In Japan, more COVID-19 cases and deaths have occurred in prefectures with lower household incomes and a higher unemployment rate, among other socioeconomic factors, according to Harvard T.H. Chan School of Public Health’s Yuki Yoshikawa and Ichiro Kawachi.
Their study, published in JAMA Network Open on July 14, 2021, was the first to investigate the association between social determinants and COVID-19 outcomes at a national level in an Asian country.
Kawachi, John L. Loeb and Frances Lehman Loeb Professor of Social Epidemiology, and Yoshikawa, a visiting scientist in the Department of Social and Behavioral Sciences, looked at the confirmed COVID-19 cases and deaths in all 47 prefectures of Japan through Feb. 13, 2021. The researchers identified an unequal pattern of COVID-19 outcomes that was associated with socioeconomic circumstances, including lower household incomes; a higher proportion of the population receiving public assistance; a higher unemployment rate; higher numbers of retail, transportation, postal, and restaurant industry workers; more household crowding; and higher smoking and obesity rates.
These findings are similar to those from other studies conducted in the U.S. and Europe that found that people living in regions with lower socioeconomic status had greater vulnerability to COVID-19.
The study results suggest that the national COVID-19 response in Japan, such as vaccination planning, should prioritize populations in socially disadvantaged regions in order to reduce cases and deaths due to the disease.