Japan: Preventive Healthcare - World Health Systems Facts

Maternal mortality ratio (per 100,000 live births), 2023: 3
Under-five mortality rate (per 1000 live births), 2023: 2.4
Neonatal mortality rate (per 1000 live births), 2023: 0.8
Tuberculosis incidence (per 100,000 population), 2023: 9.3
Probability of dying from any of cardiovascular disease, cancer, diabetes, chronic respiratory disease between age 30 and exact age 70 (%), 2021: 8.0
Suicide mortality rate (per 100,000 population), 2021: 17.4
Adolescent birth rate (per 1000 women aged 15-19 years), 2015-2024: 1.7
Diphtheria-tetanus-pertussis (DTP3) immunization coverage among 1-year-olds (%), 2023: 98%
Measles-containing-vaccine second-dose (MCV2) immunization coverage by the locally recommended age (%), 2023: 94%
Pneumococcal conjugate 3rd dose (PCV3) immunization coverage among 1-year olds (%), 2023: 97%
Human papillomavirus (HPV) immunization coverage estimates among 15 year-old girls (%), 2023: 35%
Prevalence of stunting in children under 5 (%), 2024: 5.2%
Prevalence of overweight in children under 5 (%), 2024: 2.0%
Prevalence of anaemia in women aged 15-49 years (%), 2023: 18.7%

Source: World health statistics 2025: monitoring health for the SDGs, Sustainable Development Goals. Tables of health statistics by country and area, WHO region and globally. Geneva: World Health Organization; 2025. Licence: CC BY-NC-SA 3.0 IGO.

“The MHLW [Ministry of Health, Labour and Welfare] established ‘Health Japan 21’ as the primary strategy for health promotion and risk prevention in 2013, aiming at preventing lifestyle diseases at the national level based (Knko Zoshin) Law. This strategy includes extending the healthy life expectancy, reducing health inequality, preventing non-communicable diseases, managing supportive society, and improving healthy lifestyle, etc. Under Health Japan 21 the government set out a role for prefectural and municipal governments and local health centres. Although the government set broad targets to be achieved by 2022, the specific targets are entrusted to each prefecture based on each situation (MHLW, 2012[53]). Health Japan 21 is further discussed in Chapter 2.”

Source: OECD (2019), OECD Reviews of Public Health: Japan: A Healthier Tomorrow, OECD Reviews of Public Health, OECD Publishing, Paris, doi.org/10.1787/9789264311602-en.

“Secondary prevention consists of identifying diseases at an earlier stage to enable more effective treatment and better outcomes. Screening and health checks are major pillars of secondary preventions in many OECD countries, and can be applied selectively (e.g. to a target population, based on risk and vulnerability), or to the whole population. In Japan a wide number of health checks are in place, which are detailed in Chapter 3. For example, for detecting ‘lifestyle diseases’ the Tokutei-Kenshin ‘Specific Health Check-up’ is offered to persons between 40 and 74 years old. If any irregularities are identified individuals are advised on appropriate follow-up steps (MHLW, 2018[54]).”

Source: OECD (2019), OECD Reviews of Public Health: Japan: A Healthier Tomorrow, OECD Reviews of Public Health, OECD Publishing, Paris, doi.org/10.1787/9789264311602-en.

“As in other OECD countries, the main burden of disease in Japan comes from non-communicable diseases. Hypertensive diseases, diabetes, cardiovascular diseases, cancers, and cerebrovascular disease account for 50% of all mortality; cancer has been the main cause of mortality since 1981, with the rate of 28.7% of all mortality in 2015 followed by cardiovascular disease (15.2%), pneumonia (9.4%) and cerebrovascular diseases (8.7%) (MHLW, 2015[4]). Looking at the mortality rate by major cancers, lung cancer is the highest among men and colon cancer for women. OECD data shows that overall cancer incidence is lower in Japan (217.1 aged-standardised rates per 100 000 persons) than other OECD countries (270.5 per 100 000). Although cardiovascular diseases are the second leading cause of mortality in Japan, the mortality rate with age-standardised rates per 100 000 population is the lowest among the OECD countries and shows a 40% decrease in the mortality rate between 1990 and 2015 (OECD, 2017[1]).

“Although non-communicable disease represents the most significant part of Japan’s disease burden, some communicable diseases are still present in Japan, notably tuberculosis, which has higher incidence in Japan than in other OECD countries. The incidence rate of tuberculosis in Japan was 18 (per 100 000 person) in 2014, which is lower than the other Asian countries, yet higher amongst OECD countries (WHO, 2015) (see Figure 1.4). Mortality rate from tuberculosis was 2.4 (per 100 000 people) in Japan in 2016, while the OECD average is 1.6 (WHO, 2016[5]).”

Source: OECD (2019), OECD Reviews of Public Health: Japan: A Healthier Tomorrow, OECD Reviews of Public Health, OECD Publishing, Paris, doi.org/10.1787/9789264311602-en.

“Based on the Health Promotion Law (Kenko Zoshin Hou), stakeholders such as the government, prefectures, municipalities, and medical institutions are expected to cooperate to provide health education for promoting health literacy in Japan. The MHLW has created a website for patients and health workers, called ‘“Information site for evidence-based Japanese integrative Medicine’ which focuses on promoting the importance of medical providers understanding the patient’s level of health literacy as they approach building a relationship with the patient. Communication training for medical students was only systematically introduced from 2003.

“For local governance, each municipality is responsible for promoting health education amongst citizens. For example in Chiba prefecture, besides civil lectures on preventive medicine, Chiba University Preventive Medicine Center and the municipalities have collaborated on a health project and research project based on health check data to build more effective health policies and healthier lives.

“The Ministry of Education, Culture, Sports, Science and Technology (MEXT) provides education on health knowledge for children from elementary school to high school (mostly 6-18 years old) for the purpose of promoting school health, including prevention of drug abuse and drinking, and smoking prevention education, prevention of infectious disease, and mental health awareness. For instance, preventive education for drug abuse is suggested to be performed in physical and health education class annually, supported by an intervention from an expert. This approach is understood to be widely followed, for example in Ibaraki prefecture, the implementation rate in the prefectural high school was 99% in 2010 (MEXT, 2012[95]).

“However, a survey of health literacy in Japan suggested that 85% of the Japanese population has low health literacy (Moreira, 2018[96]). According to the EU-Q47 survey performed in European countries and in Japan, which is comprehensive measure of health literacy across countries, there is a possibility that health literacy in Japan is lower compared to the European countries, especially when it comes to finding a reliable information for making a decision (Nakayama et al., 2015[97]).”

Source: OECD (2019), OECD Reviews of Public Health: Japan: A Healthier Tomorrow, OECD Reviews of Public Health, OECD Publishing, Paris, doi.org/10.1787/9789264311602-en.

“Like many other high-income countries, non-communicable diseases (NCDs) are now the leading cause of mortality and morbidity in Japan, while the burden of communicable diseases has decreased substantially over the past five decades. TB was the top leading cause of death by the middle of the 20th century in Japan, although it drastically fell in the rankings over the same period (the number of deaths decreased from over 100 000 in 1950 to 1892 in 2016). Pneumonia was also one of the top causes of death in early the 1900s but has gradually decreased over the decades. However, mainly due to an ageing society, the number of deaths attributable to pneumonia resumed an increase in the 1990s and is now the third leading cause of death in Japan.

“Table 1.5 shows the leading causes of death in Japan. Rankings are based on the number of deaths from each cause. The top three leading causes of death in 1990 were cerebrovascular disease, ischaemic heart disease, and lower respiratory infection, which remained at the top in 2015 despite substantial declines in their age-standardized rates (–19.3%, –11.6% and –6.5% between 2005 and 2015, respectively). The pace of decline in mortality from these three leading causes and many other causes has levelled off since 2005 for both men and women with the average annual percentage change in age-standardized death rates between 1990 and 2005 being –2.6%, –2.6%, and –1.2% for the top three causes, but declining to –1.9%, –1.2%, and –0.7%, respectively after 2005.”

Source: Sakamoto H, Rahman M, Nomura S, Okamoto E, Koike S, Yasunaga H et al. Japan Health System Review. Vol. 8 No. 1. New Delhi: World Health Organization, Regional Office for South-East Asia, 2018.

“Japan has successfully reduced the disease burden from NCDs [Non-Communicable Diseases] during the past decades; however, the pace of reduction has stagnated since around 2005. Although many NCDs are preventable and are linked to lifestyle and dietary patterns, challenges still remain, especially for tobacco control. Additionally, there are no effective preventive or curative measures for Alzheimer’s disease so far, and the number of cases is only expected to increase; further efforts (i.e., effective policies to support patients in the community and R&D directed at new medicines for Alzheimer’s disease) are required. There is an urgent need to scale up effective coverage of preventive and public health interventions so as to further reduce the disease burden from NCDs.”

“Under the Immunization Act, immunization services for 12 diseases started in 1948 and the vaccine schedule was periodically revised until recently. Japan now maintains a childhood vaccination programme that is broadly consistent with the WHO-recommended vaccination schedule (Government of Japan, 1948a). Key elements of Japan’s vaccination schedule are listed below (as of February 2017).

“(i) Routine immunization
“• Live vaccine: bacilli Calmette-Guerin (BCG), measles–rubella (MR),Varicella
“• Inactivated vaccine: Hepatitis B, DPT-IPV (diphtheria–tetanus–pertussis and inactivated polio vaccine), Japanese encephalitis,pneumococcal, Haemophilus influenzae type b (Hib), humanpapillomavirus (HPV)

“(ii) Non-routine immunization
“• Live vaccine: mumps, rotavirus
“• Inactivated vaccine: hepatitis A virus, influenza (for the elderly),meningococcus”

“The Health Promotion Act was enacted in 2002, which requires prefectural and municipal governments to develop health promotional plans, mandates the National Health and Nutritional Survey, and requires governments at all levels to monitor lifestyle-related diseases for effective health promotion (Ezoe S et al., 2017). The Act also sets out anti-smoking activities, including efforts to fight second-hand smoke exposure.

“In response to the demographic and epidemiological transitions (from widely prevalent communicable diseases to chronic and lifestyle-related NCDs), under the Health Promotion Act, the MHLW promoted the “National Health Promotion Movement in the 21st century” (abbreviated as “Health Japan 21” ) as a goal-oriented health promotion measure for the prevention of lifestyle-related diseases (Sakurai H, 2003). “Health Japan 21” emphasizes the prolongation of healthy life expectancy without disabilities (Government of Japan, 2002). Japan faces a growing number of older people with disabilities, and this programme aims to ease the burden on care givers and ambulatory services by promoting healthy ageing. The second term of the National Health Promotion Programme 2013–2022 (Health Japan 21, the second term) is currently in place (Ministry of Health, Labour and Welfare, 2012f).

“The fundamental goals are:
“• to improve healthy life expectancy and reduce health inequalities,
“• to prevent onset and progression of life-style related diseases(cancers, cardiovascular diseases, diabetes and chronic obstructive pulmonary disease),
“• to maintain and improve functions necessary for a healthy social life,
“• to establish a social environment in which individual health is protected and healthy behaviours are supported; and
“• to improve life-style factors affecting health, such as nutrition, physical activity and other risk factors.

“Prefectural governments are required by the Health Promotion Act to set targets within a national framework and ensure that these targets are easy for local residents to understand. They should also monitor municipal-level variations in health and lifestyle, while municipal governments should incorporate national and prefectural targets into local policy.”

Japan: Preventive Healthcare - National Policies - World Health Systems Facts

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Page last updated August 2, 2025 by Doug McVay, Editor.