 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Stephen A. Bezruchka, MD MPH, Dept. of Health Services, University of Washington, Box 357660, Seattle, WA 98195-7660, (206)932-4928, sabez@u.washington.edu
A critical element of societal structure has been found in recent years to explain many of the differences in health and well-being among populations: how equitably the fruits of society are distributed among its members. This paper will begin by briefly reviewing the current evidence, including plausible biological mechanisms, that links the life expectancy of nations and other groups with measures of equity and hierarchy, such as income distribution, for those populations.
The case of Japan after World War II will then be discussed, providing evidence for the strong and rapidly acting health benefits of decreasing hierarchical relationships within a society. Japan had relatively high mortality prior to the war, but by 1978 had (and still continues to have) the longest life expectancy of any country in the world. This paper will describe the post-war changes in Japan that appear to have produced this phenomenal shift. It is proposed that the changes largely resulted from the efforts of General Douglas McArthur, who was Supreme Commander of the Allied forces and who directed the American occupation following the war. McArthur focused on demilitarizing Japanese society, democratizing its political processes, and decentralizing Japanese wealth and power. A range of additional possible explanations for the good health of the Japanese will be explored.
Learning Objectives:
Keywords: Public Health, Policy/Policy Development
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.