Journal of epidemiology · 2026
Associations between Postcode-based Area Deprivation Index and Individual-level Socioeconomic Status: Findings from Two Population-based Cohort Studies.
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Hanafusa Mariko, Ito Yuri, Nakaya Tomoki, Arakawa Yuki, Nakayama Izumi, Kuwahara Keisuke, Xu Juan, Miyazaki Tomoyuki, Yasuda Nobufumi, Saito Isao, Maruyama Koutatsu, Aoyagi Kiyoshi, Arima Kazuhiko, Tanno Kozo, Takanashi Nobuyuki, Yamagishi Kazumasa, Muraki Isao, Yamaji Taiki, Iwasaki Motoki, Inoue Manami, Tsugane Shoichiro, Goto Atsushi, Sawada Norie
Аннотация
BACKGROUND: The Area Deprivation Index (ADI) is widely used to monitor health inequalities and often used as a proxy for individual socioeconomic status (SES). However, the extent to which it reflects individual SES remains unclear. This study aimed to establish evidence linking neighborhood-level ADI with individual SES indicators in Japan and examine whether similar patterns of association are observed across independent population-based cohorts.
METHODS: We analyzed baseline data from two population-based cohorts: the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT) (baseline survey, 2011-2016; ages 40-74 years; N=100,024) and the Yokohama Health Study (YHS) (baseline survey, 2023; ages 30-69 years; N=8,860). ADI was ranked into quartiles (Q1: lowest, Q4: highest deprivation) based on the distribution across all postcodes in Japan and linked to each participant by residential area. Logistic regression models estimated associations between ADI quartile and low income (<1.53 million JPY) or limited education (≤9 or ≤12 years) by gender.
RESULTS: Higher ADI showed increasing trends of association with low income and ≤9 years of education in both cohorts and across genders, with p for trend <0.001 for all. In contrast, associations with ≤12 years of education were less consistent across cohorts and subgroups, with no significant trend observed among women in JPHC-NEXT (p for trend = 0.74).
CONCLUSIONS: While the ADI consistently reflected income-related disadvantage across cohorts, its association with educational attainment varied across contexts. This should be carefully considered when using or interpreting ADI-based measures of health inequality in Japan.
METHODS: We analyzed baseline data from two population-based cohorts: the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT) (baseline survey, 2011-2016; ages 40-74 years; N=100,024) and the Yokohama Health Study (YHS) (baseline survey, 2023; ages 30-69 years; N=8,860). ADI was ranked into quartiles (Q1: lowest, Q4: highest deprivation) based on the distribution across all postcodes in Japan and linked to each participant by residential area. Logistic regression models estimated associations between ADI quartile and low income (<1.53 million JPY) or limited education (≤9 or ≤12 years) by gender.
RESULTS: Higher ADI showed increasing trends of association with low income and ≤9 years of education in both cohorts and across genders, with p for trend <0.001 for all. In contrast, associations with ≤12 years of education were less consistent across cohorts and subgroups, with no significant trend observed among women in JPHC-NEXT (p for trend = 0.74).
CONCLUSIONS: While the ADI consistently reflected income-related disadvantage across cohorts, its association with educational attainment varied across contexts. This should be carefully considered when using or interpreting ADI-based measures of health inequality in Japan.