Japan Health System Overview - World Health Systems Facts

Life expectancy at birth (years), 2021: 84.5 years
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
Universal Health Coverage: Service coverage index, 2021: ≥80
Population with household expenditures on health > 10% of total household expenditure or income (%), 2015-2021: 11.1%
Population with household expenditures on health > 25% of total household expenditure or income (%), 2015-2021: 2%
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%
Density of medical doctors (per 10,000 population), 2015-2023: 26.49
Density of nursing and midwifery personnel (per 10,000 population), 2016-2023: 129.78
Density of dentists (per 10,000 population), 2016-2023: 8.16
Density of pharmacists (per 10,000 population), 2015-2023: 20.26
Domestic general government health expenditure (GGHE-D) as percentage of general government expenditure (GGE) (%), 2022: 23.42%
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.

Population (in thousands), 2023: 124,371
Annual Population Growth Rate (%), 2023: -0.5%
Life Expectancy at Birth, 2023: 85 years
Share of Urban Population (%), 2023: 92%
Annual Growth Rate of Urban Population (%), 2020-2030: -0.4%
Net Migration Rate (per 1,000 population), 2023: 1.4
Under-Five Mortality Rate (per 1,000 live births), 2022: 2
Infant Mortality Rate (per 1,000 live births), 2022: 2
Neonatal Mortality Rate (per 1,000 live births), 2022: 1
Mortality Rate Among Children Aged 5-14 Years (per 1,000 children aged 5), 2022: 1
Maternal Mortality Ratio (per 100,000 live births), 2020: 4
Lifetime Risk of Maternal Death (1 in x), 2020: 1 in 22,185
Immunization for Vaccine Preventable Diseases (%), 2023:
– Percentage of live births who received bacilli Calmette-Guérin (vaccine against tuberculosis): 97%
– Percentage of surviving infants who received the first dose of diphtheria, pertussis and tetanus vaccine: 99%
– Percentage of surviving infants who received three doses of diphtheria, pertussis and tetanus vaccine: 98%
– Percentage of surviving infants who received three doses of the polio vaccine: 98%
– Percentage of surviving infants who received the first dose of the measles-containing vaccine: 94%
– Percentage of children who received the second dose of measles-containing vaccine as per national schedule: 94%
– Percentage of surviving infants who received three doses of hepatitis B vaccine: 95%
– Percentage of surviving infants who received three doses of Haemophilus influenzae type b vaccine: 98%
– Percentage of surviving infants who received the last dose of rotavirus vaccine as recommended: 95%
– Percentage of surviving infants who received three doses of pneumococcal conjugate vaccine: 97%
Adolescent Birth Rate (Births Per 1,000 Adolescent Girls and Young Women), 2017-2023:
– Aged 10-14: 0
– Aged 15-19: 2
Share of Household Income, 2015-2023:
– Bottom 20%: 8%
Gross Domestic Product (GDP) Per Capita (Current US$), 2015-2023: $33,834
Government Expenditure on Health as % of GDP, 2015-2023: 9.2%
Government Expenditure on Health as % of Government Budget, 2015-2023: 21.4%

Notes: Under-five mortality rate – Probability of dying between birth and exactly 5 years of age, expressed per 1,000 live births.
Infant mortality rate – Probability of dying between birth and exactly 1 year of age, expressed per 1,000 live births.
Neonatal mortality rate – Probability of dying during the first 28 days of life, expressed per 1,000 live births.
Mortality rate (children aged 5 to 14 years) – Probability of dying at age 5–14 years expressed per 1,000 children aged 5.
Maternal mortality ratio – Number of deaths of women from pregnancy-related causes per 100,000 live births during the same time period (modelled estimates).
Lifetime risk of maternal death – Lifetime risk of maternal death takes into account both the probability of becoming pregnant and the probability of dying as a result of that pregnancy, accumulated across a woman’s reproductive years (modelled estimates).
BCG – Percentage of live births who received bacilli Calmette-Guérin (vaccine against tuberculosis).
DTP1 – Percentage of surviving infants who received the first dose of diphtheria, pertussis and tetanus vaccine.
DTP3 – Percentage of surviving infants who received three doses of diphtheria, pertussis and tetanus vaccine.
Polio3 – Percentage of surviving infants who received three doses of the polio vaccine.
MCV1 – Percentage of surviving infants who received the first dose of the measles-containing vaccine.
MCV2 – Percentage of children who received the second dose of measles-containing vaccine as per national schedule.
HepB3 – Percentage of surviving infants who received three doses of hepatitis B vaccine.
Hib3 – Percentage of surviving infants who received three doses of Haemophilus influenzae type b vaccine.
Rota – Percentage of surviving infants who received the last dose of rotavirus vaccine as recommended.
PCV3 – Percentage of surviving infants who received three doses of pneumococcal conjugate vaccine.
Adolescent birth rate – Number of births per 1,000 adolescent girls and young women aged 10–14 and 15–19.
Share of household income – Percentage of income received by the 20 per cent of households with the highest income, by the 40 per cent of households with the lowest income and by the 20 per cent of households with the lowest income.
Gini Coefficient – Gini index measures the extent to which the distribution of income (or, in some cases, consumption expenditure) among individuals or households within an economy deviates from a perfectly equal distribution. A Lorenz curve plots the cumulative percentages of total income received against the cumulative number of recipients, starting with the poorest individual or household. The Gini index measures the area between the Lorenz curve and a hypothetical line of absolute equality, expressed as a percentage of the maximum area under the line. Thus a Gini index of 0 represents perfect equality, while an index of 100 implies perfect inequality.
Palma Index of income inequality – Palma index is defined as the ratio of the richest 10% of the population’s share of gross national income divided by the poorest 40%’s share.
GDP per capita (current US$) – GDP per capita is gross domestic product divided by midyear population. GDP is the sum of gross value added by all resident producers in the economy plus any product taxes and minus any subsidies not included in the value of the products. It is calculated without making deductions for depreciation of fabricated assets or for depletion and degradation of natural resources. Data are in current US dollars.
Government revenue as percentage of GDP – Revenue is cash receipts from taxes, social contributions, and other revenues such as fines, fees, rent, and income from property or sales. Grants are also considered as revenue but are excluded here.
Government expenditure – General government final consumption expenditure (formerly general government consumption) includes all government current expenditures for purchases of goods and services (including compensation of employees). It also includes most expenditures on national defence and security, but excludes government military expenditures that are part of government capital formation.

Source: United Nations Children’s Fund, The State of the World’s Children 2024: The Future of Childhood in a Changing World – Statistical Compendium. UNICEF, Nov. 20, 2024.

Health expenditure per capita, USD PPP, 2022
– Government/compulsory: $4,491
– Voluntary/Out-of-pocket: $759
– Total: $5,251
Health expenditure as a share of GDP, 2022
– Government/compulsory: 9.8%
– Voluntary/out-of-pocket: 1.7%
Health expenditure by type of financing, 2021
– Government schemes: 8%
– Compulsory health insurance: 77%
– Voluntary health insurance: 2%
– Out-of-pocket: 12%
– Other: 1%
Out-of-pocket spending on health as share of final household consumption, 2021: 2.4%
Price levels in the healthcare sector, 2021 (OECD average = 100): 65
Population coverage for a core set of services, 2021
– Total public coverage: 100%
– Primary private health coverage: 0%
Population aged 15 years and over rating their own health as bad or very bad, 2021: 13.6%
Life expectancy at birth, 2021: 84.5
Infant mortality, deaths per 1,000 live births, 2021: 1.7
Maternal mortality rate, deaths per 100,000 live births, 2020: 4.3
Hospital workforce per 1,000 population, 2021
– Physicians: 1.93
– Nurses and midwives: 7.52
– Healthcare assistants: 1.22
– Other health service providers: 3.68
– Other staff: 2.33
Practicing doctors per 1,000 population, 2021: 2.6
Medical graduates per 100,000 population, 2021: 7.2
Practicing nurses per 1,000 population, 2021: 12.1
Nursing graduates per 100,000 population, 2021: 52.7
Ratio of nurses to doctors, 2021: 4.7
Practicing pharmacists per 100,000 population, 2021: 199
Remuneration of hospital nurses, USD PPP, 2021: $41,000
Remuneration of hospital nurses, ratio to average wage, 2021: 1.1
Hospital beds per 1,000 population, 2021: 12.6
Average length of stay in hospital, 2021: 16.0
Average number of in-person doctor consultations per person, 2021: 11.1
CT scanners per million population, 2021: 116
MRI units per million population, 2021: 57
PET scanners per million population, 2021: 5
Proportion of primary care practices using electronic medical records, 2021: 42%
Expenditure on retail pharmaceuticals per capita, USD PPP, 2021
– Prescription medicines: $702
– Over-the-counter medicines: $128
– Total: $829
Expenditure on retail pharmaceuticals by type of financing, 2021:
– Government/compulsory schemes: 72%
– Voluntary health insurance schemes: 1%
– Out-of-pocket spending: 27%
– Other: 0%
Share of the population aged 65 and over, 2021: 28.9%
Share of the population aged 65 and over, 2050: 37.7%
Share of the population aged 80 and over, 2021: 9.5%
Share of the population aged 80 and over, 2050: 15.8%
Adults aged 65 and over rating their own health as good or very good, 2019: 26%
Share of adults aged 65 and over receiving long-term care, 2021: 2.7%
Estimated prevalence of dementia per 1,000 population, 2021: 32.2
Estimated prevalence of dementia per 1,000 population, 2040: 43.7
Total long-term care spending as a share of GDP, 2021: 2.2%
Long-term care workers per 100 people aged 65 and over, 2021: 6.8
Share of long-term care workers who work part time or on fixed contracts, 2021
– Part-time: 40.4%
– Fixed-term contract: na
Long-term care beds in institutions and hospitals per 1,000 population aged 65 years and over, 2021
– Institutions: 26.5
– Hospitals: 8.0
Total long-term care spending by provider, 2021
– Nursing home: 45%
– Hospital: 21%
– Home care: 19%
– Households: 0%
– Social providers: 0%
– Other: 15%

Source: OECD (2023), Health at a Glance 2023: OECD Indicators, OECD Publishing, Paris, doi.org/10.1787/7a7afb35-en.

Population, Midyear 2022: 123,951,692
Population Density (Number of Persons per Square Kilometer): 328.94
Life Expectancy at Birth, 2022: 84.82
Infant Mortality Rate, 2022 (per 1,000 live births): 1.68
Under-Five Mortality Rate, 2022 (per 1,000 live births): 2.35
Projected Population, Midyear 2030: 118,514,802
Percentage of Total Population Aged 65 and Older, Midyear 2022: 29.92%
Projected Percentage of Total Population Aged 65 and Older, Midyear 2030: 31.38%
Projected Percentage of Total Population Aged 65 and Older, Midyear 2050: 37.50%

Source: United Nations, Department of Economic and Social Affairs, Population Division (2023). Data Portal, custom data acquired via website. United Nations: New York. Accessed 12 May 2023.

Current health expenditure (CHE) per capita in US$, 2022: $3,889.36

Source: Global Health Observatory. Current health expenditure (CHE) per capita in US$. Geneva: World Health Organization. Last accessed Jan. 23, 2025.

Out-of-pocket expenditure (OOP) per capita in US$, 2022: $426.79

Source: Global Health Observatory. Out-of-pocket expenditure (OOP) per capita in US$. Geneva: World Health Organization. Last accessed Jan. 23, 2025.

Out-of-pocket expenditure as percentage of current health expenditure (CHE) (%), 2022: 10.97%

Source: Global Health Observatory. Out-of-pocket expenditure as percentage of current health expenditure (CHE) (%). Geneva: World Health Organization. Last accessed Jan. 23, 2025.

Domestic private health expenditure (PVT-D) as percentage of current health expenditure (CHE) (%), 2022: 13.99%

Source: Global Health Observatory. Domestic private health expenditure (PVT-D) as percentage of current health expenditure (CHE) (%). Geneva: World Health Organization. Last accessed Jan. 23, 2025.

Domestic private health expenditure (PVT-D) per capita in US$, 2022: $543.98

Source: Global Health Observatory. Domestic private health expenditure (PVT-D) per capita in US$. Geneva: World Health Organization. Last accessed Jan. 23, 2025.

Domestic general government health expenditure (GGHE-D) as percentage of current health expenditure (CHE) (%), 2022: 86.01%

Source: Global Health Observatory. Domestic general government health expenditure (GGHE-D) as percentage of current health expenditure (CHE) (%). Geneva: World Health Organization. Last accessed Jan. 23, 2025.

Domestic general government health expenditure (GGHE-D) as percentage of gross domestic product (GDP) (%), 2022: 9.82%

Source: Global Health Observatory. Domestic general government health expenditure (GGHE-D) as percentage of gross domestic product (GDP) (%). Geneva: World Health Organization. Last accessed Jan. 23, 2025.

Domestic general government health expenditure (GGHE-D) per capita in US$, 2022: $3,345.38

Source: Global Health Observatory. Domestic general government health expenditure (GGHE-D) per capita in US$. Geneva: World Health Organization. Last accessed Jan. 23, 2025.

Annual household out-of-pocket payment in current USD per capita, 2020: $552

Source: Global Health Expenditure Database. Health expenditure series. Geneva: World Health Organization. Last accessed May 13, 2023.

Total Health Spending, USD PPP Per Capita (2020): $4,665.64

(Note: “Health spending measures the final consumption of health care goods and services (i.e. current health expenditure) including personal health care (curative care, rehabilitative care, long-term care, ancillary services and medical goods) and collective services (prevention and public health services as well as health administration), but excluding spending on investments. Health care is financed through a mix of financing arrangements including government spending and compulsory health insurance (“Government/compulsory”) as well as voluntary health insurance and private funds such as households’ out-of-pocket payments, NGOs and private corporations (“Voluntary”). This indicator is presented as a total and by type of financing (“Government/compulsory”, “Voluntary”, “Out-of-pocket”) and is measured as a share of GDP, as a share of total health spending and in USD per capita (using economy-wide PPPs).”

Source: OECD (2023), Health spending (indicator). doi: 10.1787/8643de7e-en (Accessed on 14 May 2023).

“Japan’s health system is distinctly characterized by universal health insurance, which provides excellent health outcomes at a relatively low cost with equity (Ikegami N et al., 2011; Murray CJL, 2011). By law, all residents of Japan (including foreign nationals with a residence card) must be enrolled in a health insurance programme.

“There are two main types of health insurance in Japan – the Employees’ Health Insurance System and National Health Insurance (NHI) (previously called Community Health Insurance). The Employees’ Health Insurance System is provided to employed workers (company employees) and their dependents, while NHI is designed for self and unemployed people (hence those not eligible to be members of Employees’ Health Insurance) and is run by municipal governments (i.e., cities, towns and villages).

“Patients’ co-payments for medical expenses must be paid at every visit to clinics and hospitals. The nationally uniform fee schedule (i.e., amount of reimbursement, including the patients’ co-payment) covers most health-care procedures and products, including drugs. The health insurance pays 70–90% of the cost while the remainder is paid by the insured as co-payment. The co-payment rate as of March 2017 is as follows: pre-elementary school3 = 20%; elementary school up to age 69 years = 30%; age 70–75 years = 20%; and age 75 years or above = 10% (see more details in Chapter 3) (Ishii M, 2012).”

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’s journey towards the universal insurance system has been marked by eras of foundation, expansion and managed growth in a post-War nation. But seemingly, the path to universal insurance was illuminated by strong egalitarian principles. Comparatively, with reference to other countries at the same level of industrialization and wealth, it is not surprising that the universal insurance system could be achieved in Japan; however, what remains unusual is the breadth and depth of the health system that has been achieved.

“Unique to the Japanese health system is the existence of both: Employees’ Health Insurance plans and Community Health Insurance (CHI) plans, which are now classified as National Health Insurance. Employee’s Health Insurance system has its origin in the Bismarckian system of social health insurance in Germany. Although Employees’ Health Insurance and CHI have different origins, together they extended coverage to the entire population over time. CHI – which later became National Health Insurance (NHI), mainly covered self-employed and temporary workers.

“The history of national insurance systems after the Second World War was marked by a movement towards attaining a higher level of care, in terms of health-care and welfare similar to that of Western nations. Even now, tensions among contending political parties, interest groups and public opinion on health care and health insurance have continued to influence political debate, especially during national elections.”

“The government regulates and controls nearly all aspects of the health system, including the health insurance system. Across the 47 prefectures, there are a total of 1718 municipalities. There are three types of municipalities in Japan: cities, towns and villages. The Central and local (prefectural/municipal) governments are responsible by law for ensuring a system that efficiently provides quality health-care services. The Central Government sets the nationally uniform fee schedule for insurance reimbursement and subsidizes and supervises local governments, insurers and health-care providers. It also establishes and enforces detailed regulations for insurers and health-care providers at the prefecture levels.

“Based on regional context, each prefecture is required by the Health Care Structural Reform Act passed in June 2006 to create detailed descriptions called “Medical Care Plans (MCP)”. By promoting collaboration and differentiation of medical institutions, these MCP aims to secure medical services for local residents, where necessary healthcare will be provided seamlessly from the acute phase to the long-term phase, including in-home care. Initially, the MCP was introduced in 1986 to control the escalating number of hospital beds. However, the 2006 Act strengthened the MCP by adding “disease-specific integrated clinical pathways” and stipulating effective liaisons among providers (clinics and hospitals) on a disease-specific basis. One should be cautioned that “integrated clinical pathway” is different from “in-hospital clinical pathway,” which aims to streamline the hospitalization. MCP may include evaluations of quality of care on a regional basis, and some prefectures also included clinical indicators. However, most indicators are limited to structural and process measures, and outcome indicators are not included.

“Each prefectural government is responsible for developing this “MCP” for effective and high-quality health-care delivery. Prefectural governments are also in charge of annual reviews and inspections of hospitals to ensure maintenance of compliance with regulatory standards. If a hospital admits too many patients per nurse – an indication of a poor quality of hospital care – the reimbursement rate for the hospital is reduced.”

Japan: Health System Overview - National Policies - World Health Systems Facts

World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems and policies in the US and sixteen other nations.

Page last updated October 18, 2025 by Doug McVay, Editor.