Journal of Preventive Medicine and Public Health

Original Article

Age-period-cohort Analysis of Healthy Lifestyle Behaviors Using the National Health and Nutrition Survey in Japan: Tasuku Okui; J Prev Med Public Health. 2020;53(6):409-418. Published online August 13, 2020; DOI: https://doi.org/10.3961/jpmph.20.159

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Objectives
This study conducted an age-period-cohort (APC) analysis of trends in healthy lifestyle behaviors in Japan.
Methods
We used National Health and Nutrition Survey data on salt intake and prevalence of smoking, drinking, and physical activity between 1995 and 2018 in Japan. Age groups were defined from 20 years to 69 years old in 10-year increments. Cohorts were defined for each age group of each year with a 1-year shift, and cohorts born in 1926-1935 (first cohort) until 1989-1998 (last cohort) were examined. We conducted a Bayesian APC analysis, calculating estimated values for each behavior by age group, period, and cohort.
Results
Estimated salt intake decreased from cohorts born in the 1930s to the 1960s, but increased thereafter in both genders, and the magnitude of increase was larger for men. Estimated smoking prevalence increased in the cohorts starting from the 1930s for men and the 1940s for women, and then decreased starting in the cohorts born in the 1970s for both genders. Although estimated drinking prevalence decreased starting in the cohorts born in approximately 1960 for men, for women it increased until the cohorts born in approximately 1970. Estimated physical activity prevalence decreased starting in the cohorts born in the 1940s in both genders, but the magnitude of decrease was larger for women.
Conclusions
Trends in cohort effects differed by gender, which might be related to changes in the social environment for women. Improvements in dietary and exercise habits are required in more recently born cohorts of both genders.

Summary

Citations

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An Age-Period-Cohort Analysis of Biomarkers of Lifestyle-Related Diseases Using the National Health and Nutrition Survey in Japan, 1973–2018
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Brief Report

Age-period-cohort Analysis of Cardiovascular Disease Mortality in Japan, 1995-2018: Tasuku Okui; J Prev Med Public Health. 2020;53(3):198-204. Published online April 14, 2020; DOI: https://doi.org/10.3961/jpmph.20.037

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167 Download
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Abstract PDF Supplementary Material

Objectives
This study aimed to analyze the mortality of heart disease (HD), ischemic heart disease (IHD), and cerebrovascular disease (CeVD) through an age-period-cohort (APC) analysis.
Methods
We used data on mortality due to cardiovascular disease from 1995 to 2018 in Japan, as determined by Vital Statistics. Age groups from 0 years to 99 years were defined by 5-year increments, and cohorts were defined for each age group of each year with a 1-year shift. We used Bayesian APC analysis to decompose the changes in the diseases’ mortality rates into age, period, and cohort effects.
Results
The period effects for all diseases decreased during the analyzed periods for both men and women. The cohort effects for men increased substantially in cohorts born from around 1940 to the 1970s for all types of cardiovascular diseases. The cohort effects of HD decreased in the cohorts born in the 1970s or later for both men and women. Regarding IHD and CeVD, either a non-increase or decrease of cohort effects was confirmed for cohorts born in the 1970s or later for men, but the effects for women showed a continuously increasing trend in the cohorts born in the 1960s or later.
Conclusions
The cohort effects for IHD and CeVD showed increasing trends in younger generations of women. This suggests that preventive approaches against cardiovascular diseases are needed, particularly for women.

Summary

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International Journal of Environmental Research and Public Health.2020; 17(21): 8159. CrossRef
Socioeconomic Disparities in All-Cause and Cause-Specific Mortality Rates among Municipalities in Japan, 1999–2019
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International Journal of Environmental Research and Public Health.2020; 17(24): 9213. CrossRef
Age-period-cohort Analysis of Healthy Lifestyle Behaviors Using the National Health and Nutrition Survey in Japan
Tasuku Okui
Journal of Preventive Medicine and Public Health.2020; 53(6): 409. CrossRef

Original Article

Incidence of Scarlet Fever in Children in Jeju Province, Korea, 2002-2016: An Age-period-cohort Analysis: Jinhee Kim, Ji-Eun Kim, Jong-Myon Bae; J Prev Med Public Health. 2019;52(3):188-194. Published online April 24, 2019; DOI: https://doi.org/10.3961/jpmph.18.299

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149 Download
5 Crossref

Abstract Summary PDF Supplementary Material

Objectives
Outbreaks of scarlet fever in Mexico in 1999, Hong Kong and mainland China in 2011, and England in 2014-2016 have received global attention, and the number of notified cases in Korean children, including in Jeju Province, has also increased since 2010. To identify relevant hypotheses regarding this emerging outbreak, an age-period-cohort (APC) analysis of scarlet fever incidence was conducted among children in Jeju Province, Korea.
Methods
This study analyzed data from the nationwide insurance claims database administered by the Korean National Health Insurance Service. The inclusion criteria were children aged ≤14 years residing in Jeju Province, Korea who received any form of healthcare for scarlet fever from 2002 to 2016. The age and year variables were categorized into 5 groups, respectively. After calculating the crude incidence rate (CIR) for age and calendar year groups, the intrinsic estimator (IE) method was applied to conduct the APC analysis.
Results
In total, 2345 cases were identified from 2002 to 2016. Scarlet fever was most common in the 0-2 age group, and boys presented more cases than girls. Since the CIR decreased with age between 2002 and 2016, the age and period effect decreased in all observed years. The IE coefficients suggesting a cohort effect shifted from negative to positive in 2009.
Conclusions
The results suggest that the recent outbreak of scarlet fever among children in Jeju Province might be explained through the cohort effect. As children born after 2009 showed a higher risk of scarlet fever, further descriptive epidemiological studies are needed.

Summary

Korean summary
제주도 아동의 성홍열 발생건수의 증가는 출생코호트 효과에 기인한 것으로, 특히 2009년도 이후 출생자의 발생률 증가가 있었다. 기존 연구와 다른 점은, 성홍열 환자 발생률이 가장 높은 연령대가 0-2세라는 점이다. 이에 대한 추가적인 기술역학연구가 필요하다.

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Brief Report

Trends in Ischemic Heart Disease Mortality in Korea, 1985-2009: An Age-period-cohort Analysis: Hye Ah Lee, Hyesook Park; J Prev Med Public Health. 2012;45(5):323-328. Published online September 28, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.5.323

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93 Download
14 Crossref

Abstract PDF

Objectives

Economic growth and development of medical technology help to improve the average life expectancy, but the western diet and rapid conversions to poor lifestyles lead an increasing risk of major chronic diseases. Coronary heart disease mortality in Korea has been on the increase, while showing a steady decline in the other industrialized countries. An age-period-cohort analysis can help understand the trends in mortality and predict the near future.

Methods

We analyzed the time trends of ischemic heart disease mortality, which is on the increase, from 1985 to 2009 using an age-period-cohort model to characterize the effects of ischemic heart disease on changes in the mortality rate over time.

Results

All three effects on total ischemic heart disease mortality were statistically significant. Regarding the period effect, the mortality rate was decreased slightly in 2000 to 2004, after it had continuously increased since the late 1980s that trend was similar in both sexes. The expected age effect was noticeable, starting from the mid-60's. In addition, the age effect in women was more remarkable than that in men. Women born from the early 1900s to 1925 observed an increase in ischemic heart mortality. That cohort effect showed significance only in women.

Conclusions

The future cohort effect might have a lasting impact on the risk of ischemic heart disease in women with the increasing elderly population, and a national prevention policy is need to establish management of high risk by considering the age-period-cohort effect.

Summary

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Age-period-cohort Analysis of Cardiovascular Disease Mortality in Japan, 1995-2018
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Age-period-cohort Analysis of Healthy Lifestyle Behaviors Using the National Health and Nutrition Survey in Japan
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