Some studies in Western countries have suggested that education and income are differentially associated with different drinking patterns. This study aimed to examine the associations of education and income with heavy drinking and problem drinking among community-dwelling Japanese men. A questionnaire survey was conducted in metropolitan areas in Japan from 2010 to 2011 among residents aged 25 to 50 years; valid responses were received from 2004 men. Drinking patterns were categorized as non-to-moderate drinking, non-problematic heavy drinking, and problem drinking. Multiple logistic regression analyses were conducted to determine whether educational attainment or income was associated with drinking patterns, after adjustment for age, marital status, working status, income/education, self-rated health, and psychological distress. The study population included 84.4% non-to-moderate drinkers, 8.9% non-problematic heavy drinkers, and 6.7% problem drinkers. Lower educational attainment (high school or less) was significantly associated with increased risks of both non-problematic heavy drinking (odds ratio [OR], 1.80; 95% confidence interval [CI], 1.21–2.67) and problem drinking (OR, 2.06; 95% CI, 1.34–3.16), compared with university education or higher. Lower income (lowest tertile) was significantly associated with a lower risk of non-problematic heavy drinking (OR, 0.66; 95% CI, 0.43–1.00), but not of problem drinking (OR, 0.80; 95% CI, 0.50–1.30), compared with the highest income tertile. These findings indicate that education and income are differentially associated with alcohol drinking patterns among community-dwelling Japanese men.

Associations between education and obesity have been consistently reported among women in developed countries, but few studies have considered the influence of marital status and husbands’ education. This study aimed to examine differences in the association between education and overweight/obesity by marital status and to determine the contribution of husbands’ education to overweight/obesity among community-dwelling Japanese women. A questionnaire survey was conducted from 2010 to 2011 among residents aged 25–50 years in Japanese metropolitan areas. Of 2145 women who agreed to participate and completed the survey, 582 were unmarried and 1563 were married. Overweight/obesity was defined as body mass index ≥25 kg/m². Multiple logistic regression analysis was conducted to determine whether women’s or their husbands’ education was associated with overweight/obesity after adjusting for age, work status, and equivalent income. The prevalence of overweight/obesity was 11.9% among unmarried women and 10.3% among married women. Women’s own education was significantly associated with overweight/obesity among unmarried women but not among married women. The multivariate-adjusted odds ratio of high school education or lower compared with university education or higher was 3.21 (95% confidence interval: 1.59–6.51) among unmarried women. Among married women, husbands’ education was significantly associated with overweight/obesity: women whose husbands’ educational attainment was high school or lower had significantly higher odds of overweight/obesity than did those whose husbands had a university education or higher (1.67, 95% confidence interval: 1.10–2.55). Among married women whose educational attainment was college or higher, women whose husbands’ educational attainment was high school or lower had a significantly higher risk for overweight/obesity when compared with women whose husbands’ educational attainment was college or higher. Associations between women’s own education and overweight/obesity varied by marital status, and husbands’ educational level was important for married women’s overweight/obesity. These findings indicate that the social influences bound to educational background affect women’s overweight/obesity.

Preventive dental care use remains relatively low in Japan, especially among working-age adults. Universal health insurance in Japan covers curative dental care with an out-of-pocket payment limit, though its coverage of preventive dental care is limited. The aim of this study was to test the hypothesis that income inequality in dental care use is found in preventive, but not curative dental care among working-age Japanese adults. A cross-sectional survey was conducted using a computer-assisted, self-administered format for community residents aged 25–50 years. In all, 4357 residents agreed to participate and complete the questionnaire (valid response rate: 31.3%). Preventive dental care use was measured according to whether the participant had visited a dentist or a dental hygienist during the past year for dental scaling or fluoride or orthodontic treatments. Curative dental care use was assessed by dental visits for other reasons. The main explanatory variable was equivalent household income. Logistic regression analyses with linear trend tests were conducted to determine whether there were significant income-related gradients with curative or preventive dental care use. Among the respondents, 40.0% of men and 41.5% of women had used curative dental care in the past year; 24.1% of men and 34.1% of women had used preventive care. We found no significant income-related gradients of curative dental care among either men or women (p = 0.234 and p = 0.270, respectively). Significant income-related gradients of preventive care were observed among both men and women (p < 0.001 and p = 0.003, respectively). Among women, however, income-related differences were no longer significant (p = 0.126) after adjusting for education and other covariates. Compared with men with the lowest income, the highest-income group had a 1.79-fold significantly higher probability for using preventive dental care. The prevalence of preventive dental care use was lower than that of curative care. The results showed income-related inequality in preventive dental care use among men, though there were no significant income-related gradients of curative dental care use among either men or women. Educational attainment had a positive association with preventive dental care use only among women.

Background and Purpose—: Functional capacity is a predictor, as well as a consequence, of stroke. However, little research has been done to examine whether higher-level functional capacity above basic activities of daily living is a predictor of stroke. Methods—: We followed 1493 Japanese community-dwelling adults aged ≥60 years (mean age, 70.1 years) who were independent in basic activities of daily living and had no history of stroke. Baseline data were collected using a self-administered questionnaire. Higher-level functional capacity was measured using the total score and 3 subscales (instrumental activities of daily living, intellectual activity, and social role) derived from the Tokyo Metropolitan Institute of Gerontology Index of Competence. Adjusted hazard ratios and 95% confidence intervals were calculated by the Cox proportional hazards model. Results—: During a mean follow-up of 10.4 years, 191 participants developed a first stroke. Impaired higher-level functional capacity based on total score of the Tokyo Metropolitan Institute of Gerontology Index of Competence was significantly associated with stroke (hazard ratio, 1.64; 95% confidence interval, 1.15–2.33). Among the 3 subscales, only intellectual activity was significantly associated with stroke (hazard ratio, 1.64; 95% confidence interval, 1.21–2.22). Social role was significantly associated with stroke only among those aged ≥75 years (hazard ratio, 1.78; 95% confidence interval, 1.07–2.98). Conclusions—: Impaired higher-level functional capacity, especially in the domain of intellectual activity, was a predictor of stroke, even among community-dwelling older adults with independent basic activities of daily living at baseline. Monitoring of higher-level functional capacity might be useful to detect those at higher risk of developing stroke in the future.

Background: The concept of health literacy has gained prominence in the context of oral health. In Japan, curative dental care is generally under universal health coverage, while preventive dental care requires effort. We used this situation to test the hypothesis that high health literacy is associated with preventive dental care use and good oral health status, but not with curative dental care use, in Japan.Methods: A questionnaire survey was conducted from 2010 to 2011 among residents aged 25–50 years in Japanese metropolitan areas. Data from 3767 participants were used. Health literacy was measured using the Communicative and Critical Health Literacy Scale, and the total score was categorized into quartiles. Poisson regression analyses with robust variance estimators were conducted to examine the associations of health literacy with curative dental care use, preventive dental care use, and good oral health, adjusted for covariates.Results: The percentages of curative dental care use, preventive dental care use, and good oral health were 40.2%, 28.8%, and 74.0%, respectively. Health literacy was not associated with curative dental care use; the prevalence ratio (PR) of the highest relative to the lowest quartile of health literacy was 1.04 (95% confidence interval [CI], 0.93–1.18). High health literacy was associated with preventive dental care use and good oral health; the corresponding PRs were 1.17 (95% CI, 1.00–1.36) and 1.09 (95% CI, 1.03–1.15), respectively.Conclusions: These findings may provide clues for the design of effective interventions to promote preventive dental care use and improve oral health status.