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Paper published: time preference did not explain the association between education and health behavior much

Educational attainment, time preference, and health-related behaviors: A mediation analysis from the J-SHINE survey Original Research Article
Social Science & Medicine, Volume 153, March 2016, Pages 116-122
Daisuke Takagi, Naoki Kondo, Misato Takada, Hideki Hashimoto

Highlights

  • We measured time preference using choice-based measurements of time discount rate.
  • We demonstrated the relations of education to smoking, drinking and overweight.
  • However, time discount rate was not associated with binge drinking and overweight.
  • Even for smoking, the mediation effect of time discount rate was quit limited.
  • Interventions for time preference may not close the education-related gap.

Abstract

Evidence consistently shows that low education is associated with unhealthy behaviors. A recent study in behavioral economics argued that high time preferences ? the tendency to prefer immediate gain to later reward ? explain the limited self-control of individuals in making preventive health-related choices. The aim of this study was to examine the mediating effect of time preference on the associations between education and smoking, binge drinking and overweight in young and middle-aged adults living in a Japanese metropolitan area, using a quantitatively measured time discount rate. A population-based probabilistic sample of residents of 25?50 years of age living in four municipalities within Japanese metropolitan areas where economic disparity is relatively large was obtained from the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE). Respondents answered the questionnaire items using a computer-aided personal instrument (CAPI). Data from 3457 respondents were used in this study. Time preferences measured as categorical responses were converted into a continuous number of time discount rates by using the maximum likelihood method. Smoking habit, binge drinking, and body mass index were regressed on educational attainment with demographics and other confounders. The mediating effects of the time discount rate were examined with the bootstrapping method. Results showed that the time discount rate did not mediate the association between education and binge drinking and BMI. Even for smoking, the mediating effect of time discount rate was quite limited, indicating that the proportion of total effect of education mediated was only 4.3% for men and 3.0% for women. The results suggest that modifying time preferences through educational intervention has only limited efficacy in closing disparities in health-related behaviors, and that other mediators fostered by schooling, such as knowledge/skills, group norms and supportive peers/networks, may be more important as modifiable mediators in the link between education and smoking.

Keywords

Japan; Time preference; Time discount rate; Education; Smoking; Binge drinking; Body mass index

New paper: Correlates of Regular Participation in Sports Groups among Japanese Older Adults: JAGES Cross–Sectional Study

Our paper was published.
Correlates of Regular Participation in Sports Groups among Japanese Older Adults: JAGES Cross-Sectional Study

Mitsuya Yamakita ,Satoru Kanamori,Naoki Kondo,Katsunori Kondo

URL: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0141638

Background

Participation in a sports group is key for the prevention of incident functional disability. Little is known about the correlates of older adults’ participation in sports groups, although this could assist with the development of effective health strategies. The purpose of this study was to identify the demographic and biological, psychosocial, behavioral, social and cultural, and environmental correlates of sports group participation among Japanese older adults.

Methods

Data were obtained from the Japan Gerontological Evaluation study, which was a population?based cohort of people aged ?65 years without disability enrolled from 31 municipalities across Japan (n = 78,002). Poisson regression analysis was used to determine the associations between the factors and participation in sports groups.

Results

Non-regular participation in sports groups was associated with lower educational level, being employed, and working the longest in the agricultural/forestry/fishery industry among the demographic and biological factors and poor self-rated health and depression among the psychosocial factors. Of the behavioral factors, current smoking was negatively associated and current drinking was positively associated with regular participation in sports groups. Among the social and cultural factors, having emotional social support and participating in hobby clubs, senior citizen clubs, or volunteer groups were associated with a high prevalence of participation in sports groups. Perceptions of the presence of parks or sidewalks, good access to shops, and good accessibility to facilities were positively associated with participation in sports groups among the environmental factors.

Conclusions

Our study suggests that the promotion of activities that could increase older adults’ participation in sports groups should consider a broad range of demographic and biological, psychosocial, behavioral, social and cultural, and environmental factors. Although future longitudinal studies to elucidate the causal associations are needed, encouraging participation in community groups through social networks might be effective for participation in sports groups.

New paper(open access): economic crisis made the poor children obese

The global economic crisis, household income and pre-adolescent overweight and underweight: a nationwide birth cohort study in Japan

Ueda P, Kondo N, Fujiwara T.

Background

We hypothesized that children from lower income households and in households experiencing a negative income change in connection to the global economic crisis in 2008 would be at increased risk of adverse weight status during the subsequent years of economic downturn.

Methods

Data were obtained from a nationwide longitudinal survey comprising all children born during 2 weeks of 2001. For 16,403 boys and 15,206 girls, information about anthropometric measurements and household characteristics was collected from 2001 to 2011 on multiple occasions. Interactions between the crisis onset (September 2008) and household income group, as well as the crisis onset and a >30% negative income change in connection to the crisis, were assessed with respect to risk of childhood over- and underweight.

Results

Adjusted for household and parental characteristics, boys and girls in the lower household income quartiles had a larger increase in risk of overweight after the crisis onset relative to their peers in the highest income group. (Odds ratio (95% confidence interval) for interaction term in boys=1.23 (1.02–1.24); girls=1.35 (1.23–1.49) comparing the lowest with the highest income group.) Among girls, an interaction between the crisis onset and a >30% negative change in household income with respect to risk of overweight was observed (odds ratio for interaction term=1.23 (1.09–1.38)). Girls from the highest income group had an increased risk of underweight after the crisis onset compared with girls from the lowest income group.

Conclusions

Boys and girls from lower household income groups and girls from households experiencing a negative income change in connection to the global economic crisis in 2008, may be at increased risk of overweight. Vulnerability to economic uncertainty could increase risk of overweight in preadolescence.

New paper: (Open Access) Combined effects of eating alone and living alone on unhealthy dietary behaviors, obesity and underweight in older Japanese adults: Results of the JAGES

Combined effects of eating alone and living alone on unhealthy dietary behaviors, obesity and underweight in older Japanese adults: Results of the JAGES

Highlights

  • Eating alone was associated with unhealthy dietary behaviors in older men and women.
  • Eating alone was associated with obesity in older men and women.
  • Eating alone was associated with underweight in older men.
  • Among men, the effects of eating alone were stronger if they lived alone.
  • Among women, the effects of eating alone were stronger if they lived with others.

Abstract

We examined whether eating alone is associated with dietary behaviors and body weight status, and assessed the modifying effects of cohabitation status in older Japanese people. Data from the 2010 Japan Gerontological Evaluation Study, with a self-reported questionnaire for 38,690 men and 43,674 women aged ≥65 years, were used. Eating status was classified as eating with others, sometimes eating alone, or exclusively eating alone. We calculated adjusted prevalence ratios (APRs) of unhealthy dietary behaviors, obesity, and underweight, adjusting for age, education, income, disease, and dental status using Poisson regression. Overall, 16% of men and 28% of women sometimes or exclusively ate alone. Among those who exclusively ate alone, 56% of men and 68% of women lived alone. Men who exclusively ate alone were 3.74 times more likely to skip meals than men who ate with others. Among men who exclusively ate alone, those who lived alone had a higher APR than men who lived with others. Compared with subjects who ate and lived with others, the APRs of being obese (BMI ≥ 30.0 kg/m2) among men who exclusively ate alone were 1.34 (1.01–1.78) in those who lived alone and 1.17 (0.84–1.64) in those who lived with others. These combined effects of eating and living alone were weaker in women, with a potential increase in the APRs among those who ate alone despite living with others. Men who exclusively ate alone were more likely to be underweight (BMI < 18.5 kg/m2) than men who ate with others in both cohabitation statuses. Eating alone and living alone may be jointly associated with higher prevalence of obesity, underweight and unhealthy eating behaviors in men.

New paper: stronger associations between oberweight, underweight, and mortality among poor Japanese men

Influence of socioeconomic status on the association between bodymass index and cause-specific mortality among older Japanese adults: The AGES Cohort Study

Miyo Nakade, Daisuke Takagi, Kayo Suzuki, Jun Aida, Toshiyuki Ojima, Katsunori Kondo, Hiroshi Hirai, Naoki Kondo

Preventive Medicine 77 (2015) 112-118
http://dx.doi.org/10.1016/j.ypmed.2015.05.015

Objective.Many studies have suggested a U-shaped curve for the association between body size andmortality risks, i.e., mortality risks increase in those who are both overweight and underweight. The strength of the associationsmay vary according to socioeconomic statuses (SES), as they determine levels of access to healthcare and psychosocial stresses. We investigated the modifying effects of SES on the relationship between body mass index (BMI) and mortality.

Method.We used prospective cohort data of participants in the Aichi Gerontological Evaluation Study in 2003(n=14,931),whowere 65 years or older and physically and cognitively independent at baseline, and residing in eightmunicipalities in Japan. Data on all-causesmortality andmortality from cancer, cardiovascular disease, and respiratory disease was obtained from municipal government registries.

Results. Proportional hazard regression analyses showed that, among men, the associations between overweight (BMI ? 25 kg/m2) and highermortality risks by any causewere stronger among lower incomegroups. Even adjusting for multiple confounding factors, hazard ratios (95% confidence intervals) for mortality by all causes among low income group (household income b 1.5 million yen) were 1.96 (1.02-3.73) for overweight compared with BMIs between 23.0 and 24.9, whereas they were 0.94 (0.57-1.38) among men in high income group (income N 3 million yen). The modifying effects of income were not marked among women.

Conclusion. Household income, which may directly reflect accessibility to healthcare and psychosocial stress among older Japanese men, may be an important modifying factor in the health risks attributable to overweight.

New paper: Relative deprivation in income and mortality by leading causes among older Japanese men and women: AGES cohort study

Our paper was published from Journal of Epidemiology and Community Heath:

Naoki Kondo, Masashige Saito, Hiroyuki Hikichi, Jun Aida, Toshiyuki Ojima, Katsunori Kondo Ichiro Kawachi

Relative deprivation in income and mortality by leading causes among older Japanese men and women: AGES cohort study

Open Access
http://jech.bmj.com/content/69/7/680.full

Press release publisehd: Many older adults still homebound after 2011 Great East Japan Earthquake

Many older adults still homebound after 2011 Great East Japan Earthquake:

http://www.eurekalert.org/pub_releases/2014-10/oup-moa101414.php

Full paper download: http://ageing.oxfordjournals.org/content/early/2014/10/13/ageing.afu146.full