CI, 1.42–2.64) for 10–12 years and 3.00 (95% CI, 1.95–4.60) for ≤9 years; those for SHS at the workplace/school were 1.80 (95% CI, 1.36–2.39) and 3.82 (95% CI, 2.29–6.36), respectively. Knowledge of the adverse health effects of tobacco was significantly associated with lower SHS at home (OR 0.95; 95% CI, 0.91–0.98) but it was not associated with SHS at the workplace/school (OR 1.02; 95% CI, 0.98–1.06).

Conclusions: Social inequalities in SHS existed among Japanese non-smoking adults. Knowledge about tobacco was negatively associated with SHS at home but not at workplace/school.

Background: We examined the associations of alcohol consumption and liver holidays with all-cause mortality and with mortality due to cancer, heart disease, cerebrovascular disease, respiratory disease, and injury using a large-scale prospective study in Japan.

Methods: We followed 102,849 Japanese who were aged between 40 and 69 years at baseline for 18.2 years on average, during which 15,203 deaths were reported. Associations between alcohol intake and mortality risk were assessed using a Cox proportional hazards model, with analysis by the number of liver holidays (in which a person abstains from drinking for several days a week).

Results: A J-shaped association was observed between alcohol intake and total mortality in men (nondrinkers: reference; occasional drinkers: hazard ratio [HR] 0.74; 95% confidence interval [CI], 0.68–0.80; 1–149 g/week: HR 0.76; 95% CI, 0.71–0.81; 150–299 g/week: HR 0.75; 95% CI, 0.70–0.80; 300–449 g/week: HR 0.84; 95% CI, 0.78–0.91; 450–599 g/week: HR 0.92; 95% CI, 0.83–1.01; and ≥600 g/week: HR 1.19; 95% CI, 1.07–1.32) and in women (nondrinkers: reference; occasional: HR 0.75; 95% CI, 0.70–0.82; 1–149 g/week: HR 0.80; 95% CI, 0.73–0.88; 150–299 g/week: HR 0.91; 95% CI, 0.74–1.13; 300–449 g/week: HR 1.04; 95% CI, 0.73–1.48; and ≥450 g/week: HR 1.59; 95% CI, 1.07–2.38). In current drinkers, alcohol consumption was associated with a linear, positive increase in mortality risk from all causes, cancer, and cerebrovascular disease in both men and women, but not heart disease in men. Taking of liver holidays was associated with a lower risk of cancer and cerebrovascular disease mortality in men.

Conclusions: Alcohol intake showed J-shaped associations with the risk of total mortality and three leading causes of death. However, heavy drinking increases the risk of mortality, which highlights the necessity of drinking in moderation coupled with liver holidays.

Background: Good quality measures of Japanese adults’ sedentary behaviors are needed to accurately assess correlates of specific sedentary behaviors. The present study assessed criterion validity of total sedentary behavior and test-retest reliability of six domain-specific sedentary behaviors.

Methods: We administered a questionnaire, based on previous studies, that measured domain-specific sedentary behaviors. To examine validity, agreement between self-reported time spent in sedentary behaviors from the questionnaire and objectively-measured sedentary time using accelerometers was compared among 392 adults (aged 40–64 years) in two Japanese cities. For reliability, a 2-week interval test-retest was administered to a convenience sample of 34 participants.

Results: The correlation between total self-reported and objectively measured sedentary time was significant (all P < 0.001) and fair-to-good for workdays (ρ = 0.57) and whole week (ρ = 0.49), but was low for non-workdays (ρ = 0.23). The difference between the two measures was significant for whole week (z = −2.25, P = 0.03) and non-workdays (z = −5.50, P < 0.001), but was not significant for workdays (z = −0.60, P = 0.55). There was a significant positive association between the difference in the two measures and the average of these two measures (workdays: r = 0.53; non-workdays: r = 0.45; and whole week: r = 0.54, all P < 0.001). There was fair-to-good test-retest reliability of total sedentary time for each domain (workdays: interclass correlation coefficient [ICC] = 0.77, non-workdays: ICC = 0.53, and whole week: ICC = 0.7; all P < 0.01).

Conclusions: The scale of domain-specific sedentary behaviors is reliable for estimating where and for what purpose Japanese adults spend their sedentary time, and total sedentary time is valid for workdays and the whole week.

Background: In Japan, the rate of cervical cancer screening is remarkably low, especially among women in their twenties and thirties, when cervical cancer is now increasing dramatically. The aim of this study was to test whether a modified government reminder for 20-year-old women to engage in cervical cancer screening, acting through maternal education and by asking for a maternal recommendation to the daughter to receive the screening, could increase their participation rate.

Methods: In two Japanese cities, 20-year-old girls who had not received their first cervical cancer screening before October of fiscal year 2014 were randomized into two study arms. One group of 1,274 received only a personalized daughter-directed reminder leaflet for cervical cancer screening. In the second group of 1,274, the daughters and their mothers received a combination package containing the same reminder leaflet as did the first group, plus an additional informational leaflet for the mother, which requested that the mother recommend that her daughter undergo cervical cancer screening. The subsequent post-reminder screening rates of these two study arms were compared.

Results: The cervical cancer screening rate of 20-year-old women whose mothers received the information leaflet was significantly higher than that for women who received only a leaflet for themselves (11% vs 9%, P = 0.0049).

Conclusions: An intervention with mothers, by sending them a cervical cancer information leaflet with a request that they recommend that their daughter receive cervical cancer screening, significantly improved their daughters’ screening rate.