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European Journal of Public Health, Vol. 23, Supplement 1, 2013

Healthy Life Expectancy in Japan and comparison
with EUToshiyuki Ojima
T Ojima1, S Hashimoto2, I Tsuji3, H Tsutsui1,4, T Noda1, M Nakamura1,K Kondo5, M Lagergren6, H Van Oyen7, JM Robine8
1
Hamamatsu University School of Medicine, Hamamatsu, Japan
2
Fujita Health University, Toyoake, Japan
3
Tohoku University, Sendai, Japan
4
Teikyo University, Tokyo, Japan
5
Nihon Fukushi University, Nagoya, Japan
6
Stockholm Gerontology Research Center, Stockholm, Sweden
7
Scientific Institute of Public Health, Brussels, Belgium
8
INSERM, Paris and Montpellier, France
Contact: ojima@hama-med.ac.jp

J.2. Risk factors for disability
Explaining associations between shorter educationand future disability retirement among men andwomen in Sweden
Daniel Falkstedt
D Falkstedt1, M Backhans1, A Lundin, P Allebeck1, T Hemmingsson2
Department of Public Health Sciences, Karolinska Institutet, Stockholm,
Sweden2Institute of Environmental Medicine, Karolinska Institutet, Stockholm,
SwedenContact: daniel.falkstedt@ki.se1

Objectives
The aim of the present study was to analyze (1) the extent towhich the often observed association between lower educationand increased risk of disability retirement represents differences occurring in childhood, (2) the extent to which working
conditions helps to explain the association, and (3) whether
the association between education and disability retirement is
the same for those with a psychiatric compared to nonpsychiatric diagnosis of disability retirement
Methods
Two nationally representative samples of men and womenborn in 1948 (n = 12 166) and 1953 (n = 10 723) in Sweden
were pooled and linked to information from administrative
records on cause and date of disability retirement: musculoskeletal, psychiatric, and other disability pension diagnoses
from 1986 to 2008. Data on the participants’ education andfather’s education were obtained from administrative records.
Data on study ambition and intellectual performance werecollected at 13 years of age. Physical strain at work and job
control was measured using two Job Exposure Matrices linked
to the subjects’ occupational codes in 1985 and 1990.
Results
Rate of disability retirement, regardless of diagnosis, was considerably higher in women than in men. The rate of disability
retirement overall varied from 13.5% to 24.5% between thehighest and lowest educated women, while the same rate formen varied between 4% and 13%. Relative risks of disability
retirement between high and low education, however, weregreater for men than for women regardless of diagnosis.

Controlling for differences in father’s education, own ambition
to study, and intellectual performance attenuated educational
differences in total risk of disability retirement by more than
50% among the men and 70% among the women. Controllingfor physical strain at work and job control attenuated thedifferences with 37% and 50% among the men and thewomen, respectively. Risk of disability retirement withpsychiatric diagnoses did not differ between high- and loweducated women (and not much between high- and loweducated men either).
Conclusions
Differences occurring in childhood may be of greater
importance than occupational exposures in explaining theassociation between shorter education and increased risk ofdisability retirement.
Key messages
 Differences occurring in childhood may be of greater
importance than occupational exposures in explaining theassociation between shorter education and increased riskof disability retirement.
 There may be small or no educational differences indisability retirement with psychiatric diagnoses.
Poor adolescent health tracks into long-term sickness
absence and disability pension in young adulthood: aprospective population study. (Young-HUNT, Norway)
Karin De Ridder
KA De Ridder1,2, K Pape1, JH Bjørngaard1,3
Department of Public Health and General Practice, Norwegian University ofScience and Technology, Trondheim, Norway
2
2Youth Health Care, Department of Public Health and Primary Care, KU
Leuven, Leuven, Belgium
3
Forensic Department and Research Centre Bröset, St. Olav’s University
Hospital Trondheim, Trondheim, Norway
Contact: karin.de.ridder@ntnu.no1

Background
There is evidence that poor adolescent health is associatedwith higher risk for problematic labour market entrance.
Furthermore, poor adolescent health is also associated with

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Background
Joint Action European Health and Life Expectancies Information System (JA EHLEIS) annually calculates healthy life
expectancies (HLE) of EU member states. The aim is to calculate
HLE in Japan for the same indicators and to compare with EU.
Methods
HLE in 2010 were calculated from the data of the Japanesenational Comprehensive Survey of Living Conditions andthe national Life Table using Sullivan method. Because thequestionnaire of the Japanese and EU surveys are different,
a supplemental mail survey was conducted for 2,700 randomly
selected residents in 6 municipalities in Japan. All the key
questions of both Japanese and EU surveys for HLE wereincluded in the questionnaire. Then conversion tables fromthe Japanese national questionnaire to the EU questionnaire
were developed. Finally, 3 kinds of HLE, i.e. Global ActivityLimitation Indicator (GALI), chronic morbidity, and perceived
health, at age 65 were calculated for Japan, and compared withthe combined EU-27 states data, France, and Sweden in thesame year of 2010.
Results
For the supplemental survey, 1,774 (66.0%) responded. The
results of the conversion table were, for example, as follows:
proportion of people with severe limitation by GALI was 2.2%,that with moderate limitation was 25.0%, and that without
limitation was 72.8% among 75 years or older men without
activity limitation by the Japanese national survey questionnaire. HLE for women and men in Japan were 13.4 and 11.4
years for without activity limitation by GALI. Those were 9.4
and 7.6 years for without chronic morbidity. Moreover, thosewere 16.5 and 13.7 years in good, rather good, or ordinary
perceived health, while 7.4 and 5.2 years in rather bad or badperceived health.
Conclusions
HLE without activity limitation of Japan was at middle value
between EU-27 (women 8.8, men 8.6 years) or France (women9.8, men 9.0 years) and Sweden (women 15.5, men 14.1 years).
HLE without chronic morbidity of Japan was also at middle
value between EU-27 (women 7.6, men 6.7 years) or France(women 8.1, men 6.3 years) and Sweden (women 11.1, men
10.3 years). HLE rather bad or bad perceived health werelonger than EU-27, France, and Sweden. International
comparison of HLE provides useful information to assess
health status of each country.