Differences in suicide risk according to living arrangements in Japanese men and women – The Japan Public Health Center-based (JPHC) prospective study

Poudel‐Tandukar, Kalpana; Nanri, Akiko; Mizoue, Tetsuya; Matsushita, Yushu; Takahashi, Yoshihiko; Noda, Mitsuhiko; Inoue, Manami; Tsugane, Shoichiro

doi:10.1016/j.jad.2010.11.027

Cited by 22 publications

(21 citation statements)

References 32 publications

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“…Another explanatory mechanism may relate to suicide. A prospective study in Japan revealed that men, but not women, living without a spouse, irrespective of coresidence with parents or children, were at increased risk of suicide ( Poudel-Tandukar et al, 2011 ). The percentage of men living without a spouse was four times higher among those who ate alone yet lived with others compared with this percentage among those who ate and lived with others ( Supplementary Table 5 ).…”

Section: Discussionmentioning

confidence: 99%

Eating Alone Yet Living With Others Is Associated With Mortality in Older Men: The JAGES Cohort Survey

Tani

Kondo

Noma

et al. 2017

GERONB

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ObjectivesEating by oneself may be a risk factor for poor nutritional and mental statuses among older adults. However, their longitudinal association with mortality in relation to coresidential status is unknown.MethodWe conducted a 3-year follow-up of participants in the Japan Gerontological Evaluation Study, a population-based cohort of 65 years or older Japanese adults. We analyzed mortality for 33,083 men and 38,698 women from 2010 to 2013 and used. Cox regression models were used to estimate hazard ratios (HR) for mortality.ResultsA total of 3,217 deaths occurred during the follow-up. Compared with men who ate and lived with others, the HRs after adjusting for age and health status were 1.48 (95% confidence intervals [CI]: 1.26–1.74) for men who ate alone yet lived with others and 1.19 (95% CI: 1.01–1.41) for men who ate and lived alone. Among women, the adjusted HR was 1.18 (95% CI: 0.97–1.43) for women who ate alone yet lived with others and 1.10 (95% CI: 0.93–1.29) for women who ate and lived alone.DiscussionA setting in which older adults eat together may be protective for them. Promotion of this intervention should focus on men who eat alone yet live with others.

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Section: Discussionmentioning

confidence: 99%

Eating Alone Yet Living With Others Is Associated With Mortality in Older Men: The JAGES Cohort Survey

Tani

Kondo

Noma

et al. 2017

GERONB

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“…The minimum model (Model 1) was built with stratification by 11 study areas to allow a different baseline hazard due to the varying distribution of suicide rates across Japan 32 . The second model (Model 2) was adjusted for a priori covariates and several reproductive factors as follows: body mass index (BMI, in kg/m 2 ; <21.9, 22 to 24.9, or ≥25) 33,34 ; smoking status (never or ever) 35 ; alcohol consumption (no, occasional, or regular) 36 ; perceived stress level (a little, average, or stressful) 37 ; living with spouse (no or yes) 38,39 ; past history of disease 35,40 , including cancer, stroke, heart disease, diabetes mellitus, and hypertension (no, or yes); parity 8 ; age at menarche 14 ; menopausal status 19 ; and exogenous hormone use 13 . Living with a spouse was used as a surrogate of marital status.…”

Section: Methodsmentioning

confidence: 99%

Female reproductive factors and risk of external causes of death among women: The Japan Public Health Center-based Prospective Study (JPHC Study)

Tanaka

Abe²,

Sawada³

et al. 2019

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Although empirical data suggest a possible link between female reproductive events and risk of nonfatal accidents and suicidal behaviors, evidence to determine these effects on mortality is scarce. This study investigated the association between female reproductive factors and the risk of external causes of death among middle-aged Japanese women. We used a population-based cohort study consisting of 71 698 women residing in 11 public health center areas across Japan between 1990 and 1994. Multivariable-adjusted Cox proportional hazard regression models were used to estimate hazard ratios (HRs) of the risk of all external causes, suicide, and accidents according to female reproductive factors at the baseline survey. During 1 028 583 person-years of follow-up for 49 279 eligible subjects (average 20.9 years), we identified 328 deaths by all injuries. Among parous women, ever versus never breastfeeding [0.67 (95% CI: 0.49–0.92)] was associated with a decreased risk of all injuries. Risk of suicide was inversely associated with ever versus never parity [0.53 (95% CI: 0.32–0.88)]. A lower risk of death by accidents was seen in ever breastfeeding [0.63 (95% CI: 0.40–0.97)] compared to never breastfeeding. This study suggests that parity and breastfeeding are associated with reduced risk of death by all external causes, suicide and/or accidents among Japanese women.

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“…Although it has been reported that prefectures with high suicide rates are located in the Tohoku region [43], no studies have provided suggestive evidence of emerging common ecologic effects of place where people live [44] by adjusting for individual age and occupation in each prefecture. The present study applied the same adjustment strategy across 47 prefectures throughout the study period, and it is unlikely that the widening geographical inequalities simply reflect an omitted compositional effect (e.g., health behaviors such as alcohol consumption [45]–[48] and smoking [49], [50], social support [51], and living arrangement [52]). In other words, it is likely that contextual effects were behind the widening geographical inequalities, primarily among men.…”

Section: Discussionmentioning

confidence: 99%

Social and Geographical Inequalities in Suicide in Japan from 1975 through 2005: A Census-Based Longitudinal Analysis

et al. 2013

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BackgroundDespite advances in our understanding of the countercyclical association between economic contraction and suicide, less is known about the levels of and changes in inequalities in suicide. The authors examined social and geographical inequalities in suicide in Japan from 1975 through 2005.MethodsBased on quinquennial vital statistics and census data, the authors analyzed the entire population aged 25–64 years. The total number of suicides was 75,840 men and 30,487 women. For each sex, the authors estimated odds ratios (ORs) and 95% credible intervals (CIs) for suicide using multilevel logistic regression models with “cells” (cross-tabulated by age and occupation) at level 1, seven different years at level 2, and 47 prefectures at level 3. Prefecture-level variance was used as an estimate of geographical inequalities in suicide.ResultsAdjusting for age and time-trends, the lowest odds for suicide was observed among production process and related workers (the reference group) in both sexes. The highest OR for men was 2.52 (95% CI: 2.43, 2.61) among service workers, whereas the highest OR for women was 9.24 (95% CI: 7.03, 12.13) among security workers. The degree of occupational inequalities increased among men with a striking change in the pattern. Among women, we observed a steady decline in suicide risk across all occupations, except for administrative and managerial workers and transport and communication workers. After adjusting for individual age, occupation, and time-trends, prefecture-specific ORs ranged from 0.76 (Nara Prefecture) to 1.36 (Akita Prefecture) for men and from 0.79 (Kanagawa Prefecture) to 1.22 (Akita Prefecture) for women. Geographical inequalities have increased primarily among men since 1995.ConclusionsThe present findings demonstrate a striking temporal change in the pattern of social inequalities in suicide among men. Further, geographical inequalities in suicide have considerably increased across 47 prefectures, primarily among men, since 1995.

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Differences in suicide risk according to living arrangements in Japanese men and women – The Japan Public Health Center-based (JPHC) prospective study

Cited by 22 publications

References 32 publications

Eating Alone Yet Living With Others Is Associated With Mortality in Older Men: The JAGES Cohort Survey

Eating Alone Yet Living With Others Is Associated With Mortality in Older Men: The JAGES Cohort Survey

Female reproductive factors and risk of external causes of death among women: The Japan Public Health Center-based Prospective Study (JPHC Study)

Social and Geographical Inequalities in Suicide in Japan from 1975 through 2005: A Census-Based Longitudinal Analysis

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