OECD Reviews of Public Health: JAPAN A healthier tomorrow Frances esca Col Colombo, Tok okyo 6 6 Feb ebruary 2019 2019
Japan: a long-lived, healthy population…
The lo longest-lived population in in the OECD Life expectancy at birth, 1970 and 2015 (or nearest year) Years 1970 2015 90 83.9 83.0 83.0 82.6 82.5 82.5 82.4 82.4 82.4 82.3 82.1 82.1 81.7 81.6 81.6 81.7 81.5 81.3 81.2 81.1 81.1 81.0 80.9 80.8 80.7 80.6 79.6 79.1 78.8 78.7 78.0 77.7 77.6 76.7 75.7 80 75.0 74.7 74.6 74.2 70 60 50 40 Source: OECD Health Statistics 2017.
Apparently low rates of risky behaviour… Average sm smokin ing rate is is belo low th the OECD average Alc lcohol l con onsumption is is well ll belo low th the OECD average Japan’s obesity rate is the lowest in the OECD Average lif life expectancy is is th the lon longest in in th the OECD
… but a closer look reveals important health ri risks Average smoking rate is below the OECD average… but t male ale sm smokin ing is is very ry hig igh Alcohol consumption is well below the OECD average… but t incr in creasing, g, e.g. rise rise in in excess drin rinking of of women (+2 (+20g/day) Japan’s obesity rate is the lowest in the OECD… but adjusted BMI shows 30.% obesity for men Average life expectancy is the longest in the OECD… by y 20 2050 50 36 36.4 .4 % of Japan’s population will be over 65 65 an and 15.0 15 .0% over 80 80
The Public Health System can be further strengthened
OECD Public Health Reviews: Ja Japan Chapter 2. Primary Chapter 1. Prevention and Japan’s Public Health Japan 21 Health System Chapter 4. Chapter 3. Health Responding to Chapter 3 Check-Ups Public Health Emergencies
4 main areas of f action Strengthen Reinforce and refine Japan’s Public the primary Health System prevention strategy More targeted Ensure a robust health checks and response to public screening health emergencies
Strengthen Japan’s public health system Government, Robust public health employers, civil system focused on society are engaged local response with promoting health lives Japan’s decentralised Leverage data to system presents ensure good challenges – better performance coordination is across the system needed
Encourage collaboration between stakeholders Focus on involving all Ministries in key strategies, e.g. HJ21 and emergency preparedness Encourage joined-up government at the local level – support sectors working together: education, health, employment, environment…
Focus on strengthening local capacity Minimum standards or expectations for local governments and employers Share successful practices, e.g. annual conference for local government on public health Use user-friendly data to benchmark local performance in public health
Finland: benchmark local performance Finland’s TEAviisari – Benchmarking system of health promotion capacity building
2. Reinforcing HJ21 and population-level primary prevention
Health Ja Japan 21 Health Japan 21 (HJ21) – a comprehensive programme aimed at improving healthy lifestyles increasing fruit and vegetable consumption, and exercise, reducing smoking and alcohol consumption, to improving mental wellbeing and reducing stress broad strategy – 53 targets – implemented at the local level
HJ2 J21 and population-level primary ry prevention Some population- Broad set of policies level policies are in to tackle unhealthy place, e.g. tobacco behaviors and reduction promote healthy life Population-level Current focus could policies could be be too diffuse – strengthened, for many different tobacco, food and targets alcohol
Strengthening HJ2 J21 Smaller number of priorities, e.g. smoking and salt reduction Recommend evidence-based programmes Guidelines and positive/negative incentives to assure effectiveness of interventions
Population-level pri rimary ry prevention Focus on main risk factors: smoking, diet, alcohol Str tronger tobacco poli olicy in in lin line with ith WHO Fr Framework: • Expand in indoor sm smokin ing ban an • More mar arketin ing restrictions • Vis isual l war arnin ings on on pac ackagin ing
Population-level pri rimary ry prevention Focus on main risk factors: smoking, diet, alcohol Promote healt althy food ch choices: • Move to o fr front-of of-pack food lab labell llin ing • Restrictions on on ad advertis ising to o ch child ildren • Elim liminate tr trans-fat fr from in industria ial production Pop opulation-le level l alc alcohol l pol olic icies • Regulation of of th the mar arketin ing of of alc alcohol products e.g. . restrictin ing sp spon onsorship ip by y alc alcohol l producers • Pac ackage warnin ing lab labels ls • So Some restrictions on on th the availa ilabili lity of of alc alcohol l e.g. • in in petrol l stations
3. Health check-ups and cancer screening
Health check-ups and cancer screening Japan takes Cancer mortality is secondary low and survival prevention very rates are good serious with extensive screening An unusually high No national cancer number of check- screening ups – some or programme many might be ineffective
An unusually high number of f health check-ups More health check- ups than other OECD countries Delivered by schools, works, municipalities…
Focus on a streamlined health check-up offer Undertake a a comprehensiv ive revie iew of the full ll healt lth check-up fie ield ld Economic evalu luation – weed out check-ups that are bad valu lue Targeted coverage of a streamlin ined set of check-ups
Building a national cancer screening programme Cancer screening is lower than OECD average No nationwide cancer screening programme NEXT STEPS: a standardised, national approach NEXT STEPS: strengthen the health information system and develop cancer registries
4. Preparing for public health emergencies
A country ry vulnerable to natural hazards Typhoons, extreme Earthquakes and temperatures tsunamis Pandemics and Floods, landsides infectious diseases
A country ry vulnerable to hazards and threats… with public health impacts Typhoons, extreme Earthquakes and temperatures tsunamis Pandemics and Floods, landsides infectious diseases
Generally well-prepared for public health emergencies sophis isticated le legal l framework for national emergencies and public health consequences all ll min inis istrie ies concerned in involv lved in emergency preparedness and response comprehensive ris isk k assessments, , modellin ing and awareness robust in infrastructure and dedic icated capabilit ities, e.g. staff, supplies
Strengthen capacity to respond to public health emergencies MHLW should establish a permanent Emergency Operation Centre Strengthen monitoring, information sharing mechanisms, and collaboration Better-use exercises and drills to prepare and improve Better- train health professionals on public health emergency preparedness
KEY PRIORITIES FOR JAPAN • Focus on a streamlined prevention package • Wit ith a narrower set of f cle lear expectations for all ll stakeholders • Backed up by stronger population-level policies
Find out more! Email me Francesca.Colombo@oecd.org Follow us on Twitter @OECD_social www.oecd.org/els/health-systems/ Visit our website www.oecd.org/health/public-health- Read the report reviews.htm
Recommend
More recommend
