Table 2. Prevalence and correlates of deterioration of physical or mental health and current state of health during the COVID-19 pandemic, 2020, Japan.
| Respondent distribution | Physical health deteriorationa | Mental health deteriorationa | Unfavorable general health statusb | Serious psychological distressc | |||||
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| N (%) | Prevalence (%) | APR (95% CI) | Prevalence (%) | APR (95% CI) | Prevalence (%) | APR (95% CI) | Prevalence (%) | APR (95% CI) | |
| Overall | 25,482 (100) | 15.5 | — | 18.5 | — | 13.5 | — | 10.0 | — |
| Sex | |||||||||
| Male | 12,673 (49.7) | 15.5 | Ref. | 16.1 | Ref. | 14.6 | Ref. | 11.0 | Ref. |
| Female | 12,809 (50.3) | 15.5 | 1.13 (0.91–1.41) | 21.0 | 1.35 (1.10–1.66) | 12.5 | 0.94 (0.71–1.24) | 9.1 | 1.28 (1.00–1.65) |
| Age, years | |||||||||
| 15–24 | 2,813 (10.9) | 22.4 | 1.72 (1.08–2.75) | 30.9 | 2.49 (1.61–3.85) | 11.0 | 0.48 (0.23–1.01) | 28.9 | 5.31 (2.31–12.18) |
| 25–34 | 3,405 (13.2) | 21.6 | 1.86 (1.13–3.05) | 23.9 | 1.97 (1.22–3.18) | 14.8 | 0.86 (0.42–1.75) | 17.7 | 3.29 (1.48–7.28) |
| 35–44 | 4,278 (16.9) | 14.7 | 1.52 (1.06–2.16) | 18.7 | 1.65 (1.16–2.35) | 10.6 | 0.88 (0.59–1.31) | 9.4 | 2.45 (1.07–5.60) |
| 45–54 | 4,817 (18.9) | 13.5 | 1.41 (1.01–1.98) | 18.0 | 1.65 (1.16–2.33) | 12.4 | 1.03 (0.72–1.49) | 7.3 | 2.03 (0.91–4.53) |
| 55–64 | 4,017 (15.4) | 15.5 | 1.51 (1.11–2.07) | 17.4 | 1.58 (1.14–2.19) | 13.8 | 1.06 (0.78–1.43) | 4.5 | 1.33 (0.60–2.96) |
| ≥65 | 6,152 (24.8) | 11.3 | Ref. | 11.2 | Ref. | 16.6 | Ref. | 3.6 | Ref. |
| Education | |||||||||
| Junior high/high school | 8,291 (48.4) | 14.0 | 0.92 (0.73–1.17) | 17.0 | 0.87 (0.70–1.07) | 13.6 | 1.00 (0.73–1.37) | 7.7 | 0.78 (0.58–1.06) |
| Some college | 5,387 (18.2) | 14.9 | 0.95 (0.76–1.18) | 20.1 | 0.95 (0.78–1.15) | 10.6 | 0.86 (0.64–1.17) | 8.3 | 0.86 (0.65–1.14) |
| College or higher | 11,742 (33.4) | 17.7 | Ref. | 19.8 | Ref. | 14.8 | Ref. | 14.4 | Ref. |
| Income level in the past yeard | |||||||||
| ≥Baseline income (≥twice the baseline) | 12,585 (46.7) | 15.9 | Ref. | 17.1 | Ref. | 11.9 | Ref. | 10.5 | Ref. |
| ≥Baseline income (<twice the baseline) | 5,702 (23.1) | 16.7 | 1.08 (0.81–1.43) | 19.6 | 1.24 (0.99–1.55) | 15.4 | 1.17 (0.84–1.63) | 10.1 | 1.20 (0.82–1.76) |
| <Baseline income | 1,921 (8.3) | 21.9 | 1.12 (0.70–1.79) | 24.1 | 1.34 (0.89–2.02) | 23.2 | 1.37 (0.81–2.32) | 16.6 | 1.49 (1.04–2.14) |
| Indeterminate (did not answer) | 5,274 (22) | 11.0 | 0.71 (0.58–0.87) | 18.4 | 1.08 (0.88–1.33) | 11.4 | 0.94 (0.71–1.26) | 6.4 | 0.82 (0.61–1.10) |
| Marital status | |||||||||
| Married | 15,230 (63.2) | 13.4 | Ref. | 16.3 | Ref. | 12.1 | Ref. | 5.9 | Ref. |
| Single | 7,806 (23.7) | 15.5 | 0.95 (0.79–1.14) | 22.4 | 0.96 (0.82–1.12) | 13.1 | 1.27 (0.93–1.72) | 11.6 | 0.96 (0.77–1.21) |
| Divorced/widowed | 2,446 (13.1) | 25.7 | 1.25 (0.88–1.76) | 22.0 | 0.93 (0.63–1.37) | 21.3 | 1.29 (0.87–1.91) | 27.0 | 1.55 (1.01–2.47) |
| Employment/occupation | |||||||||
| Full-time employee | 9,513 (34.9) | 14.3 | Ref. | 19.0 | Ref. | 10.3 | Ref. | 9.9 | Ref. |
| Self-employed | 1,645 (7.9) | 19.6 | 1.27 (0.78–2.07) | 15.3 | 0.82 (0.48–1.41) | 14.2 | 0.98 (0.54–1.80) | 21.6 | 1.68 (0.94–3.02) |
| Part-time employee, contractor | 4,296 (19.1) | 16.2 | 1.07 (0.77–1.48) | 19.8 | 0.92 (0.71–1.20) | 14.0 | 1.13 (0.70–1.81) | 12.1 | 0.99 (0.75–1.31) |
| Unemployed (retired, student, domestic worker) | 10,028 (38.2) | 15.4 | 1.31 (0.94–1.81) | 18.1 | 0.98 (0.74–1.29) | 16.1 | 1.55 (1.02–2.35) | 6.7 | 0.85 (0.61–1.20) |
| Residential area by cumulative number of COVID-19 casese | |||||||||
| 1st tertile (1–12 cases per 100,000) | 5,245 (33.8) | 13.8 | Ref. | 17.5 | Ref. | 13.4 | Ref. | 7.8 | Ref. |
| 2nd tertile (13–29 cases per 100,000) | 5,116 (22.1) | 15.9 | 1.13 (0.91–1.40) | 19.8 | 1.15 (0.95–1.39) | 12.7 | 0.93 (0.71–1.22) | 7.1 | 0.85 (0.64–1.11) |
| 3rd tertile (30–149 cases per 100,000) | 15,121 (44.1) | 16.6 | 1.02 (0.84–1.23) | 18.7 | 1.02 (0.86–1.20) | 14.0 | 0.94 (0.76–1.17) | 13.2 | 1.01 (0.76–1.35) |
| History of physical conditionf | |||||||||
| Never | 17,840 (67.8) | 13.6 | Ref. | 18 | Ref. | 10.2 | Ref. | 7.8 | Ref. |
| Past | 4,566 (17.0) | 16 | 1.15 (0.95–1.40) | 18.2 | 1.04 (0.89–1.20) | 13.1 | 1.20 (0.96–1.50) | 10.7 | 1.20 (0.94–1.55) |
| Present | 3,076 (15.2) | 23.6 | 1.26 (0.96–1.65) | 21.4 | 1.06 (0.77–1.45) | 28.8 | 2.04 (1.51–2.76) | 19.4 | 0.78 (0.41–1.50) |
| History of mental conditionf | |||||||||
| Never | 22,342 (85.1) | 12.6 | Ref. | 15.9 | Ref. | 11 | Ref. | 5.6 | Ref. |
| Past | 1,691 (7.2) | 20.6 | 1.48 (1.13–1.92) | 25.5 | 1.56 (1.28–1.91) | 15.4 | 1.37 (1.03–1.80) | 20.1 | 2.79 (2.08–3.75) |
| Present | 1,449 (7.7) | 42.7 | 2.58 (1.84–3.61) | 41.2 | 2.30 (1.68–3.16) | 39.8 | 3.07 (2.08–4.53) | 49.3 | 5.02 (3.18–7.90) |
APR, adjusted prevalence ratio; CI, confidence interval; COVID-19, coronavirus disease 2019; Ref, reference.
The prevalence and prevalence ratios were weighted to account for selection in an internet survey. Adjusted prevalence ratios and 95% confidence intervals were calculated using Poisson regression models adjusted for all the tabulation variables presented. Results in bold type indicate P < 0.05.
aDeterioration of health were self-reported by asking respondents whether their state of health had worsened or improved compared to that in or during January 2020.
bUnfavorable general health status was defined as responses “poor” or “fair” to the question about respondents’ current health status using a 5-point Likert scale.
cPresence of serious psychological distress was defined as the score ≥13 on the Kessler (K6) scale.
dPast-year income level was classified using the latest national baseline income (poverty line).
eCumulative COVID-19 cases during January 1st–August 25th, 2020 were calculated for each of the prefectures of respondents’ residence.
fHistory of illness was assessed with aggregate variables for physical illness (any cancer or malignant tumor, diabetes, asthma, bronchitis, chronic obstructive pulmonary disease, angina, myocardial infarction, and/or cerebral infarction) and mental illness (depression or any other mental disorder).