NAGANO—Okinawa Prefecture once boasted the longest life expectancy in the country, but it has now dropped well out of the top 10.
In fact, the life span of men in the nation’s southernmost prefecture ranks near the bottom among Japan’s 47 prefectures.
Nagano and Shiga prefectures in central Japan have climbed to the top ranks in recent years while Aomori Prefecture in northeastern Japan remains stuck in last place.
The central government has released its life expectancy rankings every five years since 1965.
The most recent report was for 2020, when the overall average life expectancy for men was 81.49 years, while the nationwide average for women was 87.60 years.
Among men, Shiga Prefecture ranked first, at 82.73 years, followed by Nagano Prefecture at 82.68 years and Nara Prefecture at 82.40 years.
Among women, Okayama Prefecture took the No. 1 spot with a life expectancy of 88.29 years, followed by Shiga Prefecture’s 88.26 years and Kyoto Prefecture’s 88.25 years.
OKINAWA’S RAPID SLIDE
Okinawa Prefecture was tops among women for seven straight times from 1975 to 2005, while Okinawa men placed first in 1980 and 1985. Records for the prefecture were first made available in 1975, three years after its return to Japan.
Okinawa’s longevity was traced to the prefecture’s traditional culinary culture centering on vegetables, fish and soybeans, the islanders’ optimistic outlook on life, and the mild climate.
But the men’s ranking plummeted to 36th in 2015 and 43rd in 2020, while Okinawa women dropped to 16th place in 2020, their first time outside the top 10.
Okinawan health officials cited rising mortality rates among the working-age population caused by diseases associated with poor diets, lack of exercise, and excessive drinking and smoking as reasons behind the steep declines in the rankings.
Okinawa has turned into an “island where residents do not die from being the oldest,” Toru Itokazu, head of the Okinawa prefectural government’s public health and care department, said at the third “life expectancy conference” in Nagano in November.
The conference, held 11 years after the previous gathering, also included health officials from Nagano, Shiga and Aomori prefectures. They shared factors behind longevity trends and efforts to improve the numbers in their jurisdictions.
Okinawa officials said they studied and compared obituaries run in two local dailies in 1985 and 2015.
They found the proportion of deceased individuals who were survived by their parents increased from 27.4 percent in 1985 to 54.8 percent in 2015.
NAGANO’S REDUCED SALT PAYS OFF
Nagano Prefecture, in a mountainous region of central Japan, has established itself as a front-runner in the life expectancy rankings, largely as a result of more than half a century of prefecture-wide efforts to reduce salt consumption.
Nagano men captured first place for five consecutive rankings from 1990 and 2010, while women took the No. 1 spot in 2010 and 2015.
But the prefecture relinquished the title for men in 2015 and for women in 2020.
Yoshikiyo Kobayashi, head of the Suwa public health center in Nagano Prefecture, cited a higher death rate among children from 9 to 14, including suicides, as a key reason for losing the top spots.
SHIGA’S HEALTH APP
Shiga Prefecture replaced Nagano Prefecture as No. 1 in men’s longevity in 2015 and retained the title in 2020.
Shiga men entered the top 10 in 2000.
Women in the prefecture did not crack the top 30 until 1995. They have since captured fourth place in 2015 and second in 2020.
Shiga prefectural authorities have introduced a dedicated health app called Biwa-Teku that rewards points to residents who take health checkups and join walk rallies.
Participants can win goods by lottery after collecting enough points.
Shiga authorities are now envisioning a program that identifies health risks of individuals and recommends measures to prevent related diseases from developing.
This will involve the use of generative artificial intelligence to analyze data on individual participants, including step counts and the results of health checkups, and provide proposals tailored to each person.
AOMORI STRUGGLES
While prefectures at the top of the rankings vary from time to time, Aomori Prefecture cannot seem to emerge from the bottom.
Aomori men edged up to 46th place in 1970, with neighboring Akita Prefecture replacing them at the bottom. But that was the only exception.
Women in Aomori Prefecture fared somewhat better than their male counterparts, but they have been ranked last since 2000.
The people of Aomori Prefecture seem to have unhealthier lifestyles than others around Japan.
The ratio of Aomori people taking health checkups and doing exercise is lower than the national average, while their drinking and smoking rates are higher, according to health officials.
Aomori people also consume a higher-than-average level of salt.
NO EASY FIX
In the 2020 rankings, the gap between the prefectures with the longest and shortest life expectancy was 3.46 years for men and 1.96 years for women.
Although the difference may seem minor, the low rates have serious implications for Aomori Prefecture, according to Shigeyuki Nakaji, a doctor and special adviser to Hirosaki University who has led efforts to improve life expectancy in the prefecture.
“A life expectancy deficit of two to three years means death rates are higher across almost all generations, including working-age populations, in Aomori Prefecture, compared with Shiga and Nagano,” he said. “This amounts to a considerable social loss.”
Haruhiko Imamura, associate professor of public health at the University of Nagano who has worked to revive the life expectancy conference, said improving life expectancy numbers is a huge challenge requiring broader and longer efforts.
“You cannot accomplish it over a short period of time because it entails a change in people’s lifestyle across a region,” he said. “Life expectancy numbers are total scores reflecting the state of health of all age groups in the region.”
Imamura urged researchers and officials not to be short-sighted and react nervously to the rankings. Instead, they should identify and tackle the root causes behind downward trends and move in the right direction, he said.
On the sidelines of the meeting, bento lunch boxes, whose contents were developed by University of Nagano students, were sold as a healthy alternative to those available in the market.
The low-salt bento featured rice cooked with sorghum, a grain known as “superfood” due to its rich vitamin, mineral and antioxidant properties.
“Bento sold at a convenience store generally taste strong,” a woman from Shiga said. “But this bento had just the right flavor and tastes good.”
AloJapan.com