OECD Reviews of Public Health: JAPAN A healthier tomorrow Frances - - PowerPoint PPT Presentation

OECD Reviews of Public Health: JAPAN

A healthier tomorrow

Frances esca Col Colombo, Tok

• kyo

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)

Source: OECD Health Statistics 2017.

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 75.0 74.7 74.6 74.2 40 50 60 70 80 90 Years 1970 2015

Apparently low rates of risky behaviour…

Average lif life expectancy is is th the lon longest in in th the OECD Average sm smokin ing rate is is belo low th the OECD average Alc lcohol l con

• nsumption is

is well ll belo low th the OECD average Japan’s obesity rate is the lowest in the OECD

… but a closer look reveals important health ri risks

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 15.0 .0% over 80 80 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 in incr creasing, g, e.g. rise rise in in excess drin rinking of

• f women (+2

(+20g/day) Japan’s obesity rate is the lowest in the OECD… but adjusted BMI shows 30.% obesity for men

The Public Health System can be further strengthened

OECD Public Health Reviews: Ja Japan

Chapter 1. Japan’s Public Health System

Chapter 3

Chapter 2. Primary Prevention and Health Japan 21 Chapter 3. Health Check-Ups Chapter 4. Responding to Public Health Emergencies

4 main areas of f action

Strengthen Japan’s Public Health System More targeted health checks and screening Ensure a robust response to public health emergencies Reinforce and refine the primary prevention strategy

Robust public health system focused on local response

Strengthen Japan’s public health system

Government, employers, civil society are engaged with promoting health lives Japan’s decentralised system presents challenges – better coordination is needed Leverage data to ensure good performance across the system

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

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 Health Japan 21 (HJ21) – a comprehensive programme aimed at improving healthy lifestyles

Broad set of policies to tackle unhealthy behaviors and promote healthy life

HJ2 J21 and population-level primary ry prevention

Some population- level policies are in place, e.g. tobacco reduction Current focus could be too diffuse – many different targets Population-level policies could be strengthened, for tobacco, food and 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

• f interventions

Population-level pri rimary ry prevention

Focus on main risk factors: smoking, diet, alcohol

Str tronger tobacco poli

• licy 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

• n 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
• fr

front-of

• f-pack food lab

labell llin ing

• Restrictions on
• n ad

advertis ising to

• ch

child ildren

• Elim

liminate tr trans-fat fr from in industria ial production Pop

• pulation-le

level l alc alcohol l pol

• lic

icies

• Regulation of
• f th

the mar arketin ing of

• f alc

alcohol products e.g. . restrictin ing sp spon

• nsorship

ip by y alc alcohol l producers

• Pac

ackage warnin ing lab labels ls

• So

Some restrictions on

• n th

the availa ilabili lity of

• f alc

alcohol l e.g.

• in

in petrol l stations

• 3. Health check-ups and

cancer screening

Japan takes secondary prevention very serious with extensive screening

Health check-ups and cancer screening

Cancer mortality is low and survival rates are good No national cancer screening programme An unusually high number of check- ups – some or 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

• f 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

Earthquakes and tsunamis Typhoons, extreme temperatures Floods, landsides Pandemics and infectious diseases

A country ry vulnerable to hazards and threats… with public health impacts

Earthquakes and tsunamis Typhoons, extreme temperatures Floods, landsides Pandemics and 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 robust in infrastructure and dedic icated capabilit ities, e.g. staff, supplies comprehensive ris isk k assessments, , modellin ing and awareness

Strengthen capacity to respond to public health emergencies

Better-use exercises and drills to prepare and improve MHLW should establish a permanent Emergency Operation Centre Strengthen monitoring, information sharing mechanisms, and collaboration 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 @OECD_social Follow us on Twitter www.oecd.org/els/health-systems/ Visit our website Read the report www.oecd.org/health/public-health- reviews.htm