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AJPH First Look, published online ahead of print Feb 28, 2008
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AJPH.2007.116012v1
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April 2008, Vol 98, No. 4 | American Journal of Public Health 589-594
© 2008 American Public Health Association
DOI: 10.2105/AJPH.2007.116012

research-article

Interplay of Politics and Law to Promote Health: Improving Economic Equality and Health: The Case of Postwar Japan

Stephen Bezruchka, MD, MPH, Tsukasa Namekata, PhD, DrHSc and Maria Gilson Sistrom, RN, MSN

Stephen Bezruchka is with the School of Public Health and Community Medicine, University of Washington, Seattle. Tsukasa Namekata is with the School of Public Health and Community Medicine, University of Washington, and the Pacific Rim Disease Prevention Center, Seattle. Maria Gilson Sistrom is with the School of Nursing, Oregon Health & Science University, Portland.

Correspondence: Requests for reprints should be sent to Stephen Bezruchka, MD, MPH, Department of Health Services, School of Public Health and Community Medicine, Box 357660, University of Washington, Seattle, WA 98195-7660 (e-mail: sabez{at}u.washington.edu).

ABSTRACT

The health situation in Japan after World War II was extremely poor. However, in less than 35 years the country’s life expectancy was the highest in the world. Japan’s continuing health gains are linked to policies established at the end of World War II by the Allied occupation force that established a democratic government. The Confucian principles that existed in Japan long before the occupation but were preempted during the war years were reestablished after the war, facilitating subsequent health improvements. Japan’s good health status today is not primarily the result of individual health behaviors or the country’s health care system; rather, it is the result of the continuing economic equality that is the legacy of dismantling the prewar hierarchy.




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