Dataset Information

At Which Area Level Does COVID-19 Infection Matter Most for an Individual's Self-Rated Health? A Multilevel Fixed-Effects Model Analysis in Japan.

ABSTRACT: Several studies have reported the adverse impacts of the COVID-19 pandemic on health outcomes. However, little is known about which area of COVID-19 infection matters most for an individual's subjective health outcomes. We addressed this issue in the present study. We used the longitudinal data of 2260 individuals obtained from a two-wave internet-based nationwide survey conducted in Japan. We estimated the multilevel regression models, which controlled for fixed effects at the individual and prefecture levels, to explain an individual's self-rated health (SRH) based on the reported number of new COVID-19 infection cases at different area levels: prefecture, group of neighboring prefectures, and regional bloc. We found that SRH was highly associated with the average and maximum number of new infection cases among neighboring prefectures or in the regional bloc, but not with those at the prefecture level, if used jointly as explanatory variables. The results suggest that inter-prefectural coordination is needed not only to contain COVID-19 but also to reduce its adverse impact on the subjective health outcomes of residents.

SUBMITTER: Oshio T

PROVIDER: S-EPMC9331239 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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At Which Area Level Does COVID-19 Infection Matter Most for an Individual's Self-Rated Health? A Multilevel Fixed-Effects Model Analysis in Japan.

Oshio Takashi T Kimura Hiromi H Nishizaki Toshimi T Kuwahara Susumu S

International journal of environmental research and public health 20220722 15

Several studies have reported the adverse impacts of the COVID-19 pandemic on health outcomes. However, little is known about which area of COVID-19 infection matters most for an individual's subjective health outcomes. We addressed this issue in the present study. We used the longitudinal data of 2260 individuals obtained from a two-wave internet-based nationwide survey conducted in Japan. We estimated the multilevel regression models, which controlled for fixed effects at the individual and pr ...[more]

PMID: 35897283

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Project description:Although social capital has been linked to population health, there is a dearth of studies on the phenomenon especially in sub-Saharan Africa. We investigated the individual and contextual effects of social capital indicators (group membership, registered to vote, perception towards safety in community and generalised trust) on the self-rated health (SRH) of the residents of Gauteng province. We used data from the 2015 Quality of Life (QoL) survey, which included a random representative sample of 27476 residents (level 1) in 508 administrative wards (level 2). We employed a multilevel logistic regression to examine the association of social capital and SRH (good vs poor). After adjusting for individual and area-level factors, no main effect of group membership (Adjusted OR: 0.93: 95% CI: 0.85-1.02), generalised trust (Adjusted OR: 1.01: 95% CI: 0.89-1.49) and registered to vote (Adjusted OR: 0.95; 95% CI: 0.82-1.10) was observed. However, if respondents were positive in their perception towards safety in community, there was a positive association with good SRH (Adjusted OR: 1.15; 95% CI: 1.01-1.31); while if residents reported a negative perception towards safety in community, a strong negative association with good SRH (Adjusted OR: 0.70; 95% CI: 0.62-0.79) was observed. Both ward variance and median odds ratio (MOR) indicate significant differences in good SRH by wards. A strong positive joint effect on the multiplicative scale was observed between satisfied with safety and the ward-level South African Multiple Deprivation Poverty Index (SAMPI), while a strong negative joint effect was also observed on a multiplicative scale between dissatisfied with safety and the SAMPI. Perception of safety in community is the core domain of social capital that significantly impacts the SRH of residents of Gauteng. Although the effect of perception towards safety in community on good SRH is influenced by ward deprivation,the effect is not dependent on the level of deprivation. Contextual factors as evidenced by the persistent MOR, in addition to individual factors, explain variation in reporting good SRH in the study area.

Project description:BackgroundHealth literacy (HL) has gained increasing attention as a factor related to health behaviors and outcomes. This study aimed to investigate geographic differences in HL levels and effect modification by geographic area on their relationship with self-rated health in the Japanese population using a nationwide sample.MethodsData for this study were derived from a nationally representative cross-sectional survey on health information access for consumers in Japan using a mailed self-administered questionnaire in 2020 (INFORM Study 2020). Valid responses from 3,511 survey participants, selected using two-stage stratified random sampling, were analyzed in this study. HL was measured using the Communicative and Critical Health Literacy Scale (CCHL). Multiple regression and logistic regression analyses were conducted to examine the associations between geographic characteristics and HL and effect modification on the association between HL and self-rated health by geographic area, controlling for sociodemographic characteristics.ResultsThe mean HL score was 3.45 (SD = 0.78), somewhat lower compared with previous studies on the Japanese general population. HL was higher in Kanto area than in Chubu area, after controlling for sociodemographic factors and municipality size. Furthermore, HL was positively associated with self-rated health after controlling for sociodemographic and geographic factors; however, this association was more evident in eastern areas than in western areas.ConclusionThe findings indicate geographic differences in HL levels and effect modification by geographic area on the relationship between HL and self-rated health in the general Japanese population. HL was more strongly associated with self-rated health in eastern areas than in western areas. Further investigation is needed to explore the moderating effects of areal features, including the distribution of primary care physicians and social capital, when formulating strategies to improve HL in different contexts.

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Project description:Introduction:Although education is among the major socioeconomic status (SES) resources that influence populations' and individuals' health, social marginalization may reduce the health gain that follows access to SES indicators such as education, a pattern called marginalization-related diminished return (MDR). The literature on MDRs, however, has been mainly derived from studies that have defined marginalization based on race, ethnicity, and sexual orientation. Thus, more research is needed on MDRs that may follow as a result of immigration. To extend what is known on immigration status related MDRs, this study compared a national sample of immigrants and non-immigrants for the effect of education on the poor self-rated health (SRH) of adults in the United States. Methods:With a cross-sectional design, this study employed data from the 2015 National Health Interview Survey (NHIS), a survey that had enrolled 33,654 adults who were either immigrants (n = 6225; 18.5%) or non-immigrants (n = 27 429; 81.5%). The independent variable was education level, treated as a categorical variable. The dependent variable was SRH treated as a dichotomous variable. Race, ethnicity, age, gender, marital status, and region were the confounders. Immigration (nativity) was the moderator. Logistic regression was used for data analysis. Results:Higher education credentials were associated with better SRH in the pooled sample; however, immigration showed a significant statistical interaction with education level (college graduation) on the outcome. This interaction was indicative of a smaller protective effect of college graduation on poor SRH among immigrants than non-immigrant adults. Conclusion:In line with the MDRs framework, the effect of education on SRH is weaker for immigrants than for non-immigrant adults. There is a need to help highly educated immigrants to mobilize their human capital to secure their best health outcomes, similar to non-immigrants. Such strategies may require bold and innovative policy solutions to reduce discrimination against immigrants, so they can more effectively translate their education and human capital into tangible outcomes such as health.

Dataset Information

At Which Area Level Does COVID-19 Infection Matter Most for an Individual's Self-Rated Health? A Multilevel Fixed-Effects Model Analysis in Japan.

Publications

At Which Area Level Does COVID-19 Infection Matter Most for an Individual's Self-Rated Health? A Multilevel Fixed-Effects Model Analysis in Japan.

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