Japan – Health Issues

What are the most common health issues and diseases in Japan?

Cancer, heart disease, and cerebrovascular disease (CVD) have collectively dominated Japan’s mortality statistics since the 1950s, and they remain the three leading causes of death today. These patterns are shaped substantially by the country’s ageing demographic profile and by lifestyle variables including diet, physical activity, and tobacco use.

Cancer accounts for 24.6% of all deaths in Japan, ahead of heart disease at 14.8%, senility at 11.4%, and cerebrovascular disease at 6.9%. Since 1981, cancer has held the top position among causes of death, with its incidence rising steadily over the decades.

The five most prevalent cancer types in Japan are colorectal, female breast, prostate, lung, and stomach cancers, which together account for the majority of new diagnoses each year. One notable achievement has been the decline in stomach cancer mortality: Japan’s age-standardised stomach cancer death rate fell from 33.8 to 13.2 per 100,000 people between 1990 and 2021, driven by reductions in Helicobacter pylori infection rates, lower dietary salt consumption, improved food storage methods, and more effective early screening programmes.

Beyond these major killers, the growing prevalence of Alzheimer’s disease, other forms of dementia, and type 2 diabetes is attracting increasing concern. Risk factors including elevated fasting blood glucose and high BMI are areas requiring targeted interventions. Japan’s rapidly ageing population is fundamentally reshaping the country’s disease burden, driving up rates of chronic illness and intensifying demand for long-term care services.

In 2020, approximately 6.7 million individuals required some form of long-term care or support — a record figure for the preceding decade. Since 2015, there has been a perceptible slowing of health improvement, particularly in the pace of mortality reduction for conditions such as stroke and ischaemic heart disease.

Significant variation exists across Japan’s prefectures. Shizuoka recorded the longest healthy life expectancy for both sexes — 76.68 years for women and 73.75 years for men — while Iwate had the shortest, at 74.28 years for women and 70.93 for men (as of 2022). Age-standardised mortality rate reductions between 1990 and 2015 ranged from 22.0% in Okinawa to 32.4% in Shiga.

A particularly concerning trend is the rise in exposure to preventable metabolic risk factors — including elevated systolic blood pressure, high fasting plasma glucose, increased BMI, and reduced bone mineral density — which is fuelling a heavier burden of non-communicable disease across the population.

Is Japan considered a healthy country? How do health outcomes compare internationally?

Japan is widely recognised as one of the healthiest nations on earth, routinely placing at or near the summit of global health rankings. This standing reflects a combination of universal healthcare access, deeply ingrained dietary traditions, and cultural values that encourage physical activity and social cohesion.

According to Japan’s Ministry of Health, Labour and Welfare, average life expectancy in 2024 stands at 81.09 years for men and 87.13 years for women. Japanese women have held the global longevity record for 40 consecutive years, as documented in the Ministry’s Abridged Life Table.

Between 1990 and 2021, life expectancy across Japan rose from 79.4 to 85.2 years, although disparities between prefectures have been widening. Among G7 nations, Japan leads on average life expectancy, a distinction driven primarily by exceptionally low mortality from ischaemic heart disease and from certain cancers, particularly breast and prostate cancers.

Japan also performs strongly on healthy life expectancy — the number of years a person can expect to live in full health without requiring nursing care. In 2022, this figure stood at 75.45 years for women and 72.57 years for men, calculated by the Ministry of Health, Labour and Welfare every three years using national survey data.

On the international stage, Japan outperforms the OECD average on 7 out of 10 key indicators of healthcare access and quality. Universal coverage means that every resident is enrolled in a scheme providing a comprehensive core set of services, and 80% of people in Japan expressed satisfaction with the availability of quality healthcare — markedly higher than the OECD average of 64% (as of 2025).

Japan’s exceptional health profile is attributed to a range of interacting factors: a nutritious traditional diet, favourable risk factor profiles, high standards of sanitation and hygiene, equitable universal health coverage, and supportive social determinants of health. For the most current national data, readers should consult the WHO Japan country profile and the Japanese Ministry of Health, Labour and Welfare (MHLW).

What infectious diseases or environmental health risks should expats be aware of in Japan?

By international standards, Japan’s infectious disease risk is low, underpinned by rigorous sanitation infrastructure, a robust public health system, and widespread hygiene-conscious behaviour. Even so, there are particular infectious and environmental hazards that newcomers — especially those from regions where these risks are unfamiliar — should understand before making the move.

Influenza and seasonal respiratory illness
Seasonal flu outbreaks can be severe. In late 2024, Japan recorded its largest influenza outbreak in 25 years, partly attributable to a reduction in community immunity following COVID-19 precautionary measures. The resulting surge overwhelmed medical facilities and caused temporary shortfalls in antiviral supplies. Annual vaccination against influenza is widely accessible and strongly encouraged.

Streptococcal Toxic Shock Syndrome (STSS)
Japan has seen an unprecedented rise in cases of streptococcal toxic shock syndrome — a serious and frequently fatal bacterial infection. By mid-2024, 977 cases had been confirmed in that year alone, with a mortality rate that can reach 30%. Health authorities continue to investigate the underlying drivers, and expats should monitor local health advisories for updates.

Japanese Encephalitis and vector-borne diseases
Japanese encephalitis is a mosquito-transmitted viral infection that occurs predominantly in rural farming communities, particularly during summer and early autumn. Urban residents face a relatively low risk, but those relocating to the countryside or spending extended time near rice cultivation areas should seek advice on vaccination from a travel health specialist. Japan also harbours ticks capable of transmitting Severe Fever with Thrombocytopenia Syndrome (SFTS), most commonly in western parts of the country. Vigilance around ticks is advisable in wooded and agricultural settings.

Helicobacter pylori
H. pylori infection is a major driver of stomach cancer in Japan, though prevalence has declined considerably through targeted public health programmes. Screening and eradication therapy are routinely offered in Japan, and it may be worth discussing this with your doctor after settling in, especially if you have not been previously tested.

Water and food safety
Japan’s tap water is among the cleanest in the world, and drinking it directly from the tap is standard practice throughout the country. Food safety standards are rigorously maintained. However, eating raw or lightly prepared fish and shellfish — a staple of Japanese cuisine — carries a small risk of parasitic or bacterial illness; immunocompromised individuals should exercise appropriate caution.

Air quality and environmental hazards
Residents of Japan are exposed to an average of 12.6 micrograms of ambient particulate matter (PM2.5) per cubic metre, modestly above the OECD average of 11.2 micrograms. Air quality in urban centres is generally acceptable but can deteriorate during spring, when winds carry yellow dust (kosa) and fine particulates from mainland Asia. People with asthma or other respiratory conditions should keep track of air quality alerts. Japan also lies within one of the world’s most seismically active zones, and expats should acquaint themselves with earthquake safety procedures and local emergency response plans.

Vaccinations
No vaccines are legally required for entry into Japan. Depending on individual circumstances and travel plans, health authorities may suggest confirming that you are current on hepatitis A, hepatitis B, Japanese encephalitis (for rural locations), rabies (for those in certain rural or high-exposure roles), and standard routine immunisations. Always check with your home country’s official travel health service — such as NHS Fit for Travel, the US CDC Travel Health, or a comparable national authority — and cross-reference with guidance published by the Japanese Ministry of Health, Labour and Welfare before departing.

Is smoking common in Japan, and what are the laws around it?

Around 18.3 million adults in Japan currently smoke. Although smoking rates have trended downward over recent decades, Japan has historically maintained higher rates than many comparable high-income nations, and tobacco use remains culturally visible — particularly among older male demographics. A defining characteristic of Japan’s tobacco landscape is the extraordinary prominence of heated tobacco products (HTPs), sometimes referred to as “heat-not-burn” devices.

HTPs commanded a 36% market share as of 2022, positioning Japan as the world’s leading market for these products. Introduced commercially in 2016, brands such as IQOS have achieved wide adoption. Because HTPs generate vapour rather than combustion smoke, they are frequently permitted in designated indoor smoking areas alongside conventional cigarettes, though their long-term health implications continue to be actively studied.

Japan’s regulatory framework around public smoking has undergone meaningful reform. The revised Health Promotion Act, which came into full effect in April 2020, substantially tightened restrictions on indoor smoking. The legislation bans smoking in most enclosed public spaces and workplaces — encompassing government buildings, educational institutions, hospitals, and restaurants. Certain venues may establish designated smoking rooms, and smaller owner-operated restaurants that predated a specified deadline were initially granted a temporary exemption, though the scope of this exemption has been progressively reduced. While Japan’s approach has historically been more permissive than the comprehensive indoor bans found across the EU, Australia, or Canada, the 2020 reforms mark a clear trajectory toward stricter controls.

To limit involuntary exposure to second-hand smoke, smoking inside facilities that serve large numbers of people is now prohibited. Designated outdoor smoking zones are a common feature of urban environments in cities such as Tokyo and Osaka, and street smoking outside these designated areas is banned across many municipalities. Expats who do not smoke may still encounter tobacco vapour or smoke in some hospitality venues, and those with respiratory sensitivities should factor this into their choice of restaurants and entertainment spaces.

Tobacco use is a primary risk factor for the four most significant non-communicable diseases — cancer, cardiovascular disease, respiratory illness, and diabetes — and Japan’s national health strategy includes explicit targets for reducing smoking prevalence as part of its broader NCD prevention framework.

Is obesity or poor diet a significant health concern in Japan?

Japan consistently records some of the lowest obesity rates among high-income nations. The traditional Japanese diet — rich in fish, rice, vegetables, fermented foods, and soy-based products — is widely regarded as a central pillar of the country’s remarkable longevity record.

The relatively low mortality rates from ischaemic heart disease and specific cancers are thought to reflect the low prevalence of obesity, limited consumption of red meat and saturated fats, and generous intakes of fish, plant-based foods including soybeans, and beverages that are not sugar-sweetened.

Japan’s comparatively lean population profile and strong adherence to infection control behaviours contributed to its favourable outcomes during the COVID-19 pandemic. Despite this generally positive picture, emerging dietary risks are a cause for concern. Increases in potentially preventable metabolic risk factors — including elevated fasting blood glucose and rising BMI — are being tracked alongside behavioural risk factors such as tobacco use, alcohol consumption, high-sodium diets, and insufficient intake of whole grains.

Excess dietary sodium has been a long-standing public health issue, especially in northern Japan, where traditional eating patterns historically relied heavily on salt-preserved foods such as miso, pickles, and soy sauce. These dietary patterns have been associated with elevated rates of hypertension and stomach cancer in certain regions, though nationwide campaigns to reduce sodium consumption have produced measurable results over time.

In 2012, the Ministry of Health, Labour and Welfare introduced the updated national health strategy “Health Japan 21 (the second),” which established specific numerical targets — covering smoking rates, vegetable intake, and BMI — to be met by the end of fiscal year 2022. The third phase of Health Japan 21, launched in 2024, has set new action plans at both national and local levels aimed at tackling NCDs and health inequalities.

For expats, adapting to Japan’s food culture can go either way. Those who embrace the traditional diet — lower in processed foods and animal fats — may find it beneficial to their health. Others accustomed to larger portion sizes or Western-style foods may find selection limited in rural areas, though major urban centres offer a broad range of international cuisine that makes dietary adjustment considerably more manageable.

What are the mental health attitudes and services like in Japan?

Mental health represents one of the most nuanced aspects of wellbeing for expats to navigate in Japan. Cultural attitudes diverge substantially from those prevalent in many other countries, and while awareness is increasing — particularly among younger people — considerable stigma continues to surround mental illness.

Historically in Japan, psychological difficulties have been framed as a source of personal or familial shame, and the deeply rooted cultural value of gaman — stoic endurance without complaint — can create powerful disincentives to seeking professional help. The concept of “karoshi” (death from overwork) and pervasive occupational stress, especially in corporate environments, illustrate how workplace-related mental health pressures can become acute. Japan’s suicide rate, though declining, has historically exceeded OECD averages, and mental health has been identified as a key priority within the country’s national health strategy.

Psychiatric care is included within Japan’s universal healthcare system and is covered by the national health insurance scheme. However, provision is uneven: rural areas have fewer mental health professionals, and waiting times can be lengthy. The number of psychiatrists and psychologists per capita falls below that of countries such as France or Germany, which have historically maintained more substantial community mental health infrastructure. Unlike many Western healthcare systems where a GP referral is the standard gateway to mental health care, in Japan it is customary to consult a psychiatrist (seishinka) directly, without requiring a referral.

For expats, language is a significant practical barrier. The majority of mental health practitioners in Japan work exclusively in Japanese, making it challenging for those without fluency to access appropriate support. That said, larger cities — particularly Tokyo, Osaka, Kyoto, and Yokohama — host clinics and individual practitioners who offer services in other languages, including English, Korean, and Mandarin. Organisations such as TELL Japan (telljp.com) provide multilingual mental health support and operate a helpline tailored specifically to the international community residing in Japan.

The third phase of Health Japan 21, launched in 2024, has prompted national and local governments to develop updated action plans that give greater weight to mental health alongside physical health. There is growing recognition that workplace wellbeing, community connectedness, and social isolation are meaningful contributors to overall population health, and these themes are increasingly reflected in public health policy.

Are there any health risks specific to expats living in Japan?

Japan is a generally safe and healthy place to live, but the experience of relocating brings its own set of challenges — stemming from the relocation process itself, cultural adaptation, and the transition into a different health environment.

Climate adjustment
Japan encompasses an unusually wide range of climates, from the subtropical warmth of Okinawa to the harsh, snow-laden winters of Hokkaido. Expats arriving from more temperate environments may find the extremes demanding. In central Honshu — and especially in cities such as Tokyo — the combination of intense heat and high humidity during July and August can be oppressive. Heatstroke (netsubyo) is a recurring and serious public health issue throughout the summer; staying well hydrated, taking advantage of air-conditioned spaces, and following local heat health advisories are essential precautions.

Hay fever (kafunsho)
Japan has remarkably high rates of cedar and cypress pollen allergy, known locally as kafunsho. The extensive post-war planting of Japanese cedar (sugi) forests, combined with particulate air pollution in urban areas, is thought to produce an especially allergenic pollen. Seasonal allergic rhinitis affects a substantial share of the population — estimates indicate that roughly 40% of Japanese people have some form of pollen allergy. Expats who have never previously suffered from hay fever sometimes develop symptoms after living in Japan for a period.

Adjusting to the disease environment
Acute infectious illnesses remain a periodic concern. As noted earlier, Japan’s late 2024 influenza season was the most severe in 25 years. New residents who have not been exposed to Japanese influenza strains may face greater vulnerability during their first winter, making pre-arrival vaccination a sensible step.

Navigating the healthcare system
All residents holding long-term visas in Japan are legally obliged to enrol in the national health insurance scheme — either kokumin kenko hoken (for the self-employed and students) or shakai hoken (for employees). This covers a substantial portion of medical expenses, with patients typically paying 30% of costs out of pocket. Many expats supplement this with private health insurance to cover expenses such as private hospital rooms, dental treatment, or emergency repatriation. Identifying a clinic or hospital with multilingual staff is a practical priority upon arrival, particularly outside major urban centres.

Mental health and cultural adjustment
Culture shock and social isolation are familiar experiences for newcomers in any country, but Japan’s particular combination of social formality, language barriers, and demanding work culture can intensify these pressures. Proactively cultivating social networks — through community organisations, expat associations, or recreational clubs — and knowing where to turn for mental health support in your preferred language can make a significant difference to long-term wellbeing.

Practical steps for expats

1. Register with the local municipal office (yakusho) promptly on arrival — this is required for health insurance enrolment.
2. Enrol in the national health insurance scheme within 14 days of establishing residency.
3. Find a local clinic (klinik or naika) and, if possible, one with language support relevant to you.
4. Get an annual health check (ningen dock or kenko shindan) — comprehensive health screenings are widely available, affordable, and culturally embedded in Japanese workplace culture.
5. Ensure you are up to date with vaccinations, including influenza and any region-specific recommendations.
6. Familiarise yourself with emergency services: dial 119 for ambulance and fire services in Japan.

Where can expats find reliable health information and services in Japan?

Keeping abreast of health developments in Japan requires knowing which official and community-based resources to consult. Health guidelines, vaccination schedules, and public health alerts can shift — sometimes quickly, as events such as the COVID-19 pandemic and the 2024 influenza surge demonstrated — so familiarising yourself with key sources before and after your move is a valuable investment.

Official Japanese sources

• Ministry of Health, Labour and Welfare (MHLW) — Japan’s principal public health authority, offering an English-language section covering health policy, disease notifications, and vaccination guidance.
• National Institute of Infectious Diseases (NIID) — publishes alerts and epidemiological data on infectious disease outbreaks occurring within Japan.
• MHLW Infectious Diseases page — regularly updated public health alerts and guidance on specific infections.

International health references

• WHO Japan Country Profile — provides life expectancy, mortality, and disease burden data specific to Japan.
• Your home country’s official travel health authority (e.g. the US CDC, NHS Fit for Travel, the ECDC, or an equivalent national body) — for pre-departure vaccination advice and up-to-date travel health notices concerning Japan.

Expat-focused health resources

• TELL Japan — a mental health support service serving the international community in Japan, offering multilingual counselling and a dedicated helpline.
• The Japan Health Info website — provides practical guidance on navigating clinics, hospitals, and health insurance as a foreign resident.
• Local municipal offices (yakusho) — frequently publish multilingual health guides for new residents, including instructions on enrolling in the national health insurance scheme.

Japan outperforms the OECD average on 7 out of 10 key indicators of healthcare access and quality, and its healthcare system enjoys strong international recognition. Nevertheless, specific figures, vaccination schedules, and public health advisories are subject to change. Always verify current information directly with authoritative sources both before your departure and again once you have registered as a resident in Japan.

Frequently Asked Questions About Health Issues in Japan

Is Japan a safe country to live in from a health perspective?

Japan is home to one of the highest life expectancies on earth, reflecting both the strength of its healthcare system and the broadly healthy lifestyle of its population. Universal health coverage, stringent food and water safety standards, and a well-resourced public health infrastructure all contribute to a very favourable health environment. While specific risks exist — periodic influenza outbreaks, pollen allergies, and certain infectious diseases among them — the overall picture is considered very safe relative to most other countries.

Do I need vaccinations before moving to Japan?

No vaccinations are legally required for entry into Japan. However, health authorities typically recommend confirming that your routine immunisations are current (including MMR, tetanus, and hepatitis B) and may advise additional vaccines — such as Japanese encephalitis for those relocating to rural areas — depending on individual circumstances. Always consult your home country’s official travel health service and review current guidance on the MHLW website, as recommendations may be updated.

Will I be covered by Japan’s public health insurance as an expat?

Yes — if you hold a qualifying long-term visa, you are legally required to join Japan’s national health insurance system (kokumin kenko hoken for the self-employed and students, or shakai hoken for company employees). The scheme provides comprehensive coverage, with patients generally paying 30% of medical costs and the insurer covering the remaining 70%. Enrolment must be completed within 14 days of establishing residency, and registration is handled through your local municipal office.

How does Japan’s diet affect expat health?

Japan’s low obesity prevalence, modest red meat consumption, and high intake of fish, plant-based foods such as soybeans, and non-sugar-sweetened beverages are broadly credited with contributing to the country’s outstanding health outcomes. Many expats find that adopting elements of the traditional Japanese diet improves their wellbeing, though the high sodium content found in certain traditional staples — miso, soy sauce, and pickled vegetables — is worth moderating, particularly for anyone managing blood pressure.

Is air pollution a significant health concern in Japan?

People in Japan are exposed to 12.6 micrograms of ambient particulate matter (PM2.5) per cubic metre, slightly above the OECD average of 11.2 micrograms. Pollution transported from mainland Asia — particularly during spring — can temporarily elevate PM2.5 concentrations. Individuals with asthma or other respiratory conditions should use local air quality monitoring apps or official alert services to track conditions, especially during spring months.

How accessible are mental health services in Japan for non-Japanese speakers?

Services in languages other than Japanese remain limited, though they are gradually expanding. Major cities — notably Tokyo, Osaka, and Yokohama — have clinics and individual therapists who can work in other languages. Organisations such as TELL Japan offer multilingual counselling and helpline support specifically for the international community. In rural areas, options are considerably more restricted, and expats living outside urban centres may need to rely on remote or online mental health services.

What is Japan’s main public health challenge going forward?

Japan’s rapidly growing elderly population is reshaping the country’s disease profile, intensifying the burden of chronic illness and creating unprecedented demand for long-term care services. The third phase of Health Japan 21, launched in 2024, has set out new national and local action plans to address non-communicable diseases and health disparities — with a particular focus on the challenges posed by Japan’s accelerating transition to a super-aged society.

What should I do if I get seriously ill or need emergency care in Japan?

Call 119 to summon an ambulance anywhere in Japan — this service is free and available around the clock. Many hospitals in major cities have international patient units or staff who speak English, particularly in Tokyo, Osaka, and Kobe. Establishing a relationship with a local clinic soon after your arrival ensures that you have a known healthcare provider to turn to before any emergency arises. It is also wise to carry your national health insurance card at all times, as this will be needed at any clinic or hospital consultation.