By most standards of modernization, the Japanese industry and economy have reached the same level of development as that of advanced countries and Japan is clearly a serious contender for the top position among the world's post-industrial nations today. Yet, the everyday experiences of the Japanese are permeated with cultural traditions that give meaning and direction to their lives. One of the aspects of the Japanese way of life that portrays most clearly this combination of tradition and modernity is in the realm of health and illness.

Indeed, Japan offers a very interesting case of the coexistence of traditional and modern medical systems and this chapter will review its main current features. The presentation is organized into three sections. The first section deals with the supply of services in the modern medical system. The second section describes the traditional medical services. And the third section presents some significant trends in the utilization of both medical systems. This final section is based on survey data collected by Japanese researchers who studied various subsamples of the population in Japan.

The Modern Medical System

By international standards, the Japanese enjoy today a large and growing modern medical system. The most reliable statistics on the size and characteristics of the modern medical system are provided by Japan's Ministry of Health and Welfare (MHW). Comparing the MHW's national figures on modern medical personnel from 1972 to 1984 (Table 3.1), it is clear that the pattern of growth is found in all categories of personnel from medical doctors to assistant nurses. The only exception to this trend are midwives; their number declined from 30,246 in 1972 to 25,887 in 1984. However, the increase in personnel has not been even. The most rapid growth has been that of the number of nurses. There were 334,146 nurses (including assistant nurses) in Japan in 1972; this figure represented 331.3 nurses per 100,000 population. In 1984 the number of nurses had increased to 625,773 or 520.5 per 100,000 population. The increase in medical doctors has been higher than that of dentists, pharmacists, and public health nurses, but much lower than that of nurses.