Area-level deprivation is well known to have an adverse impact on mortality, morbidity, or other specific health outcomes. This study examined how area-level deprivation may affect self-rated health (SRH) and life satisfaction (LS), an issue that is largely understudied. We used individual-level data obtained from a nationwide population-based internet survey conducted between 2019 and 2020, as well as municipality-level data obtained from a Japanese government database (N = 12,461 living in 366 municipalities). We developed multilevel regression models to explain an individual’s SRH and LS scores using four alternative measures of municipality-level deprivation, controlling for individual-level deprivation and covariates. We also examined how health behavior and interactions with others mediated the impact of area-level deprivation on SRH and LS. Participants in highly deprived municipalities tended to report poorer SRH and lower LS. For example, when living in municipalities falling in the highest tertile of municipality-level deprivation as measured by the z-scoring method, SRH and LS scores worsened by a standard deviation of 0.05 (p < 0.05) when compared with those living in municipalities falling in the lowest tertile of deprivation. In addition, health behavior mediated between 17.6 and 33.1% of the impact of municipality-level deprivation on SRH and LS, depending on model specifications. Results showed that area-level deprivation modestly decreased an individual’s general health conditions and subjective well-being, underscoring the need for public health policies to improve area-level socioeconomic conditions.

中文翻译：

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区域层面的剥夺如何降低个人的自我评估健康和生活满意度？来自日本全国人口调查的证据

众所周知，地区一级的剥夺对死亡率，发病率或其他特定的健康后果产生不利影响。这项研究调查了区域剥夺如何影响自我评估的健康（SRH）和生活满意度（LS），这一问题在很大程度上尚未得到研究。我们使用了从2019年至2020年进行的全国性基于人口的互联网调查获得的个人级别数据，以及从日本政府数据库（居住在366个城市中的N = 12,461）获得的市政级别数据。我们开发了多级回归模型，使用四种替代方法来解释个人的SRH和LS得分，这些方法包括市级剥夺，控制个人剥夺和协变量。我们还研究了健康行为以及与他人的互动如何介导区域剥夺对SRH和LS的影响。高度贫困的城市的参与者往往报告说SRH较差而LS较低。例如，当以z计分法测得居住在城市等级剥夺程度最高的城市中的居民时，与居住在城市中的城市居民相比，SRH和LS得分恶化了0.05个标准差（p <0.05）处于最贫困的三分之二。此外，取决于模型规格，健康行为介导了市一级剥夺对SRH和LS的影响的17.6％至33.1％。结果表明，地区一级的剥夺温和地降低了个人的总体健康状况和主观幸福感，强调了需要公共卫生政策来改善地区一级的社会经济状况。