皆川 友香

ABSTRACT Extensive literature exists on the physical health of the Japanese population whereas relatively little is known about their mental health. Moreover, most studies have assessed physical and mental health separately, and this further confounds the relationship between the two. Using the concept of health expectancy, this study investigated the trends in the relationship between physical and mental health among Japanese men and women aged 20 years or more between 2010 and 2022. Psychological distress, based on the Comprehensive Survey of Living Conditions, was used as an indicator of mental health. We employed Sullivan's method to estimate the length of life with or without distress of varying degrees. Our results showed substantial improvements in distress‐free life expectancy for both genders during the study period. Younger people have gained more distress‐free years than their older counterparts, placing older individuals, especially men, at an increased risk of psychological distress. These findings contribute to the literature on longevity in Japan by quantifying the role of mental health in the population's overall health. Given the recent increase in mental health problems, greater policy emphasis on the relationship between physical and mental health status is required.

Abstract Background The European Union has used Healthy Life Years (HLY) as an indicator to monitor the health of its aging populations. Scholarly and popular interest in HLY across countries has grown, particularly regarding the ranking of countries. It is important to note that HLY is based on self-assessments of activity limitations, raising the possibility that it might be influenced by differences in health reporting behaviours between populations, a phenomenon known as differential item functioning (DIF). Methods We estimated DIF-adjusted HLY at age 50 for Belgium, France, Germany, Greece, Italy, the Netherlands, Spain, and Sweden to determine the extent to which differences in HLY might be influenced by reporting heterogeneity across countries. We used anchoring vignettes, taken from the 2004 Survey of Health, Ageing and Retirement in Europe, to estimate DIF-adjusted prevalence rates of activity limitations measured by the Global Activity Limitations Indicator (GALI). The Sullivan method was used to calculate DIF-adjusted HLY. Results Changes in HLY before and after adjustment ranged from a 1.20-year decrease for men in Italy to a 1.61-year increase for women in Spain. Adjustment for DIF produced changes in the rankings of the countries by HLY, with upward and downward movements of up to three positions. Conclusion Our results show that DIF is likely to affect HLY estimates, thereby posing a challenge to the validity of comparisons of HLY across European countries. The findings suggest that HLY should be used to monitor population health status within a country, rather than to make comparisons across countries.

Abstract Background and Objectives Existing research has suggested that older adults in Japan enjoy phenomenal physical health status, but they have poor subjective well-being (SWB). Limited empirical evidence exists, however, on how physical health and SWB intersect and are linked to the lives of older men and women in Japan. Using the concept of health expectancy, this study examines the role of SWB, as measured by life satisfaction, in the mortality and morbidity experiences of Japanese adults 65 years old and older. Research Design and Methods We used the nationally representative Nihon University Japanese Longitudinal Study of Aging (NUJLSOA), 1999-2009. Our measurement of morbidity is disability, based on difficulty in activities in daily living (ADLs) and instrumental ADLs (IADLs). We use the Interpolation of Markov Chains (IMaCh) approach to compute life expectancy (LE), LE without disability (active LE), and LE with differing severity of disability for those who are satisfied with life and for those who are not. Results We documented significant differences in LE and active LE by the state of life satisfaction among older adults in Japan. Men and women who are satisfied with life are expected to live longer and spend more years without having disability compared to those who are not satisfied. We found no differences in the length of life with disability of differing severity by the state of life satisfaction. Discussion and Implications Our results highlight the important role of SWB at older ages in Japan, since it is directly related to the physical health of its aging population. Fully understanding the health of the older population requires research that focuses on both objective and subjective dimensions of well-being.

<b><i>Background:</i></b> Although there is evidence of improvements in health expectancy among the Japanese population, existing estimates are based on the prevalence of morbidity taken from cross-sectional survey data. <b><i>Objectives:</i></b> This study employed a multistate life table approach to compute incidence-based health expectancy measures, namely active and inactive life expectancy (LE), for two longitudinal survey cohorts from 1990 to 2009. <b><i>Methods:</i></b> This study used data from two longitudinal surveys of older adults in Japan: the National Survey of the Japanese Elderly (1990–1999) and the Nihon University Japanese Longitudinal Study of Aging (1999–2009). We employed the Interpolation of Markov Chains technique to compute the number of years at age 65 years to be spent with and without difficulty in performing activities of daily living (ADLs) or instrumental ADLs. <b><i>Results:</i></b> We documented significant increases in active LE for men and women at age 65 years over the 10-year study period. There were significant changes in total LE for men and in the percentage of active life for women. Inactive LE did not significantly change across the two survey cohorts during the study period. <b><i>Conclusions:</i></b> Our results show that the health status of older adults in Japan has largely improved over the 10-year study period, with increases in both the duration of life and time spent in an active state. This finding offers evidence of compression of morbidity among older men and women in Japan.

<title>Abstract</title> <sec> <title>Objectives</title> It is underweight, rather than overweight or obesity, that has been a pressing public health concern in Japan. This study examines the impact of being underweight on the health of older Japanese men and women, measured by active life expectancy at age 65. Following the Japanese government’s guideline, underweight in this study is defined using the body mass index (BMI) value of 20. </sec> <sec> <title>Method</title> Data came from five waves (1999–2009) of the Nihon University Japanese Longitudinal Study of Aging (NUJLSOA). We used the Interpolation of Markov Chain approach to estimate the number of years underweight (BMI &amp;lt; 20), normal weight (20 &amp;lt; BMI &amp;lt; 25), and overweight (25 &amp;lt; BMI) individuals were expected to live without difficulty in activities of daily living (ADLs) or instrumental ADLs. </sec> <sec> <title>Results</title> We found differences in life and health expectancies across the three weight categories. Underweight people were expected to live the shortest lives and spend the fewest years in an active state compared with normal and overweight individuals. Results remained unchanged even when accounting for educational attainment, smoking history, and a count of existing chronic conditions. </sec> <sec> <title>Discussion</title> Being underweight is associated with poor quality of life lived among Japanese older adults. This finding suggests the importance of maintaining proper weight and avoids nutritional risks at advanced ages. </sec>

The second phase of Healthy Japan 21 seeks to increase disability-free life expectancy (DFLE) more than life expectancy (LE) between 2013 and 2022. In the face of the rising incidence of disability, the feasibility of achieving this goal remains unclear. We examine changes in DFLE at birth between 2000 and 2010 across 47 prefectures, with particular attention given to changes in the absolute number of years and in the proportion of disability-free life years. Although LE increased across all prefectures, there is a variation in DFLE. While the number of disability-free life years increased in many parts of the country, some prefectures had decreases in DFLE. Downturns become particularly evident when DFLE is interpreted in relative terms. The proportion of life spent without disability declined in the majority of prefectures. Results from subnational level analyses suggest that the rate of increase in DFLE lagged behind that in LE across Japanese prefectures during the past decade. More policy attention should be devoted to health-promotion initiatives at the prefecture level to achieve the nationwide health agenda.

A large literature suggests that active social participation contributes to the well-being of older people. Japan provides a compelling context to test this hypothesis due to its rapidly growing elderly population and the phenomenal health of the population. Using the Nihon University Japanese Longitudinal Study of Aging, this study examines how social participation, measured by group membership, is related to the risk of overall mortality among Japanese elders aged 65 and older. Results from Cox proportional hazards models show that group affiliation confers advantages against mortality risk, even after controlling for sociodemographic characteristics, physical health measures, and family relationship variables. In particular, activities geared more toward self-development, such as postretirement employment and lifelong learning, are strongly associated with lower levels of mortality. Findings suggest that continued social participation at advanced ages produces positive health consequences, highlighting the importance of active aging in achieving successful aging in the Japanese context.

Background: There has been increasing interest in the impact of information and communication technologies, such as the computer and Internet, on physical and mental health status, but relatively little is known about the health effects of using cell phones. Objective:This study investigates how cell phone usage is associated with levels of depressive symptoms among Japanese men and women aged 65 years and older. We focus on social relationships, particularly inter-generational relationships between older parents and adult children, as a possible mediator in the association of cell phone use with late-life depressive symptoms. We therefore hypothesize that using cell phones contributes to the psychological well-being of older adults primarily through encouraging social relationships. Methods: We used 4 waves of data from the Nihon University Japanese Longitudinal Study of Aging (2001-2009) to analyze the impact of cell phone use on depressive symptoms. Results are based on ordinary least squares regression analyses. Results: Although the use of cell phones was related to lower levels of depressive symptoms among elderly Japanese people, controlling for socio-demographic characteristics and physical health conditions wiped out the effects for men. In contrast, the protective effects of using cell phones persisted among women, even net of all controls. Moreover, the impact of using cell phones was not explained by filial relationship measures, suggesting that cell phone use influences the mental health of older women independently of social engagement. Conclusions: Among the many advantages brought about by recent technological developments, cell phones appear to be an important contributor to the psychological well-being of Japanese elders. Researchers and policy makers should prioritize access to new technologies for older adults. (C) 2014 S. Karger AG, Basel

Compared to the large body of research on mortality differentials between East Central Europe and the former Soviet Union, little attention has been paid to how overall population health status differs between these two country groups. This article investigates disparities in population health, measured by healthy life expectancy (HLE) between ages 20 and 74, for 23 Eastern European countries in 2008. There are substantial disparities in partial HLE between East Central Europe and the former Soviet Union, amounting to differences of 10 years on average for men and women. In addition, factors reflecting the malfunction of existing social structure are inversely associated with partial HLE. Accordingly, populations in countries where corruption, restriction of freedom, and violence are prevalent spend fewer years in good health. © 2013 The Population Council, Inc.

Aims: Qualitative studies find that men and women in Russia have different preferences for alcoholic beverages, but quantitative evidence for gender differences in beverage type choice remains scarce. The purpose of this article is to test numerically whether and to what extent men and women in Russia differ in terms of preferences for type of drink, such as vodka, wine and beer. Methods: Results are based on multinomial logistic regression and ordinary least squares regression analyses of the Russian Longitudinal Monitoring Survey-Higher School of Economics 2008 data. Results: We observed significant gender differences in preferences for alcoholic beverages. Men have strong preferences for vodka, and they drink it in much larger amounts in comparison with women. Women are more likely to either refrain from drinking or drink mild types of alcoholic beverages, such as wine and beer. Gender differences remain statistically significant even when sociodemographic factors are well accounted for. Conclusions: The present study confirms the previous research findings about gender differences in drinking practices among Russians. Our results provide quantitative evidence of the pronounced differences in beverage types consumed by men and women. © 2012 S. Karger AG, Basel.

The Russian Federation has experienced simultaneous declines in health and rises in international migration. Guided by the "healthy migrant effect" found elsewhere, we examine two questions. First, do the foreign-born in the Russian Federation exhibit better overall health than the native-born? Second, to the extent positive health selectivity exists, is it transferred to the second generation? Using the first wave of the Russian Generations and Gender Survey, our findings support the idea of positive health selection among international migrants from non-Slavic regions. The effect of migrant status, regardless of origin, diminishes when age, sex, and native language are taken into account.