The Journal The Authority on Global Business in Japan

Health2The American Chamber of Commerce in Japan (ACCJ) and the European Business Council in February launched a joint white paper urging the Japanese government to help improve the health of its female citizens. The paper seeks to draw attention to a vital but generally overlooked element in Prime Minister Shinzo Abe’s plan to increase female participation in the economy.

To date, the government’s reforms to narrow the gender gap have focused on increasing the number of women in managerial positions and supporting working mothers. The ACCJ has encouraged these efforts through its annual Women in Business Summit and other initiatives.

The latest advocacy paper—sponsored by ACCJ member companies GE, BD Japan, Bayer, MSD, Merck Serono, MetLife, and Cosmo PR—argues that healthcare-related measures are also critical to the attainment of Japan’s gender equality goals and should go hand in hand with structural and social reforms.

“Prime Minister Abe last year announced a new set of policy ‘arrows’ that combine efforts to shape a stronger economy with assistance for raising children to stabilize the population decline,” says William Bishop, director of corporate affairs at BD Japan and chair of the ACCJ Healthcare Committee, which produced the white paper.

“Clearly, the role of women in the economy and women’s health issues are central to the success of these new policies.”

Lagging behind
Japan has more to do to fully meet the healthcare needs of its female citizens.

Despite breast cancer claiming the lives of tens of thousands of women each year, the screening rate in Japan is only 41 percent, compared with 80.8 percent in the United States and 67.6 percent in South Korea.

Cervical cancer is second to breast cancer as the most prevalent cancer affecting women, yet only 42.1 percent of Japanese women underwent screening in 2013, one of the lowest rates among nations in the Organisation for Economic Co-operation and Development.

Japan, unlike other countries, has no laws or regulatory guidelines for comprehensive health checks and gynecological care for women. As a result, Japanese women are less likely than those in the United States to have an annual gynecological checkup, even though more than 70 percent of Japanese women suffer from menstrual problems, which could be indicative of, or lead to, more serious health issues.

“There is a great need for sustained education to build awareness of diseases and therapies, which is currently missing in Japan,” says Kumi Sato, president and CEO of Cosmo PR, which specializes in healthcare communication.

Japanese women also fall behind their peers in terms of fertility knowledge, which limits informed choices about when to start a family. Japanese women are also less likely to have access to oral contraceptives and assisted reproductive technologies, such as in-vitro fertilization, which makes balancing career advancement and having children an even greater challenge.

“For the one in six Japanese couples that face infertility, the cost of treatment often limits access,” says Leo Lee, president of Merck Serono. “Despite improving national and local subsidy programs, many women are still unable to pursue treatment.”

Global best practices
Japan is also slower than other countries to introduce best-practice technology and preventative treatments for diseases affecting women. For example, cervical cancer is preventable through the use of both screening and HPV vaccination—a combination that Japanese authorities are still reviewing, despite a statement from the World Health Organization that HPV vaccines are safe.

“Japan should resume the active recommendation of the HPV vaccination as soon as possible, so that Japanese women can benefit from the same vaccination environment as in many other countries,” says Tony Alvarez, representative director and president of MSD K.K.

The white paper also calls for the implementation of liquid-based cytology screening to increase the accuracy of cervical cancer testing, as well as the use of more accurate screening and diagnostic methods for breast cancer, such as digital breast tomosynthesis and magnetic resonance imaging, as alternatives to mammography.

“Evidence shows that Japanese women have a higher likelihood of a so-called dense breast tissue, which can require more advanced methods to detect and diagnose cancerous growths,” says Kumi Ito, chief marketing officer of GE Healthcare Japan. “It is important to continue to raise awareness about adequate breast screening and introduce personalized care according to individual genetic risk factors.”

SOURCES: OECD Health Data 2013; Japanese Ministry of Health, Labour and Welfare

SOURCES: OECD Health Data 2013; Japanese Ministry of Health, Labour and Welfare

Wider benefits
Improving the health of Japanese women will have wider benefits for the country’s economy and society as a whole. According to the Health and Global Policy Institute, a Tokyo-based think tank, the cost to the Japanese economy of gynecological conditions in terms of medical expenses and lost productivity is estimated to be at least ¥6.37 trillion per year.

Meanwhile, evidence from other countries suggests that the higher the osteoporosis screening rate, the lower the eventual nursing care needs in the elderly population—an important consideration amid Japan’s aging population and rapidly increasing social security costs.

“As Japanese people increasingly bear more individual risk in areas such as health and nursing care, it is critical to ensure that women understand the specific health risks they face and are empowered to achieve a more holistic work–life–health balance,” says Sachin N. Shah, CEO of MetLife Japan and a member of the ACCJ Board of Governors.

As with gender equality in the workplace, improving female health in Japan is not solely a job for the government. The white paper provides recommendations for businesses to improve the health of female employees, for example by offering training on life and family planning, including screening for breast cancer and other conditions in health check-ups as standard opt-out items, and by providing schedule flexibility for women undergoing fertility treatment.

“Policies and guidelines on comprehensive support for women’s health are vital to minimize the risk of otherwise treatable conditions and enable women to achieve their career and social aspirations,” says Yasuko Aitoku, operating officer and head of market access at Bayer Yakuhin. “Meeting these healthcare challenges will address and accelerate the advancement of women in society.”

Women’s Health Policy Recommendations

Health literacy and education
Educational intervention to improve health literacy and
support women’s advancement

Health for self
Increase comprehensive screening and access to
gynecological care
Reduce the spread of sexually transmitted infections
Promote cervical cancer prevention and screening
Improve the accuracy of breast cancer screening
Prevent fractures due to osteoporosis

Reproductive health
Improve access to oral contraceptives
Improve access to fertility treatment

Andrew Joyce is senior manager of Government Relations at MetLife and a member of the ACCJ Healthcare Committee
Japan has more to do to fully meet the healthcare needs of its female citizens.