The Great Expansion of Health & Medical Sociology in Japan:
Past, Present, and Future
The Japanese Society of Health and Medical Sociology
1. Postwar Japan (1945-1988)
Inflow of American Medical Sociology: Medical Sociology Study Circle (1955-1965)
Japan’s surrender in 1945 was a great historical event, comparable to the Meiji Restoration thatmarked the beginning of modern Japan in 1868. Japan was defeated for the first time in her history
and occupied by the Allied Forces, centered mainly around the American Forces. After a few yearsof post-war chaos, American academic information, including medical sociology as a branch ofsociology, flowed into Japan. Around the mid-1950s a small medical sociology circle of about ten
members was formed that was comprised of public health doctors and nurses working for medical
schools, as well as sociologists working for medical schools and national research institutes onmental health and health service administration. They held monthly meetings, mainly to study
American medical sociology.
Joint community surveys between public health doctors and sociologists date back to the early
1950s. Such contact between public health doctors and sociologists enabled the former to get a feelfor the importance of sociology and the latter to become aware of the existence of medical sociology
in the U.S.A. The Medical Sociology Study Circle did not issue any joint publications, but somemembers of the circle published introductory books on medical sociology, (Tanaka 1968; Ajiki 1970)
and academic papers and books on hospital workers’ strikes and the Japan Medical Association’s
fight against the Japanese government (Ajiki and Katano 1963), both of which spread throughout
Japan in the 1960s.
One member of the circle compiled a mimeographed textbook for social workers entitled
Introduction to Medical Sociology (Ajiki 1960) which was based on Medical Sociology: Theory,
Scope and Methods by Norman G. HAWKINS (1958). The former textbook contains an extremely
long, extensive list of books and papers on medical sociology and related areas mainly published in
the U.S.A., and consists of more than 200 titles divided among 12 sub-areas. This list starts with
“The Importance of the Study of Medical Sociology” (Bulletin of the American Academy ofMedicine, 1, 1894) and covers literature in this field until the end of the 1950s, e.g. “The Sociology
of Medicine” by George G. READER and Mary E. W. GOSS in Sociology Today edited by Robert K.
MERTON, Leonard BROOM, and Leonard S. COTTRELL, Jr, Basic Books, 1959. The American
Journal of Sociology, American Sociological Review, Rural Sociology, and other journals thatcarried medical sociology papers and the medical sociology books included in the above-mentioned
list were available in Japan in the 1950s.
Some of them were introduced at the Medical Sociology Study Circle’s meetings.

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The Birth of Health and/or Medical Sociology Departments in Medical Schools (Mid-1960s)
When the Medical Sociology Study Circle came to an end in the mid-1960s, health and medicalsociology departments were born in at least two medical schools in Tokyo. In these health andmedical sociology departments, public health doctors chaired the departments at first, but later
associate professors in sociology succeeded to the professor’s chairs. In those days a few, but not
many, sociologists began to be employed in the public health departments at medical schools or
schools of public health. Since those days, in Japan we have begun intentionally to use the term
‘health and medical sociology’ rather than ‘medical sociology’ to stress the point that sociology
should cover not only curative medicine but also the positive side of human health.
In 1968, the First International Conference of Social Science and Medicine was held in
Aberdeen, Scotland, and was attended by several former members of the Medical Sociology Study
Circle, who presented papers. One former member of the circle was appointed as a regional editor ofSocial Science and Medicine and was to edit a special issue entitled “Social Science and Medicine inJapan,” which was published later in November 1978 (Yamamoto 1978).
From the mid-1960s Japanese health and medical sociology began to be accepted domesticallyand made its debut internationally.
The results of a survey of members’ subspecialties conducted by the Japan Sociological Society
in the mid-1960s are as follows (the figures in brackets represent the number of respondents for eachsubspecialty): rural sociology (77); family sociology (38); industrial sociology (45); generalsociology (36); educational sociology (31); urban sociology (24); history of sociology (23); social
psychology (22); public opinion and mass communication (22); social welfare (22); social pathology
and criminal sociology (20); sociology of culture (15); political sociology (14); sociology of religion(13); social groups or small groups (13); studies on labor (13); social stratification (11); population(8); social thought (7); sociology of knowledge (7); economic sociology (6); folk, nation, andnationalism (6); medical sociology (6); social organization and bureaucracy (6); moral sociology (4);societies and cultures of developing countries (4); and legal sociology (3). The total number of
respondents was 496, among which there were six members who had chosen medical sociology,
which came to 1.2% of the total respondents (Fukutake 1969).
On the Eve of the Birth of The Society for the Study of Health & Medical Sociology(1974-1989)
After the post-war recovery, rapid economic development began in the mid-1950s. This rapid
economic growth began to destroy the environment and people’s health. From the mid-1950s to theearly 1960s, a strange disease causing spastic paralysis became prevalent in a fishing village called
Minamata. This disease was named Minamata disease. The cause of Minamata disease was
identified as seafood contaminated by organic methyl mercury discharged form a chemical factory.
In the mid-1960s cases of a similar disease were found very far from Minamata, along a river inwhich the water was contaminated by another large factory. This disease was called ’Ouch ouch’disease. Air pollution produced by petrochemical complexes in different industrial towns throughout
Japan caused many cases of asthma.
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In almost the same period of time, negligence by pharmaceutical companies caused
drug-related health hazards: subacute myelo-opticoneuropathy (SMON), caused by clinoquinol, ananti-diarrheal, as well as babies with deformed limbs born from mothers who had taken sleeping
drugs containing thalidomide in their pregnancy. Not only medical research for the purpose offinding the causes and treatment of the diseases but also sociological research into the lives of thepatients was required, and sociologists carried out surveys into the lives of the victims of industrial
waste, air pollution, and negligence by pharmaceutical firms.
As a result of reactions to the rapid economic development under the conservative national
government, progressive governors and mayors were elected in various local governments, including
the Tokyo Metropolitan Government. The Tokyo Metropolitan Government established agerontology research institute and a neuroscience research institute in which sociology departments
were set up. The progressive policies initiated by the progressive local governments and theaccumulated results of high national economic growth made the year 1973 a turning point for thehealth and welfare system. The government instituted free medical care for the aged, reduced thepercentage of co-payments required from dependents from 50% to 30%, and introduced a ceiling on
the total amount of co-payments. Tragically, all of these benefits originating in Japan’s higheconomic growth came to a halt in October of the same year, when the Fourth Arab-Israeli War
began. The Organization of Oil Exporting Countries (OPEC) used oil supplies as a diplomatic
weapon, and restricted exports to the countries supporting Israel. Most Western countries as well asJapan were affected, and oil prices increased by 30% to 50%. Japan’s high economic growth was
slowed. Eventually, the government had to introduce cost-containment measures in all areas,
including health services.
The Birth of the Society for the Study of Health & Medical Sociology (1974-1989)
Under the abovementioned conditions, in 1974 sociologists from medical schools and research
institutes who were seeking new roles as sociologists in the field of health as it faced new challenges
took the initiative of organizing the Society for the Study of Health & Medical Sociology. The
society started with just over 60 members.
In the following year of 1975, the number of members increased to almost 100. In 1989, when
the name of the society was changed to the Japanese Society of Health & Medical Sociology, thesociety expanded to 200 members.
Monthly meetings and an annual general meeting became regular events for the society.
The Japan Sociological Society Recognized the Society: Introduction of a Session on Health &Medical Sociology into the Annual Convention of the Japan Sociological Society
In 1973, for the first time, a session on health & medical sociology was introduced into theannual conventions of the Japan Sociological Society. Besides this session, three papers out of thefour presented in the session on Social Welfare and Social Pathology at the same convention were
papers relating to health & medical sociology. Thus, seven papers relating to health & medicalsociology were given at the 1973 annual convention. In the following year, 1974, when the Society
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for the Study of Health & Medical Sociology was established, ten papers on health & medicalsociology were given at three sessions at the annual convention of the Japan Sociological Society.
Until the end of the 1970s, nine or ten papers on health & medical sociology were given at three orfour sessions at the annual conventions of the Japan Sociological Society, with the exception of 1975,
when 13 papers were given at the annual convention. In the 1980s, the number of papers relating tohealth & medical sociology decreased to three papers in one session, except for seven papers in two
sessions in 1984, six papers in two sessions in 1985, and ten papers in two sessions in 1988. There
were no papers on health & medical sociology at the annual convention of the Japan SociologicalSociety in 1990 or 1991. A little ironically, in 1990 the Society for the Study of Health & Medical
Sociology was registered with the Science Council of Japan and upgraded to a registered academic
society called the Japanese Society of Health & Medical Sociology. After three papers were given in
1992, the health & medical sociology and social welfare sessions were combined under Social
Welfare, Health & Medical Sociology in 1993.
Publications
In 1976, a special issue on health and medical sociology was published in the official journal of
the Japan Sociological Society, The Japanese Sociological Review, to which several members of thissociety contributed.
This society published eight books from 1977 to 1988 (all in Japanese and published by
Kakiuchi Publishing Inc., Tokyo): Achievements and Issues of Health and Medical Sociology, 1977;
Development of Health and Medical Sociology, 1978; Organizations and Behaviors in Health andMedicine, 1979; Integration of Health, Medicine, and Welfare, 1980; Strategies for Primary HealthCare, 1981; Professionalization in Health and Medicine, 1982; and Trends in Health and Medical
Sociology, 1988.
Besides this series of publications, it is noteworthy that the second edition of The Handbook of
Medical Sociology edited by Howard E. FREEMAN, Sol LEVINE, and Leo G. REEDER(Prentice-Hall, 1972) was translated into Japanese and published in 1975 under the supervision of
three leading members of the society (Hinohara et al. 1972). In addition, as noted above a former
president of the society edited and published the aforementioned special issue of Social Science &Medicine in 1978, to which several members of the society contributed. (Yamamoto 1978).
These publications were followed by books on health and medical sociology written byindividuals or groups of Japanese sociologists, mainly in Japanese.
Two Asian International Meetings on Health and Medical Sociology
It is worth mentioning specially that this society hosted two Asian international meetings on
health and medical sociology in 1980 and 1986 in Yokohama and Urayasu, both of which areneighboring towns of Tokyo. These two international meetings were supported by the WHO
Regional Office for the Western Pacific, the Research Committee on Medical Sociology of theInternational Sociological Association, the Ministry of Health & Welfare, the Ministry of Education,
the Ministry of Foreign Affairs, local prefectural and municipal governments, and health and164medical care-related professional organizations. At each meeting there were around ten participantsfrom different parts of Asia and the Pacific; around ten from North America (the U.S.A. and Canada)
and Europe, and 100 to 120 from Japan. Both meetings devoted three days to academic sessions andone day to a study tour. The 1980 meeting focused on primary health care under the influence of thepresident of the meeting, Professor YAMAMOTO Mikio, a public health doctor, and the influence ofthe WHO’s emphasis on primary health care. At the 1986 meeting various other topics werediscussed, with particular attention being paid to urbanization and health problems, under the
influence of the president of the meeting, Professor ISOMURA Eiichi, an urban sociologist. These
two international meetings were epoch-making events not only for the Society for Study of Healthand Medical Sociology, but also for Japan’s sociological world.
2. The Era of the Japanese Society of Health and Medical Sociology (Two Decades: 1989-2011)
The First Decade of the Society (1989-2000): The Last Decade of the 20th Century
In May 1989, the Society for Study of Health & Medical Sociology was promoted to an
academically accredited society called the Japanese Society of Health and Medical Sociology. Its
official journal, The Japanese Journal of Health and Medical Sociology, which featured a peer
review system, began to be published once a year starting from 1990.
In the early 1990s there were some other new developments in the field of health and medicalsociology. The Research Group of the Sociology of Nursing was organized in the Japanese Societyof Health and Medical Sociology mainly by the teaching staff of nursing colleges and universities
and some clinical nurses. It has held regular meetings, contributed research papers to the official
journals of the society or those of the Japanese Nursing Association, and published translated
versions of books like The Nursing Shortage and the 1990s: Realities and Remedies by Richard C.
MCKILLIN. From 2004 on this research group has expanded its research repertoire from nursing
alone to nursing and social welfare care. At present, in 2011, this research group was comprised of
26 nurses and seven sociologists.
In 1992, the Medical Sociology Study Group was organized in the western part of Japan in
Kyoto and Osaka. They have held regular meetings once or twice a month and members havepublished several books on medical sociology from the mid-1990s to 2010.
In 1994, the Japan Association of Mental Health was launched when the Interim Conference of
the Research Committee 49 (RC 49) of Mental Health and Illness of the International Sociological
Association (ISA), was held in a town close to Tokyo. Since then this association has been affiliatedwith RC 49 of Mental Health and Illness of the ISA, just as the Japanese Society of Health andMedical Sociology has been with RC15 of Sociology of Health. They have held the annual
conventions and also run training courses for mental health consultants. They publish the journal
Sociology of Mental Health annually.
[The Number and the Academic Backgrounds of the Members]
Since its promotion to an accredited society, the number of members of the society has doubled
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from 200 in 1990 to 400 in 2000. Half of the members have come from the social sciences and arts:sociology (the majority), psychology, education, social welfare, anthropology, economics, politicalscience; 30% have come from nursing; and 20% from health sciences from the Health Sociology
Department in the School of Medicine, University of Tokyo and social medicine or public health. In
the second decade from 2001 to 2011, this breakdown of the academic backgrounds of the members
did not change much, even though the proportion of those who were connected with theabovementioned Health Sociology Department increased.
[Trends in Research Papers in the Journals from 1990 to 2000]
From 1990 to 2000, 11 official society journals were issued and 34 academic papers were
accepted. The number of papers contributed and accepted has been increasing in the second half of
this decade. Regarding the classification of the contents of the papers, ten out of the 34 papers(29.4%) were concerned with the “provision and utilization of health and medical care services,”
which ranked first. Secondly, six papers (17.6%) were on “relations between health and medical careproviders and patients”. Papers concerned with the “theory and methodology of health and medicalsociology” and the “QOL of patients and their families” both came in at four (11.8%) and came
third.
When the papers in the journals were classified according to three categories of researchmethods, “theoretical literature research papers” numbered 18 (51.4%) coming first, followed by“quantitative and statistical research papers” at 12 (34.3%), and “qualitative and descriptive or casestudy research papers” at five (14.7%) (see Table 1).
[Trends in the research papers presented at the annual conventions from 1991 to 2001]
The total number of papers given at the annual conventions from 1991 to 2001 was 126. Mostof the papers given at the annual conventions were concerned with the “QOL of patients and theirfamilies” (30 papers: 23.8%), the second most common were concerned with “relations between
health and medical care providers and patients” (28 papers: 22.2%), and the third most common
were concerned with two topics: the “education of health care providers” and the “provision andutilization of health and medical care services” (21 papers: 16.7%). Regarding the research methods,“quantitative and statistical research papers” numbered 59 (46.8%), coming first, “qualitative anddescriptive or case study research papers” numbered 36 (28.6%) in second place, and “theoretical
literature research papers” at 24 (19.0%) came in third place (see Table 2).
The Second Decade of the Society (2001-2011): The Start of the New Millennium[A Steady Increase in the Number of Members]
The number of members increased by more than 100 during the first five years from 2001 to
2005, and totaled more than 500. For the three years from 2005 to 2008, the number of members
increased by more than 100 and in 2008 exceeded 600. During the ten years from 2001, the numberof members increased by 30 each year and in 2011 it exceeded 700. The number of members willcontinue to rise from now on.
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[Trends in the Research Papers in the Journals from 2001 to 2011]
Since 2001, the official journal of the society has been published bi-annually. Twenty-one
issues of the journals brought out from 2001 to 2011, carrying 61 research papers. In this second
decade, the number of papers doubled as compared with the first decade from 1990 to 2000.
Regarding the themes of the papers, the “QOL of patients and their families” came first (17 out of
65: 27.9%). The second place was a tie between the three themes of the “education of health careproviders,” “relations between health and medical care providers and patients,” and “health andmedical ethics and thanatology” (ten papers each out of 65: 15.4%). The most popular theme in theprevious decade was the “provision and utilization of health and medical care services,” but thisdeclined to fifth place. The number of papers on “health and medical ethics and thanatology” hasbeen on an upward trend. Concerning the research methods, the number and proportion of papers on“qualitative and descriptive research or case studies” increased from five (14.3%) in the first decadeto as many as 34 papers (50.7%) in the second decade. By contrast the proportion of papers on“theoretical literature research” decreased from 51.4% to 26.9% and that of papers on “quantitativeand statistical research” decreased from 34.3% to 22.4% (see Table 1).
[Trends in the Research Papers Presented at the Annual Conventions from 2001 to 2011]
Among the papers given at the annual conventions during the decade from 2001 to 2011, papers
concerned with the “QOL of patients and their families” came in first (69 papers: 27.1%). Papers on“health-related awareness and behavior” were in second place (47 papers: 18.4%), in third place
were papers on the “education of health care providers” (31 papers: 12.2%), and in fourth place were
papers on “relations between health and medical care providers and patients” (28 papers: 11.0%).
The most rapid increase in the number of papers in this decade was shown by those in the “educationof health care providers.” They were followed by those on the “QOL of patients and their families.”
Concerning the research methods, the number and proportion of papers on “qualitative anddescriptive research or case studies” increased from 36 (28.6%) in the first decade to as much as 100
papers (39.2%). In particular, the proportion of papers on “quantitative and statistical research”
which had been the conventional research method decreased from 46.8% to 34.9% (see Table 2).
[The Main Themes of the Annual Conventions from 1989 to 2011]
As mentioned above and as seen in the trends in the main themes of the annual conventions of
the society, since the Japanese Society of Health and Medical Sociology is comprised of memberswith a sociology or social science backgrounds and those with health sciences backgrounds, i.e.
nursing and public health and medicine, in approximately equal numbers, research on the sociology
of medicine and sociology in medicine, as classified by Robert STRAUSS (1957), have gone hand in
hand, stimulating each other in making advances. This is a good characteristic of health and medicalsociology in Japan and should continue to develop (See Table 3).

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[Great East Japan Earthquake]
The Great East Japan Earthquake in 2011 caused extensive damage to Japanese society.
Socially vulnerable people, including the sick and the elderly, tended to fall victim to the disaster,and healthcare systems suffered severe damage. Health and medical sociologists have investigated
the social impact of this disaster. For example, there were attitude surveys for foreign healthcare
workers before they visited Japan and interview surveys that examined the evacuation and healthawareness of elderly people on a small island.
[The Future Prospects for Health and Medical Sociology in Japan]
Regardless of the distance from the practice of health and medical care or the health science
disciplines, health and medical sociology research is expected to be carried out from the point ofview of people living with health problems rather than that of health and medical specialists. As forthe methodology, the illness experienced approach, narrative approach, salutogenic approach, andempowerment approach should be strengthened. As its theme, sociological research on the systems
and policies for providing health care should be extended further in the future.
REFERENCES:
Ajiki Masao, 1960, Introduction to Medical Sociology (in Japanese), Japan National Council ofSocial Welfare.
Ajiki Masao, 1970, Medical Sociology (in Japanese), Igakushoin.
Ajiki Masao and Katano Takashi, 1963, The Behaviour and Characteristics of Medical Groups (inJapanese), Seishinshobo.
Anesaki Masahira, 2008, “History of public health in modern Japan: The road to becoming thehealthiest nation in the world.” pp. 55-72 in Public health in Asia and the Pacific: historicaland comparative perspectives, edited by Milton J. LEWIS and Kerrie L. MACPHERSON.
Routledge.
Fukutake Tadashi, 1969, “Trends and Problems in Japanese Sociology.” in Methodology andProblems of Sociology, Tokyo University Press.
Hinohara Shigeaki, Hashimoto Masami, and Sugi Masataka, 1975, Iryoshakaigaku (= Medical
Sociology), Ishiyakushuppan. (Japanese Translation of The Handbook of Medical Sociology
edited by Howard E. Freeman, Sol Levine, and Leo G. Reeder. Prentice-Hall, 1972).
Powell, Margaret and Anesaki Masahira, 1990, Health care in Japan, Routledge.
Strauss, Robert, 1957, “The nature and status of medical sociology,” American Sociological Review,
22, 200-204
Tanaka Tsuneo, 1968, Medical Sociology (in Japanese), Gakubunsha.
Yamamoto Mikio, 1978, “Special Issue - Social-Science and Medicine in Japan,” Social Science &Medicine: Part a Medical Sociology 12(6A):441-41.
Note: This paper, except for the section on the Great East Japan Earthquake, is, with written
permission, a reprint of an article by Anesaki and Yamazaki entitled “Health & Medical Sociology in
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Japan: Past, Present, and Future” in the following journal: Guido GIARELLI and Roberto
VIGNERA (eds.), Salute e Società XI-n, 2/2012, pp.116-130.
Contact Information:
The Japanese Society of Health and Medical Sociology
E-mail：jshms-office@bunken.co.jp
URL: http://square.umin.ac.jp/medsocio/index_e.htm

Table1. No. of papers in the journals.
1990～2000

Total
(%)

No.

(%)

No.

2001～2011
(%)

No.

99

100

34

100

65

100

Health and medical ethics and thanatology

13

13.1

3

8.8

10

15.4

Health related recognition and behaviour

6

6.1

3

8.8

3

4.6

Education of health care providers

13

13.1

3

8.8

10

15.4

Relations between health and medical careproviders and patients

16

16.2

6

17.6

10

15.4

Provision and utilization of health and medical careservices

18

18.2

10

29.4

8

12.3

Theory and methodology of health and medicalsociology

9

9.1

4

11.8

5

7.7

QOL of patients and their families

21

21.2

4

11.8

17

26.2

Social etiology and social inequality

3

3.0

1

2.9

2

3.1

Theoretical literature research

36

35.3

18

51.4

18

26.9

Qualitative and descriptive research or case studies

39

38.2

5

14.3

34

50.7

Quantitative and statistical research

27

26.5

12

34.3

15

22.4

Total
【Subjects】【Research methodology】

Two are doublle counted as quantitive and qualitative research.

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Table2. No. of presentations at the annual conventions.
1991,93,94,97
-99

total

2002-04,
2007-09

No.

(%)

No.

(%)

No.

(%)

381

100

126

100

255

100

Health and medical ethics and thanatology

22

5.8

2

1.6

20

7.8

Health related recognition and behaviour

68

17.8

21

16.7

47

18.4

Education of health care providers

47

12.3

16

12.7

31

12.2

56

14.7

28

22.2

28

11.0

48

12.6

21

16.7

27

10.6

6

1.6

3

2.4

3

1.2

QOL of patients and their families

99

26.0

30

23.8

69

27.1

Social etiology and social inequality

18

4.7

3

2.4

15

5.9

Others

1

0.3

1

0.8

0

0

Theoretical literature research

77

20.2

24

19.0

53

20.8

Qualitative and descriptive research or case studies

136

35.7

36

28.6

100

39.2

Quantitative and statistical research

148

38.8

59

46.8

89

34.9

Total
【Subjects】

Relations between health and medical care providers andpatients
Provision and utilization of health and medical careservices
Theory and methodology of health and medicalsociology【Research methodology】

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Table3. The main themes of the annual conventions from 1989 to 2011year

The main themes

1989

Health Problems in Globalization

1990

Nursing and Sociology

1991

Today’s Problems of Health and Medical Sociology

1992

Regional Health Care and Social Welfare Planning and Sociology

1993

Institutional Care for the Elderly: Planning and Assessment

1994

Family Support in Health and Medical Care

1995

Health, Medical and Welfare Reform and Health Care Professions

1996

Changes in Health Care Provider-Patient Relationship and Patient’s Autonomy

1997

Information Disclosure and Self-determination in Health and Medical Care

1998

Modern and Post-modern in Health Care

1999

Interdisciplinary and Vertical Approach in Gerontology

2000

Health Care Professions in the 21 Century

2001

Theory and Methodology of Health and Medical Sociology

2002

Human services and Health and Medical Sociology

2003

Possibility of Health and Medical Sociology

2004

Past. Present and Future of Health and Medical Sociology

2005

Frontier of Health and Medical Sociology

2006

Living with Chronic Illness and Severe Stress2007

Social Inequality and Health, Medicine and Welfare

2008

Health in the City and Health Promotion

2009

Medical Accidents and Health and Medical Sociology

2010

Risk and Stress and Health and Medical Sociology

2011

Expansion of Health Communicationst

171