Health Profile of JapanHealth Profile of JapanHealth Profile of JapanHealth Profile of Japan

M.P.H. international 2008M.P.H. international 2008

Kumi Matoba, Maiko Hashimoto, Shigeru TomitaKumi Matoba, Maiko Hashimoto, Shigeru Tomita

BackgroundBackgroundBackgroundBackground Before 1950’s;

- Low average life span- Main cause of death = Infectious disease TB had been called as “National Disease”

After 1950’s;- Infectious disease = Decrease- Lifestyle-related disease = Increase

Since 1984;- The average life span = Top in the world- Disabilities such as immobility, dementia- Super-aging society is coming

Health Indicator (1)Health Indicator (1)Health Indicator (1)Health Indicator (1)

Source: CIA, Ministry of Health, Labour and Welfare (Japan)

Total area (2005) 377,835 (sq km)Total Population (2008) 127,288,419Population Density (2005) 343 (people/km²)

Percentage of population (2006) <15 years old >65 years old

14 %21 %21 %

Rate of natural increase of pop. (2006) 0.00

Crude birth rate (2006) 8.7 (per 1000 pop.)

Crude death rate (2006) 8.6 (per 1000 pop.)

Life expectancy at birth (2006) - Total - Male - Female

82.5 (years)82.5 (years)79 (years) 79 (years) 86 (years)86 (years)

Health Indicator (2)Health Indicator (2)Health Indicator (2)Health Indicator (2)

Source: Ministry of Health, Labor and Welfare (Japan), WHO

IMR (2006) 2.6 (1000 IB)MMR (2006) 4.8 (100,000 IB)CMR < 5 years old (2006) 4.0 (1000 IB)Population with safe water (2006) 97.2%

Health man power (2006) -Physicians -Professional Nursing and Midwifery Personnel

206 (per 100,000 pop.)986 (per 100,000 pop.)

Fully immunized (2004) - TB, - Polio 3, - DPT 3 99 %, 97 %, 99 %GDP US$ 4,883,000

(US$ 34,155 per capita) GDP expenditure on health 8.2%Expenditure on health per capita US$ 2,936 (8.6%)US$ 2,936 (8.6%)

Medical Service InfrastructureMedical Service InfrastructureMedical Service InfrastructureMedical Service Infrastructure

Ministry of Health, Labor and Welfare

National Hospitals (218)76 National Hospitals,

138 National Sanatoriums, National Cancer Center,

National Cardiovascular Center, National Center of Neurology and Psychiatry,

International Medical Center of Japan

Research Institutions (6)

Social Insurance Agency

Health and Welfare Bureau for Elderly

Health ServiceBureau

General Affairs Division, Specific Disease Control Division,

Tuberculosis and Infectious Diseases Control Division, Environmental Health Division, Water Supply Division

General Hospital 9,000Clinic 10,000

Prefecture level(81 ）Local municipal level(2000)

Regional Social Insurance Bureau (47)

"Long-term Care Insurance"

Medical Insurance SystemMedical Insurance SystemMedical Insurance SystemMedical Insurance System

Patients

HospitalsSocial Insurance

(Government Sector)

Medical Insurance PremiumMedical

Service

Quota payment

Quota payment

Claim

>75 yrs.10%

General30%

<3yrs. 20%

Trend of Major cause of Death 1899-Trend of Major cause of Death 1899-19991999Trend of Major cause of Death 1899-Trend of Major cause of Death 1899-19991999

Others

Infectious Disease

Unknown

Stroke

Heart Disease

Cancer

Tuberculosis

1.Cancer 30.5%

2.Heart Disease 15.7%

3.Stroke 13.0%

Pneumonia 9.3%

Suicide 3.2%

Accident 3.8%

Natural Death 2.3%

Natural death

Toward Aging Society… (1)Toward Aging Society… (1)Toward Aging Society… (1)Toward Aging Society… (1)

National Institute of Population and Social Security Research, Japan. General population statistics 2008.National Institute of Population and Social Security Research, Japan. Estimated population database 2008.

Toward Aging Society… (2)Toward Aging Society… (2)Toward Aging Society… (2)Toward Aging Society… (2)

　 age million

>75yrs12

9.3%

65～ 7514

11.1%

<65101

79.6%

total127millio

n

Medical expenditure

$1,600/ person <65yrs vs $6,600/person >65yrs

4times larger!

2004

% annual incom

e

Hundreds B

illion

☆Rapid-Aging population☆Life-style related diseases☆Long Life (post retirement)

Dementia & Bed-ridden ↑↑↑Financial and

Social Burden ↑↑↑

How to keep elder people healthy ( & minimize burden)?

★Set 9 AreasNutrition, Diet, Exercise, Diabetes ,Cancer, Dental, Smoking, Alcohol, Mental

★Set Realistic Goals in municipal level

★Follow up ！

Toward Aging SocietyToward Aging Society “People‘s Health Promotion Campaign for the 21st Century (Health Japan 21)”“People‘s Health Promotion Campaign for the 21st Century (Health Japan 21)” ～～ Plan-Do-SeePlan-Do-See ～～

Toward Aging SocietyToward Aging Society “People‘s Health Promotion Campaign for the 21st Century (Health Japan 21)”“People‘s Health Promotion Campaign for the 21st Century (Health Japan 21)” ～～ Plan-Do-SeePlan-Do-See ～～

3pilers1.Primary Prevention 2.Secondary Prevention3.Health Promotion and Education at all Ages 　

Health Japan 21 2000 ～ 2012

Behavior Change for Brighter Aging Life

ConclusionConclusionConclusionConclusion Public Health Problem

-Life-related diseases-Disabilities such as bed-ridden, mental illness, and dementia

Super-aging society-Bringing huge burdens of disease

Primary prevention of not only premature death but also disabilities of the elderly

The new challenge of creating a society in which elderly people enjoy a healthy life based on health promotion strategy

JapanJapan

Kumi Matoba, Maiko Hashimoto, Shigeru TomitaKumi Matoba, Maiko Hashimoto, Shigeru Tomita