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“Health Japan 21”

Health Promotion in Japan. “Health Japan 21”. -National Health Promotion in the 21 st Century- Evaluation of Health Japan 21 Ministry of Health, Labour and Welfare. Background of Health Promotion Program. Unprecedented Rapid Aging Diversification of Lifestyle

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“Health Japan 21”

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  1. Health Promotion in Japan “Health Japan 21” -National Health Promotion in the 21st Century- Evaluation of Health Japan 21 Ministry of Health, Labour and Welfare

  2. Background of Health Promotion Program • Unprecedented Rapid Aging • Diversification of Lifestyle ↓ • Increase of Lifestyle-Related Diseases (LSRDs) ↓CVD, Heart Diseases, Diabetes,Cancer • Need to Strengthen Primary Prevention   in order to: (1) Extend healthy life expectancy (2) Improve QOL of every person (3) Prevent premature death “Health Japan 21”

  3. Four Unique Points of Health Japan 21 • Emphasis on primary prevention • Building of supportive environment • Setting of concrete goals and establishment of evaluation systems • Collaboration among multi-sectorial stakeholders

  4. Nine Foci of “Health Japan 21” and Target Setting 70 Targets in 9 areas: (1)Nutrition and Diet (2)Physical activity and Exercise (3)Rest and Mental Health (4)Tobacco (5)Alcohol (6)Dental Health (7)Diabetes (8)Diseases of circulatory system (9)Cancer

  5. (1) Nutrition and Diet1 Physiological factors Increase the number of people who maintain appropriate body weight • Indicators; • Under-weight females aged 20-2923.3% →< 15% • Obese males aged 20-60 24.3%　 → < 15% 2010 Target Definition; Under-weight: BMI < 18.5, Obesity: BMI > 25

  6. Nutrition and Diet2 Nutritional factors Decrease salt intake • Indicators; • Average salt intake (adults) 13.5g → < 10g 2010 Target Per day Increase vegetable intake • Indicators; • Average vegetable intake (adults) 292g → > 350g 2010 Target Per day

  7. Nutrition and Diet3 Behavioral factors Increase the number of people who control body weight • Indicators; • Male 62.6% , Female 80.1% →> 90% 2010 Target Decrease the number of people who do not eat breakfast • Indicators; • Junior & senior high school students 6.0% →0% • Male (20’s years old) 32.9%→<15% 2010 Target

  8. Nutrition and Diet4 Environmentalfactors Making “healthy menu” more available at restaurants, delis, and canteens, etc. Increase the number of activity groups to promote health and nutrition within communities or at working places Indicators and targets have been currently developed.

  9. Relevant National Activities Dietary Guidelines (1) • Establish a healthy rhythm by keeping regular hours for meals. ■Enjoy your meals. • Eat well-balanced meals with staple food , as well as main and side dishes. • Eat enough grains such as rice and other cereals. • Combine vegetables, fruits, milk products, beans and fish in your diet.

  10. Dietary Guidelines (2) • Recognize your healthy body weight and balance the calories you eat with physical activity. ■ Avoid too much salt and fat. • Take advantage of your dietary culture and local food products, while incorporating new and different dishes. • Reduce leftovers and waste through proper cooking and storage methods. • Assess your daily eating.

  11. (2) Physical Activity1 For Adults Increase in the number of people who exercise for health promotion • Indicators; • Male 52.6% , Female 52.8% →> 63% 2010 Target More walk in daily life • Indicators; • Male 8,202 steps →> 9,200 steps • Female 7,282 steps →> 8,300 steps 2010 Target per day

  12. Physical Activity2 For the Elderly Increase the number of people who participate in community events • Indicators; • Male 48.3% →> 58% • Female 39.7%→> 50% 2010 Target More walk in daily life • Indicators; • Male 5,436 steps →> 6,700 steps • Female 4,604 steps →> 5,900 steps 2010 Target per day

  13. (3) Rest and Mental Health Decrease the number of people who feel stress during the last month 2010 Target Indicators; 54.6%→< 49% Decrease the number of suicides 2010 Target Indicators; 31,755 →< 22,000

  14. (4) Tobacco1 The spread of right knowledge upon smoking and health 〈Proportion of informed persons〉 2010 Target Indicators; lung cancer 84.5%→100% Asthma 59.9% → 100% Bronchitis 65.5% → 100% Heart diseases 40.5% → 100% Stroke 35.1% → 100% Gastric ulcer 34.1% → 100% Abnormalities related to pregnancy 79.6% → 100% Periodontal disease 27.3% → 100%

  15. Tobacco2 Eliminating smoking by minors 2010 Target 〈Smoking rate〉 Indicators; Male (12 years old) 7.5%→0% Male( 17 years old) 36.9% → 0% Female(12 years old) 3.8% → 0% Female(17 years old) 15.6% → 0%

  16. (5) Alcohol Decrease the number of people who drink in large quantities 2010 Target Indicators; Male 4.1%→< 3.2% Female 0.3%→< 0.2% Eliminating drinking by minors Indicators; Male (14 years old) 25.4%→0% Male( 17 years old) 51.5% → 0% Female(14 years old) 17.2% → 0% Female(17 years old) 35.9% → 0%

  17. (6) Dental Health Increase the number of small children(3 years old) without tooth decay 2010 Target Indicators; 59.5%→ > 80% Increase the number of people who have 20 or moreteeth at age 80 and 24 or more at age 60 Indicators; 20 or more teeth at age 80 (75-84 years old) 11.5% → > 20% 24 or more teeth at age 60 (55-64 years old) 44.1% → > 50%

  18. (7) Diabetes Decrease estimated prevalence of diabetes mellitus 1997 2010 Target Indicators; 6.9 million→ 10 million* *10.8 million are estimated if their lifestyle is not improved Increase the number of people who continue the treatment of diabetes 2010 Target 〈among diabetic patients〉 Indicators; 45% → 100%

  19. (8) Diseases of circulatory system ・Decrease salt intake ・Increase potassiumintake ・Decrease obese adults ・Increase persons who exercise regularly ・Improvement of Hypertension ・Greater action on tobacco control ・Decrease the patients with hyperlipidemia ・Decrease the prevalence of diabetes ・stronger action on alcohol drinking ・Increase the number of people who undergo health examinations ・Decrease the death from diseases of circulatory system due to lifestyle improvement

  20. (9) Cancer ・Stronger action on tobacco control ・Decrease saltintake ・increase vegetable intake ・increase the number of people who eat fruits daily ・Decrease fat energy ratio ・Stronger action on alcohol drinking ・Increase the number of people who undergo cancer screening

  21. How to evaluateHealth Japan 21 • Assessment of targets and Evaluation • National health and nutrition survey • Diabetes Mellitus Survey • Cardiovascular disease survey • Time frame • Mid-term evaluation • Final evaluation

  22. National nutrition survey Health promotion law National health and nutrition survey National health and nutrition survey

  23. 19000 subjects (randomly selected 300 districts) Target population: National health and nutrition survey Component for the data collection: • Physical check for individual subjects • anthropometry • physical activity • Interview on medication, smoking, alcohol and exercise habit B. Dietary survey questionnaire on the kind of meals in the survey day C. Additional questionnaire on diet and lifestyle

  24. (NNS-J) Trends in prevalence of overweight (BMI>=25) (%) (%) Females Males (year of age)

  25. Diabetes Mellitus Survey • Blood test • HbA1c was used to detect the subjects with DM • Questionnaire • (On a questionnaire basis, the following questions were asked.) • Have you ever received medical treatment for DM? • Have you ever been diagnosis as DM by physicians? • How do you get the information about prevention or • treatment for DM?

  26. Estimated prevalence of diabetes mellitus(NSDM, 2002) Males Females Case: HbA1c>=6.1% or treated, Suspected: HbA1c 5.6-<6.1%

  27. Cardiovascular Diseases Survey • Questionnaire • Anthropometry • Blood pressure • Blood test (cholesterol, TG etc.) • Electrocardiogram(ECG)

  28. Proportion of people with hypertension (CVD survey 2000) Criteria for “hypertension” is >140/90mg/dl (2000 the Japanese society of hypertension) （％） 80.0 male 70.0 female 60.0 50.0 40.0 30.0 20.0 10.0 0.0 total ３０－３９ ４０－４９ ５０－５９ ６０－６９ ７０ -

  29. ２００５ ２０００ ２０１０ Time frame The time span of initiative is the end of the fiscal year 2010. • Mid-term evaluation：Fiscal year 2005 • Final evaluation ：Fiscal year 2010. Making plan Mid-term evaluation Final evaluation

  30. Thank you for your kind attention! Ministry of Health, Labour and Welfare Government of Japan

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