The New York Times reports that the Japanese government, concerned by rising health costs, has begun an ambitious program to rein in its citizens waistlines. As per a law passed three months ago,companies and local governments are required to measure the waist sizes of all employees and retirees between the ages of 40 and 74 , and their families. This will be done as part of the annual check-up and those whose waists are over the limit will be provided counselling. In Japan, as in the U.S, most Japanese are covered under public health care or through their employer and it is felt that these measures will lower health costs by reducing strokes, diabetes and cardio-vascular complaints. If the percentage of those overweight does not shrink appreciably over the next several years , the government will impose financial penalties on companies and local governments that do not meet targets.
The Japanese are among the healthiest people in the world and I find it surprising that Japan should have embarked on such a program. Even more surprising are the prescribed limits– 33.5 inches for men and 34.5 inches for women. Even taking into consideration that the Japanese are relatively small built, these would seem to be on the low side. Another point to note is that the women’s threshold is higher than the men’s.
The standards established by the International Diabetes Federation are higher for Americans since we are bigger built. For Caucasian Americans, the norms are 40 inches for men ( actual average is 39 inches) and 34.6 inches for women ( actual average 36.5 inches, almost two inches higher). This is surprising to me for a couple of reasons. Firstly, I would have thought that the 40 inch norm for men was generous and the 34.6 inch norm for women too low. Secondly, I am astounded to hear that the men are below the norm and the women above it. It seems to me that women are far conscious of their appearance than men are.
Regardless of the statistics, this is one program that the U.S. government should have implemented long ago. We are constantly hearing about the alarming incidence of obesity and diabetes in American children and yet , except for jawboning, nothing seems to be done about it. Given the skyrocketing healthcare costs in this country one would have expected the government and health insurers to have been more pro-active.
Japanese critics of their government’s initiative claim that the norms are too low, that it will result in overmedication and ultimately higher healthcare costs. They ask why the government is not doing anything about smoking ; Japanese smoking rates are among the highest in the developed world. “Perhaps it has to do with the powerful smoking lobby ?” they insinuate.
On that score , we seem to be ahead. By a combination of lawsuits and public awareness, smoking has been considerably reduced in the U.S , though of course it could be still lower. Now if only the same thing could be done about our unhealthy eating habits.
P.S. . A visitor from India had this interesting thought. ” In India”, he said” the rich are fat and the poor are thin. In America, the poor are fat and the rich are thin. ”