How the US Occupation forces made Japan the healthiest country in the world

[Hannah Bell]

The health situation in Japan after World War II was extremely poor. However, in less
than 35 years the country’s life expectancy was the highest in the world. Japan’s continuing
health gains are linked to policies established at the end of World War II by the Allied occupation
force that established a democratic government.

The Confucian principles that existed in Japan long before the occupation but were preempted
during the war years were reestablished after the war, facilitating subsequent health improvements.

Japan’s good health status today is not primarily the result of individual health behaviors or the
country’s health care system; rather, it is the result of the continuing economic equality that
is the legacy of dismantling the prewar hierarchy.

(Am J Public Health. 2008;98:589–594. doi:10.2105/AJPH.2007.116012)


In the late 1860s, the Meiji Restoration in Japan dismantled the feudal Tokugawa Empire. A
reasonable standard of living existed in the country from the 17th through the 19th centuries,
with relatively small disparities between the ruling Samurai class and commoners.14,15 There was
a focus on education during the Tokugawa period, when Japan’s literacy rates were comparable to those of many European countries...

As Japan industrialized beginning in the late 1890s, powerful families called zaibatsu (including
the Mitsubishi, Mitsui, and Sumitomo families) established themselves as corporate-like entities.
They amassed great wealth and political control and dominated Japanese society. Income inequality
increased dramatically leading up to World War II.18 The zaibatsu influenced political and military
leaders, creating fear of United States hegemony in the region and pushing for militarism in the
Pacific. Entitlements declined and the central government did not attempt to redistribute resources. Japanese health and longevity suffered greatly during the zaibatsu reign and the war years subsequent to the Meiji renaissance according to vital statistics records from the period, which are widely believed to be accurate...

****Summary****

The paper goes on to detail reforms instituted by the Occupation, particularly land reform & the breakup of the zaibatsu, then goes on:

Crawford F. Sams, director of the Public Health and Welfare Section under MacArthur, noted
Japan’s astounding health gains during and after the period of the Allied occupation:

"Between the years 1895 and
1946, the life expectancy of
Japanese men remained stationary
at 42.8 years. The life expectancy
for women during the
same period was increased only
from 44.3 to 51.1 years.

But between the years 1946 and
1951 the life expectancy at
birth for males took an astounding
jump from 42.8 to 60.8 years, and that for women
increased from 51.1 to 64.8."

He went on to describe this phenomenon as “unequaled in any country in the world in medical
history in a comparable period of time..."

Johansson and Mosk reported that after the war life expectancy rose at a pace unprecedented in
both Japanese and world history. This increase occurred “despite the fact that income per head had
not yet returned to pre-war levels..."

CONCLUSION

Today’s huge health gap between Japan and the United States could not be bridged even by eradicating heart disease, the leading cause of death in the United States.47 Moreover, the United States continues to fall further behind, ranking 21st in life expectancy in the 1992 United Nations report48 and 30th in 2004 (& most recently 44th or something like that).

The discrepancy between the two countries may result from Japan not experiencing
the levels of income inequality and wealth polarization found in the United States in recent
decades. Changes in a society’sChanges in a society’s economic
hierarchy can have profound health effects, and Japan’s example is remarkable. The Allied
occupation provided Japan with the opportunity to establish a democratic, peaceful, and
relatively economically egalitarian society. The country’s economic recovery was aided by a
new constitution facilitated by Japanese values. These structural changes produced social
conditions conducive to health and longevity, and the benefits of an increasing life span continue.

http://depts.washington.edu/eqhlth/pages/BezruchkaJapan_08.pdf


For more on equality & health, here's a recent lecture in seattle. click on the first link here, "Watch the town hall jan 8th"

http://depts.washington.edu/eqhlth/


It's interesting that MacArthur/the Occupation was very consciously trying to "create a middle class". So the conditions which do this are evidentally quite well-known in policy circles, & have been for some time.

Thus we might conclude that the conditions which destroy middle classes are also well known, & if broad-based prosperity is declining, that is in some sense a conscious policy choice as well.

[rug]

1. Iraq must be the healthiest country on earth today.

[Hannah Bell]

2. nope, vastly different policy choices.

[xchrom]

3. recommend

[blindpig]

4. These things do not appear out of thin air

and neither do their opposite...

[Hannah Bell]

5. k

[Starry Messenger]

6. k&r

You only get a middle class if you are allowed to have one, if it is necessary to the plans of the ruling class. There is no spontaneous "rise" of the middle class anymore.

[Art_from_Ark]

7. The writer of this piece could use a course in Japanese history

There was income disparity before the Meiji Restoration. Japanese society was actually divided into several classes, notably the saumrais (busshi), the merchants (sho), engineers (ko), farmers (nomin) and untouchables (burakumin). Officially, the farmers were just below samurais in social status, but in reality they were actually quite low on the social totem pole.

The wealth of the samurais and their feudal lords was measured in units of rice called koku, which they received from the farmers. However, in terms of monetary wealth, the merchants became the wealthiest class, eventually achieving status equal to that of the samurais because of their ability to provide monetary loans to the samurais.

Almost as soon as the Meiji Era began in 1868, the new government set about on a course of modernization in an effort to prevent Japan from being subjugated like China by Western powers. Part of this modernization was to introduce foreign technologies and methods to the country. While the Americans were the first to open Japan to the outside (Euro-American) world, and the British also came, it was the Germans who emerged as the most influential in Japan. German doctors and engineers began coming to Japan to instruct the Japanese in modern industrial, medical and agricultural techniques. In 1890, Japan adopted a Constitution that was based on the Prussian model.

Since Japan had few resources of its own, it looked to other countries as sources of materials for its industrial needs. At that time, the European powers were busy building empires, and Japan also embraced empire-building as a way of procuring industrial supplies. The Hawaiian coup of 1893 that was led by US businessmen was an indication to Japan that the United States wanted to expand its influence westward across the Pacific. In response, Japan wrested Taiwan away from China in the Sino-Japanese War of 1894-95. To counter what appeared to be a Japanese drive southward, the United States declared war on a very weak Spain in 1898 and ended up taking control of most of Spain's remaining overseas territories, including the Philippines, which stood between Taiwan and the resource-rich Dutch East Indies (Indonesia).