Income Inequality, Social Capital and Health Status among the Urban Elderly in Japan: A Multilevel Analysis

This study conducts a multilevel analysis to examine the association between community-level income inequality, social capital and health status among the urban elderly in Japan. An urban subsample of the Japan Gerontological Evaluation Study (JAGES) - a countywide social epidemiological survey of community-dwelling and functionally-independent individuals aged 65 and over - is used for the analysis (n=7,527). The community-level social capital is measured by the proportion of the respondents who “generally trust others in the community”. The ecological-level analysis finds significant community-level variations in income inequality and the social capital indicator, and they are correlated with the residents’ self-rated health. The results of the multilevel analysis confirm that, controlling for individual-level demographic and socioeconomic characteristics, a greater extent of income inequality increases the likelihood of reporting poor health. It is further observed that living in a community with a higher level of social capital attenuates the association between income inequality and health status. These results imply the importance of facilitating social connectedness and enhancing social cohesion in dealing with elderly health issues under the combination of population ageing and growing socioeconomic inequality.