Measures for National Health Promotion

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1 References. Health and Medical Services Measures for National Health Promotion Overview Changes in National Health Promotion Measures The st National Health Promotion Measures (FY 98988) (Basic idea). Lifetime health promotion Promote primary prevention of geriatric diseases. Encourage health promotion projects through three major elements (diet, fitness exercises, and rest) (special focus on diet) (Outline of measures) Lifetime health promotion Establishment of health checkups and a complete health guidance system from infants and small children through to the elderly " Establishment of health promotion bases Establishment of health promotion centers, municipal health centers, etc. Securing sufficient manpower such as public health nurses and dieticians # Dissemination and enlightenment of health promotion Establishment of municipal health promotion councils Promoting the use of recommended dietary allowances Nutritional content labelling for processed food Conducting studies on health promotion, etc. etc. The nd National Health Promotion Measures (FY 988 ) (Active 8 Health Plan) (Basic idea). Lifetime health promotion. Encourage health promotion projects with the focus on exercise habits as they are lagging behind the other two of the three elements (diet, fitness exercise, and rest) (Outline of measures) Lifetime health promotion Enhanced health checkup and guidance system from infants and small children through to the elderly " Establishment of health promotion bases Establishment of health science centers, municipal health centers, health promotion facilities, etc. Securing sufficient manpower such as health fitness instructors, registered dieticians, and public health nurses # Dissemination and enlightenment of health promotion Promoting the use of and revising recommended dietary allowances Promoting recommended exercise allowance Promoting the system to approve health promotion facilities Promoting Tobacco Action Program Promoting a system of nutrition information labelling for meals eaten outside home Promoting cities with health oriented cultures and health resorts Conducting studies on health promotion, etc. etc. Healthy Japan (FY ) (st Century Measures for National Health Promotion) (Basic idea). Lifetime health promotion Focusing on primary prevention, extending healthy life expectancy and enhancing people's quality of life. Setting specific targets to serve as an index for national health and medical care standards and promoting health building programs based on evaluations. Creating social environments that support individuals' health promotion (Outline of measures) National health promotion campaign Dissemination and enlightenment of effective programs and tools with regular revision Dissemination and enlightenment of the acquisition of good exercise habits and improved dietary habits with a focus on metabolic syndrome " Implementation of effective medical examinations and health guidance Steady implementation of health checkups and health guidance with a focus on metabolic syndrome for insured persons/dependents aged or older by Health Care Insurers (since FY 8) #$Cooperation with industry Further cooperation in voluntary measures of industries % Human resource development (improving the quality of medical professionals) Improved training for human resource development in cooperation between the government, prefectures, related medical organizations, and medical insurance organizations & Development of evidencebased measures Revision of data identification methods to enable outcome evaluations etc. (Guidelines) Dietary guidelines for health promotion (98) Report on nutritional content labelling for processed food (986) Announcement of a weight scale diagram and table (986) Report on smoking and healthrelated issues (98) (Guidelines) Dietary guidelines for health promotion (by individual characteristics: 99) Guidelines for nutrition information labelling for meals eaten outside home (99) Report on smoking and healthrelated issues (Revised) (99) Exercise guidelines for good health (99) Promoting guidelines on rest for health promotion (99) Report on the study group on Tobacco Action Program (99) Report by the study group on separate smoking areas in public places (996) Physical activity guidelines by age (99) (Guidelines) Dietary guidelines () Report by the committee for establishing standards to determine the effect of separating smoking areas () Sleep guidelines for health promotion () Guidelines on implementation of health checkups () Japanese Dietary Reference Intake ( edition) () Guidelines for wellbalanced diet () Smoking cessation support manual (6) Exercise and Physical Activity Reference for Health Promotion 6 (6) Exercise guidelines for good health 6 (exercise guide 6) (6)

2 References. Health and Medical Services OverviewoftheHealthPromotionLaw Chapter.GeneralProvisions ()Purpose Providebasicmattersregardingcomprehensivepromotionofpeople'shealthandmaketheefforttoimprovepublichealththrough implementationofmeasuresforpromotingpeople'shealth. ()Responsibilities People:Improvedinterestandunderstandingoftheimportanceofhealthylifestylehabitsinbeingawareofone'sownhealthstatusand maketheefforttostayhealthythroughoutlife. "Thegovernmentandlocalgovernments:Makeeffortstodisseminatetheappropriateknowledgeonhealthpromotion, collect/organize/analyze/makeavailableinformation,developandimprovethequalityofhumanresources,andprovidetherequired technicalsupport. #Healthpromotionserviceproviders(insurers,businessoperators,municipalities,schools,etc.):Makeanactiveefforttopromotehealth promotionprogramsforpeopleincludinghealthconsultations. ()Cooperationbetweenthegovernment,localgovernments,healthpromotionserviceproviders,andotherrelatedentities. Chapter.BasicPolicies(legallyestablishing HealthyJapan ) ()Basicpolicies Basicpoliciesforcomprehensivepromotionofpeople'shealthareformulatedbytheMinisterofHealth,LabourandWelfare. Basicdirectionwithpromotingpeople'shealth "Mattersregardinggoalsinpromotingpeople'shealth #Basicmattersregardingformulationofhealthpromotionplansofprefecturesandmunicipalities $Basicmattersregardingnationalhealthandnutritionsurveysand others %Basicmattersregardingcooperationbetweenhealthpromotionserviceproviders &Mattersregardingdisseminationoftheappropriateknowledgeondietaryhabits,exercise,rest,smoking,drinking,dentalhealth,and otherlifestylehabits 'Otherimportantmattersregardingpromotionofpeople'shealth ()Formulationofhealthpromotionplansforprefecturesandmunicipalities(healthpromotionmeasureplansforthepeople) ()Guidelinesonimplementationofhealthcheckups Guidelinesonimplementationofhealthcheckupsbyhealthpromotionserviceproviders,notificationoftheresults,ahealthhandbook beingissued,andothermeasuresareformulatedbytheministerofhealth,labourandwelfareinsupportingpeople'slifelongself managementofhealth. RevisionoftheHealthandMedicalServiceLawfortheAged(revisedin6) Improvedhealthcheckupsforpreventinglifestylediseasesandcontinuedimplementationofvariousother healthcheckupsandhealthservices <Atpresent> <Aftertherevision(sinceFY8)> HealthandMedical ServiceLawfortheAged Medicalcarebenefitsfortheelderly Contributionforhealth [ ] servicesfortheaged,etc. Healthservicesincludinghealth checkupsbymunicipalities Publicfundedsubsidies Formulationofbasicpoliciesforpromoting people'shealth Implementationoflifestylehabitconsultationsby municipalities Followand expandpurpose andobjectiveof thehealth PromotionLawto reviseintothe "Actforthe Assuranceof MedicalCarefor theelderly" Continue implementationofall theongoingvarious programsthrough thehealthpromotion Law,etc. TheActforAssuranceof MedicalCarefortheElderly Medicalcarebenefitsfortheelderly Longlifemedicalcaresystem(medicalcare systemforelderlyinthelatterstageoflife) [ Elderlyintheearlystage ] FinancialadjustmentforMedicalServices Promotionofmedicalexpenditurecontrol Obligatinghealthcheckupsforlifestylediseases andhealthguidancebeingprovidedbyhealth careinsurers,includingmunicipalities Publicfundedsubsidies Legallysecurecooperation Formulationofbasicpoliciesforpromoting people'shealth Implementationoflifestylediseaseconsultations andhealthcheckupsotherthanforlifestyle diseasesbymunicipalities Cooperativeimplementationofcomprehensivehealthpromotion TheHealthPromotion Law,etc. TheHealthPromotion Law,etc.

3 References. Health and Medical Services OverviewoftheNewHealthFrontierStrategy [Purposeofthestrategy] Aimedatextendingthehealthylivesofpeopleaccordingtotheirindividualsituationthroughanationalhealthpromotioncampaign,with thefocusonpreventivemeasures,effortswillbemadetocreateahealthynationwherepeoplesufferingfromdisease,peoplewith disabilities,andtheelderlycanfullydisplaytheirabilitiesandlivefulllivesthroughreviewingtheroleofthefamily,enhancinglocal communities,andinnovativenewtechnologiesandsystems. [Concretecontentofthestrategy] ()Healthmeasurestobetakenbypeopleindividuallyaccordingtotheirsituation Healthmeasuresforprotectingandraisingchildren(childhealth) "Healthprogramstoaidfemales(women'shealth) #Furtherpromotionofmetabolicsyndromemeasures(overcomingmetabolicsyndrome) $Furtherpromotionofmeasuresagainstcancer(overcomingcancer) %Mentalhealthpromotion(mentalhealth) &FurtherpromotionofNursingCarePreventionmeasures(NursingCarePrevention) 'Dentalhealthpromotion(dentalhealth) ()Promotionoffoodeducation(foodselection) *Promotionofexercise/sports(physical) ()Families,communities,technologies,andindustriestosupporttheNewHealthFrontierStrategy Families/communitiesasahealthsupportentity(family/community) "Effortstoexpandhumanactivityareas(humanactivityareaexpansion) #Innovationsinmedicalcare/welfaretechnologies(researchanddevelopment) [Nationalstrategypromotioncampaign] Effortswillbemadetodevelopanationalcampaignincooperationwithlocalgovernmentsthroughactivepublicitythatutilizestheinternet andothermediaandtheappointmentof healthambassadors toclarifythecontentofthestrategyforthepublicandfacilitateasmany peopleaspossibletakingconcreteaction [Implementationperiodofthestrategy] ForyearsfromFYtoFY6 [Procedureofthestrategy] Formulateconcreteimplementationplans(actionplans)andimplementconcretemeasures. [Guidelinesofthestrategy] Inordertorepresenttheprogressofthestrategyinanunderstandablemannerguidelineswillbeformulatedandincludedintheaction plans.

4 References. Health and Medical Services Detailed Data Status of formulating health promotion plans in prefectures/municipalities [Status of formulating health promotion plans in prefectures] Plans were alredy formulated in every prefecture (at the end of March ) [Status of formulating health promotion plans in municipalities and special wards] Health centerdesignated cities Special wards in Tokyo Other municipalities 6, Already formulated, To be formulated in FY 8 To be formulated in FY 8 To be formulated in FY 9 or later (As of Dec., ) [Status of formulating health promotion plans in municipalities by prefectures] Prefecture Hokkaido Aomori Iwate Miyagi Akita Yamagata Fukushima Ibaraki Tochigi Gunma Saitama Chiba Tokyo Kanagawa Niigata Toyama Ishikawa Fukui Yamanashi Nagano Gifu Shizuoka Aichi Mie Shiga Kyoto Osaka Hyogo Nara Wakayama Tottori Shimane Okayama Hiroshima Yamaguchi Tokushima Kagawa Ehime Kochi Fukuoka Saga Nagasaki Kumamoto Oita Miyazaki Kagoshima Okinawa Number of municipalities Already formulated Formulation rate.%.8% 8.% 8.%.8% % 9.%.9% 66.% 8.9% 9.%.%.9% 9.% 8.%.%.% 6.%.% 6.% 8.% 8.% 98.%.8% 6.%.% 8.% 86.% 8.6% 8.6%.9% 6.% 8.% 6.% 6.%.% 8.%.% 8.8% 6.%.6% 6.9%.% 6.%.%.% 8.% In FY In FY In FY 9 or later ,, (Note) Excluding health centerdesignated cities and special wards. 8.9% 8

5 References. Health and Medical Services Detailed Data Number of Patients/Deaths Related to Lifestyle Diseases number of patients (, persons) Number of deaths (Person) Rate of deaths (Per,) Malignant neoplasm, 6,9 66. Diabetes,69,9. Hypertensive diseases,89 6,.9 Heart diseases,68,96 9. Cerebrovascular diseases,6 6,9. Source: < number of patients> "Patient Survey ", Statistics and Information Department, Minister's Secretariat, MHLW <Number/rate of deaths> "Summary of Monthly Report of Vital Statistics ", Statistics and Information Department, Minister's Secretariat, MHLW Detailed Data Estimated Numbers Related to Diabetes Age (investigation objects:, men) Those strongly suspected of having diabetes Those with possibilities of having diabetes (investigation objects:, women) Those strongly suspected of having diabetes Those with possibilities of having diabetes 9 %.9% %.% 9.%.9%.%.6% 9.8% 9.%.%.% 9.%.% 8.%.6% 6 69.%.%.8% 6.%.%.%.% 9.% When the above figures are applied to the estimated population as of October, 6, the estimated numbers nationwide are as follows: Those strongly suspected of having diabetes: approximately 8. million people Those with possibilities of having diabetes: approximately. million people Source: "The national health and nutrition survey in Japan 6", Health Service Bureau, MHLW

6 References. Health and Medical Services Detailed Data Status of Patients and Those Having a High Risk of Contracting Metabolic Syndrome (Visceral Fat Syndrome) Of people aged to, in every men and in every women are either patients or are having a high risk of contracting metabolic syndrome (visceral fat syndrome). The estimated numbers are approximately 9.6 million patients, approximately 9.8 million people at high risk, and approximately 9. million in total. Those with a high risk of contracting metabolic syndrome (visceral fat syndrome) (abdominal circumference 8cm or longer and at least item is applicable) Those strongly suspected of having metabolic syndrome (abdominal circumference 8cm or longer and at least items are applicable) (%) (%) Those with a high risk of contracting metabolic syndrome (visceral fat syndrome) (abdominal circumference 9cm or longer and at least item is applicable) Those strongly suspected of having metabolic syndrome (abdominal circumference 9cm or longer and at least items are applicable) (Included in left) (Included in left) Those strongly suspected of having metabolic syndrome (visceral fat syndrome) Those with abdominal circumference 8cm or longer for men and 9cm or longer for women and at least of items (blood lipid, blood pressure, and blood glucose) are applicable. Those with a high risk of contracting metabolic syndrome (visceral fat syndrome) Those with abdominal circumference 8cm or longer for men and 9cm or longer for women and at least of items (blood lipid, blood pressure, and blood glucose) is applicable. Source: "The national health and nutrition survey in Japan 6", Health Service Bureau, MHLW Detailed Data Status of Exercise Habits (%) The percentage of people with exercise habits ( or older, by sex/age) or older (Note) People with exercise habits: Those who have continued exercise of at least minutes per day and at least days per week for at least a year. Source: "The national health and nutrition survey in Japan 6", Health Service Bureau, MHLW

7 References. Health and Medical Services DetailedData6 ChangesintheDistributionoftheFatEnergyRatio(orOlder) % % % 6% 8% % % % % 6% 8% % % % % 6% 8% % (Note)Fatenergyratio:Percentageofenergyintakefromfat Source:"ThenationalhealthandnutritionsurveyinJapan6", HealthServiceBureau,MHLW DetailedData [g] [g] [g] (.g).. (orolder) (.8g).. (orolder) (includedinright) (9.g) 9.. (orolder) (includedinright) 9yearsold 9yearsold 9yearsold 9yearsold 9yearsold 9yearsold 9yearsold 9yearsold 9yearsold Lessthan% %to9% %ormore AverageIntakeofVegetables,etc.(orOlder,bySex/Age) (6.g) (.g) (6.g). 8.6 (66.6g) (8.g) (.g). 8. (.g) (8.g) (6.8g). 8. Brightred,greenoryellowvegetables (.8g).. 9yearsold (6.6g) yearsold (8.9g). 8. 9yearsold (8.6g).. 669yearsold (8.g) yearsold (.g) yearsold (.9g) 6.9. orolder (8.g) orolder (9.g) 9.. orolder Othervegetables(excludingbrightred,green oryellowvegetables) (Note)Figuresinparenthesesrepresentthetotalintakeof"brightred,greenoryellowvegetables"and"othervegetables". Source:"ThenationalhealthandnutritionsurveyinJapan6",HealthServiceBureau,MHLW

8 References. Health and Medical Services Detailed Data 8 Percentage of People who Skip Breakfast ( or Older, by Sex/Age) (%) Source: "The national health and nutrition survey in Japan 6", Health Service Bureau, MHLW Detailed Data 9 (%) Status of Smoking Rate Smoking rate in Japan Source: "The national nutrition survey" until and "the national health and nutrition survey in Japan" since (Note) Definition of smoking and survey methods differ in the national nutrition survey until and the national health and nutrition survey in Japan hence simple comparison of these figures may be difficult Country Japan Germany France Netherlands Italy U.K. Canada U.S. Australia Sweden 669 (9.) 9.9 (9.). (8.6) (.).8 (.). (.). (.). (.). (.) 8.6 (9.) 6. or older Smoking rate in other countries (%) (.). (.) 8 (.). (9.) 8. (.). (6.). (.). (.) 9. (8.) 6. (9.) 8. Source: WHO Tobacco ATLAS (6) "The national health and nutrition survey in Japan 6" for the figures in Japan (Note) Figures in parentheses are from WHO Tobacco ATLAS () and the national nutrition survey

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