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The secret to Japan’s long life expectancy isn’t all about health

Michael McTague, Ph.D., is executive vice president at private equity firm Able Global Partners in New York.
Michael McTague, Ph.D., is executive vice president at private equity firm Able Global Partners in New York.

Diet, violence and genetics all play a role

Japan is regarded as the “healthiest” large country in the world. On the other end of the scale is the Czech Republic, which is surrounded by economically developed nations in Europe. In fact, it’s a member of the European Union and a candidate to join the euro zone.

Today we’re going to delve into why one nation does better than another in health and life expectancy, and discover some surprises along the way.

To the delight of medical Puritans, the Czech Republic’s poor showing is linked to a good deal of drinking and smoking. These health risks are frowned upon in some countries but hang on in Eastern Europe.

Smoking is connected to lung and other forms of cancer, according to a variety of sources. Life expectancy in the Czech Republic stands at 79.8 years, as reported by CVDs (cardiovascular diseases) span heart, blood vessels, coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions, and form a greater cause of death than cancer in the Czech Republic, according to CVDs relate closely to smoking.

Investors will note that companies like Philip Morris PM have gained a large portion of their profit from countries outside the US, where American cigarettes are highly prized.

According to the OECD (Organisation for Economic Co-operation and Development), Japan came in 38th of 49 countries in alcohol consumption. Compare this to the Czech Republic, which far outpaces Japan and ranks near the top. During Prohibition in the US, life expectancy rose, giving credence to staying away from liquor. In fact, life expectancy has been on a general upward trend since the Civil War. In 1925, five years after Prohibition started, US life expectancy was 58.2 years, which was several years better than in 1920.

Japan, the long-life leader of big, well-established countries standing at 84.95 years, features such attractive elements as a low obesity rate, a healthy diet and access to high-quality healthcare. These measures of health relate to considerable wealth and common sense about eating. A preference for fish and an aversion to sugar play a role also. In contrast to the Czech Republic, tobacco use remains low.

Violence plays a role in how countries stack up on these grim statistics. Murder rates and the prevalence of violence as it affects ordinary people offer shocking evidence. According to the United Nations Office on Drugs and Crime’s Global Study on Homicide, 464,000 people were murdered in 2017 — more than five times as many as were killed in armed conflicts during the same period.

Japan has one of the 10 lowest murder rates in the world, 0.26 per 100,000 people. The Czech Republic comes in at 0.45, nearly double, but the trend has been downward. Clearly, violence represents a significant factor and provides one reason why the US does not perform well on these surveys.

Genetics also plays a role in two ways. Certain genetic categories might be more prone to deadly illnesses. Conversely, one’s genes are inherited. So, life expectancy relates in part to the length of life of your ancestors. Also, and this is a subject we have covered in previous entries, some rare diseases have gotten a great deal of attention with a few breakthroughs achieved. For example, several studies looked at the relatively low prevalence of Covid-19 in Japan, which appears linked to genes. In addition, rare diseases tend to be prevalent in particular populations. Counties with more wealth and more medical research are much more likely to address such conditions. About 50 million people in Africa are affected by rare diseases. However, diagnosis and treatment remain limited.

Healthcare also forms a major consideration in the search for the healthiest place on earth. Japan is regarded as having excellent healthcare, and the Czech Republic also gets high marks when compared to its fellow European Union members. Note that despite the great lead the US holds in healthcare, research and medical services, the US is far from the healthiest country.

Access to medicine, especially antibiotics, needs to be noted. While a major concern in the US, Europe and Japan is antibiotic resistance, access to penicillin is limited in other parts of the world. Recently, Pfizer PFE reported a general shortage of penicillin supply. Such medical basics remain critical for extending life expectancy. 

One popular contemporary approach to finding out why life expectancy varies from country to country delves into elaborate blood tests and gene profiling. But a few social basics stand out. The current gene pool, in part, reflects the habits and conditions of contemporary life and the experiences of one’s ancestors.

There is a general upward trend of life expectancy. Even so, a difference of five years remains significant. Look on the bright side, 100 years ago in the US, life expectancy was 56.1 years for men and 58.5 years for women.