## The beginning of active health promotion measures

• "All Japan Physical Fitness" began, triggered by Tokyo Olympics (1964).

The mortality rate of neonatal and infants went down, while life expectancy at birth increased. Diseases affecting adults were emerging in spite of an improvement in nutrition and body size.

• 1st Public Health Promotion Measures (1978 and after), 2nd Public Health Promotion Measures (1988 and after)

From ‘adult disease’, whose focus is aging, to “life-style related disease”, whose focus is the pathogenesis process (Council on Public Health, 1996).

Re-engineering of healthcare measures in the region: The roles played by municipalities and Public Health Centers were clearly defined by the “Community Health Law” (1994), which was a revision of the ‘Health Center Law’.

Promotion of measures in the fields of maternal, child, geriatric and occupational health.

## The beginning of comprehensive health promotion measures

• The MHLW was founded (2001).

• Formulation of Health Japan 21 (2000) and the enactment of the Health Promotion Law (2003): Health promotion adopted a nationwide approach aiming at the goal of improving lifestyle, etc. in response to the changes in the disease structure.

• Switchover to the prevention oriented, long-term care insurance systems (2006): Review of preventive long-term care insurance benefits, and introduction of community support projects.

- Specific medical checkups and specific health guidance begun (2008): “Metabolic syndrome” became a focus to promote countermeasures against life-style related disease.

Trends in life expectancy at birth, infant mortality rates and neonatal mortality rates

Source: Life expectancy at birth from 'Abridged life tables' and 'Complete life tables', Statistics and Information Department of the Minister's Secretariat, MHLW

Infant mortality rates and neonatal mortality rates from 'Vital Statistics', Statistics and Information Department of the Minister's Secretariat, MHLW

(note): 1. Life expectancy at birth before 1972 does not include Okinawa Pref.

2. Infant mortality rates and neonatal mortality rates before 1972 do not include Okinawa Pref.

Intake of food group (1 person/day)	Average height
1950	1960	1970	1980	1950	1960	1970	1980
grains	77%	71%	56%	49%	10 yrs . old	Boy	127.1 cm	131.6 cm	135.3 cm
Vegetables	242g	219g	249g	251g	Girl	126.6 cm	132.0 cm	136.2 cm
Fruit	42g	59g	81g	155g	Boy	161.8 cm	165.0 cm	167.8 cm
Sea food	61g	76g	87g	93g	Girl	152.7 cm	153.7 cm	155.6 cm
Meat	8 g	30 g	43 g	68 g

Source: Ministry of Health and Welfare “National nutrition

Source: Ministry of Education, Culture, Sports, Science and Technology 'School health statistics survey'

Indicators	1950	1960	1970	1980	Source	Remarks
Leading causes of death	1st: Tuberculosis 2nd: Cerebrovascular diseases 3rd: Pneumonia & Bronchitis	1st: Cerebrovascular diseases 2nd: Malignant neoplasms 3rd: Heart diseases	1st: Cerebrovascular diseases 2nd: Malignant neoplasms 3rd: Heart diseases	1st: Cerebrovascular diseases 2nd: Malignant neoplasms 3rd: Heart diseases	Statistics and Information Department of the Minister's Secretariat, MHLW "Vital Statistics"	"Malignant neoplasms" became the top killer in 1981. Excluding Okinawa Pref. in 1950, 1960 and 1970.
Percent distribution of cerebrovascular diseases, malignant neoplasms and heart diseases	24.7 %	44.2 %	54.8 %	61.9 %	Statistics and Information Department of the Minister's Secretariat, MHLW "Vital Statistics"	Excluding Okinawa Pref. in 1950, 1960 and 1970.