Exposure, Resistance and Life Expectancy: Disease and Death During the Economic Development of Japan, 1900–1960

Abstract

By 1900 Japan was still extremely poor, rural and predominantly agrarian: but it had achieved effective mortality parity with the more economically advanced and/or wealthier countries of Western Europe. As standards of living rose, life expectancy remained relatively stagnant until the end of World War II. Subsequently, in spite of the economy being still partially crippled by wartime destruction, life expectancy in Japan increased very rapidly. The analysis of these puzzling trends is undertaken by means of an historical model of mortality change in which life expectancy is interpreted as the function of both the relative overall resistance of the population to disease, and the degree to which it was protected from exposure to the leading causes of death. It is argued that the early and late Japanese achievement of relatively high life expectancy at relatively low levels of income rested on the government's efficient delivery of a very high level of protection from exposure to disease. The middle period, 1910 to 1940, represented a relative failure of protection due to the concentration of financial resources on the military sector; a failure which better diets etc. could not effectively counter. The post-war period involved a return to higher levels of investment in public health during a period of technological progress and structural shifts which enhanced the efficiency of such investment.