OECD Reviews of Public Health: Japan

A Healthier Tomorrow

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This review assesses Japan's public health system, highlights areas of strength and weakness, and makes a number of recommendations for improvement. The review examines Japan's public health system architecture, and how well policies are responding to population health challenges, including Japan's ambition of maintaining good population health, as well as promoting longer healthy life expectancy for the large and growing elderly population. In particular, the review assesses Japan's broad primary prevention strategy, and extensive health check-ups programme, which is the cornerstone of Japan's secondary prevention strategy. The review also examines Japan's exposure to public health emergencies, and capacity to respond to emergencies as and when they occur.



Assessment and recommendations

The Japanese population, the longest-lived in the OECD, is undergoing a profound transformation. Japan’s birth rate has been falling; based on OECD projections by 2050 36.4% of Japan’s population will be over 65, and 15.0% over 80, making Japan’s population older than that of all other OECD countries. In some ways, Japan’s public health challenges are unlike those of other OECD countries. Japan’s obesity rate is the lowest in the OECD (23.8% of the population was overweight or obese in 2015, compared to the OECD average of 53.9%), the rate of smoking is slightly below the OECD average (18.3% of the population were daily smokers in 2015, compared to the OECD average of 18.5), and alcohol consumption is well below the OECD average. In many other respects, though, the health challenges that Japan is facing are very familiar: in particular, a rising burden of chronic disease, and a rising number of frail and elderly persons. In addition, Japan faces some relatively unique public health risks, notably a significant exposure to natural hazards such as earthquakes, floods, typhoons, and tsunamis. In some instances, these risks have intersected – for example the frail elderly have been particularly affected by some natural hazards.


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