Silviase/jgov_v1.4_full_ann huggingface dataset:
# (3) Health Promotion/Disease Measures

## Health Centers, etc

## Overview

## Activities of Health Centers

Health centers are front-line comprehensive public health administrative institutions that offer both personal and objective health services. Personal health services include broad-based services, services requiring specialized technologies, and services requiring team work of various health care professionals. In addition, health centers provide required technical assistance for health services provided by municipalities.

Health centers are established in 370 locations in 47 prefectures, 101 locations in 70 designated cities, and 23 locations in 23 special wards under the Community Health Act (As of April 1, 2013).

##

Health checkups, reporting emergence of patients, etc.

Non-regular health checkups of Tuberculosis, preventive vaccination, home-visit guidance, controlled medical examination, etc.

(Infectious Diseases Act)

AIDS individual counselling programs (including free anonymous examination), AIDS consultation

(AIDS guidelines)

Medical consultation of

intractable diseases, etc.

(Outlines of infectious disease

neasures)

Identification of current situation regarding mental health, mental health and welfare consultation, home-visit guidance of mental health, office works regarding medical care and protection, etc.

(Mental Health and Welfare Act)

Home-visit guidance for premature infants, providing medical aid for premature infants, etc.

(Maternal and Child Health Act)

##

##

Providing business license for restaurants, supervising business facilities, guidance, etc. (Food Sanitation Act)

##

Providing business license, notification, on-site investigation, etc.

(Act on Coordination and Improvement of Environmental Health Industry, Entertainment Places Act, Public Bath Houses Act, Inns and Hotels Act, Barbers Act, Cosmetologists Act, Laundries Act)

## Health centre administration council Directors of health centers (doctors)

• Health risk management

• Technical support/advice for municipalities

• Adjustment between municipalities

• Formulation/promotion of regional health/medical care plans

## 494 health centers

370 in prefectures 101 in designated cities

23 in special wards

Doctors

Physical therapists

Dentists

Occupational therapists

Pharmacists

Public health nurses

Veterinarians

Midwives

Clinical radiologic technologists

Nurses

Medical social workers

Certified psychiatric social workers

Laboratory-medical technologists

Medical technologists

Food sanitation inspectors

Environmental sanitation inspectors

Registered dietitians

Dietitians

Dental hygienists

Abattoir inspectors, etc.

###

On-site investigation of hospitals, clinics, medical corporations, dental clinics, clinical laboratories, etc. (Medical Care Act, Dental Technicians Act, Act on Clinical Laboratory Technicians, etc.)

### <>

Publicity

Dissemination and

enlightenment

Health statistics

Health consultation
## Detailed Data 2 Changes in Number of Public Health Nurses

Changes in Number of Health Centers

FY	1998	1999	2000	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013
Total number of health centers	663	641	594	592	582	576	571	549	535	518	517	510	494	495	495	494
Prefectures	490	474	460	459	448	438	433	411	396	394	389	380	374	373	372	370
Cities	137	136	108	109	111	115	115	115	116	101	105	107	97	99	100	101
Special wards	36	31	26	24	23	23	23	23	23	23	23	23	23	23	23	23

Source: Health Service Bureau, MHLW

(Note) The number of clinics is as of April 1 of each year.

Detailed Data 1 Number of Medical Personnel at Health Centers by Occupation

Occupation	Number of personnel
Doctors	794
Dentists	95
Pharmacists	2,823
Veterinarians	2,236
Public health nurses	7,781
Midwives	66
Nurses	405
Assistant nurses	13
Radiology technicians, etc.	546
Medical technologists, etc.	826
Registered dietitians	1,119
Dietitians	171
Dental hygienists	314
Physical/occupational therapists	99
Others	11,267
<Included in the upper column>
Medical social workers	41
Mental health welfare counselors	1,065
Nutrition counselors	1,026
Total	28,555

Source: “Report on Regional Public Health Services and Health Promotion Services”, Statistics and Information Department, Minister's Secretariat, MHLW

(Modified by Health Service Bureau) (as of the end of FY2012)

(Unit: person)

FY1998	FY1999	FY2000	FY2001	FY2002	FY2003	FY2004	FY2005	FY2006	FY2007	FY2008	FY2009	FY2010	FY2011	FY2012
Municipalities	15,355	15,366	15,643	15,856	16,004	15,908	15,629	15,315	14,519	14,483	14,498	14,613	14,179	15,015	14,753
Designated cities/ special wards	4,167	4,450	4,584	4,696	4,907	5,047	5,281	5,524	5,563	5,604	5,964	6,094	6,081	6,280	6,256
Subtotal	19,522	19,816	20,227	20,552	20,911	20,955	20,910	20,839	20,082	20,087	20,462	20,707	20,260	21,295	21,009
Prefectures	4,620	4,535	4,481	4,439	4,311	4,242	4,178	4,014	3,935	3,889	3,800	3,737	3,640	3,689	3,659
Total	24,142	24,351	24,708	24,991	25,222	25,197	25,088	24,853	24,017	23,976	24,262	24,444	23,900	24,984	24,668

Source: FY1998: "Report on Regional Public Health Services", Statistics and Information Department, Minister's Secretariat, MHLW

FY1999-2007: "Report on Regional Public Health Services and Health Services for the Aged", Statistics and Information Department, Minister's Secretariat, MHLW

FY2008 onward: "Report on Regional Public Health Services and Health Promotion Services", Statistics and Information Department, Minister's Secretariat, MHLW

(Note) The figures from FY1998 onward as of the end of March of the next year.

The figures for FY2010 do not include some municipalities in Iwate Prefecture (Kamaishi City, Otsuchi Town, Miyako City, and Rikuzentakata City), clinics and municipalities in Miyagi Prefecture apart from Sendai City, and some municipalities in Fukushima Prefecture (Minamisoma City, Naraha Town, Tomioka Town, Kawauchi Village, Futaba Town, litate Town, and Aizuwakamatsu City) due to the effect of the Great East Japan Earthquake.
## Measures against Hepatitis

## Basic Act on Hepatitis Measures

Basic Act on Hepatitis Measures (Act No.97 of 2009)

Comprehensive formulation/enforcement of measures against hepatitis

• To stipulate basic principles for measures against hepatitis;

• To clarify responsibilities of the government, local governments, medical insurers, citizens, and doctors, etc.;

• To formulate guidelines concerning promotion of measures against hepatitis; and

Basic measures

• To comprehensively promote measures against hepatitis by stipulating basic articles for them.

Promotion of prevention and early detection

• Prevention of hepatitis

• Quality improvement of hepatitis examinations, etc.

Research promotion

## Promotion of equalization of medical services for hepatitis patients, etc

• Training of doctors and other medical professionals to acquire the expertise

• Establishment and improvement of medical institutions

• Financial support for medical care expenses on hepatitis patients

• Establishment and improvement of systems for collecting and providing information on hepatitis care, etc.

Measures must be taken with careful consideration given to the human rights of patients and elimination of discrimination against them

• Securing opportunities for hepatitis care

## Formulation of basic measures against hepatitis

The Council for Promotion of Hepatitis Measures

• Representatives of hepatitis patients, etc.

• The medical profession engaged in hepatitis care

• Persons with relevant knowledge and experience

Relevant administrative organizations

Minister of Health, Labour

Basic measures against hepatitis

## Response to cirrhosis and liver cancer

## ● Creation of an environment for improved treatment level

● Review the patient support system as necessary taking into consideration the situation of medical treatments
Detailed Data 2 Number of Patients and Deaths Related to Lifestyle Diseases

Total number of patients (1,000 persons)	Number of deaths (Person)	Mortality rate (Per 100,000 persons)
Malignant neoplasms	1,526	364,721	290.1
Diabetes mellitus	2,700	13,783	11.0
Hypertensive diseases	9,067	7,161	5.7
Heart diseases (excluding hypertensive)	1,612	196,547	156.4
Cerebrovascular diseases	1,235	118,286	94.1

Source:

“Patient Survey 2011”, Statistics and Information Department, Minister's Secretariat, MHLW

“Vital Statistics”, Statistics and Information Department, Minister's Secretariat, MHLW

(2013 approximate figures)

(Note) Total number of patients excludes Ishinomaki and Kesennuma medical districts of Miyagi Prefecture and Fukushima Prefecture due to the effect of the Great East Japan Earthquake.

Detailed Data 3 Prevalence related to Diabetes

Males (survey samples: 1,619)	Females (survey samples: 2,384)
Age	Strongly suspected of having diabetes	With possibilities of having diabetes	Strongly suspected of having diabetes	With possibilities of having diabetes
20-29	1.1%	0%	0%	0.9%
30-39	3.0%	3.0%	0.5%	5.4%
40-49	7.6%	11.0%	2.9%	10.4%
50-59	12.1%	16.7%	5.6%	20.8%
60-69	22.1%	17.3%	14.1%	18.2%
70 or older	22.6%	18.4%	11.0%	23.8%

When the above figures are applied to the estimated population as of October 1, 2007, the estimated numbers nationwide are as follows:

• Those strongly suspected of having diabetes: approx. 8.9 million persons

• Those with possibilities of having diabetes: approx. 13.2 million persons

Source: "National Health and Nutrition Survey 2007", Health Service Bureau, MHLW
## Overview 8020 (Eighty-Twenty) Campaign

[History of 8020 (Eighty-Twenty) Campaign]

1989	A Study Group on the Dental Health Policy for Adults made public its interim report in which the “8020 (Eighty-Twenty) Campaign” calling for the retention of 20 or more teeth even at age 80 was proposed.
1991	“Promotion of 8020 Campaign” was set to be the major objective for the Dental Hygiene Week (June 4-10).
1992	“8020 Campaign promotion measure projects” launched for dissemination and enlightenment of the 8020 Campaign (until 1996).
1993	8020 Campaign promotion support projects launched for smooth implementation of 8020 Campaign promotion measure projects (until 1997).
1997	Municipal dental health promotion projects (menu projects) launched.
2000	Prefecture-led “8020 Campaign promotion special projects” launched.
2006	The results of the “Survey of Dental Diseases (2005)” was published to reveal that the percentage of persons achieving 8020 reached over 20% for the first time since the survey started.
2011	The Act on Advancement of Dental and Oral Health was approved.
2012	The “Basic Matters regarding the Advancement of Dental and Oral Health” was announced by the Minister in accordance with the “Act on Advancement of Dental and Oral Health”. “Health Japan 21 (second campaign)”, which provides efforts for further advancing 8020 activities, was announced by the Minister. The results of the “Survey of Dental Diseases (2011)” were published to reveal that the percentage of persons achieving 8020 reached over 40%.
2013	The title of “Dental Hygiene Week” was changed to “Dental and Oral Health Week” and the priority objective “advancement of dental and oral health that supports the power to live - new development of 8020 Campaign throughout life -”

The “Basic Matters regarding the Advancement of Dental and Oral Health” and “Health Japan 21 (second campaign)”, announced in July 2012, mutually harmonized and provided further advancement of the “8020 Campaign”. Both set the goal of “raising the percentage of those retaining 20 or more teeth at age 80” and the FY2022 target value of 50%. Efforts for dental and oral health promotion through dental health measures (8020 Campaign) throughout life continue to be important.

Changes in Percentage of Persons Having 20 or More Teeth by Age Group

Age Year	40-44	45-49	50-54	55-59	60-64	65-69	70-74	75-79	80-85	85+
1999	97.1%	90.0%	84.3%	74.6%	64.9%	48.8%	31.9%	17.5%	13.0%	3.0%
2005	98.0	95.0	88.9	82.3	70.3	57.1	42.3	27.1	21.1	8.3
2011	98.7	97.1	93.0	85.7	78.4	69.6	52.3	47.6	28.9	17.0

Source: “Survey of Dental Diseases”, Health Policy Bureau, MHLW
Detailed Data Statistics on Cancer (as of March 1, 2012)

Item	Current status	Source
Number of deaths	Total of 364,721 persons (28.8% of all causes of death)
[216,883 males (32.9% of all causes of death)]
[147,838 females (24.2% of all causes of death)]
→“1 in every 3.5 Japanese die of cancer”
* Risk of cancer increases with age
→The gross number of deaths is increasing (effect of aging)
* The age-adjusted mortality (younger than 75) has been on a declining trend since 1995 (108.4 in 1995 → 84.3 in 2010)
* Types of cancers are changing	Vital Statistics of Japan
(2013 approximates)
(Recounted by the Center for Cancer Control and Information Services, National Cancer Center)
Incidence rate	743,664 persons
[427,949 males]
Major sites: [1] stomach, [2] large intestine, [3] lung,
[4] prostate gland, [5] liver
[315,715 females]
Major sites: [1] breast, [2] large intestine, [3] stomach, [4] lung,
[5] uterine cervix
* Including esophageal, colon, lung, skin, breast, uterine cervix, and carcinoma in situ bladder cancer	Estimates based on population-based cancer registry (2007)
Lifetime risk	Male: 54%, Female: 41%
→“1 in every 2 persons will contract cancer in Japan”	Estimates by Center for Cancer Control and Information Services, National Cancer Center (2005)
Patients and persons receiving treatment	The number of persons requiring constant treatment was 1.53 million
• The number of persons hospitalized at the time of the survey was 134,800
• The number of outpatients was 163,500
• 298,300 persons received treatment per day
(3.5% of those receiving treatment)	Patient Survey
(2011)
Medical care expenditure for cancer	¥3,183.1 billion
* 11.4% of total medical fees of medical treatment	Estimates of National Medical Care Expenditure (FY2011)

(Note) The figures of Patient Survey exclude Ishinomaki and Kesennuma medical districts of Miyagi Prefecture and Fukushima Prefecture due to the effect of the Great East Japan Earthquake.
## Overview Outline of Intractable Disease Measures

Various projects have been implemented in accordance with the "Outline of Intractable Disease Measures" compiled in 1972.

Types of projects

*1 Diseases subjected to focused research and cross-sectional basic research are the same as those subjected to clinical investigations/research.

*2 In addition to the 56 diseases the research project on the treatment of specified diseases includes the research project on hemophilia treatment, etc.
## Tuberculosis Measures

## Overview Outline of Tuberculosis Prevention Measures

A. Regular physical checkups (tuberculin test, X-ray test, etc.)	Elderly, (high school) students, employees working at school and hospitals, and facility residents
B. Regular preventive vaccination (BCG)	Infants younger than 6 months old
C. Patient management	Notification	At the time of diagnosis, at the beginning/end of hospitalization
Registration	Tuberculosis registration cards, identification of the current situation of patients
Health guidance	Home-visit, public health education, etc.
Screening for proper disease management	Persons requiring follow-ups, patients who have suspended treatment, etc.
D. Infection prevention	Work restriction, etc.	Restricting patients who may transmit diseases to others from working, recommendation/order for hospitalization
Sterilization, etc.	Sterilization of houses/buildings, sterilization and disposition of goods
On-site investigatio	Investigation of patients, etc.
E. Medical care (public fund)	Hospitalization care	Medical care expenses for tuberculosis patients who have been given recommendation/order for hospitalization
Proper medical care	Medical fees for promoting proper medical care for tuberculosis

Detailed Data 1 Changes in Number of Newly Registered Tuberculosis Patients, Prevalence Rate, and the Number of Deaths

Number of newly registered patients	Prevalence rate	Number of deaths	Rate of deaths
(Person)	(Per 100,000 persons)	(Person)	(Per 100,000 persons)
1960	489,715	524.2	31,959	34.2
1965	304,556	309.9	22,366	22.8
1970	178,940	172.3	15,899	15.4
1975	108,088	96.6	10,567	9.5
1980	70,916	60.7	6,439	5.5
1985	58,567	48.4	4,692	3.9
1990	51,821	41.9	3,664	3.0
1995	43,078	34.3	3,178	2.6
1999	43,818	34.6	2,935	2.3
2000	39,384	31.0	2,656	2.1
2001	35,489	27.9	2,491	2.0
2002	32,828	25.8	2,317	1.8
2003	31,638	24.8	2,337	1.9
2004	29,736	23.3	2,330	1.8
2005	28,319	22.2	2,296	1.8
2006	26,384	20.6	2,269	1.8
2007	25,311	19.8	2,194	1.7
2008	24,760	19.4	2,220	1.8
2009	24,170	19.0	2,159	1.7
2010	23,261	18.2	2,129	1.7
2011	22,681	17.7	2,166	1.7
2012	2,110	1.7
2013	$ ^{*} $ 2,084	$ ^{*} $ 1.7

Source:

"Aggregate Result of the Annual Reports of Surveillance of Tuberculosis", Health Service Bureau, MHLW

“Vital Statistics”, Statistics and Information Department, Minister's Secretariat, MHLW

(Note) 1. The figures for 1998 and later do not include those of atypical mycobacteria positive.

2. The figures indicated by “*” are approximates.
Detailed Data 1 Accumulated Number of Organ Transplantations

Number of donors	Number of transplantations performed	Patients on waiting lists
Under brain death	Under brain death
Heart	201 persons	201 persons	201 cases	201 cases	316 persons
Lung	177 persons	177 persons	217 cases	217 cases	235 persons
Liver	216 persons	216 persons	231 cases	231 cases	408 persons
Kidney	1,524 persons	247 persons	2,822 cases	486 cases	12,697 persons
Pancreas	193 persons	190 persons	192 cases	190 cases	187 persons
Small intestine	13 persons	13 persons	13 cases	13 cases	3 persons
Eyeball (cornea)	15,873 persons	107 persons	25,591 cases	196 cases	2,217 persons

Source: Japan Organ Transplant Network, Japan Eye Bank Association

(Note) 1. The number of donors and the number of transplantations performed indicate the cumulative total from October 16, 1997 (the day of the enforcement of the Act on Organ Transplantation) to April 30, 2014. The number of patients on waiting lists is as of April 30, 2014.

2. There have been 268 cases of brain death tests conducted nationwide under the Act on Organ Transplantation since the enforcement of the law until April 30, 2014. In the eighth case, the donor was determined legally brain dead, but the organ was not removed for medical reasons. The case is therefore not included in the number of donors.

3. The number of donors of pancreas and kidneys, the number of transplantations performed, and the number of patients on waiting lists include cases of simultaneous pancreas and kidney transplantations.

4. The number of donors of hearts and lungs, the number of transplantations performed, and the number of patients on waiting lists include cases of simultaneous heart and lung transplantations.

Detailed Data 2

Changes in Numbers of Hematopoietic Stem Cell Transplantations Performed

Unrelated donors	Number of unrelated transplantations
Number of registered donors	Number of registered cord blood	Bone marrow	Peripheral blood stem cell	Cord blood
FY1991	3,176	—	—	—	—
FY1992	19,829	—	8	—	—
FY1993	46,224	—	112	—	—
FY1994	62,482	—	231	—	—
FY1995	71,174	—	358	—	—
FY1996	81,922	—	363	—	1
FY1997	94,822	—	405	—	19
FY1998	114,354	—	482	—	77
FY1999	127,556	—	588	—	114
FY2000	135,873	4,343	716	—	169
FY2001	152,339	8,384	749	—	220
FY2002	168,413	13,431	739	—	297
FY2003	186,153	18,424	737	—	702
FY2004	204,710	21,335	851	—	678
FY2005	242,858	24,309	908	—	658
FY2006	276,847	26,816	963	—	754
FY2007	306,397	29,197	1,027	—	778
FY2008	335,052	31,149	1,118	—	875
FY2009	357,378	32,793	1,232	—	907
FY2010	380,457	32,994	1,191	1	1,074
FY2011	407,871	29,560	1,269	3	1,106
FY2012	429,677	25,385	1,323	15	1,199
FY2013	444,143	13,281	1,324	19	1,130
Total	—	—	16,694	38	10,758

Source: Japan Marrow Donor Program, Japan Cord Blood Bank Network

* The figures for cord blood stem from FY1996 to FY1998 indicate the number of transplantations coordinated by cord blood banks before the establishment of the Japanese Cord Blood Bank Network.

* Number of donors is as of the end of the respective years.
Detailed Data 1 Number of Licenses for Marketing Authorization Holder of Drugs, etc.

(As of the end of 2013)

Category	Drugs	Class 1 drugs	Class 2 drugs	Quasi-drugs	Cosmetics	Total
Marketing	1,206	266	940	1,406	3,608	6,220

Source: Pharmaceutical and Food Safety Bureau, MHLW

(Note) Licenses are granted by prefectureel governors (from April 1, 2005).

Detailed Data 2 Number of Approvals for Manufacturing/Import/Marketing Drugs, etc. (2013)

Prescription drugs	Over-the-counter drugs	Quasi-drugs	Cosmetics
Manufacturing	Approval	1	0	0	0
Approval with partial revision	2	0	0	0
Total	3	0	0	0
Import	Approval	0	0	0	0
Approval with partial revision	5	0	0	0
Total	5	0	0	0
Marketing	Approval	1,929	628	1,680	0
Approval with partial revision	2,585	265	290	0
Total	4,514	893	1,970	0

Source: Pharmaceutical and Food Safety Bureau, MHLW

(Note) The figures exclude in vitro diagnostics.

Detailed Data 3 Number of Approvals for Manufacturing Drugs, etc.

(As of the end of 2013)

Category	Drugs	Quasi-drugs	Cosmetics	Total
Manufacturing	2,349	1,707	3,530	7,586

Source: Pharmaceutical and Food Safety Bureau, MHLW

(Note) Licenses are granted by prefecture/governors from April 1, 1995 (excluding some drugs).
## Medical Device Approval/Licensing System

Overview Review for the Approval of Medical Devices

Detailed Data 1 Number of Licenses for Marketing Authorization Holder of Medical Devices

(As of the end of 2013)
Category	Class 1 medical devices	Class 2 medical devices	Class 3 medical devices	Total
Marketing	644	973	904	2,521

Source: Pharmaceutical and Food Safety Bureau, MHLW

(Note) Licenses are granted by prefecture governors (from April 1, 2005).

Detailed Data 2 Number of Approvals for Manufacturing, Import, and Marketing Medical Devices (2012)

Medical devices
Manufacturing	Approval	8
Approval with partial change	0
Total	0
Import	Approval	0
Approval with partial change	0
Total	0
Marketing	Approval	609
Approval with partial change	885
Total	1,494

Source: Pharmaceutical and Food Safety Bureau, MHLW

## Detailed Data 3 Number of Licenses for Manufacturing Medical Devices, etc

Medical devices
Manufacturing	3,569
Repairs	6,389

Source: Pharmaceutical and Food Safety Bureau, MHLW (as of the end of 2012)

(Note) Licenses are granted by prefecture governors from April 1997 (excluding some medical devices).
Post-Marketing Measures for Drugs/Medical Devices

Flow of Post-Marketing Surveillance and Re-examination/Re-evaluation of Drugs

Outline of the Adverse Drug Reaction, etc. Reporting System

$ ^{*} $ 1: International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use

$ ^{*} $ 2: International Medical Device Regulators Forum

$ ^{*} $ 3: From November 25, 2014, medical institutions, etc. will report to the Pharmaceuticals and Medical Devices Agency.

Note: Other than the above, collection of adverse drug reaction information from patients has commenced as an original service of the Pharmaceuticals and Medical Devices Agency on a trial basis since March 26, 2012.