[A comparison of coping behavior among middle-aged males with health problems in different types of communities in...

Coping behaviors of middle-aged men living in areas of Tokyo with differing mortality rates were analyzed to determine if regional differences exist and if so why. Coping behaviors were divided into 3 separate levels: 1) coping behavior for slight symptoms, where a small change in lifestyle would seem to be a countermeasure, 2) coping behavior for symptoms which may be signs of a serious illness, and 3) coping behaviors for illness which have been identified and diagnosed by a physician. The sample was randomly selected from men 35 to 64 years of age living in two separate communities, Koto-Ward with a high middle-aged male mortality rate and Bunkyo-Ward where it is low. The following results were obtained. 1) In both communities, the proportion of interviewees who modified their lifestyle when slight symptoms occurred was associated with educational level and occupational status. The individuals who were junior high school graduates, and blue-collar workers in small enterprises, showed a low tendency toward changing their lifestyle when confronted with slight symptoms. College graduates, and white-collar workers who were members of large or medium sized enterprises, showed a strong tendency toward changing their lifestyle when confronted with slight symptoms. 2) In both communities, there were differences in coping behaviors when confronted with potentially serious illness dependent upon self-rated health and working hours per day. Interviewees with good self-rated health status and working more than ten hours a day showed a lower tendency to see a physician. 3) Compliance with the advice of a physician was lower among those interviewees who were younger and among those who did not have a family physician. In Koto-Ward, a correlation was seen between a low rate of compliance to physician advice and the non-availability of adequate medical facilities nearby. 4) In Koto-Ward where middle-aged male mortality is high, the proportion of interviewees who changed lifestyle in response to slight symptoms was significantly lower than in Bunkyo-Ward. The proportion of those who complied with the advice of a physician was also lower. 5) Regional differences in coping behaviors associated with slight symptoms appears to be due to differences in educational level and occupational status. Differences in availability of family physicians and nearby clinics could account for regional differences in the coping behavior of individuals with diagnosed illnesses.