Health in Japan
Encyclopedia
The high level of health in Japan is due to a number of factors including cultural habits, isolation, and an efficient universal
health care system. Japan has one of the healthiest populations in the world according to many medical indicators. In particular, John Creighton Campbell, professor at the University of Michigan
and Tokyo University, has told The New York Times that Japanese people are "the healthiest" group on the planet.
rate is high compared to the USA; the Yomiuri Shimbun
reported in June 2008 that more than 30,000 people had killed themselves every year for the past decade. A study published in 2006, suspects that health problems were a factor in almost 50 percent of the Japan's suicides in 2006. However the Yomiuris 2007 figures show 274 school children were among those who took their own lives. Bullying is often a factor in such cases. In 2009, suicide continues to rise.
, which according to Tadao Kakizoe (honorary president of the National Cancer
Center) kills more than 100,000 people per year and is responsible for one in ten deaths.
, services are provided either through regional/national public hospitals or through private hospitals/clinics, and patients have universal access to any facility, though hospitals tend to charge higher for those without a referral. However space can be an issue in some regions. More than 14,000 emergency patients were rejected at least three times by Japanese hospitals before getting treatment in 2007, according to the latest government survey. In the worst case, a woman in her 70s with a breathing problem was rejected 49 times in Tokyo
. Public health insurance covers most citizens/residents and pays 70% or more cost for each care and each prescribed drug. Patients are responsible for the remainder (upper limits apply). The monthly insurance premium is 0–50,000 JPY
per household (scaled to annual income). Supplementary private health insurance is available only to cover the co-payments or non-covered costs, and usually makes a fixed payment per days in hospital or per surgery performed, rather than per actual expenditure. In 2005, Japan spent 8.2% of GDP on health care, or US$2,908 per capita. Of that, approximately 83% was government expenditure.
Western medicine was introduced to Japan with the Rangaku
studies during the Edo period
. A number of books on pharmacology and anatomy were translated from Dutch and Latin to Japanese. During the Meiji period
(late 19th century), the Japanese health care system was modelled after the model of Western biomedicine. At that time, western doctors came to Japan to create medical faculties at the newly built Japanese universities
, and students also went abroad. Innovations like vaccine
s were introduced to Japan, improving average life expectancy. From the Meiji period through the end of World War II German
was a mandatory foreign language for Japanese students of medicine. Patient charts in Japanese teaching hospitals were even written in German.
But even today, a person who becomes ill in Japan
has a number of alternative options. One may visit a priest
, or send a family member in his or her place. There are numerous folk remedies, including hot springs baths (onsen
) and chemical and herbal over-the-counter medications. A person may seek the assistance of traditional healers, such as herbalist
s, masseurs, and acupuncturists.
cases remained small by international standards, public health officials were concerned in the late 1980s about the worldwide epidemic of acquired immune deficiency syndrome (AIDS). The first confirmed case of AIDS in Japan was reported in 1985. By 1991 there were 553 reported cases, and by April 1992 the number had risen to 2,077. While frightened by the deadliness of the disease yet sympathetic to the plight of hemophiliac AIDS patients, most Japanese are unconcerned with contracting AIDS themselves. Various levels of government responded to the introduction of AIDS awareness into the heterosexual population by establishing government committees, mandating AIDS education, and advising testing for the general public without targeting special groups. A fund, underwritten by pharmaceutical companies that distributed imported blood products, was established in 1988 to provide financial compensation for AIDS patients.
Universal health care
Universal health care is a term referring to organized health care systems built around the principle of universal coverage for all members of society, combining mechanisms for health financing and service provision.-History:...
health care system. Japan has one of the healthiest populations in the world according to many medical indicators. In particular, John Creighton Campbell, professor at the University of Michigan
University of Michigan
The University of Michigan is a public research university located in Ann Arbor, Michigan in the United States. It is the state's oldest university and the flagship campus of the University of Michigan...
and Tokyo University, has told The New York Times that Japanese people are "the healthiest" group on the planet.
Health
Japan has universal health care that is one of most efficiently run in the world. Japanese visit a doctor nearly 14 times a year, more than four times as often as Americans. Personal bankruptcy due to medical expenses is unheard of in Japan. Japan also has about three times as many hospitals per capita as the United States does.Suicide problem
Japan's suicideSuicide
Suicide is the act of intentionally causing one's own death. Suicide is often committed out of despair or attributed to some underlying mental disorder, such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse...
rate is high compared to the USA; the Yomiuri Shimbun
Yomiuri Shimbun
The is a Japanese newspaper published in Tokyo, Osaka, Fukuoka, and other major Japanese cities. It is one of the five national newspapers in Japan; the other four are the Asahi Shimbun, the Mainichi Shimbun, Nihon Keizai Shimbun, and the Sankei Shimbun...
reported in June 2008 that more than 30,000 people had killed themselves every year for the past decade. A study published in 2006, suspects that health problems were a factor in almost 50 percent of the Japan's suicides in 2006. However the Yomiuris 2007 figures show 274 school children were among those who took their own lives. Bullying is often a factor in such cases. In 2009, suicide continues to rise.
Smoking
One of the biggest public health issues is smoking in JapanSmoking in Japan
Smoking in Japan is much less restricted than in many other nations, and Japan accounts for much of the tobacco consumption in Asia. Nearly 30 million people smoke in Japan, making the country one of the world's largest tobacco markets...
, which according to Tadao Kakizoe (honorary president of the National Cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
Center) kills more than 100,000 people per year and is responsible for one in ten deaths.
Access to care
In JapanJapan
Japan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south...
, services are provided either through regional/national public hospitals or through private hospitals/clinics, and patients have universal access to any facility, though hospitals tend to charge higher for those without a referral. However space can be an issue in some regions. More than 14,000 emergency patients were rejected at least three times by Japanese hospitals before getting treatment in 2007, according to the latest government survey. In the worst case, a woman in her 70s with a breathing problem was rejected 49 times in Tokyo
Tokyo
, ; officially , is one of the 47 prefectures of Japan. Tokyo is the capital of Japan, the center of the Greater Tokyo Area, and the largest metropolitan area of Japan. It is the seat of the Japanese government and the Imperial Palace, and the home of the Japanese Imperial Family...
. Public health insurance covers most citizens/residents and pays 70% or more cost for each care and each prescribed drug. Patients are responsible for the remainder (upper limits apply). The monthly insurance premium is 0–50,000 JPY
Japanese yen
The is the official currency of Japan. It is the third most traded currency in the foreign exchange market after the United States dollar and the euro. It is also widely used as a reserve currency after the U.S. dollar, the euro and the pound sterling...
per household (scaled to annual income). Supplementary private health insurance is available only to cover the co-payments or non-covered costs, and usually makes a fixed payment per days in hospital or per surgery performed, rather than per actual expenditure. In 2005, Japan spent 8.2% of GDP on health care, or US$2,908 per capita. Of that, approximately 83% was government expenditure.
Cultural influences
Traditional Chinese medicine was introduced to Japan with other elements of Chinese culture during the 5th to 9th century. Since around 1900, Chinese-style herbalists have been required to be licensed medical doctors. Training was professionalized and, except for East Asian healers, was based on a biomedical model of disease. However, the practice of biomedicine was influenced as well by Japanese social organization and cultural expectations concerning education, the organization of the workplace, and social relations of status and dependency, decision-making styles, and ideas about the human body, causes of illness, gender, individualism, and privacy. Anthropologist Emiko Ohnuki-Tierney notes that "daily hygienic behavior and its underlying concepts, which are perceived and expressed in terms of biomedical germ theory, in fact are directly tied to the basic Japanese symbolic structure."Western medicine was introduced to Japan with the Rangaku
Rangaku
Rangaku is a body of knowledge developed by Japan through its contacts with the Dutch enclave of Dejima, which allowed Japan to keep abreast of Western technology and medicine in the period when the country was closed to foreigners, 1641–1853, because of the Tokugawa shogunate’s policy of national...
studies during the Edo period
Edo period
The , or , is a division of Japanese history which was ruled by the shoguns of the Tokugawa family, running from 1603 to 1868. The political entity of this period was the Tokugawa shogunate....
. A number of books on pharmacology and anatomy were translated from Dutch and Latin to Japanese. During the Meiji period
Meiji period
The , also known as the Meiji era, is a Japanese era which extended from September 1868 through July 1912. This period represents the first half of the Empire of Japan.- Meiji Restoration and the emperor :...
(late 19th century), the Japanese health care system was modelled after the model of Western biomedicine. At that time, western doctors came to Japan to create medical faculties at the newly built Japanese universities
Higher education in Japan
- University entrance :University entrance is based largely on the scores that students achieved in entrance examinations . Private institutions accounted for nearly 80% of all university enrollments in 1991, but with a few exceptions, the public national universities are the most highly regarded...
, and students also went abroad. Innovations like vaccine
Vaccine
A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe or its toxins...
s were introduced to Japan, improving average life expectancy. From the Meiji period through the end of World War II German
German language
German is a West Germanic language, related to and classified alongside English and Dutch. With an estimated 90 – 98 million native speakers, German is one of the world's major languages and is the most widely-spoken first language in the European Union....
was a mandatory foreign language for Japanese students of medicine. Patient charts in Japanese teaching hospitals were even written in German.
But even today, a person who becomes ill in Japan
Japan
Japan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south...
has a number of alternative options. One may visit a priest
Priest
A priest is a person authorized to perform the sacred rites of a religion, especially as a mediatory agent between humans and deities. They also have the authority or power to administer religious rites; in particular, rites of sacrifice to, and propitiation of, a deity or deities...
, or send a family member in his or her place. There are numerous folk remedies, including hot springs baths (onsen
Onsen
An is a term for hot springs in the Japanese language, though the term is often used to describe the bathing facilities and inns around the hot springs. As a volcanically active country, Japan has thousands of onsen scattered along its length and breadth...
) and chemical and herbal over-the-counter medications. A person may seek the assistance of traditional healers, such as herbalist
Herbalist
An herbalist is:#A person whose life is dedicated to the economic or medicinal uses of plants.#One skilled in the harvesting and collection of medicinal plants ....
s, masseurs, and acupuncturists.
AIDS
Although the number of AIDSAIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
cases remained small by international standards, public health officials were concerned in the late 1980s about the worldwide epidemic of acquired immune deficiency syndrome (AIDS). The first confirmed case of AIDS in Japan was reported in 1985. By 1991 there were 553 reported cases, and by April 1992 the number had risen to 2,077. While frightened by the deadliness of the disease yet sympathetic to the plight of hemophiliac AIDS patients, most Japanese are unconcerned with contracting AIDS themselves. Various levels of government responded to the introduction of AIDS awareness into the heterosexual population by establishing government committees, mandating AIDS education, and advising testing for the general public without targeting special groups. A fund, underwritten by pharmaceutical companies that distributed imported blood products, was established in 1988 to provide financial compensation for AIDS patients.
See also
- Aging of JapanAging of JapanThe ageing of Japan outweighs all other nations with the highest proportion of elderly citizens, 21% over the age of 65. In 1989, only 11.6% of the population was 65 years or older, but projections were that 25.6% would be in that age category by 2030...
- Erwin BälzErwin BälzErwin Bälz was a German internist, anthropologist, personal physician to the Japanese Imperial Family and cofounder of modern medicine in Japan.- Biography :...
—an oyatoi gaikokujin and cofounder of modern medicine in Japan - Health care compared—tabular comparisons with the U.S., Canada, and other countries not shown above.
- Public health centres in JapanPublic health centres in JapanIn Japan, a public health centre is a facility with responsibility for public health matters. It is responsible for treatment of people with chronic health problems such as mental illness....
- Social welfare in JapanSocial welfare in JapanSocial welfare, assistance for the ill or otherwise disabled and for the old, has long been provided in Japan by both the government and private companies. Beginning in the 1920s, the government enacted a series of welfare programs, based mainly on European models, to provide medical care and...
Further reading
See in particular Chapter 6 "Japan: Bismark on Rice", pp. 82–124; this book is a further expansion of Reid's 2008 stories.- Campbell, John Creighton, and Naoki Ikegami. The Art of Balance in Health Policy: Maintaining Japan's Low-Cost, Egalitarian System. New York: 1998. ISBN 0-521-57122-7