Hygiene Statistics - Hygiene Statistics
What are health statistics?The meaning of health statisticsHealth statistics are the expression of health characteristics of a human population through appropriate processing of information on the health of that population. Health information includes information on death and disease, where the source of information is the human body itself, as well as other information such as national medical expenses and sewerage coverage rate. Furthermore, indicators have both absolute and relative values. In health statistics, relative values indicate the number of occurrences (quantity) or occurrences (quantity) of health-related events per population in a certain group, over a certain period of time, or at a certain point in time. For example, the death rate in Japan in 2006 (Heisei 18) was 8.6 cases per 1,000 population. Health statistics express the health (hygiene) status of a group. These relative indicators can be compared over time and space. For example, the death rate in Japan in 1950 (Showa 25) was significantly higher than that in 2000. The rate is calculated as numerator/denominator. The relationship between the two is based on the principle that the occurrence or occurrence of the "numerator" event comes from within the "denominator." Uterine cancer is a disease that only affects women, never men. With regard to uterine cancer, women are said to be a population at risk. The purpose of compiling health statistics is to contribute to the peace, well-being and prosperity of a human group or of all humanity, particularly in order to obtain economic and non-economic benefits related to health. Health statistics are particularly useful in public health activities. If a certain health indicator of a certain group is poor, the problem can be recognized and measures to solve it can be planned and implemented. After the measures are implemented, evaluation is possible by knowing the degree of improvement in the health indicator. This allows improved health measures to be implemented again. If this type of cycle (PDCA cycle) is appropriate, it is possible to expect a further improvement in the health of the group. One example is the relationship between influenza deaths and influenza vaccination. When Japan's influenza and related death rates and vaccination rates in 1999 (Heisei 11) were compared with those of developed Western countries, information was obtained that showed a high death rate and a low vaccination rate. As a result, a public health policy was planned and implemented to bring the vaccination rate up to the same level as developed Western countries. By looking at Japan's influenza death rates after that, the public health policy of increasing the vaccination rate can be evaluated. If the reduction in influenza death rates is insufficient, policies such as further increasing the vaccination rate could be considered. [Minoru Sugita] DemographicsDemographics is a part of health statistics, and includes static population statistics and vital statistics. The former is population at a certain point in time, and the latter is population inflows and outflows such as births and deaths over a certain period of time. [Minoru Sugita] Health Statistics Compilation AgencyPublic organizations that handle health statistics in Japan include the Statistics Bureau of the Ministry of Internal Affairs and Communications, the Statistics and Information Department of the Ministry of Health, Labor and Welfare, the Ministry of the Environment, and the Ministry of Education, Culture, Sports, Science and Technology, as well as international organizations such as the United Nations (UN) and the World Health Organization (WHO). Private companies include insurance companies. Academic organizations include the Japanese Society of Pathology, which compiles pathological autopsy reports. [Minoru Sugita] Static population statisticsStatic population statistics are the population at a certain point in time. This information is obtained from the census, which is conducted every five years. The survey items include name, sex, date of birth, relationship to the head of household, marital status, and nationality, and the population by sex, age, and nationality at that time can be obtained. This can be compared over time and space. In years when the census is not conducted, the approximate numbers are estimated from various sources. [Minoru Sugita] Japan's National PopulationThe annual trends in Japan's national population, growth rate, population density, and population sex ratio are shown in According to this, Japan's population reached its peak in 2004. [Minoru Sugita] Population by gender and ageA population pyramid, as shown in , shows the population by gender and age. It allows you to visually recognize the aging of the population, the declining birthrate, the effects of war, and so on. If you create this by region and calendar year, it becomes possible to visually compare the quality of the population. The population pyramid for 2006 has a narrow base, indicating a declining birthrate. In contrast, Japan's population pyramid for 1935 (Showa 10) is roughly an isosceles triangle, indicating a large younger demographic. The population is broken down by age group: those aged 0-14 are called the young population, those aged 15-64 are called the working-age population, and those aged 65 and over are called the elderly population. These ratios, including future projections, are shown by calendar year in From this, we can see the rapid progress of the aging of the population and the declining birthrate. [Minoru Sugita] Labor forceThe labor force is people who have the will to work, and can be classified into employed and unemployed. After the collapse of the bubble economy, the number (rate) of unemployed people has increased. Those who have no will to work are called non-labor force. [Minoru Sugita] Population by marital statusMarital status can be classified as unmarried, married, divorced, or widowed. shows these types of status on the population pyramid for 2005 (Heisei 17). This shows the recent trend toward later marriage. [Minoru Sugita] Number of householdsDue to the trend towards nuclear families and an increase in people living alone, there has been an increase in the number of households and a decrease in the number of people per household. [Minoru Sugita] Future population estimateFrom various information, it is possible to estimate the future population. Japan's population peaked at approximately 127.9 million around 2004, and is assumed to have been declining since then. Japan's future population estimates are shown in According to this table, a decrease in the young population and an increase in the elderly population are expected in the future, and the aging of the population will likely progress further. [Minoru Sugita] Population by prefectureLooking at the population by prefecture, Tokyo had the highest population of 12.66 million in 2006, and Tottori had the lowest at 600,000. By age, the working-age population is high in large cities and their surrounding areas, while the elderly population is high in rural areas. Population increase (decrease) can be broken down into natural increase (decrease) and social increase (decrease). Natural increase is the difference between births and deaths, while social increase is the difference between in-migration and out-migration. Social population increase is large in large cities where young people gather, and their surrounding areas. On the other hand, in rural areas, young people move out, so social population increase is small or negative. When these values are negative, it is called natural decrease or social decrease. [Minoru Sugita] Population by countryChina, with a population of about 1.3 billion, and India, with a population of about 1.1 billion, are the countries with the largest populations in 2004. Looking at the annual population growth rate by country, it is small or negative in developed countries, and positive and large in developing countries. [Minoru Sugita] Vital StatisticsVital statistics look at the natural increase or decrease in population, including births, deaths, stillbirths, marriages and divorces. With regard to deaths, although there is some overlap, maternal mortality, perinatal mortality and infant mortality are also included as useful indicators of maternal and child health. By comparing these statistical figures by time, space and cause, it is possible to learn about the hygiene level of the target population. shows an overview of Japan's vital statistics and total fertility rate for 2005-06. Population static statistics, vital statistics and other hygiene statistics in developed countries such as Japan are highly reliable, but in developing countries, their unreliability is often a problem. In the case of death, a doctor's death certificate is issued; in the case of birth or stillbirth, a certificate issued by those who were present; in the case of marriage or divorce, a notification form issued by the parties involved is issued; all of this information is collected and compiled by the Ministry of Health, Labor and Welfare. [Minoru Sugita] birthshows the trends in Japan's birth rate and total fertility rate, from which we can see the downward trend. , which shows a calendar year comparison of birth rates by maternal age, shows the increasing age of mothers at the time of childbirth. (1) Population reproduction rate Population reproduction rates are indicators that show the increase or decrease in population between generations. Of these, the total fertility rate is the average number of children a woman will have in her lifetime. shows the trends in Japan. When this value is just over 2, the increase or decrease in population between generations is zero. Even in such a situation, population can still increase or decrease at that point in time. For example, in a society with a large number of women of childbearing age, the population will increase, and in a society with a large elderly population, the population will decrease. As an example, in 1995, Japan's total fertility rate was 1.42, but the population was increasing. However, if this state continues, the population will eventually begin to decrease. If the increase or decrease in population between generations remains zero for a long period of time, the population will eventually stop increasing or decreasing. This steady state is called a stationary population. (2) Total fertility rate by prefecture In recent years, the total fertility rate of the population has been low in large cities and their surrounding areas with large working-age populations, while the rate is high in rural areas with small working-age populations. (3) Total fertility rates by country shows an international comparison of total fertility rates. Japan’s figure is clearly low. [Minoru Sugita] deathDeath statistics are compiled by collecting information from death certificates completed by doctors at the Ministry of Health, Labor and Welfare. The cause of death is recorded on the death certificate, and the underlying cause of death is determined according to the rules of the International Classification of Causes of Diseases, Disabilities and Death (ICD) by the World Health Organization. The underlying cause of death is defined as the disease or injury that initiated the series of events that directly led to death. For example, if a person with diabetes dies of heart failure due to poor management of diabetes, the underlying cause of death is diabetes, not heart failure. (1) Mortality shows Japan's crude death rate by calendar year and age-adjusted death rate. The mortality rate has been on a downward trend since 1950 (Showa 25), but an upward trend in the crude death rate can be seen since 1990 (Heisei 2). The crude death rate is calculated simply as the number of deaths divided by the population. In populations with many elderly people and few young people, the crude death rate tends to be higher than in other populations. Therefore, the age-adjusted death rate is calculated by assuming a certain age structure and calculating the death rate under those circumstances. In recent years, the crude death rate has been on the rise due to the aging of the population, but due to improved sanitary conditions, the age-adjusted death rate has been on the decline. Also, around 1950 (Showa 25), there were many young people, so the age-adjusted death rate was higher than the crude death rate. shows a comparison of age-specific mortality rates in Japan since 1935. It shows high mortality rates among the elderly and among newborns and infants. Also, the small peak around age 20 in 1935 indicates that many young people died from tuberculosis. shows an international comparison of crude death rates, age-standardized death rates and infant mortality rates. It can be seen that Japan's age-standardized death rate is low compared to other developed countries. To calculate the death rate, the population, which serves as the denominator, must be obtained accurately. This is easy to do in developed countries, but is often difficult in developing countries. However, the number of deaths aged 50 and over out of the total number of deaths is easy to obtain even in developing countries. This indicator is called the 50 and over mortality ratio (PMI or PMR). (2) Cause of Death shows age-adjusted mortality rates by major cause of death and by sex in Japan by calendar year. According to this, cerebrovascular disease used to be the leading cause of death, but this has dropped significantly, and malignant neoplasms (epithelial cancer, non-epithelial cancer = when written in kanji as cancer, strictly speaking it refers only to epithelial cancer) have been the leading cause since around 1980. This too is showing a declining trend. Between 1935 and 1950, tuberculosis was the leading cause. The decline in age-adjusted mortality rates by cause of death shows the success of measures against that disease. In recent years, the leading causes of death by age group are congenital malformations, deformities, and chromosomal abnormalities in people aged 0, accidental accidents in people aged 1 to 19, suicide in people aged 20 to 39, malignant neoplasms in people aged 40 to 89, heart failure in people aged 90 to 99, and senility in people aged 100 or over. The age-adjusted mortality rates for the three major diseases, malignant neoplasms, heart disease, and cerebrovascular disease, are shown in . The values for these diseases are on a downward trend. This means that the measures taken against these diseases are not entirely wrong. and show the annual trends in age-adjusted death rates for malignant neoplasms by sex and site in Japan. From these figures, we can see that the most common causes of death from malignant neoplasms by site in recent years are lungs (trachea, bronchi and lungs), stomach, and liver in men, and colon and stomach in women. It is important to take measures against cancer in sites where the death rate is increasing and in sites where the death rate is still high. In international comparison with developed Western countries, Japan's age-adjusted mortality rate for stomach cancer is high, but that for ischemic heart disease is low. External causes of death include accidents, suicide, homicide, etc. shows the proportion of external causes of death to all deaths in Japan by age group in 2005 (Heisei 17), which indicates the high rate of external causes of death among young people. show the annual trends in suicide mortality rates by gender and age group in Japan since 1950 (Showa 25). From these figures, we can see that there has been a significant increase in the suicide mortality rate and total number of suicides among men in their 30s to 50s. The background to this is said to be the decline in labor distribution rates among companies due to the recession following the collapse of the bubble economy, specifically the widening social gap caused by low wages and unstable employment for non-regular workers. It can be interpreted that if this situation is left unchecked, there is a risk that Japanese society will fall into great chaos. [Minoru Sugita] Maternal mortalityshows an international comparison of maternal mortality rates by calendar year. This table shows that Japan's maternal mortality rate has dropped significantly, approaching that of Western countries. However, it is still somewhat higher than low-rate European countries, and the decline since the late 1990s has not been large. In order to make international comparisons, the denominator in this table is not the risk population, and the maternal mortality rate is calculated per 100,000 births. In reality, this should be calculated per 100,000 births. However, births include live births and stillbirths. [Minoru Sugita] stillbirthIn vital statistics, a stillbirth refers to the birth of a dead baby after 12 full weeks of pregnancy. Stillbirths are further divided into natural and induced stillbirths. shows stillbirths and perinatal deaths in vital statistics, as well as the period during which induced abortions are possible under the Maternal Protection Act, while shows the annual changes in Japan's stillbirth rate. A downward trend in stillbirth rates has been evident since around 1960. There was a spike in 1966, but this was an abnormal situation resulting from a superstition against women born in the year of the horse (Hinoeuma). Looking at stillbirths by gestational age, most occur in the early stages of pregnancy. Induced stillbirths occur before the 22nd week of pregnancy as stipulated by the Maternal Protection Act, and rarely occur after that. Spontaneous stillbirths decrease from the early stages of pregnancy as the pregnancy progresses. The stillbirth rate by age of the mother is lowest for those aged 25-29. [Minoru Sugita] Perinatal deathsPerinatal deaths include stillbirths after 22 weeks of pregnancy and early neonatal deaths less than one week after birth. The perinatal mortality rate is calculated per 1,000 births and stillbirths after 22 weeks of pregnancy. A remarkable decrease has been observed, and Japan is one of the countries with the lowest perinatal mortality rates when compared internationally. [Minoru Sugita] Infant deathInfant mortality refers to death within the first year of life. shows an international comparison of annual trends in infant mortality rates. Japan is one of the countries with the lowest infant mortality rates due to a significant decrease ( ). The most common causes of infant deaths these days are congenital malformations and chromosomal abnormalities. Infant mortality is also a very important indicator from the perspective of social science. In 1976, French demographer E. Todd predicted the collapse of the Soviet Union 15 years later, based on a slight increase in infant mortality in the Soviet Union between 1970 and 1974. The infant mortality rate is the best indicator to comprehensively express the smooth functioning of a social system. Japan's figure has been the lowest in the world since around 1980, so Japan can be proud of the good condition of its social and medical systems. In 2002, Todd also pointed out the failure of racial integration in the United States, based on a slight increase in infant mortality among African-Americans between 1997 and 1999. Incidentally, the infant mortality rate in the United States has been the highest among developed countries since the mid-1980s. [Minoru Sugita] Marriage and DivorceIn recent years, Japan has seen a plateau in marriage rates and an upward trend in divorce rates. There is a notable increase in the age of wives when first-time couples enter married life. [Minoru Sugita] Life Tables and Life ExpectancyLife tablesLife tables assume a stationary population, where the increase or decrease in population between generations is exactly zero and steady state. In other words, there is a constant number of births and a constant age-specific mortality rate each year. A life table is a table in which a constant number of newborns decrease in number with age under a constant age-specific mortality rate. From a life table, it is possible to calculate how many years on average a person of a certain age can expect to survive. This value is the average life expectancy at that age. In particular, the average life expectancy at age 0 is called life expectancy. The function used to calculate this table is called the life function. Given the age-specific mortality rates for a country (region) in a given year, it is possible to create a life table. The Ministry of Health, Labor and Welfare creates life tables by calculating age-specific mortality rates from Japan's annual vital statistics. Accurate complete life tables are created for years when the population census is conducted, and simplified life tables are created for other years. If we focus on a group of people born in a certain calendar year in a certain country (region) and give the age-specific mortality rates for that generation, we can create a life table for that generation. This is called a generation life table. In addition, life tables can be created by looking at the age-specific mortality rates for a particular cause of death, or excluding that cause of death, such as life tables for cancer patients looking at the prognosis for different treatments, or life tables for those who are completely successful in overcoming cancer-related mortality. [Minoru Sugita] Life expectancy and life expectancyand show the annual trends in Japan's life expectancy by age and sex, and by country and sex. These figures show a remarkable increase in Japan's life expectancy (lifespan). In particular, makes it clear that Japan is the country with the longest life expectancy. In the life table in , the survival rate up to a certain age indicates Japan's increased longevity. The main reasons for the increase in Japan's life expectancy (lifespan) are the decline in infant mortality due to improved sanitary conditions, and the decline in the mortality rate from cerebrovascular disease. In recent years in Japan, the disease that has contributed the greatest increase in life expectancy due to overcoming disease-specific mortality is malignant neoplasms, which is about 4 years for men and 3 years for women, respectively. shows the relationship between average life expectancy by country and gross domestic product (GDP) per capita. According to this, average life expectancy increases up to about US$5,000 per capita GDP, but there is no increase in average life expectancy if the GDP increases beyond that. This shows that a certain level of economic wealth is necessary, but that incomes greater than that are ineffective in improving health standards. [Minoru Sugita] Other Health StatisticsWhile there are few delays, falsehoods, or inaccuracies in reporting birth and death statistics, there are many cases of illness involving these. Therefore, when discussing statistics other than birth and death statistics, there are many cases where errors and biases must be taken into consideration. Examples of statistics on disease, health, and lifestyle compiled by government agencies include "Survey on Trends in Infectious Diseases," "Food Poisoning Statistics," "Basic Survey on National Living Conditions," "Patient Survey," "National Health and Nutrition Survey," "Survey of Doctors, Dentists, and Pharmacists," "Reports on Health Administration Operations," "Survey of Medical Facilities," "Hospital Reports," "Survey on Medical Treatment Seeking Behavior," "Examples of Health Administration Reports," "Reports on Regional Insurance and Elderly Insurance Operations," "National Medical Expenditures," "Annual Report on the Status of National Health Insurance Medical Benefits," "Survey on Occupational Diseases," and "School Health Statistics Survey." shows the evolution of national medical expenses. As shown in the figure, both the absolute amount and its ratio to national income have risen sharply due to the effects of aging, which has become a major political issue. In terms of living environment, in 2005 the coverage rate of running water in Japan was nearly 100%, while that of sewerage was around 70%, showing a marked discrepancy. [Minoru Sugita] "Inequality is Harmful to Health," translated and supervised by Nishi Nobuo, Takao Soji, and Nakayama Takeo (2004, Nippon Hyoronsha)" ▽ "Health Disparity Society: What is Undermining Mind and Health?" by Kondo Katsunori (2006, Igaku Shoin)" ▽ "E. Todd, La chute finale: Essai sur la décomposition de la sphére soviétique (1976, Laffont, Paris)" ▽ "E. Todd, Aprés l'empire: Essai sur la décomposition du systéme américain (2002, Gallimard, Paris)" ▽ "I. Kawachi, BP Kennedy, The Health of Nations: why inequality is harmful to your health 44 (2002, The New Press, New York)" [Reference items] | |(1) is the population as of October 1st of each year (Okinawa Prefecture was not included until 1970). (2) is the increase or decrease from October of the previous year to September of the current year divided by the previous year's population. * is the estimated population after interpolation (interpolation refers to retroactively correcting past estimated populations using confirmed numbers from the census and vital statistics). Note: Sources are the Statistics Bureau of the Ministry of Internal Affairs and Communications' "Annual Population Census Report" and "Estimated Population as of October 1st, 2007" (Health and Welfare Statistics Association's "National Health Trends 2008") ©Shogakukan "> Japan's population trends (Table 1) Note: Source: National Institute of Population and Social Security Research, "Japan's Future Population Projections" (December 2006 estimate) (based on the Health Statistics Association's "National Health Trends 2007" ) Japan's Future Population Projections (Table 2) * indicates approximate number, △ indicates negative number. Note: Source: Ministry of Health, Labor and Welfare "Vital Statistics" (Health Statistics Association "National Health Trends 2007") ©Shogakukan "> Overview of Vital Statistics and Total Fertility Rate (Table… The table shows the ratio to a population of 1,000. * indicates approximate figures. The crude death rate is simply called the death rate because it is listed together with the age-adjusted death rate. The base population for the age-adjusted death rate is the "model population for 1985," and it was calculated based on the death rate by 5-year age group. Note: Source: Ministry of Health, Labor and Welfare, "Vital Statistics" (Health and Welfare Statistics Association, "National Health Trends 2008") ©Shogakukan "> Trends in crude and age-adjusted mortality rates [Table 4] The crude death rate is simply called the death rate because it is written together with the age-adjusted death rate. The standard population for the age-adjusted death rate is the world population. Japan is the same, so it differs from [Table 4]. Note: Sources are the Ministry of Health, Labor and Welfare's "Vital Statistics," WHO "," and UN "" (Health Statistics Association's "National Health Trends 2008") ©Shogakukan "> Crude mortality rate, age-adjusted mortality rate, infant mortality rate… The table shows the ratio per 100,000 births. *1 Germany's figures up to 1980 are for the former West Germany. *2 UK's figures up to 1980 are for England and Wales. Note: Sources are the Ministry of Health, Labor and Welfare's "Vital Statistics" and UN "2003" (Health Statistics Association's "National Health Trends 2008") ©Shogakukan "> International comparison of maternal mortality rates by calendar year [Table 6] The population of people aged 90 and over is omitted. Estimated as of October 1, 2006 (Heisei 18) Note: Source: Statistics Bureau of the Ministry of Internal Affairs and Communications "Estimated population as of October 1, 2006" (based on the Health and Welfare Statistics Association's "National Health Trends 2007") ©Shogakukan Japan's population pyramid (Figure A) Note: Actual values from 1955 to 2005 are from the Ministry of Internal Affairs and Communications Statistics Bureau's "Population Census Report," and estimates from 2006 onwards are from the median estimates of the National Institute of Population and Social Security Research's "Japan's Future Population Projections" (December 2006 estimates) (based on the Health Statistics Association's "National Health Trends 2007") . Trends in population composition by age and future projections (Figure… As of 2005 (Heisei 17) Note: Source: Statistics Bureau of the Ministry of Internal Affairs and Communications, "Heisei 17 Census Report" (based on the Health and Welfare Statistics Association, "National Health Trends 2007") ©Shogakukan Age distribution of population by marital status (Figure C) Note: Source: Ministry of Health, Labor and Welfare "Vital Statistics" (Health Statistics Association "Trends in National Health 2007") ©Shogakukan Trends in birth numbers and total fertility rates (Figure D) The figure shows the ratio to the population of 1,000 Japanese women by age. Note: Source: Ministry of Health, Labor and Welfare "Vital Statistics" (Health Statistics Association "Trends in National Health 2007") ©Shogakukan Comparison of birth rates by calendar year according to mother's age (Figure E) Germany's figures up to 1991 are for the former West Germany. UK figures up to 1985 are for England and Wales. Japan's figures for 2006 are approximate figures. Note: Sources are the Ministry of Health, Labor and Welfare's "Vital Statistics," the National Institute of Population and Social Security Research's "Population Statistics Collection," the UN, Council of Europe, NCHS, and EU (based on the Health Statistics Association's "National Health Trends 2007"). ©Shogakukan "> International comparison of total fertility rates (Figure F) The figure shows the ratio to a population of 1,000. Note: Source: Ministry of Health, Labor and Welfare "Vital Statistics" (Health and Welfare Statistics Association "National Health Trends 2007") ©Shogakukan Annual comparison of mortality rates by age group (Figure G) The figure shows the ratio per 100,000 population. The standard population for age-adjusted mortality rates is the "Model population for 1985." Also, up until 1994, the figures were based on the old classification. Note: Source: Ministry of Health, Labor and Welfare "Vital Statistics" (Health Statistics Association "National Health Trends 2007") ©Shogakukan Trends in age-adjusted mortality rates by major cause of death (males) [… The figure shows the ratio per 100,000 population. The standard population for age-adjusted mortality rates is the "Model population for 1985." Also, up until 1994, the figures were based on the old classification. Note: Source: Ministry of Health, Labor and Welfare "Vital Statistics" (Health Statistics Association "National Health Trends 2007") ©Shogakukan Trends in age-adjusted mortality rates by major cause of death (female) The figure shows the ratio per 100,000 population. (1) Large intestine refers to the colon, rectosigmoid junction, and rectum. However, until 1965, the rectal anal region was included. (2) Colon is a repeat of the large intestine. (3) Liver refers to the liver and intrahepatic bile duct. (4) The reference population for age-adjusted mortality rates is the "Model population for 1985." Note: Source: Ministry of Health, Labor, and Welfare, "Vital Statistics" (Health and Welfare Statistics Association, "National Health Trends 2007") ©Shogakukan "> Changes in age-adjusted mortality rates for malignant neoplasms by site… The figure shows the ratio per 100,000 population. (1) Large intestine refers to the colon, rectosigmoid junction and rectum (however, up until 1965, it included the rectal anal region). (2) Colon is a repeat of the large intestine. (3) Liver refers to the liver and intrahepatic bile duct. (4) The reference population for age-adjusted mortality rates is the "Model population for 1985." Note: Source: Ministry of Health, Labor and Welfare, "Vital Statistics" (Health and Welfare Statistics Association, "National Health Trends 2007") ©Shogakukan "> Changes in age-adjusted mortality rates for malignant neoplasms by site… External causes of death include accidents, suicide, and homicide. Note: Source: Ministry of Health, Labor and Welfare, "Vital Statistics" (Health and Welfare Statistics Association, "National Health Trends 2007") ©Shogakukan Proportion of external causes of death to total deaths by age group [... The figure shows the ratio per 100,000 population. Note: Source: Ministry of Health, Labor and Welfare "Vital Statistics" (Health and Welfare Statistics Association "National Health Trends 2008") ©Shogakukan Changes in suicide mortality rates by age group (male) [Figure... The figure shows the ratio per 100,000 population. Note: Source: Ministry of Health, Labor and Welfare "Vital Statistics" (Health and Welfare Statistics Association "National Health Trends 2008") ©Shogakukan Changes in suicide mortality rates by age group (female) [Figure... ○ indicates less than 1. This is limited to emergency evacuation to save the life of the mother (from the "Death Certificate, Birth Certificate, and Stillbirth Certificate Filling Manual" (1997 edition)) *2. Since 1991 (Heisei 3), the conventional "before 23 weeks of pregnancy" became "less than 22 weeks of pregnancy" Note: According to the Health Statistics Association's National Health Trends 2007 ©Shogakukan "> Stillbirth, perinatal death, and abortion [Figure L] The figure shows the ratio of births to 1,000: Note: The document is based on the Ministry of Health, Labor and Welfare's "Vectoral Statistics" (according to the Health and Welfare Statistics Association's "National Health Trends 2007") ©Shogakukan "> Trends in stillbirth rates [Figure M] The figure shows the ratio of 1,000 births. Until 1990, the figures for the former West Germany. The figures for the UK and France were provisional for 2003 Note: The documents are for the Ministry of Health, Labor and Welfare's "Vectoral Statistics", WHO "", UN " 2003", and UN " (according to the Health Statistics Association's "National Health Trends 2007") ©Shogakukan "> International comparison of changes in infant mortality rates [Figure N] Note: The materials are based on the Ministry of Health, Labor and Welfare's "Simple Life Table" and "Complete Life Table" (according to the Health Statistics Association's "National Health Trends 2007") ©Shogakukan "> Trends in average life expectancy by gender age [Figure O] Numerical notes from Germany before 1990 and former West Germany: Materials include "" etc. (according to the Health Statistics Association's National Health Trends 2007) ©Shogakukan "> Comparison of average life expectancy by country and gender [Figure P] Until 2000 and 2005 are based on the complete life table. Before 1970, numerical notes except for Okinawa Prefecture are based on the Ministry of Health, Labor and Welfare's "Simple Life Table" and "Complete Life Table" (according to the Health Statistics Association's "National Health Trends 2007") ©Shogakukan "> Survival rates up to a specific age on the life table [Figure Q... Note: Materials are available at Kawachi I, Kennedy BP., The New Press, New York, 2002 (according to the UN Development Programme, Human Development Report) ©Shogakukan "> Average life expectancy by country and GDP per person (G… Note: The documents are based on the Ministry of Health, Labor and Welfare's National Medical Expenses (according to the Health and Welfare Statistics Association's National Health Trends 2007) ©Shogakukan "> Trends in national medical expenses and national income ratio [Figure S] Source: Shogakukan Encyclopedia Nipponica About Encyclopedia Nipponica Information | Legend |
衛生統計とは衛生統計の意味衛生統計とは、人間集団の健康に関する情報に適切な処理をして、その集団の健康特性を表現したものである。健康情報には、死亡や疾病のように人間の身体そのものが情報の発生源であるものと、それ以外の国民医療費や下水道の普及率などがある。 また、その指標には絶対的な値と相対的な値がある。衛生統計で相対的な値は、ある集団で人口何人当り、ある期間あるいは一時点で健康に関する事象の発生件数（量）あるいは保有件数（量）の大きさを示す。たとえば、日本の2006年（平成18）の死亡率は人口1000人当り8.6件であった、などである。衛生統計はその集団の健康（衛生）状況を表現するものである。その相対的な指標を時間的空間的に比較することができる。たとえば、日本の1950年（昭和25）の死亡率は2000年の値よりかなり高かった、などである。 率は分子／分母で計算される。両者の関係として、「分子」の事象の発生や保有は「分母」の中からという原則がある。子宮癌(がん)は女性のみ罹患し、決して男性は罹患しない疾患である。子宮癌に関し、女性は危険人口（population at risk）であるという。 衛生統計を作成する目的は、ある人間集団あるいは全人類の平和・安寧と繁栄に役だてるためで、とくに健康に関する経済的・非経済的利益の獲得のためである。衛生統計は公衆衛生活動にとくに有用である。ある集団のある健康指標が劣悪であれば、その問題点を認識でき、解決のための対策行動を計画して実施できる。対策行動実施後、健康指標の改善の程度を知ることにより、評価が可能となる。それにより、改良された健康対策行動が再度実施できる。この種の循環（PDCAサイクル）が適切であれば、その集団の健康度のさらなる上昇が期待できる。 実例として、インフルエンザによる死亡とインフルエンザワクチンの接種の関係がある。1999年（平成11）の日本のインフルエンザおよびそれに関連した死亡率とワクチンの接種率を欧米先進国と比較して、死亡率が高く、接種率が低いとの情報が得られた。そこで、ワクチンの接種率を欧米先進国なみにする公衆衛生政策が計画され、実施されている。その後の日本のインフルエンザによる死亡率をみることにより、ワクチンの接種率上昇という公衆衛生政策が評価される。もしインフルエンザによる死亡率低下が不十分ならば、接種率のさらなる上昇という政策などが考慮されよう。 ［杉田 稔］ 人口統計人口統計は衛生統計の一部で、それには人口静態統計と人口動態統計がある。前者はある一時点の人口で、後者はある期間の出生や死亡などの人口の出入りである。 ［杉田 稔］ 衛生統計作成機関衛生統計を取扱っている公的機関は、日本では総務省統計局、厚生労働省統計情報部、環境省、文部科学省などで、国際機関では国際連合（UN）、世界保健機関（WHO）などである。民間会社としては保険会社などがある。また、学術団体として、病理剖検輯(しゅう)報を作成している日本病理学会などがある。 ［杉田 稔］ 人口静態統計人口静態統計とはある一時点の人口である。この情報は5年ごとに行われる国勢調査によって得られる。調査項目は氏名、性、生年月、所帯主との続柄、配偶関係、国籍などであり、その時点の性年齢別国籍別人口が得られる。これは時間空間的に比較可能である。国勢調査が実施されない年では、諸情報によりその概数を推定している。 ［杉田 稔］ 日本の全国人口日本の全国人口、増加率、人口密度、人口性比の年次推移をに示す。これによると2004年に日本の人口は最大となった。 ［杉田 稔］ 性年齢別人口性年齢別に人口をのように示したものを人口ピラミッドという。人口の高齢化、少子化、戦争の影響などを視覚的に認識できる。これを地域暦年別に作成すれば、その人口の質の比較が視覚的に可能となる。2006年の人口ピラミッドは底辺が狭く、少子化を示している。これに対し、1935年（昭和10）の日本の人口ピラミッドはほぼ二等辺三角形で、若年層の多かったことが示される。 人口を年齢別に、0～14歳を年少人口、15～64歳を生産年齢人口、65歳以上を老年人口という。この割合を、将来推計を含め、暦年別にに示す。ここから、人口の老齢化と少子化の急速な進行が読みとれる。 ［杉田 稔］ 労働力人口労働力人口とは就業の意思がある者で、就業者と完全失業者に分類できる。バブル経済の崩壊後に完全失業者数（率）の上昇が現れている。なお、就業の意思がない者を非労働力人口という。 ［杉田 稔］ 配偶関係別人口配偶関係は未婚、有配偶、離別、死別と分類できる。2005年（平成17）の人口ピラミッドにそれらを載せたものをに示す。ここから最近の晩婚傾向が分かる。 ［杉田 稔］ 世帯数核家族化の進行と一人暮らしの増加で、世帯数の増加と1世帯当りの人員の減少が観察されている。 ［杉田 稔］ 将来推計人口諸情報より、将来の人口を推計できる。2004年ごろに日本の人口は約1億2790万人で最大となり、その後減少しつつあると推測できる。日本の将来推計人口をに示す。この表によると、今後年少人口の減少と老年人口の増加が予想され、さらなる人口の老齢化が進行するであろう。 ［杉田 稔］ 都道府県別人口都道府県別に人口をみると、2006年の東京都の1266万人が最多で鳥取県の60万人が最少であった。年齢別では、大都市とその周辺で生産年齢人口が多く、地方で老年人口が多い。人口増加（減少）を自然増（減）と社会増（減）に分解できる。自然増は出生と死亡の差で、社会増は転入と転出の差である。若者の集まる大都市とその周辺では人口の社会増が大きくなる。一方、地方では若者が転出するから、人口の社会増が小さくあるいは負になる。それらの値が負の場合を、自然減、社会減という。 ［杉田 稔］ 国別人口2004年で人口の多い国として、約13億人の中国と約11億人のインドがあげられる。人口の年間増加率を国別にみると、先進国で小さくあるいは負で、開発途上国では正で大きい。 ［杉田 稔］ 人口動態統計人口動態統計とは人口の自然増減をみるもので、出生、死亡、死産、婚姻と離婚である。死亡に関しては重複するが、母子保健の有効な指標として、妊産婦死亡、周産期死亡と乳児死亡を加えている。これらの統計数値を時間空間別原因別で比較することにより、対象集団の衛生水準を知ることができる。に、日本の2005～06年の人口動態統計と、合計特殊出生率の概況を示す。日本など先進国の人口静態統計や人口動態統計などの衛生統計はその信頼性が高いが、開発途上国ではその信頼性の低さが問題になることが多い。 死亡に関しては医師による死亡診断書、出生と死産に関してはそれに立ち会った者による証明書、婚姻と離婚に関しては当事者による届出書の情報が厚生労働省に集められて、集計される。 ［杉田 稔］ 出生に日本の出生率と合計特殊出生率の推移を示す。ここからその低下傾向がみてとれる。母の年齢別にみた出生率の暦年比較を示したからは、出産時の母の高齢化がわかる。 (1)人口の再生産率 人口の再生産率とは世代間の人口の増減を示す諸指標である。このうち合計特殊出生率は、女性が一生に生む子どもの数の平均値である。日本での推移がに示されている。その値が2強のとき、世代間での人口の増減が0となる。そのような状況でも、その時点の人口の増減は起こる。たとえば、出産可能年齢の女性が多い社会では人口増となり、高齢層の多い社会では人口減となる。実例として、1995年の日本の合計特殊出生率は1.42であったが、人口は増加していた。しかし、この状態が持続すれは、いずれ人口は減少に転ずる。世代間での人口の増減が0の状態で長期間持続すれは、いずれ人口の増減はなくなる。このような定常状態を静止人口という。 (2)都道府県別合計特殊出生率 最近では、生産年齢人口が大きい大都市とその周辺で人口の合計特殊出生率が低く、生産年齢人口が小さい地方でその値が高い。 (3)国別合計特殊出生率 に合計特殊出生率の国際比較を示す。日本の値の低さがわかる。 ［杉田 稔］ 死亡医師が記載する死亡診断書の情報を厚生労働省で収集して、死亡統計が作成される。死亡診断書には死因が記載され、世界保健機関による国際疾病障害死因分類（ICD）の規則によって、原死因が決定される。原死因の定義は直接に死亡を引き起こした一連の事象の起因となった疾病または損傷である。たとえば、糖尿病に罹患した人が、その管理が不十分で心不全により死亡した場合、その原死因は心不全ではなく糖尿病である。 (1)死亡率 に、日本の暦年別粗死亡率と年齢調整死亡率を示す。死亡率は1950年（昭和25）からは低下傾向だが、1990年（平成2）から粗死亡率の上昇傾向が認められる。 粗死亡率は単純に死亡数／人口で計算される。高齢者が多く若年者の少ない集団では、そうでない集団と比較して、粗死亡率が大きくなりがちである。そこで、ある年齢構成を仮定して、その状況下での死亡率を計算した値が年齢調整死亡率である。近年は人口の高齢化により粗死亡率は上昇傾向だが、衛生状態の改善により、年齢調整死亡率は低下傾向である。また、1950年（昭和25）ころは若年者が多かったから、年齢調整死亡率の方が粗死亡率より大きかった。 に、日本の1935年からの年齢階級別死亡率の年次比較を示す。ここから老年層と新生児・乳児の高死亡率がわかる。また、1935年の20歳前後の小さなピークは結核による青少年層の死亡が多かったことを示している。 に、粗死亡率、年齢調整死亡率と乳児死亡率の国際比較を示す。他の先進国と比較して日本の年齢調整死亡率の低さが認められる。死亡率を計算するには分母となる人口が正確に得られていなければならない。先進国ではそのことは容易だが、開発途上国では困難なことが多い。しかし、全死亡者数に占める50歳以上の死亡者数であれば開発途上国でも入手容易である。この指標を50歳以上死亡比（PMIまたはPMR）という。 (2)死因 に、日本の暦年別性別主要死因別年齢調整死亡率を示す。これによると、以前は脳血管疾患が死因別死亡率の首位であったが、顕著に低下し、悪性新生物（上皮性癌(がん)、非上皮性がん＝癌と漢字で表記する場合厳密には上皮性のもののみをさす）が1980年ころより首位となっている。また、それも低下傾向にある。なお、1935～50年は結核が首位であった。死因別年齢調整死亡率の低下はその疾病に対する対策の成果を示している。 最近の年齢別死因別死亡率の首位は、0歳で先天奇形・変形および染色体異常、1～19歳で不慮の事故、20～39歳で自殺、40～89歳で悪性新生物、90歳～99歳で心不全、100歳以上で老衰である。 悪性新生物、心疾患、脳血管疾患の三大疾患の年齢調整死亡率はに示されており、これらの疾患の値は低下傾向にある。これは、これらの疾病に対する諸対策が大きく間違ってはいないことを意味する。 に、日本の性別部位別悪性新生物の年齢調整死亡率の年次推移を示す。この図から、最近の部位別悪性新生物の死亡率は、男性では肺（気管、気管支と肺）、胃、肝の順、女性では大腸、胃の順であることがわかる。死亡率の増加傾向にある部位およびまだ死亡率の高い部位の癌対策が重要である。 欧米先進国と国際比較をすると、日本の胃癌の年齢調整死亡率は高く、虚血性心疾患では低いことが特徴である。 外因死とは不慮の事故、自殺、他殺などをいう。に示した2005年（平成17）の日本の年齢階級別外因死の全死亡に占める割合から、青少年層の外因死の多さがわかる。 に1950年（昭和25）以降の日本の性年齢階級別自殺の死亡率の年次推移を示す。この図から、30～50歳代男性の自殺死亡率とその総数の増加が顕著であることがわかる。この背景として、バブル経済崩壊後の不景気により企業が労働分配率を低下させたこと、具体的には非正規労働者の低賃金と不安定雇用による社会格差の拡大が指摘されている。この状態の放置は日本社会が大混乱に陥るリスクとなる、と読み取れる。 ［杉田 稔］ 妊産婦死亡に暦年別妊産婦死亡率の国際比較を示す。この表から日本の妊産婦死亡率は顕著に低下し、欧米諸国に近づいたことがわかる。しかし、依然としてヨーロッパの低率国より多少高く、1990年代後半からの下落は大きくはない。 なお、この表では国際比較のため、分母が危険人口ではなく、また妊産婦死亡率を出生10万件当りで計算している。本来はこれを出産10万件当りで計算すべきである。ただし、出産とは、出生（生産）と死産である。 ［杉田 稔］ 死産人口動態統計で死産とは、妊娠満12週以後の死児の出産をいう。また、死産を自然死産と人工死産に分ける。に人口動態統計における死産と周産期死亡および母体保護法による人工妊娠中絶の可能な期間を、に日本の死産率の年次推移を示す。死産率は1960年ころ以降減少傾向が認められる。なお1966年に突出があるが、これは丙午(ひのえうま)生まれの女性に対する迷信から生まれた異常な事態である。 死産を妊娠期間でみると、妊娠初期が多い。人工死産は母体保護法により妊娠満22週未満と規定されているため、それ以後はほとんどない。自然死産は妊娠初期から妊娠週数とともに減少する。母親の年齢別死産率は25～29歳でもっとも低い。 ［杉田 稔］ 周産期死亡周産期死亡とは妊娠満22週以後の死産と生後1週未満の早期新生児死亡をあわせたものである。周産期死亡率は出生と妊娠満22週以後の死産数の合計1000当りで計算される。顕著な減少がわかり、国際比較をしても日本は周産期死亡率でもっとも低い国々に属する。 ［杉田 稔］ 乳児死亡乳児死亡とは生後1年未満の死亡をいう。に乳児死亡率の年次推移の国際比較を示す。日本は乳児死亡率の顕著な減少により、そのもっとも低い国々に属する（）。最近の乳児死亡の原因は、先天奇形・変形および染色体異常がもっとも多い。 乳児死亡率という指標は社会科学の面からも非常に重要である。1976年にフランスの人口学者トッドE. Toddは、ソ連における1970～74年の乳児死亡率がすこし上昇したことから、15年後のソ連崩壊を予想した。乳児死亡率は社会システムの順調さを総合的に表現するもっとも良好な指標である。日本のこの数値は1980年頃以降世界最低であるから、日本の社会・医療システムの良好性を自負できる。また、トッドは1997～99年の間にアフリカ系アメリカ人の乳児死亡率がすこし上昇したことから、アメリカの人種統合の失敗を2002年に指摘した。ちなみに、アメリカの乳児死亡率は1980年代なかば以降先進国中で最高である。 ［杉田 稔］ 婚姻と離婚近年の日本では婚姻率の横ばい傾向と離婚率の上昇傾向が認められる。 初婚の夫婦の結婚生活に入ったときの妻の年齢の上昇が顕著である。 ［杉田 稔］ 生命表と平均余命生命表生命表は世代間の人口の増減がちょうど0の定常状態である静止人口を仮定している。つまり、毎年一定の出生数と一定の年齢別死亡率の状態である。一定数の新生児が一定の年齢別死亡率のもとで年齢上昇とともに数を減少させていく表が生命表である。生命表から、ある年齢の人が平均あと何年生存できるか計算できる。この値がその年齢の平均余命である。特に、0歳の平均余命を平均寿命という。この表の計算に使用される関数を生命関数という。 ある年のある国（地域）の年齢別死亡率が与えられると、その生命表を作成できる。厚生労働省は毎年の日本の人口動態統計から、年齢別死亡率を算出して、生命表を作成している。国勢調査実施年に関しては正確な完全生命表が、それ以外の年に関しては簡易生命表が作成される。 ある国（地域）である暦年に生まれた集団に着目して、その世代の年齢別死亡率が与えられれば、その世代の生命表が作成されうる。これを世代生命表という。 また、特定の疾患による死亡に着目して、その死因による年齢別死亡率あるいはその死因を除外した年齢別死亡率から、生命表を作成できる。たとえば、癌患者の治療法別予後をみる生命表、癌による死亡を完全に克服できた場合の生命表である。 ［杉田 稔］ 平均余命と平均寿命とに日本の性年齢別平均余命と国別性別平均寿命の年次推移を示す。これらの図から、日本の平均余命（寿命）の顕著な上昇がわかる。とくに、からは日本が最長寿国であることが判明する。の生命表上で、特定年齢までの生存割合は日本の長寿化を示している。日本の平均余命（寿命）の延長の大きな原因は、衛生状態の改善による乳児死亡率低下と、脳血管疾患死亡率の低下などである。 日本の近年の傾向として、疾患別死亡克服による平均寿命の延長が最大のものは悪性新生物である。その値は、男女それぞれ4歳と3歳程度である。 国別平均寿命と1人当りの国内総生産（GDP）の関係をに示す。これによると、1人当りのGDPが5000USドル程度までは平均寿命が上昇するが、それより大きくなっても平均寿命の上昇はない。このことは、ある程度の経済的豊かさは必須だが、それより大きな収入は健康水準の向上に無効であることを示している。 ［杉田 稔］ その他の衛生統計出生や死亡に関する統計にはその届出に遅滞、虚偽や不正確はあまりないが、疾病ではそれらのことを伴う場合が少なくない。したがって、出生や死亡以外の統計を論ずるとき、その誤差や偏りを考慮しなければならないときもすくなくない。 疾病、健康や生活に関する統計で官庁が作成する例として、「感染症発生動向調査」「食中毒統計」「国民生活基礎調査」「患者調査」「国民健康・栄養調査」「医師・歯科医師・薬剤師調査」「衛生行政業務報告」「医療施設調査」「病院報告」「受療行動調査」「衛生行政報告例」「地域保険・老人保険事業報告」「国民医療費」「国民健康保険医療給付実態年報」「業務上疾病調べ」「学校保健統計調査」などがある。 国民医療費の変遷をに示す。これによると、その絶対額もその国民所得比も、高齢化の影響で急上昇していて、そのことが大きな政治問題になっている。 また生活環境として、2005年には日本の上水道の普及率はほぼ100％であるのに対し、下水道では70％程度で、その乖離(かいり)が顕著である。 ［杉田 稔］ 『西信男・高尾総司・中山健夫監訳『不平等が健康を損なう』（2004・日本評論社）』▽『近藤克則著『健康格差社会―何が心と健康を蝕むのか』（2006・医学書院）』▽『E. ToddLa chute finale: Essai sur la décomposition de la sphére soviétique （1976，Laffont, Paris）』▽『E. ToddAprés l'empire: Essai sur la décomposition du systéme américain（2002，Gallimard, Paris）』▽『I. Kawachi， B. P. KennedyThe Health of Nations: why inequality is harmful to your health 44（2002，The New Press, New York）』 [参照項目] | |(1)は、各年とも10月1日現在人口（1970年までは沖縄県を含まない）(2)は、前年10月から当年9月までの増減数を前年人口で除したもの＊は、補間補正後の推計人口（補間補正とは、国勢調査と人口動態統計の確定数により、過去の推計人口をさかのぼり、補正することをいう）注：資料は総務省統計局「各年国勢調査報告」、「平成19年10月1日現在推計人口」（厚生統計協会『国民衛生の動向2008』による）©Shogakukan"> 日本の人口の推移〔表1〕 注：資料は国立社会保障・人口問題研究所「日本の将来推計人口」〈2006年12月推計〉（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 日本の将来推計人口〔表2〕 ＊は概数、△はマイナスを表す注：資料は厚生労働省「人口動態統計」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 人口動態統計と合計特殊出生率の概況〔表… 表は、人口1000に対する比率。＊は概数。粗死亡率は、年齢調整死亡率と併記したための表記で、単に死亡率といっているものである。年齢調整死亡率の基準人口は「昭和60年モデル人口」であり、年齢5歳階級別死亡率により算出した注：資料は厚生労働省「人口動態統計」（厚生統計協会『国民衛生の動向2008』による）©Shogakukan"> 粗死亡率と年齢調整死亡率の推移〔表4〕 粗死亡率は、年齢調整死亡率と併記したための表記で、単に死亡率といっているものである。年齢調整死亡率の基準人口は世界人口である。日本も同様であるため、〔表4〕と異なる注：資料は厚生労働省「人口動態統計」、WHO“”、UN“”（厚生統計協会『国民衛生の動向2008』による）©Shogakukan"> 粗死亡率・年齢調整死亡率・乳児死亡率の… 表は、出生数10万に対する比率＊1 ドイツの1980年までは旧西ドイツの数値＊2 イギリスの1980年まではイングランド・ウェールズの数値注：資料は厚生労働省「人口動態統計」、UN“ 2003”（厚生統計協会『国民衛生の動向2008』による）©Shogakukan"> 暦年別妊産婦死亡率の国際比較〔表6〕 90歳以上人口については省略。2006年（平成18）10月1日現在推計注：資料は総務省統計局「平成18年10月1日現在推計人口」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 日本の人口ピラミッド〔図A〕 注：1955～2005年の実績値は総務省統計局「国勢調査報告」、2006年以降の推計値は国立社会保障・人口問題研究所「日本の将来推計人口」〈2006年12月推計〉の中位推計値（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 年齢別人口構成割合の推移と将来推計〔図… 2005年（平成17）現在注：資料は総務省統計局「平成17年国勢調査報告」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 配偶関係別人口の年齢構成〔図C〕 注：資料は厚生労働省「人口動態統計」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 出生数と合計特殊出生率の推移〔図D〕 図は、年齢別日本人女子人口1000に対する比率注：資料は厚生労働省「人口動態統計」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 母の年齢別にみた出生率の暦年比較〔図E… ドイツの1991年までは旧西ドイツの数値。イギリスの1985年まではイングランド・ウェールズの数値。日本の2006年は概数注：資料は厚生労働省「人口動態統計」、国立社会保障・人口問題研究所「人口統計資料集」、UN“”、Council of Europe“”、NCHS“”、EU“”（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 合計特殊出生率の国際比較〔図F〕 図は、人口1000に対する比率注：資料は厚生労働省「人口動態統計」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 年齢階級別死亡率の年次比較〔図G〕 図は、人口10万に対する比率。年齢調整死亡率の基準人口は「昭和60年モデル人口」。また、1994年までは旧分類によるもの注：資料は厚生労働省「人口動態統計」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 主要死因別年齢調整死亡率の推移（男）〔… 図は、人口10万に対する比率。年齢調整死亡率の基準人口は「昭和60年モデル人口」。また、1994年までは旧分類によるもの注：資料は厚生労働省「人口動態統計」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 主要死因別年齢調整死亡率の推移（女）〔… 図は、人口10万に対する比率(1)大腸は、結腸と直腸S状結腸移行部および直腸とを示す。ただし、1965年までは直腸肛門部を含む(2)結腸は、大腸の再掲(3)肝は、肝および肝内胆管を示す(4)年齢調整死亡率の基準人口は「昭和60年モデル人口」注：資料は厚生労働省「人口動態統計」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 部位別悪性新生物の年齢調整死亡率の推移… 図は、人口10万に対する比率(1)大腸は、結腸と直腸S状結腸移行部および直腸とを示す（ただし、1965年までは直腸肛門部を含む）(2)結腸は、大腸の再掲(3)肝は、肝および肝内胆管を示す(4)年齢調整死亡率の基準人口は「昭和60年モデル人口」注：資料は厚生労働省「人口動態統計」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 部位別悪性新生物の年齢調整死亡率の推移… 外因死は、不慮の事故、自殺、他殺など注：資料は厚生労働省「人口動態統計」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 年齢階級別外因死の全死亡に占める割合〔… 図は、人口10万に対する比率注：資料は厚生労働省「人口動態統計」（厚生統計協会『国民衛生の動向2008』による）©Shogakukan"> 年齢階級別自殺の死亡率の推移（男）〔図… 図は、人口10万に対する比率注：資料は厚生労働省「人口動態統計」（厚生統計協会『国民衛生の動向2008』による）©Shogakukan"> 年齢階級別自殺の死亡率の推移（女）〔図… ○は未満を示す※1 母体の生命を救うための緊急避難の場合などに限られる（「死亡診断書・出生証明書・死産証明書記入マニュアル」〈平成7年版〉より）※2 1991年（平成3）以降、従来の「妊娠満23週以前」が「妊娠満22週未満」となった注：厚生統計協会『国民衛生の動向2007』による©Shogakukan"> 死産と周産期死亡・人工妊娠中絶〔図L〕 図は、出産数1000に対する比率注：資料は厚生労働省「人口動態統計」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 死産率の推移〔図M〕 図は出生数1000に対する比率。ドイツの1990年までは旧西ドイツの数値。イギリスとフランスの2003年は暫定値注：資料は厚生労働省「人口動態統計」、WHO“”、UN“ 2003”、UN“”（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 乳児死亡率の推移の国際比較〔図N〕 注：資料は厚生労働省「簡易生命表」、「完全生命表」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 性年齢別平均余命の推移〔図O〕 1990年以前のドイツは旧西ドイツの数値注：資料は“”など（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 国別性別平均寿命の比較〔図P〕 2000年までおよび2005年は完全生命表による。1970年以前は沖縄県を除く数値注：資料は厚生労働省「簡易生命表」、「完全生命表」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 生命表上の特定年齢までの生存割合〔図Q… 注：資料はKawachi I, Kennedy BP. , The New Press, New York, 2002（国連開発計画『人間開発報告書』による）©Shogakukan"> 国別平均寿命と1人当りの国内総生産（G… 注：資料は厚生労働省「国民医療費」（厚生統計協会『国民衛生の動向2007』による）©Shogakukan"> 国民医療費と対国民所得比の推移〔図S〕 出典 小学館 日本大百科全書(ニッポニカ)日本大百科全書(ニッポニカ)について 情報 | 凡例 |
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