The Japanese society is one that is frequently misinterpreted. Stereotypically, in America, we tend to group all Asian values and beliefs together, which is incorrect. The purpose of this writing is to inform people of the differences within the Japanese culture including; health practices, health-care dysfunctions, and nutrition.
To begin, the Japanese approach to health stems largely from religious and philosophical beliefs. In agreement with Healthcare Beliefs of the Japanese (Blanch, 2018), Japan attributes their faith to the Shintoism and Buddhism religions. Shintoism is based on the belief that gods are represented in natural surroundings such as rivers, trees and mountains. One of the ways they show respect for these gods upon entering a shrine is by washing their hands. Cleanliness is corresponded with spiritual purity, and according to Shintoism, illness and disease are considered unclean and impure. Buddhism, however, treats aging and illness as a natural process and many individuals choose to embrace this later in life.
As explained by Japanese Americans and self-care: a lesson in cross-cultural care (Galanti, 2001), “American health care professionals must realize that self-care is not always the result of medical necessity, but rather because of the social structure on health care practices.” In America, self-care is important because independence is valued so highly as opposed to the emphasis in the Japanese culture as being on family interdependence. This is the reason many Asians live in large extended family households.
Another thing to remember when caring for the Japanese is the difference between egalitarian and hierarchic culture. The egalitarian culture can be found in the United States and is where everyone, in theory, is equal and no one in the family is considered subservient to anyone else. In hierarchic cultures, such as found in Japan, certain family members have a clear dominance while others are clearly subordinate. Dominance and/or control is important. For example, if an illness causes a symptom of weakness, the man of the household then issues an order to have their family attend to their every need in order to demonstrate their dominance. It may be seen as helplessness, but is actually a way of maintaining control (Galanti, 2001, p. 208).
As stated in Japanese Americans and self-care: a lesson in cross-cultural care (Galanti, 2001), when referring to self-care, personal hygiene is generally performed by the patient, if able. Japanese women, tend to be modest with family members, especially their elders, and those of the opposite sex. This is why it is best to assign same sex caregivers to patients. Daily tub baths are the preferred bathing method and should be completed in the evening before bed. Hair washing occurs daily or several times per week, and nails are generally kept short.
Although today Western medicine is widely practiced in Japan, a combination of both traditional and Western medicine is much more common. The Japanese believe in an integral mind-body connection; they think that illness stems from the interruption of the flow of Qi, or energy. Kampo is the study of traditional Chinese medicine in Japan and is a very popular form of healing that uses medicinal herbs to restore the flow of said energy. Another traditional therapy is shiatsu massage in which pressure is applied to specific points on the body, also with the aim of restoring Qi (Blanch, 2018). As with Western culture, the holistic approach is slowly growing whereas Japan has been practicing for many years.
Another way that the Japanese culture and merges with a westernized one is through diet. The Japanese diet is known to be one of the healthiest in the world. Its focus is on simplicity with seasoning. Traditional meals contain fresh, unprocessed ingredients and includes rice, vegetables, fish, and miso. Previously, the cuisine was heavily influenced by Chinese cooking, but Japan is a fishing nation and so its people consume far more fish and seafood than other Asian countries (Exploring the Traditional Japanese Diet, 2019). These factors result in a well-balanced diet that is low in fat and high in nutritional value which is why the Japanese have some of the lowest rates of obesity and cardiovascular disease. Another principal that can be credited to their high health status the Japanese’s attitudes towards food; the culture encourages eating until only 80% full. This practice prevents overeating and may contribute to the calorie deficit needed to lose weight.
Although the traditional Japanese diet still exists, it has evolved. Economic, social, and political changes have all influenced the type of food consumed in Japan. (Exploring the Traditional Japanese Diet, 2019). Wheat-based products are now eaten regularly, while rice consumption is declining. What makes the Japanese diet stand out are their strong traditions, simple ingredients, and emphasis on nutrition. A major item in their everyday intake is green tea. The tea is thought to help digestion, lower blood pressure, and has even been shown to prevent some cancers which explains why the Japanese people drank green tea for medicinal purposes and has been one of the few things that remain unchanged.
“Japan’s health care system is considered one of the best health care systems in the world for various reasons, including its availability, effectiveness, and efficiency.” (Zhang & Oyama, 2016, p. 21). The Japanese have the longest life expectancy when compared to those from any other country. It is thought to be accredited to their diet, their proficiency in balancing demands and supplies, and their ability to control medical prices under the universal health insurance system (Zhang & Oyama, 2016). The universal health insurance system encompasses the policies of maintaining a strict payment policy with the ability to provide care to the entire population. Another main focus of this universal system is to deliver necessary and adequate medical services.
The issue with Japan’s healthcare system is that the local public hospitals are suffering from monumental debt. The local hospitals are those that care for and treat majority of the population, which is why this is a major dysfunction. These facilities house more patients than any other institute and tend to have scarce resources. Because a large number of patients do not carry private insurance, and they cannot be turned away for care, the hospitals are held responsible for the payment. The private-insurance hospitals in recent years, have turned their focus onto increasing revenue whilst local ones are attempting to control expenditure. This debt is in turn, creating an increasing national financial burden.
In summary, the Japanese culture is based around traditional values with an added hint of the westernized society. The given information has been provided to ensure that Japan is differentiated from all other Asian countries. The desire is that there is now a better understanding of their unique health care system and its dysfunction, health practices, and what their diet typically entails. With hopes that your awareness of the Japanese culture is heightened, your explorations is appreciated.
References
- Blanch, L. (2018, June 24). Healthcare Beliefs of the Japanese. Retrieved from https://classroom.synonym.com/healthcare-beliefs-japanese-12859.html
- Exploring the Traditional Japanese Diet. (2019, March 19). Retrieved from http://japanology.org/2019/03/exploring-the-traditional-japanese-diet/
- [bookmark: _Hlk31898419]Galanti, G. A. (2001, March). Japanese Americans and self-care: a lesson in cross-cultural care. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071320/
- Zhang, X., & Oyama, T. (2016, March 18). Investigating the health care delivery system in Japan and reviewing the local public hospital reform. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4807930/
