Economic, cognitive, and social paths of education to health-related behaviors: evidence from a population-based study in Japan.

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Tytuł:: Economic, cognitive, and social paths of education to health-related behaviors: evidence from a population-based study in Japan.
Autorzy:: Murakami K; Tohoku Medical Megabank Organization, Tohoku University.; Graduate School of Medicine, Tohoku University.; Department of Health and Social Behavior, School of Public Health, The University of Tokyo.
Kuriyama S; Tohoku Medical Megabank Organization, Tohoku University.; Graduate School of Medicine, Tohoku University.; Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University.
Hashimoto H; Department of Health and Social Behavior, School of Public Health, The University of Tokyo.
Źródło:: Environmental health and preventive medicine [Environ Health Prev Med] 2023; Vol. 28, pp. 9.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: 2022- : [Kyoto, Japan] : Japanese Society for Hygiene
Original Publication: Sapporo, Japan : Japanese Society for Hygiene, c1996-
MeSH Terms:: Health Behavior*
Health Literacy*
Humans ; Japan ; Educational Status ; Exercise ; Surveys and Questionnaires ; Cognition
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Contributed Indexing:: Keywords: Education; Health literacy; Health-related behaviors; Income; Japan; Social support
Entry Date(s):: Date Created: 20230129 Date Completed: 20230131 Latest Revision: 20230202
Update Code:: 20240105
PubMed Central ID:: PMC9884565
DOI:: 10.1265/ehpm.22-00178
PMID:: 36709974
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Background: There is substantial evidence on the association between lower education and unhealthy behaviors. However, the mechanism underlying this association remains unclear. This study aimed to examine whether income, health literacy, and social support mediate the association between education and health-related behaviors.
Methods: A questionnaire survey was conducted in metropolitan areas in Japan from 2010 to 2011 among residents aged 25-50 years. Data from 3663 participants were used in this study. Health literacy was measured using the Communicative and Critical Health Literacy scale. Health-related behaviors were current smoking, poor dietary habits, hazardous drinking, and lack of exercise. Poisson regression analyses with robust variance estimators were conducted to examine the associations between education and these health-related behaviors. Multiple mediation analyses were conducted to estimate the magnitudes of the mediating effects of income, health literacy, and social support on these associations.
Results: Less educated participants had higher risks of all unhealthy behaviors. Income mediated the associations of education with smoking (6.4%) and exercise (20.0%). Health literacy mediated the associations of education with dietary habits (15.4%) and exercise (16.1%). Social support mediated the associations of education with dietary habits (6.4%) and exercise (7.6%). The education-drinking association was mediated by income in the opposite direction (-10.0%). The proportions of the total effects mediated by income, health literacy, and social support were 9.8% for smoking, 24.0% for dietary habits, -3.0% for drinking, and 43.7% for exercise.
Conclusions: These findings may provide clues for designing effective interventions to reduce educational inequalities in health-related behaviors.

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