The Association Between Living Area in Childhood and Respiratory Disease Mortality in Adulthood

Objective: No studies have examined the association between characteristics of urban areas and future respiratory disease mortality. We examined whether the type of living area during childhood was associated with all-cause and respiratory disease mortality in adulthood.Methods: A total of 81,413 Japanese participants aged 40-79 years old completed a lifestyle questionnaire including the type of childhood living areas. The Cox proportional hazards regression model was used to calculate the multivariable hazard ratios (HRs) with 95% confidence intervals (CIs) of all-cause and respiratory disease mortality.Results: Living in large city areas in childhood was associated with a higher risk of all-cause mortality [HR = 1.05 (95% CI, 1.01-1.10)], but not with respiratory disease mortality [HR = 1.04 (95% CI, 0.92-1.18)] compared to rural and remote areas. The excess risk of all-cause and respiratory disease mortality was primarily found in industrial areas among men; the respective multivariable HRs were 1.28 (95% CI, 1.00-1.64) and 1.90 (95% CI: 1.10-3.29).Conclusion: Eliminating childhood health hazards associated with living in industrial areas suggested to reduce the risk of mortality from respiratory diseases in adulthood.