Japan

Being able to swim empowers individuals to make choices, have agency, and be free to choose core aspects of their life, such as working safely on or near water. It is also associated with lifelong health benefits and reduces the risk of drowning. Using data from the Lloyd’s Register Foundation World Risk Poll 2019, this paper provides the first global estimates of adults’ ability to swim without assistance. Individuals in high-income countries are considerably more likely to report being able to swim without assistance than individuals in low-income countries. Disparities also exist within countries. In particular, women are less likely to be able to swim without assistance than men in virtually all countries, birth cohorts, and levels of education. Investing in reducing inequalities in life skills, such as swimming, can foster economic development and empowerment, especially in light of threats, such as climate change.

Air pollution is a global challenge to people’s health and has severe economic consequences. The region of Northeast Asia is no exception. Across most regions in Japan, and in the entire territories of Korea and China, annual average concentrations of fine particulate matter are above the guideline levels indicated by the World Health Organisation, indicating a risk to health. Policy action to tackle air pollution across the three countries, could prevent air pollution related illnesses and deaths, without affecting economic growth. This report presents projections for the impact of air pollution polices until 2050, with differing levels of regional coordination. Projections for current policies are compared with unilateral policy action, whereby each of the three countries introduce more stringent policies to tackle air pollution; alongside regionally coordinated policy action by all three countries; and policy action on a global level. The report presents the health, agricultural and economic impacts, and identifies considerable benefits from further coordination on air pollution policies, such as with regional and global policy action.

This review assesses Japan's public health system, highlights areas of strength and weakness, and makes a number of recommendations for improvement. The review examines Japan's public health system architecture, and how well policies are responding to population health challenges, including Japan's ambition of maintaining good population health, as well as promoting longer healthy life expectancy for the large and growing elderly population. In particular, the review assesses Japan's broad primary prevention strategy, and extensive health check-ups programme, which is the cornerstone of Japan's secondary prevention strategy. The review also examines Japan's exposure to public health emergencies, and capacity to respond to emergencies as and when they occur.

Currently, Japan has the highest old-age dependency ratio of all OECD countries, with a ratio in 2017 of over 50 persons aged 65 and above for every 100 persons aged 20 to 64. This ratio is projected to rise to 79 per hundred in 2050. The rapid population ageing in Japan is a major challenge for achieving further increases in living standards and ensuring the financial sustainability of public social expenditure. However, with the right policies in place, there is an opportunity to cope with this challenge by extending working lives and making better use of older workers' knowledge and skills. This report investigates policy issues and discusses actions to retain and incentivise the elderly to work more by further reforming retirement policies and seniority-wages, investing in skills to improve productivity and keeping up with labour market changes through training policy, and ensuring good working conditions for better health with tackling long-hours working culture.

The present report on Japan is the seventh report in the Investing in Youth series. In three statistical chapters, the report provides an overview of the labour market situation of young people in Japan, presents a portrait of young people who are not in employment, education or training (the NEETs) and analyses the income situation of young people in Japan. Two policy chapters provide recommendations on how Japan can improve the school-to-work transition of disadvantaged young people, and on how employment, social and training programmes can help the NEETs find their way back into education or work. Earlier reviews in the same series have looked at youth policies in Brazil (2014), Latvia and Tunisia (2015), Australia, Lithuania and Sweden (2016).

This report reviews the quality of health care in Japan, and seeks to highlight best practices, and provides a series of targeted assessments and recommendations for further improvements to quality of care. One of Japan’s foremost policy challenges is to create an economically-active ageing society. Excellent health care will be central to achieving this. A striking feature of the Japanese health system is its openness and flexibility. In general, clinics and hospitals can provide whatever services they consider appropriate, clinicians can credential themselves in any speciality and patients can access any clinician without referral. These arrangements have the advantage of accessibility and responsiveness. Such light-touch governance and abundant flexibility, however, may not best meet the health care needs of a super-ageing society. Japan needs to shift to a more structured health system, separating out more clearly different health care functions (primary care, acute care and long-term care, for example) to ensure that peoples’ needs can be met by the most appropriate service, in a coordinated manner if needed. As this differentiation occurs, the infrastructure to monitor and improve the quality of care must simultaneously deepen and become embedded at every level of governance –institutionally, regionally and nationally.