Changes in an Aging Society vol.1

In the beginning of the 21st century, Japan has been the most aging country in the world. The two major factors of population aging are fewer birth (a decline in fertility rate) and longer life (an increase in life expectancy).
I would like to look back how they have proceeded in Japanese society.

Changes in an Aging Society

Longer Life, Fewer Births and Social Trends in Japan
-From the End of World War II to the End of the 20th Century-

It was 1945, the end of World War II. No statistical data are available for this period. According to Dr. Yoichi Okazaki’s estimates based on his research, the birth rate then was about 23 permillage, and the death rate was about 29 permillage. The vital statistics showed a negative natural growth rate for the first time since the Meiji period (the end of the 19th century) , which would prove that wars could destroy development of human societies.

Maternal and Child Health Handbook, Eugenic and Maternal Protection Law

In 1946, when the society was still in chaos, a national election was held under GHQ’s control. It was the first time for women to participate in politics, and 39 women were elected, including Ms. Shizue Kato. Sen. Kato and Sen. Tenrei Ota (OG Dr.) were the major contributors of the enactment of Eugenic and Maternal Protection Law, which started in 1948. This law allows abortion for the purpose of protecting mothers’ health.*
* Eugenic and Maternal Protection Law was revised later so that it would allow abortions for financial reasons and with agreement by both parents.

Maternal and Child Health Handbook was also created in January 1948 before the Eugenic Maternal Protection Law started. Thanks to the MCH handbook, local municipalities and public health centers nationwide started comprehensive public health programs for pregnant women, infants, children, and mothers. The MCH handbook not only decreased infant mortality rates dramatically but also disseminated information on maternal health, child care, and family planning. When Japan accomplished social and economic development, developing countries tried to learn from Japanese experiences. The MCH handbook attracted a lot of attention from these countries, and it has been translated into various languages and used in numerous countries. Afghanistan seems to be currently working on developing a similar program. Dr. Mitsuo Segi, the first director of Maternal Health Department at Ministry of Health and Welfare, played a major role in developing and implementing the MCH handbook. Dr. Segi resigned this position because he did not get along with GHQ. He later worked at Statistics and Research Department and taught at Tohoku University. After the retirement, he did research on cancer and regional characteristics of related causes of deaths in Nagoya, and he gave warm and kind welcome to visitors from developing countries.

Changes in an Aging Society vol.2

Baby Boom and Family Planning

The “Baby Boom” started in 1947 with 2.9 million births. The average number of births per year between 1947 and 1949 was 2.7 million (the average birth rate was 33.8 permillage). During this period, Japanese population grew rapidly due to declining death rates and a dramatic increase in life expectancies. There had been great concerns about overcrowding in such a small land and the appropriate population size until the country saw special demands in Korean War and manufacturing industries such as shipbuilding.

The poor living conditions led to a growing number of abortions which were allowed under Eugenic and Maternal Protection Law, so that Japan was then called “Abortion Heaven”. It is said that the decline in birth rates after the baby boom was mainly due to abortions.

People, who were involved in Eugenic and Maternal Protection Law, as well as media, started taking actions to find a way out of this sad condition. For example, Mainichi Newspapers (in 1950) and Cabinet PR Office (in 1951) conducted opinion surveys on family planning. Moreover, Ministry of Health and Welfare started a family planning program to protect maternal health in 1952, International Planned Parenthood Federation (IPPF) was founded in the same year in London for the same purpose, and Family Planning Federation of Japan was founded around this time.

New Life Movements

Since the end of World War II, various productive and job-creation activities took place nationwide to maintain and improve the citizens’ quality of life. These activities were called “New Life Movements”, among which were “Movement for the Improvement of Living Conditions” by agricultural cooperatives in rural areas and “Corporate New Life Movement” which was driven by corporations. Based on a belief that it would be beneficial for organizational and societal development if residents and employees made plans and efforts to improve their own lives, these movements mainly consisted of money planning and family planning. It was particularly easier for corporations to see the effects of these movements in employees’ productivity. Hence, companies such as Nippon Kokan and Toyota started disseminating the effects of the movement around 1953. By 1960, most corporations in various industries (e.g., transportation, utilities, manufacturing, and mining) started their own movements.

Changes in an Aging Society vol.3

Universal Health Insurance System

The national universal health insurance system and the pension for all the working people were established in 1961 when the campaign against the Japan-U.S. Security Treaty was held. According to Dr. Shunichi Wakatsuki (Director of Saku Hospital), who worked hard in the field of rural health care, he was “against the Treaty but thankful for the health insurance system”. It is well-known that the health insurance system contributed to a decline in death rates and a growth in life expectancies. The average life expectancy was 65.3 years for males and 70.2 years for females in 1960.

As you may already know, Japanese economy developed dramatically thanks to national policies to double income and citizens’ efforts to improve their lives. The average life expectancy in 1965, a year after Tokyo Olympic, was 67.7 years for males and 72.9 years for females, among the highest in the world. Considering that the average life expectancy was 50.1 years for males and 54.0 years for females in 1947 (according to the special census), the number had grown by 1 year annually, or 18 years between 1947 and 1965.

The international community paid attention to Japanese social conditions around this time, and the New Life Movement was also introduced worldwide. Rockefeller III, the worldwide opinion leader then, introduced this movement in his report “Japanese Development and Family Planning (Reader’s Digest, Japanese translation is available)” on which Japanese leaders were written. The voluntary and enthusiastic works for the development of this movement were done by Dr. Yoshio Koya (Director of Institute of Public Health, President of Family Planning Federation of Japan) and Dr. Toru Nagai (President of Population Association of Japan, President of Association of Newlife Movement. The example of Nippon Kokan (Steel Co.) seems to be mentioned in an ILO report.

Population Explosion and International Collaboration by Japan

In late 1960s, when Japanese citizens gradually gained confidence in the country’s economic development, the international community (especially Asian countries) started seeing population growth as a problem. A book “Asian Drama” by Gunnar Myrdal, a Swedish Nobel Prize Laureate in Economics, was also translated into Japanese language.

Other examples include the second World Population Conference in Belgrade (1965), which was mainly sponsored by the World Bank group. The report on the world population (proposal for implementing population policies) in 1966 by Mr. U Thant, then Secretary General of the United Nations; and the joint declaration on population problems, which was signed by the leaders from 30 countries and submitted to the United Nation Secretary General (1967). The population growth was particularly dramatic in Asian countries, which comprised 60% of the global population, due to high birth rates and low death rates. The growth was so dramatic that Paul Ehrlich called it “population explosion.” Hence, birth control became a global challenge. Asian countries and their collaborators (e.g., the World Bank, UNDP, and UNICEF) paid attention to Japan, which reduced its birth rate by a half in 10 years during 1950s, and they asked Japan to collaborate with the international community.

In response to such an international request, Japan started taking actions. However, because population problems were deeply related to each country’s sovereignty, Japan mainly made monetary contributions to the UNFPA (multilateral cooperation). As for the collaboration with individual countries (bilateral cooperation), Japan made contributions in staff education. Japan spread its experiences in maternal health and family planning through taking trainees. Currently the collaboration with individual countries (in the field of population) is mainly on statistical techniques and research. Such ways of collaboration were well received at NGO forum which was held at the World Population Conference in 1974.