Yonsei Med J.  2019 Oct;60(10):998-1003. 10.3349/ymj.2019.60.10.998.

Why Do Japan and South Korea Record Very Low Levels of Perceived Health Despite Having Very High Life Expectancies?

• Kim M
• Khang YH

• KMID: 2459154
• DOI: http://doi.org/10.3349/ymj.2019.60.10.998

Abstract

Japan and Korea follow a unique trend in which, despite reporting two of the highest life expectancies (LEs) among the Organization for Economic Co-operation and Development (OECD) countries, the proportion of people with good self-rated health (SRH) is disproportionately low. We sought to explain this high-LE-low-SRH paradox by examining associations among LE, the prevalence of good SRH, and healthcare utilization. Our hypothesis was that countries with more frequent healthcare use would demonstrate poorer SRH and that SRH would not show a meaningful association with LE among developed countries. This study extracted data from Health at a Glance 2017 by the OECD for 26 countries with valid and comparable information on LE, SRH, and the number of doctor consultations per capita. Correlations among LE, good SRH, and number of doctor consultations per capita were analyzed. The number of annual doctor consultations per capita and the prevalence of good SRH were closely correlated (correlation coefficient=−0.610); excluding outliers produced a higher correlation coefficient (−0.839). Similar patterns were observed when we replaced good SRH with poor SRH. Meanwhile, the correlation coefficient between annual per capita doctor consultations and LE was quite low (−0.216). Although good SRH is closely related to better LE at the individual level, this was not true at the national level. Frequent use of healthcare in Japan and Korea was strongly correlated with poorer SRH, without any meaningful correlation with LE.

Keyword

Health status; life expectancy; delivery of health care; Republic of Korea; Japan

MeSH Terms

Delivery of Health Care
Developed Countries
Japan*
Korea*
Life Expectancy*
Organisation for Economic Co-Operation and Development
Prevalence
Referral and Consultation
Republic of Korea

Figure

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  Fig. 1 Good self-rated health and life expectancy in 2015 or the nearest year. Correlation coefficient=0.292.

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  Fig. 2 Number of annual doctor consultations per capita and good self-rated health in 2015 or the nearest year. Correlation coefficient=−0.610. When the three outliers (Portugal, Latvia, and Estonia) in the relationship were excluded, the correlation coefficient became −0.839.

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  Fig. 3 Number of annual doctor consultations per capita and life expectancy in 2015 or the nearest year. Correlation coefficient=−0.216.

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