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Japan: Japan Health Profile 2012






Japan Health Profile 2012

Ministry of Health's missions, vision and objectives

The basic principle governing the delivery of health care services is that all citizens should be able, at any time and place, to receive the care they require, with an affordable personal contribution.

The Ministry of Health, Labour and Welfare announced a health promotion programme, the National Health Promotion Movement in the 21st Century (Healthy Japan 21), in 2000. The movement, unlike traditional programmes, emphasizes ‘primary prevention’, aiming at early detection and treatment of diseases. Under the campaign, particular areas that are going to be important for the health and medical care of nationals are selected, and concrete numerical targets are set. These targets function as indicators for evaluation of the population’s health status. The goal of the programme, which is to be completed in 2012, is to realize a society where all Japanese nationals live healthy and happy lives, free of disease.

  • Improving healthy dietary habits: The Ministry of Health, Labour and Welfare has carried out the National Health and Nutrition Survey every year since 1945. The recommended dietary allowances (Dietary Reference Intakes) are revised every five years. In 2009, they underwent their eighth revision. Dietary guidelines for Japanese, the benchmark for dietary improvement, were established in 2000.
  • Promoting physical activities and exercise: Healthy Japan 21 encourages people to take physical exercise. In 2006, the Ministry of Health, Labour and Welfare drew up Exercise Criteria for Health Promotion 2006, describing the amount of physical activity and exercise needed to prevent lifestyle diseases, with updated evidence.
  • Promoting appropriate rest and sleep: The need for relaxation and the part it plays in maintaining and improving health is well recognized. Therefore, ‘relaxation and health of the mind’ is one of the targets in Healthy Japan 21. In 2003, the Ministry of Health, Labour and Welfare drew up guidelines for good sleep as a tool for achieving the sleep target in Healthy Japan 21.
  • Smoking and health: The Ministry of Health, Labour and Welfare publicizes accurate information about smoking and its harm to human health, not only for smokers but also generally. The Ministry tries to prevent juveniles being tempted to smoke through health education, has presented the basic direction on smoke-free policies in public places or offices in order to reduce second-hand smoking, and assists smokers who want to quit smoking through support programmes. Medical insurance covers treatment for nicotine-dependent patients.

Organization of health services and delivery systems

Health policy, planning and regulatory framework

With increasing financial constraints, the Government is planning to introduce structural reforms in the heath system to increase efficiency while maintaining equity and the quality of services. These reforms are closely associated with the ongoing demographic transition—longer life expectancy and lower birth rate—that has resulted in a rapid increase in the percentage of elderly citizens.

Japanese society is ageing at an unprecedented rate compared with other developed countries. In 2005, Japan’s ageing rate reached 22.7%, showing that the country is still ageing at a high speed. According to population projections, the ageing trend will continue and the ageing rate will exceed 35% in 2040. This ageing population will need to pay attention to lifestyle-related diseases. Maintaining healthy lifestyles and the early detection of disease could help to reduce the incidence of the three major killer diseases: malignant neoplasms, cardiovascular diseases and cerebrovascular diseases. The new Health Promotion Law (2002) emphasizes the importance of establishing an environment conducive to healthier lifestyles as a key strategy for the ageing society.

Health care financing
National expenditure on health has been rising year after year. In 2008, total health expenditure reached US$ 396 010.71 million, about 8.1% of GDP. The rapidly growing number of senior citizens has resulted in a sharp rise in medical costs for the elderly and is a major reason for the upward trend in medical care expenditure. The average per capita total expenditure on health in 2008 was US$ 3101.88.

Human resources for health
As of 2008, there were 286 699 doctors and 1 295 670 nurses, public health nurses and assistant nurses in Japan. Due to population ageing, along with the growing sophistication and specialization of medical services, among other factors, it is presumed that the demand for health, medical and welfare service personnel will increase in the future.
Challenges to health system strengthening
The health insurance system in Japan maintains universal coverage and there is free access to all health institutions. While this system has ensured equitable health care delivery across different socioeconomic groups and different areas of the country, it has given rise to an inefficient supply of services. Under the free-access system, patients have a tendency to skip the general practitioner and go directly to hospitals for even relatively common illnesses. At the same time, the current fee-for-service payment scheme tends to invite overtreatment. For example, the average length of a hospital stay in Japan is about five weeks, more than double that in the majority of developed countries.
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