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CHAPTER 24 HEALTH AND SANITATION
This chapter covers health, sanitation, injuries and diseases, and medical institutions.
The section of health contains statistics on intake of nutrition and physique and physical fitness, etc. The sources of data are "National Health and Nutrition Survey" by the Ministry of Health, Labour and Welfare, "School Health Examination Survey" and "Physical Fitness Test" by the Ministry of Education, Culture, Sports, Science and Technology.
The section of sanitation contains statistics on meal service facilities, environmental health facilities and activities of health centres. The sources of data are "Report on Public Health Administration and Services" and "Report on Regional Public Health Services and Health Promotion Services" by the Ministry of Health, Labour and Welfare.
The section of injuries and diseases contains statistics on disease contraction, medical treatment and causes of deaths of the Japanese people. The sources of data are "Statistics on Food Poisoning", "Comprehensive Survey of Living Condition of People on Health, Labour and Welfare", "Patient Survey" and "Vital Statistics" (see "2 Population and Households") by the Ministry of Health, Labour and Welfare. In addition, data on diseases or physical anomalies of pupils and students are obtained from the above-mentioned "School Health Examination Survey" by the Ministry of Education, Culture, Sports, Science and Technology.
The section of medical institutions contains statistics on medical and pharmaceutical institutions and persons engaged in these institutions. The sources of data are "Survey of Medical Institutions", "Hospital Reports", "Survey of Physicians, Dentists and Pharmacists" and the above-mentioned "Report on Public Health Administration and Services" by the Ministry of Health, Labour and Welfare.
National Health and Nutrition Survey
This survey has been conducted annually since 1945 by the Ministry of Health, Labour and Welfare with an aim to clarify the physical conditions, intake of nutrition, etc. and lifestyle of the people. In 2003, the Act for Promotion of Health was promulgated, and the former National Nutrition Survey was extended to cover the health of people, and the name was changed to the present one. It had been conducted four times a year (spring, summer, autumn and winter) until 1963, but the frequency was changed to once a year from 1964.
The survey covers households and their members within the districts selected at random from the survey districts of Comprehensive Survey of Living Condition of People on Health and Welfare, and is conducted by the method of enumerator's interview through prefectures, cities having health centres and special wards, and health centres. The survey for 2013 was conducted in November on 5,204 households in 300 districts.
Intake of nutrition
Intake of nutrition is calculated, according to the Standard Tables of Food Composition in Japan (2010), from the results of a survey of foodstuff taken by the selected households in an ordinary day of nutritional intake, avoiding public holidays and ceremonial occasions.
School Health Examination Survey (Fundamental Statistical Survey)
This survey is conducted every year by the Ministry of Education, Culture, Sports, Science and Technology with the aim to clarify conditions of growth and health of pupils and students of schools. This survey is based on the health examination regularly conducted at schools. The statistics were first published in 1900 in the "Statistics on Physical Measurement of Pupils and Students", but suspended temporarily during the war, and then restarted in 1948 as the "School Health Statistics". The survey included medical examination in addition to the items on physical measurement theretofore surveyed, and was renamed, in 1960 and onward, as "School Health Examination Survey", following the enactment of the School Health Act in 1958.
The survey is a sample survey covering pupils and students of 5 years through 17 years of age enrolled in kindergartens, elementary, lower secondary, upper secondary and secondary schools. Reports on physical conditions, diseases, physical anomalies, etc. are made by the heads of the selected schools through prefectures from April to June every year. While the sampling design was formerly the sampling with proportionate probabilities, the stratified two stage sampling is used for the survey on physical conditions, and the stratified cluster sampling is applied to the survey on health conditions. The survey of fiscal 2014 covers 7,755 schools, and about 700,000 pupils and students for physical conditions survey and about 3,340,000 for health condition survey.
Physical Strength Test
This survey has been conducted annually since 1964 by the Ministry of Education, Culture, Sports, Science and Technology in order to clarify the present conditions of the national physical fitness and physical ability. The survey originally covered elementary, lower secondary and upper secondary schools and working youths, but the coverage has been extended to include adult population.
The survey is a sampling survey covering pupils and students attending public elementary, lower secondary and upper secondary schools, male students at national technical colleges, female students at public and private junior colleges, and national colleges and universities as well as working adult of 20--64 years old and elderly persons 65--79 years old. Pupils and students are surveyed annually from May to October at schools, and others are surveyed by the boards of education of shi (cities), machi (towns) or mura (villages). The survey of fiscal 2013 covered about 74,000 persons.
Report on Public Health Administration and Services
The Report on Public Health Administration and Services is compiled by the Ministry of Health, Labour and Welfare to clarify the actual performances of sanitation administration in the prefectures, the designated cities and the core cities. This report was initiated as "Case Reports of Ministry of Health and Welfare" along with the establishment of the Ministry of Health and Welfare (now, the Ministry of Health, Labour and Welfare) in 1938. The basis of the report was established by the complete revision made in 1954. It was reorganised and renamed to the present name based on the corresponding to the partial revision of the Local Autonomy Act in fiscal 2000, and has been conducted on the basis of the Paragraph 1, Part 4 of Article 245 of the Local Autonomy Act.
The report is compiled every year based on the annual reports from prefectures, designated cities and core cities. Since 1982, however, following paramedical workers are surveyed every two years: masseurs, finger pressure therapists, acupuncturists, moxa- cauterizers, judo reposition experts, dental hygienists, dental technicians, public health nurses, midwives, nurses, assistant nurses.
Meal service facilities
Specific meal service facilities refer to those continuously providing 100 meals or more at a time or 250 meals or more per day for a large number of specified persons; and other meal service facilities are those other than the specific meal service facilities, continuously providing meals for a large number of specified persons.
Report on Regional Public Health Services and Health Promotion Law
This report is compiled with an aim of efficient and effective implementation of the local health measures on the basis of reports submitted to the Ministry of Health, Labour and Welfare for every fiscal year. It was initiated in 1954 as the "Report on Management of Health Centers", and was renamed as "Report on Local Health Activities" in 1997, and then, became "Report on Local Health and Elderly Health Activities" in 1999 by integrating with the "Report on Elderly Health Activities". In 2008, the "Act on Elderly Health" was revised, and such elderly health services that are not rendered by the insurers of health insurance became to be handled by municipalities based on the "Act on Assurance of Medical Care for Elderly People", and then, the title was changed to "Report on Regional Public Health Services and Health Promotion Services". The report is composed of two parts, namely, Local Health Part and Health Promotion Part.
The report is compiled by the Ministry of Health, Labour and Welfare by collecting reports from all the health centres (hokenjo) and municipalities through the prefectures, designated cities or core cities.
Health centres
The centres are established by prefectures or cities designated by cabinet order, in accordance with the Local Health Act. The centres serve as the core institution for the public sanitation activities such as disease prevention, health promotion, environmental sanitation.
Statistics on Food Poisoning
The Statistics on Food Poisoning were compiled with the aim to grasp the occurrence of food poisoning and its victims (including deaths) effectively on the basis of reports submitted to the Ministry of Health, Labour and Welfare. The Statistics on Food Poisoning were first compiled in 1878 when the system of notification of cases of food poisoning and misuse of medicines was established. Later in 1947, the survey system was rearranged in accordance with the enactment of the Food Sanitation Act. Since 1952, the statistics on food poisoning had been provided by the "Abridged Statistics on Food Poisoning" and "Detailed Statistics on Food Poisoning" until 1973 when the both statistics were integrated as the "Statistics on Food Poisoning".
The Statistics on Food Poisoning cover food poisoning, etc. regulated by the Food Sanitation Act. Questionnaires are completed monthly at the health centres, based on the notifications by the doctors who diagnosed diseases or conducted post-mortem examinations, and are submitted to the Ministry of Health, Labour and Welfare through prefectures, cities having health centres and special wards.
Comprehensive Survey of Living Conditions (Fundamental Statistical Survey)
This survey is conducted by the Ministry of Health, Labour and Welfare with the aim to provide basic data for the effective planning and implementation of welfare and labour policy. It was initiated in 1986 by consolidating "Basic Survey for Welfare Policy", "National Health Survey" and "Basic Survey for Health and Hygiene". Full scale surveys are conducted every three years and simplified surveys are conducted in other years.
The survey is a sampling survey covering all the households and their members within the sample districts chosen by a stratified random sampling method from the enumeration districts. The household questionnaires and the questionnaires on health are distributed and collected by the enumerators through the channels of prefectures, cities having health centres and special wards, and health centres. The 2013 survey, the tenth large-scale one, was conducted as of 6 June covering about 300,000 households and about 740,000 household members in 5,530 districts.
Patient Survey (Fundamental Statistical Survey)
This survey is conducted by the Ministry of Health, Labour and Welfare with the aim to clarify the number and their diseases conditions of patients who use hospitals or clinics, etc. The survey was initiated as the predecessor "Survey on Conditions of Diseases Viewed from Institutions" in 1948. And since 1953, including the survey of discharged patients, the survey had been conducted every year. In 1984, expanding the survey contents and sample size, the survey frequency was changed to once in three years.
It is a sample survey covering medical institutions selected by stratified random sampling, by secondary medical area for inpatients and discharge of hospitals, and by prefecture for the clinics and outpatients of hospitals. The survey is conducted by the method of entering the questionnaires by the administrators of medical institutions through the channel of prefectures, cities having health centres and special wards, and health centres. The reference date was originally a day in July, but since 1984, it is a day designated for each medical institution among three days in the middle of October. All the patients who received treatment on the survey date at the survey institutions and those who were discharged in September are surveyed.
Survey of Medical Institutions (Fundamental Statistical Survey)
This survey has been conducted by the Ministry of Health, Labour and Welfare since 1953, with the aim to clarify geographical distribution and conditions of hospitals and clinics throughout the country. It had been conducted annually until 1972. In 1973, the ordinance was revised and the survey was reorganised into the present form consisting of two parts: the static survey and the dynamic survey. The static survey is conducted every three years with the aim to grasp the conditions of all the medical institutions, whereas the dynamic survey is conducted monthly on the basis of the applications and reports of opening and closing submitted by medical institutions.
The static survey covers all the hospitals and clinics established under the Medical Care Act, and conducted by the method of entering questionnaires by the administrators of medical institutions through the channel of prefectures, cities having health centres and special wards, and health centres. The reference date had been 31 December until 1981, but it has been 1 October since 1984. The dynamic survey is conducted through the channel of prefectures, and cities having health centres and special wards.
Hospital Reports
The reports have been compiled every month since 1949 by the Ministry of Health, Labour and Welfare in order to clarify the utilisation of hospitals and clinics equipped with beds by the patients. Since 1973, the situation of persons engaged as of 1 October has been inquired by this survey.
The survey covers all the hospitals prescribed by the Medical Service Act, and is conducted by the method of entering the questionnaires by the administrators of hospitals through prefectures, cities having health centres and special wards, and health centres.
Survey of Physicians, Dentists and Pharmacists
This survey is conducted by the Ministry of Health, Labour and Welfare with the aim to clarify the distribution and working conditions of physicians, dentists and pharmacists. Under the provisions of the Medical Practitioners Act and the Dental Practitioners Act both enacted in 1948 and the Pharmacists Act enacted in 1960, all the physicians, dentists and pharmacists are obliged to notify of the conditions as of the end of December every year to the Minister of Health, Labour and Welfare. The survey is based on the notices and had been conducted every year until the partial revision of the acts in July 1982. It has been conducted every two years since then.
The reference date is 31 December, and the survey is conducted through the channel of prefectures, cities having health centres and special wards, and health centres.