What has made the population of Japan healthy?

The Lancet, Volume 378, Issue 9796, Pages 1094 - 1105, 17 September 2011

Published Online: 30 August 2011 

doi:10.1016/S0140-6736(11)61055-6 

Nayu Ikeda PhD a, Eiko Saito MSc a, Naoki Kondo PhD b, Manami Inoue MD c, Prof Shunya Ikeda PhD d, Prof Toshihiko Satoh MD e,Koji Wada PhD f, Andrew Stickley PhD a, Kota Katanoda PhD g, Tetsuya Mizoue PhD h, Mitsuhiko Noda MD i, Prof Hiroyasu Iso PhDj, Prof Yoshihisa Fujino PhD k, Tomotaka Sobue MD g, Shoichiro Tsugane MD c, Prof Mohsen Naghavi PhD l, Prof Majid Ezzati PhDm, Prof Kenji Shibuya MD a 

Summary

People in Japan have the longest life expectancy at birth in the world. Here, we compile the best available evidence about population health in Japan to investigate what has made the Japanese people healthy in the past 50 years. The Japanese population achieved longevity in a fairly short time through a rapid reduction in mortality rates for communicable diseases from the 1950s to the early 1960s, followed by a large reduction in stroke mortality rates. Japan had moderate mortality rates for non-communicable diseases, with the exception of stroke, in the 1950s. The improvement in population health continued after the mid-1960s through the implementation of primary and secondary preventive community public health measures for adult mortality from non-communicable diseases and an increased use of advanced medical technologies through the universal insurance scheme. Reduction in health inequalities with improved average population health was partly attributable to equal educational opportunities and financial access to care. With the achievement of success during the health transition since World War 2, Japan now needs to tackle major health challenges that are emanating from a rapidly ageing population, causes that are not amenable to health technologies, and the effects of increasing social disparities to sustain the improvement in population health.