Rural-urban Differences in Sociodemographic, Social Network and Lifestyle Factors Related to Mortality of Middle-aged Japanese Men from the Komo-Ise Cohort Study

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To examine rural-urban differences in the relationships of sociodemographic, social network, and lifestyle factors to mortality in middle-aged men, we used the data from a community based prospective cohort study, the Komo-Ise study.The subjects were all men aged 40-69 years living in Komochi Village, the rural group (n=2, 295), or the downtown district of Isesaki City, the urban group (n=3, 334), as of 1993.They completed a self-administered questionnaire in 1993 and were followed for all-cause deaths until 2000.The Cox proportional hazards model was used to compute relative risks (RRs) with 95% confidence intervals (CIs).Low educated men and men without a spouse in the rural group had an increased risk of mortality (RR=4.4;95%Cl:1.1- 18.2, RR=2.4;95%Cl:1.2-4.5).Men who did not enjoy good fellowship with their neighbors in the rural group had a decreased risk of mortality (RR=0.58;95%Cl:0.35-0.97).Mortality risks were significantly higher in urban men not participating in hobbies, club activities or community groups (RR=1.6;95%Cl:1.1-2.4).These variables remained significant risk factors, even after controlling for all sociodemographic, social network, lifestyle, and health status variables. Educational level, marital status and relation to neighborhoods showed significant rural-urban differences.J Epidemiol, 2002;12:93-104
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