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OECD Reviews of Public Health: Japan a HEALTHIER TOMORROW

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OECD Reviews of Public Health: Japan a HEALTHIER TOMORROW OECD Reviews of Public Health: Japan A HEALTHIER TOMORROW 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 OECD Reviews of Public 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 Health: Japan examines Japan's exposure to public health emergencies, and capacity to respond to emergencies as and when they occur. A HEALTHIER TOMORROW OECD Reviews of Public Health: Japan A HEALTHIER TOMORROW HEALTHIER A Consult this publication on line at https://doi.org/10.1787/9789264311602-en. This work is published on the OECD iLibrary, which gathers all OECD books, periodicals and statistical databases. Visit www.oecd-ilibrary.org for more information. ISBN 978-92-64-31159-6 81 2019 03 1 P 9HSTCQE*dbbfjg+ OECD Reviews of Public Health: Japan A HEALTHIER TOMORROW This work is published under the responsibility of the Secretary-General of the OECD. The opinions expressed and arguments employed herein do not necessarily reflect the official views of OECD member countries. This document, as well as any data and any map included herein, are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. Please cite this publication as: OECD (2019), OECD Reviews of Public Health: Japan: A Healthier Tomorrow, OECD Publishing, Paris. https://doi.org/10.1787/9789264311602-en ISBN 978-92-64-31159-6 (print) ISBN 978-92-64-31160-2 (pdf) The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank under the terms of international law. Photo credits: © Paul Oakley. Corrigenda to OECD publications may be found on line at: www.oecd.org/about/publishing/corrigenda.htm. © OECD 2019 You can copy, download or print OECD content for your own use, and you can include excerpts from OECD publications, databases and multimedia products in your own documents, presentations, blogs, websites and teaching materials, provided that suitable acknowledgement of OECD as source and copyright owner is given. All requests for public or commercial use and translation rights should be submitted to [email protected]. Requests for permission to photocopy portions of this material for public or commercial use shall be addressed directly to the Copyright Clearance Center (CCC) at [email protected] or the Centre français d’exploitation du droit de copie (CFC) at [email protected]. FOREWORD │ 3 Foreword This report is the second in the OECD’s series of reports reviewing public health policies across selected OECD countries. Health care systems across OECD are increasingly under pressure from social changes – including demographic changes and aging populations – and emerging new health challenges – from a growing burden of chronic disease, to re-emerging and new communicable diseases, or a growing burden of mental ill-health – which demand a strong public health response. The OECD Reviews of Public Health provide in-depth analysis and policy recommendations to strengthen priority areas of countries’ public health systems, highlighting best practice examples that allow learning from shared experiences, and the spreading of innovative approaches. In particular, this series of Reviews of Public Health builds on the OECD’s long-standing programme of work on the economics of public health, applying this extensive expertise to country-specific challenges. The OECD Reviews of Public Health are a tool to help countries to strengthen their national public health systems, and help countries to develop and implement innovative public health actions. This OECD Public Health Review of Japan seeks to assess the current scale of public health challenges, and efficacy of existing public health policies to respond to them, in Japan. In many respects Japan’s population is in strikingly good health compared to many OECD populations, with relatively low rates of risky health behaviour, the longest life expectancy in the OECD, and comprehensive primary and secondary disease prevention programmes. Nonetheless, Japan’s rapidly aging population means that the need to support healthy and disease-free lifestyles well into old age is greater than ever. This review recommends that Japan focus on a select number of priority interventions, especially when it comes to primary and secondary prevention, and takes steps to promote these across the country. In doing this, and across all public health policies, joined-up government, data-driven policies, and good citizen engagement will all be key. OECD REVIEWS OF PUBLIC HEALTH: JAPAN © OECD 2019 4 │ ACKNOWLEDGEMENTS Acknowledgements This report was prepared by Charles Baubion, Michele Cecchini, Rie Fujisawa, Emily Hewlett and Sabine Vuik, with input from Yuka Nishina, and research assistance from Chihiro Sudo. The authors also wish to thank Stefano Scarpetta, Mark Pearson, Francesca Colombo and Rabia Kahn from the OECD Directorate of Employment, Labour and Social Affairs for their comments. Thanks also go to Lucy Hulett and Liv Gudmundson for editorial input and to Isabelle Vallard, Lukasz Lech and Duniya Dedeyn for logistical assistance. The completion of this report would not have been possible without the generous support of Japanese authorities. This report has benefited from the expertise and material received from many health officials, health professionals, patient groups and other health experts that the OECD review team interviewed during a research mission in Japan in February 2018. In particular, the team spoke with numerous officials from the Japanese Government including from the Ministry of Health, Labour and Welfare, the Cabinet Office, and the Ministry of Education. This report has also benefited from the comments of the Japanese authorities and experts who reviewed earlier drafts; the authors’ particular thanks go to the numerous Japanese experts who took the time to provide thoughtful and detailed feedback at the review stage. The OECD also spoke with stakeholders including the National Institute of Public Health, National Institute of Health and Nutrition, the National Institute of Infectious Diseases, The Japanese Association of Public Health Centre Directors at Arakawa City, the Yokohama City Hall, and the Adachi City Hall. Thanks also go to the National Federation of Industrial Health Organizations, the Aichi Health Promotion Public Interest Foundation, the Tokyo Metropolitan Information Service Health Insurance Association, Uchida Yoko Health Insurance Association, Itoki Corporation, SCSK Corporation, for taking the time to meet with the OECD team. The authors would also like to thank the academics who provided important insights into the Japanese health system and public health, including Professor Hiroya Ogata, Dr Tomonori Okamura, Professor Ryozo Nagai, and Professor Toru Takebayashi. Particular thanks go to Professor Hideki Hashimoto, from the University of Tokyo, and Sirpa Sarlio from the Finnish Ministry of Social Affairs and Health, for the useful comments that they gave as peer reviewers for this report. Thanks also to Kaisa Lahdepuro for supporting the engagement of the Finland with this process. A draft summary of the report and of the key recommendations were discussed at the 2018 meeting of the OECD Expert Group on the Economics of Public Health. Authors would like to thank all the participants for their review and comments. Finally, the review team is especially thankful to their key contacts in the Japanese Delegation to the OECD – Hisayo Nomura and Teruhiko Kawabata – and to Masayuki Azuma and Tomohiro Murakami at the Japanese Ministry of Health, Labour and Welfare, whose logistical and coordination support throughout the review process has been critically important. OECD REVIEWS OF PUBLIC HEALTH: JAPAN © OECD 2019 TABLE OF CONTENTS │ 5 Table of contents Foreword ................................................................................................................................................ 3 Acknowledgements ................................................................................................................................ 4 Acronyms and abbreviations ................................................................................................................ 9 Executive summary ............................................................................................................................. 11 Assessment and recommendations ..................................................................................................... 13 Japan’s public health system .............................................................................................................. 17 Primary prevention and the Health Japan 21 strategy ........................................................................ 21 Health check-ups in Japan ................................................................................................................
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