北海道の二次医療圏を単位とした死亡率,栄養摂取状況の地域差の実態とその関連の検討

Tomoko Kishi, Emiko Okada, Atsuko Sato, Masako Ishikawa, Shigekazu Ukawa, Koshi Nakamura, Akiko Tamakoshi

Objective　Hokkaido is a geographically vast area comprising a variety of natural environments and major industries. Therefore, we presume that there are large differences in lifestyles and lifestyle-related disease mortality in community people based on region. The aim of this study was to investigate the regional differences in mortality and food and nutrient intake, and their associations among secondary healthcare service areas in Hokkaido.Methods　This study's design was ecological. We collected mortality data using public health statistics from the year 2005 to 2009 of the Hokkaido prefecture. We calculated the average of the standardized mortality ratio (SMR) over those five years. Data on food and nutrient intake were obtained from the Hokkaido Health and Nutrition Survey in 2006 conducted in the Hokkaido prefecture. The association between mortality and nutritional status was examined using the Spearman rank correlation coefficient.Results　The mortality rates were higher in the southern and eastern areas of Hokkaido and in the lower internal area in the northern area of Hokkaido and the Tokachi area. There were regional differences of 400-500 kcal of energy, 20-30 g of protein, 4-5 g of salt, 60 g of green and yellow vegetables, and 100 g of other vegetables among 21 secondary healthcare service areas in Hokkaido.　In women alone, we observed a positive association between cancer mortality and fat intake from dairy products. By contrast, we observed an inverse, significant association between cancer mortality and rice intake, and cardiovascular mortality and soybean and soybean product intake, only in women.Conclusion　We present regional differences in mortality and food and nutrient intake among secondary healthcare areas in Hokkaido. We also reveal a significant association between mortality and food and nutrient intake only in women. Further research is needed to examine whether socioeconomic, environmental, or other lifestyle factors are associated with regional health gaps.