Yuasa Motoyuki
Global Society Course, Faculty of International Liberal Arts, Juntendo University.
Nihon Koshu Eisei Zasshi. 2017;64(3):123-132. doi: 10.11236/jph.64.3_123.
Objective During the two decades following Japan's World War II surrender in 1945, tremendous improvement in the population's health was observed, particularly in infant mortality and life expectancy. How did Japanese rural dwellers achieve such remarkable health improvement during this relatively short time span while its economy remained heavily damaged following the war? While the efforts from government-driven public health strategies and programs are well known, relatively little is known about the contributions of policies in non-health sectors. Therefore, the main aim is to verify, using literature based sources, whether non-health sectors contributed to the betterment of the population's health in addition to the public health sector policies.Hypotheses Synergistic efforts of diverse interventions from different policies and programs likely catalyzed the drastic health improvement observed in the Japanese population in the two decades after World War II. The Ministry of Health and Welfare, for example, implemented programs to provide health care services. These are thought to have contributed directly to reducing maternal and child mortality, as well as tuberculosis-related mortality. Additionally, the Ministry of Agriculture and Forestry carried out a nationwide livelihood improvement program to enhance individual and family lifestyles, improve indoor and outdoor environments, and strengthen social solidarity. The ministry also attempted to generate income stability for farmers through an agricultural improvement program to ensure allocation of household income to family health. The Ministry of Education also had an initiative to disseminate the concepts of democracy and rational thought to the Japanese population through a social education program. Through these efforts, superstition and pre-modern customs were reduced, and subsequently health awareness increased, leading to an improvement in the population's health.Conclusion The public health policies implemented in Japan as well as the integration of various policies and programs addressing livelihoods, economics, and education greatly improved the population's health in a relatively short time. These non-health initiatives intersected with a wide range of health determinants. Verifying these hypotheses in detail would help develop effective measures for international aid to poverty-stricken regions. It also encourages alternative ways through which Japan could overcome its present-day challenges such as a rapidly aging population with limited access to national schemes for social security.
目标 在1945年日本二战投降后的二十年里,民众健康状况有了巨大改善,尤其是婴儿死亡率和预期寿命方面。在战后经济仍严重受损的情况下,日本农村居民是如何在相对较短的时间内取得如此显著的健康改善的呢?虽然政府主导的公共卫生战略和项目所做的努力广为人知,但对于非卫生部门政策的贡献却知之甚少。因此,主要目的是利用基于文献的资料来源,验证除了公共卫生部门政策外,非卫生部门是否也对民众健康状况的改善做出了贡献。
假设 二战后二十年里,日本民众健康状况急剧改善可能是不同政策和项目的多种干预措施协同努力的结果。例如,厚生省实施了提供医疗服务的项目。这些项目被认为直接有助于降低母婴死亡率以及与结核病相关的死亡率。此外,农林省开展了一项全国性的生活改善项目,以改善个人和家庭生活方式、改善室内外环境并加强社会团结。该部还试图通过一项农业改良项目为农民创造收入稳定性,以确保家庭收入用于家庭健康支出。文部省也有一项倡议,通过社会教育项目向日本民众传播民主和理性思维的概念。通过这些努力,迷信和前现代习俗减少了,随后健康意识提高了,从而使民众健康状况得到改善。
结论 日本实施的公共卫生政策以及各种涉及生计、经济和教育的政策与项目的整合,在相对较短的时间内极大地改善了民众健康。这些非卫生举措与广泛的健康决定因素相互交织。详细验证这些假设将有助于制定针对贫困地区国际援助的有效措施。这也鼓励日本探索其他途径来应对当前的挑战,比如人口快速老龄化且难以获得国家社会保障计划的情况。