Kusunoki Hiroshi
Department of Internal Medicine, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata 573-1121, Osaka, Japan.
Healthcare (Basel). 2025 May 30;13(11):1305. doi: 10.3390/healthcare13111305.
Since the onset of the COVID-19 pandemic, Japan has experienced a significant rise in mortality, with excess deaths surpassing historical projections. Statistical data indicate a sharp increase in mortality rates from 2021 onward, attributed to COVID-19, aging demographics, cardiovascular diseases, and malignancies. Preliminary 2024 data suggest continued excess mortality, fueling public debate. This review analyzes national and municipal mortality trends using official Japanese statistics and comparative data from South Korea, the U.S., and the EU. Findings reveal a sharp mortality rise post-2021 in Japan and South Korea, while Western nations experienced peak deaths in 2020, followed by declines. The review explores contributing factors, including potential vaccine-related adverse effects, declining healthcare access, pandemic-induced stress, and demographic shifts. Notably, older adults' reluctance to seek medical care led to delayed diagnoses, treatment interruptions, and preventable deaths. Although some argue that declining COVID-19 vaccination rates in 2023 may have contributed to rising mortality in 2024, available data suggest a multifactorial causation. Japan's rapidly aging population, coupled with increasing mortality and declining birth rates, presents profound social and economic challenges. A nuanced approach, avoiding simplistic causal claims, is crucial for understanding these trends. This review highlights the need for a sustainable societal framework to address demographic shifts and improve healthcare resilience. Future pandemic strategies must balance infection control measures with mitigating unintended health consequences to ensure a more adaptive and effective public health response.
自新冠疫情爆发以来,日本死亡率显著上升,超额死亡人数超过历史预期。统计数据显示,自2021年起死亡率急剧上升,原因包括新冠疫情、人口老龄化、心血管疾病和恶性肿瘤。2024年的初步数据表明超额死亡率仍在持续,引发了公众的讨论。本综述利用日本官方统计数据以及来自韩国、美国和欧盟的对比数据,分析了全国和各城市的死亡率趋势。研究结果显示,日本和韩国在2021年后死亡率急剧上升,而西方国家在2020年出现死亡高峰,随后下降。本综述探讨了促成因素,包括潜在的疫苗相关不良反应、医疗服务可及性下降、疫情引发的压力以及人口结构变化。值得注意的是,老年人不愿寻求医疗护理导致诊断延迟、治疗中断以及可预防的死亡。尽管有人认为2023年新冠疫苗接种率下降可能导致了2024年死亡率上升,但现有数据表明这是多因素造成的。日本人口迅速老龄化,加上死亡率上升和出生率下降,带来了深刻的社会和经济挑战。采用细致入微的方法,避免简单化的因果论断,对于理解这些趋势至关重要。本综述强调需要一个可持续的社会框架来应对人口结构变化并提高医疗系统的恢复力。未来的疫情应对策略必须在控制感染措施与减轻意外健康后果之间取得平衡,以确保更具适应性和有效性的公共卫生应对措施。