An article published in The Lancet September 1 2011 reveals that people in Japan have the longest life expectancy at birth in the world. Female life expectancy at birth was 86 years in 2009, the highest ever recorded in the world.
The proportion of people aged 65 years and older has quadrupled during the past 60 years to 23% in 2010. However, despite the ageing population, Japan’s health expenditure is only 8·5% of gross domestic product, one of the lowest in the OECD countries.
Why is the Japanese population so healthy? How has Japan achieved the longest life expectancy at birth worldwide?
Understanding what has contributed to making the Japanese population healthy in such a fairly short period is important for global health policy, particularly for countries struggling to improve health.
Improvements in the health of the Japanese population were noted in the 1920s. Declines in infant mortality rates were partly attributed to increased literacy of mothers through provision of free and compulsory education. By the early 20th century almost all girls attended primary school.
Japanese people give attention to hygiene in all aspects of their daily life. The Japanese are exceptionally health conscious, regular health check-up is the norm. Mass screening is available in the community, at school and the work place.
Japanese diet, which has improved in tandem with economic development over the last five decades, is balanced and highly nutritional. The prevalence of adult obesity in Japan is 4 % compared to 26.6 % in the United States of America.
Previous studies have shown that strong ties in Japanese communities appear to be associated with improved outcomes in mental health, dental health, and physical functioning, while buffering against the adverse effects of income inequality.
Japan’s impressive population health outcomes demonstrate that a reduction in mortality rates can be brought about by the interplay of improvements in both medical care and other societal factors such as income, education, nutrition, and sanitation.
As early as the 1950s, mortality rates for non-communicable diseases, other than stroke, were already low owing to a favorable lipid profile and glucose metabolism, a generally low body-mass index, and other lifestyle factors relating to diet and low to moderate alcohol intake.
The contrast between Japan's life expectancy and those of Sub-Saharan African countries is disconcerting. For instance, the life expectancy in South Africa is 51.6 years. Kenya’s life expectancy is 54.9 years. Nigeria, Africa’s most populous country has a life expectancy of just 48 years.
The poor status of Africa’s population health is comparable to Japan’s in 1947, when male life expectancy at birth was 50 years and female life expectancy was 54 years.
The Lancet article suggests that the main driving force for improved population health was the strong stewardship of the new Japanese Government in implementing major structural reforms in the health sector and placing priority on investment in key interventions for public health in the early phase of economic growth.
The Japanese experience presents relevant and invaluable lessons, especially for Sub-Saharan African countries.