|Implemented in this survey?|
The Law passed the Diet in July 26, 2002, and was implemented in May 1,2003. The Law aims to provide a basic framework for overall promotion of public health improvement, because the importance of improving public health increases remarkably in the progress of population aging and the changing of disease structure. The Law also attempts to improve public health through better nourishment of people and other public health measures.
The Public Health Law passed the Diet, the Japanese parliament, on July 26, 2002, and became effective May 1, 2003. Part of a major framework on Health Care Reform, it aims to provide a
basic framework for recognizing overall promotion of public health improvement, enhancing the importance of public health in the light of demographic change and a changing pattern of disease. The Law
also attempts to improve public health promoting healthy eating habits and other public health measures.
Guideline for health examinations
At present, entities to manage health promotion activities conduct health examinations by contracting-out with health examination institutions and hospitals. Methods of examinations differ a lot from entity to entity and the data collected in the examinations are not in the form that can be utilized in other entities. Therefore, it has been pointed out that the collected data cannot be utilized once insurers or examination bodies change after transfer of jobs, etc.. In order to build a consistent system for health examinations, the Law stipulates a common guideline on items such as a method of examinations, notification of results, and a format of a health handbook.
Survey and guidance: "only on nutrition" to "on lifestyle as a whole"In the past, the National Nutrition Survey had been conducted based on the Nutrition Improvement Law. This reform package includes expansion of this survey from nutrition to lifestyle as a whole (National Health and Nutrition Survey), utilizing the result of the survey to promote related measures based on scientific grounds and to evaluate those measures. The previous nutrition guidance activities were also expanded to lifestyle as a whole, and the former legislation (abolition of the Nutrition Improvement Law) abolished. In terms of specific cooking facilities, regulations of the nutrition management in mass-feeding facilities by the present Nutrition Improvement Law were succeeded, and necessary regulations were added to the existing scheme.
Prevention of passive smoking
"Passive smoking" describes a situation where a person (who usually does not smoke) is forced to breathe in the smoke of others' cigarettes in a closed environment. Article 25 of the Law stipulates that "those who are in charge of managing the facilities where many unspecified people gather shall make efforts in taking necessary measures to prevent passive smoking." Facilities specified in Article 25 include schools, hospitals, government and municipal offices, restaurants, department stores, shops, hotels, trains, buses, etc. However, at the point of implementation of the Law, Article 25 is only for promoting related efforts. Violation on this duty does not accompany any penalties.
The Public Health Law also specifies what is expected from the general public, on one side, and the various levels of public adminsitration, on the other. They are to foster greater interests and understandings on the significance of healthy lifestyles to be aware of their own health condition and to make efforts promote their own health throughout their life.
Central and local government entities are expected
Health promotion institutions i.e., those who conduct health promotion activities, such as insurers of health insurance, are to promote necessary activities for the nation's health promotion, such as health education, health counseling, etc.
non-financial - disease prevention, health promotion
financial - reduction of health care cost in the future
The general public, Governments (central/local), Health promotion institutions (those who conduct health promotion activities, such as insurers of health insurance)
|Medienpräsenz||sehr gering||sehr hoch|
Health promotion plans in municipalities will be boosted by this legislation. This reform will be successful if, in the process of drawing up municipal plans, local characteristics are discussed
and awareness of the public is raised toward health promotion.
In terms of health examination, standardization of the procedure based on common guidelines will be conducted among examinations for maternity health, school health, industry health, elderly health, etc. in order to compare those various fields of health examinations. It is desirable to make changes to the existing scheme and to standardize examinations with reference to scientific study.
In terms of "health handbooks," it is hoped that they will be beneficial to primary prevention as a part of health activities. In addition, if information in the handbook can be used when the holder of the handbook consult doctors for some complications, the result of health examination will not only be beneficial to reducing health care cost but also be precious source of information in medical treatment.
Anti-tobacco measures in the Law are highly evaluated because they signify an epoch-making progress. However, additional effort will be necessary in order to raise awareness of the public about smoke hazard and to foster a favorable environment for having sympathy and consideration to others. In addition, it is not clear how to ensure compliance with the rules (for example, relevant provisions in the Law do not accompany punishment in case of incompliance), which makes some doubt about their effectiveness.
|Implemented in this survey?|
The approach of the idea is described as:
amended: Combination of health promotion activities
Pilot project - There was a case that each enterprise was conducting the project.
There are no agencies or institutions with a special mandate to evaluate the result of the reform, but municipalities and many researchers/scholars will try to evaluate the result because the public had shown much interest in this matter.
|Qualität||kaum Einfluss||starker Einfluss|
|Gerechtigkeit||System weniger gerecht||System gerechter|
|Kosteneffizienz||sehr gering||sehr hoch|
The Health Promotion Law lays the legal ground for the "Healthy Japan 21" campaign and for the development of regional plans in municipalities. The fact that the Law was proposed to the Diet in a health reform package (also including proposed amendments to the Health Insurance Law, etc.) indicates that implementation of the Health Promotion Law might have a future impact as a tool for reducing health care cost through disease prevention and health promotion. However, it is too early to judge how the overall impact of the Law is at present.
Tetsuya Aman, Masayo Sato