Different Income Information as an Indicator for Health Inequality among Japanese Adults

BACKGROUND: There are several alternative indicators of income information, which is a fundamental measure of individual socioeconomic position. In this study, we compared the degrees of associations of four types of income information with health variables among Japanese adults. METHODS: Using a nationally representative sample of 29,446 men and 32,917 women aged 20 years and over, the associations between four income indicators and health variables were examined using the odds ratio in logistic regression analysis and the concentration index by sex and age group (20-59 years and 60+ years). Income indicators consisted of total household income, equivalent household income, total household expenditure, and equivalent household expenditure. Current smoking and self-rated health statuses were used as health variables. RESULTS: A low income was associated with a high prevalence of smoking and fair/poor self-rated health, with some differences among sex and age groups and income indicators, but less difference among methods of statistical analyses. Total and equivalent incomes were similarly and more markedly associated with smoking and self-rated health statuses, whereas equivalent expenditure showed the smallest degree of health difference. For the population aged 60+ years, the degree of health differences in smoking was similar between income and expenditure. CONCLUSIONS: Although the degree of income-related health differences is dependent on health outcome and both sex and age group, this study suggests that either crude or equivalent household income is a useful indicator for health inequality among Japanese adults.