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Inequalities in Noncommunicable Disease Mortality in the Ten Largest Japanese Cities

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Abstract

The burden of noncommunicable diseases and social inequalities in health among urban populations is becoming a common problem around the world. This phenomenon is further compounded by population aging. Japan faces the task of maintaining its high level of population health while dealing with these challenges. This study focused on the ten largest cities in Japan and, using publicly available administrative data, analyzed standardized mortality ratios to examine inequalities in relative mortality levels due to major noncommunicable disease at both city and subcity levels. On average, the ten major cities had excess mortality due to cancer and lower mortality due to heart disease and cerebrovascular disease compared to the country as a whole. Substantial inequalities in relative mortality were observed both between and within cities, especially for heart disease and cerebrovascular disease among men. Inequalities in relative mortality levels within cities appear to be increasing over time even while relative mortality levels are decreasing overall. The widely observed health inequalities signal the need for actions to ensure health equity while addressing the burden of noncommunicable diseases. Increasingly, more countries will have to deal with these challenges of inequity, urbanization, aging, and noncommunicable diseases. Local health governance informed by locally specific data on health determinants and outcomes is essential for developing contextualized interventions to improve health and health equity in major urban areas.

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Acknowledgements

This study was funded by the World Health Organization (WHO). The views expressed in this article are those of the authors and do not necessarily represent the views or policies of the WHO. This research used publicly available literature and de-identified data from an official source; thus, it did not require a full ethical review by the WHO Research Ethics Review Committee (Protocol #RPC522). The authors thank the anonymous reviewers who provided constructive feedback on an earlier version of this manuscript.

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Authors and Affiliations

  1. Centre for Health Development, World Health Organization, I.H.D. Centre Building 9F, 1-5-1 Wakinohama-Kaigandori, Chuo-ku, Kobe, 651-0073, Japan

    Megumi Kano & Amit Prasad

  2. Graduate School of Medicine Faculty of Medicine, Osaka University, 2-2 Yamadaoka Suita, Osaka, 565-0871, Japan

    Miyuki Hotta

Authors
  1. Megumi Kano
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  2. Miyuki Hotta
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  3. Amit Prasad
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Correspondence to Megumi Kano.

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Kano, M., Hotta, M. & Prasad, A. Inequalities in Noncommunicable Disease Mortality in the Ten Largest Japanese Cities. J Urban Health 90, 1041–1052 (2013). https://doi.org/10.1007/s11524-013-9808-9

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  • DOI: https://doi.org/10.1007/s11524-013-9808-9

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