Japan has garnered global attention for several reasons, including its notable achievement in human longevity, as a consequence of effectively implementing practices conducive to longer lifespans. While Switzerland enjoys one of the highest average health statuses among OECD nations, Japan reigns among the G7 nations in terms of population life expectancy.
Japan’s success is not accidental, according to the Swiss Re Institute’s recent report, The future of life expectancy: Forecasting long-term mortality improvement trends for insurance. Through well-planned, decades-long public health initiatives, Japan has adequately navigated the path of emerging healthcare risks and opportunities. These have enabled advancements in medicine, greater healthcare access, and the adoption of healthier lifestyles – Japan’s experience provides an exemplary model for other countries in pursuit of similar healthcare triumphs.
It is vital that policymakers and we as insurers stand vigilant against emerging risks and take the steps necessary to ensure societies remain protected. In this regard, Japan’s success serves as an inspiring blueprint.
Japan’s mortality rates have declined significantly since the 1960s, largely as a result of greatly improved cardiovascular disease (CVD) survival rates. Added to that, the country saw a marked decline in cerebrovascular and stomach cancer-related deaths, both of which had also contributed to lower life expectancies. Between 1980 and 2012, the nation’s population between 35 and 84-years old experienced a 61% decrease in age-adjusted mortality rates from ischemic heart disease and an 83% decline from stroke. To put this into perspective, these declines represent thousands of lives saved annually and given that these conditions often affect the elderly, contribute to Japan’s world-leading longevity. While many of these gains were achieved by an improvement in healthy behavior, this was led by robust regulations and proactive public health education: such as the launch of a national CVD prevention program in 1982 and the Health Promotion Act in 2003 to enhance disease prevention and prevent passive smoking. Continued commitment to better public health should yield more progress, with chronic heart disease and stroke deaths projected to decrease 16.5% between 2011 and 2030.
Japan is already one of the oldest nations in the world, with 29.1% of people over the age of 65. As we look to the future, Japan is likely to remain the global bellwether of human longevity limits. However, this comes with its own set of challenges. Overall demographic shifts cited in the Swiss Re Institute research – a rapidly aging society, coupled with a population projected to shrink one-fifth by 2050 – foreshadow challenges that could weigh on the economy and strain social safety nets. The country must extend its targeted and decisive management of the population’s health to prepare for this fundamental shift, which may include additional pressures on the healthcare system to tackle aging-related conditions such as neurodegenerative diseases, as well as addressing the difficult challenges of long-term care.
Escalating commitment on existing policies may not be the sole answer. Historically, life expectancy improvements rise and wane along with medical innovation and tapering effects over the long term. Advances in life expectancy for both Japan and Switzerland have started to slow down since 2010 as progress in areas like CVD management slows. In addition, an increasingly urban population with a preference for sedentary lifestyles and diets high in ultra-processed foods has resulted in rising obesity and diabetes rates, which may have long-term consequences on mortality and morbidity.