Impact of Culture in Japan

According to Skolnik (2021), the modern definition of culture is described as rules or standards shared by members of society - "a group of people who occupy a specific locality and share the same cultural traditions" (p. 167) - who act on established behavioral norms that are deemed proper and acceptable. Culture plays an important and multifaceted role when it comes to the concept of health. Culture can determine how society approaches (health-related) decisions, actions, and practices based on their attitude and background toward different topics or beliefs (Skolnik, 2021).
The people of Japan have deep cultural roots based on traditional values - belonging, harmony, politeness, modesty, gentleness, patience, and formality - that influence their actions and perspectives (Scroope, 2021). In Japan, cultural influence can determine communication decorum, and it can also dictate the types of food being consumed and how it can impact a person's health. Culture can also influence how a person can perceive - their own or others - illness and the treatment needed, whether that is through western medicine or other medical systems (Skolnik, 2021).

Common Cultural Practices

In Japan, age and status play an important role in cultural practices and relationships, as the Japanese are a relationship-oriented culture. It is important to know and trust someone before an interaction because it determines the level of formality or if the interaction is casual and informal. Respect for age and status is extremely important. It is important to greet the high-status individual first and then the oldest.

Bowing is a large part of Japanese culture and a greeting and sign of respect for those who are senior to them. For example, the junior individual initiates the bow - at the waist approximately 30 to 45 degrees. Men bow with arms at their side, while women bow with hands and fingers crossed at thigh height. It is poor manners and aggressive to hold and maintain eye contact when bowing!

Japan is a traditional country that often focuses on conformity and modesty. Women often dress conservatively with subdued colors with minimal accessories and jewelry. Men are often seen in a dark business suit and white dress shirt with a time unless circumstances - situation or job - dictate otherwise. The people of Japan emphasize modesty with it comes to communication by speaking in quiet tones to promote a calm and humble impression.

Gender Norms in Japan

Often Japan's culture is steeped in Confucianism idea with pre-determined roles for both men and women and fore the most part these ideals have remained true with some progressive changes (Kincaid, 2019).

Family (kazoku) is the foundation of life and culture in Japan.

Men - husbands and fathers - fulfill the role of head of the household as the primary provider for income, the breadwinners.
Women - mothers and wives - are relegated to the management and protection of the household and eventually raising children

In Japan, the traditional life revolves around the family structure based on the Confucian ideology of social hierarchy involving multi-generational family members led by a patriarch, who would establish authority and delegate responsibilities to family members (Scroope, 2021). Koseki, the official family registry in Japan, is required to report "birthplace, date of birth, relocation of the family to another municipality, marriages, divorces, acknowledgment of paternity of children, adoptions and deaths" (Scroope, 2021). In the last few decades, the traditional family structure has shifted to focus on two-generational families - the parents and their children - with both parents fully engaged in the paid workforce (Scroope, 2021).

Women:

are the full-time parent.
expected to be ideal worker and company/business is the priority and comes before family.
motherhood is the defining characteristic of a woman
single women between last 20's and early 30's are considered shakaijin, official members of society
expression of affection through intimacy and validation through actions (make dinner or meal requests towards husband)

Men:

work often and are underpaid often resulting in extended work days or commuted home only for the weekends.
- mandatory overtime
expected to be ideal worker and company/business is the priority and comes before family.

Recent Changes in Gender Norms (Kincaid, 2019):

Both men and women express strong intentions to marry. In Japan, marriage is a marker of adulthood.
The rate of married women's participation is increasing in part-time and full-time jobs.
Dual income households report less stress on the husband compared to traditional households. Both men and women feel more satisfied with the increase in a dual income households and share family roles.
Japan faces a shortage of children because of the shifting roles of women, economic realities, and the lack of men wanting to participate in tasks that were once considered female tasks.
Women are increasingly educated. Japanese women with college level education are overtaking men.

Harmful Cultural Mentality: "Karoshi"

There is a growing and harmful cultural mentality within Japan that is so new and unexpected that there was not a name or term for this ideology until recently; the term karoshi means "death by overwork" (Hunt, 2021). In 1969, this term was originally called "occupational sudden death" and was brought to the public's attention after a supposedly 29-year-old died of a heart attack (Kincaid, 2016). The research was conducted and determined that the karoshi deaths were the result of "long hours, shift work, and irregular work schedules" that equated to a minimum of 60-hours per week (Kincaid, 2016). Hunt (2021) provides evidence that "55 hours' work or more is a 'serious health hazard" and while Japan acknowledges 80 hours' of overtime is a health risk for karoshi, it is not illegal to work that amount of time. With the rise of the COVID-19 pandemic, researchers are more concerned now than ever because remote or hybrid working is still working; a study conducted in 2020 found that 3.1. million people worked an average of 48 minutes more remotely than in person (Hunt, 2021).

Japanese Cuisine

Japanese cuisine is most known for its delicate and subtle flavors and the raw or cooked options with popular dishes such as sushi, sashimi, or tempura. Sake - a traditional alcoholic beverage made from fermented rice = and tea, especially green tea, are popular drinks within the Japanese culture and can be considered staples of the country.

According to recent research, there are three types of nutritional intake patterns among the Japanese people: traditional, westernized, and meat and fats (Htun, Suga, Shimizu, Takimoto, 2017). The traditional diet in Japan mainly consists of "miso soup, soy sauce, fresh vegetables and fruits, beans and potatoes" which is linked to the increase in BMI and waist circumference but the overall decline of hypertension in men (Htun et al, 2017). While there is a decline in hypertension in men, there was an increase in blood pressure in women due to the high sodium content within miso soup and Japanese pickles (Htun et al, 2017).

The westernized food intake in Japan focused on the consumption of "bread, dairy, butter and margarine, and jam with a low intake of rice and miso soup" which led to the decrease in blood pressure as the result of a high intake of potassium and calcium (Htun et al, 2017). There was also a positive relationship between the westernized food intake and the increased rate of HDL and LDL in women, with only an increase in LDL for men (Htun et al, 2017). The meat and fats food pattern in Japan focuses on "meat, fat, sauce, mayonnaise, wheat and wheat products" and sets a higher prevalence for hypertension, diabetes, and hypercholesterolemia in men and is the pattern most attributed to the increase in cardiovascular disease (Htun et al, 2017).

References

Hunt, E. (2021). Japan's Karoshi culture was a warning. we didn't listen. WIRED UK. Retrieved from https://www.wired.co.uk/article/karoshi-japan-overwork-culture.

Htun, N. C., Suga, H., Imai, S., Shimizu, W., & Takimoto, H. (2017). Food intake patterns and cardiovascular risk factors in Japanese adults: analyses from the 2012 National Health and nutrition survey, Japan. Nutrition journal, 16(1), 61. https://doi.org/10.1186/s12937-017-0284-z

Kincaid, A. (2016). Worked to Death–Karoshi and Japan's Deadly Work Culture. Japan Powered. Retrieved from https://www.japanpowered.com/japan-culture/worked-to-death-karoshi-and-japans-deadly-work-culture.

Kincaid, C. (2019). Gender roles of women in Modern Japan. Japan Powered. Retrieved from https://www.japanpowered.com/japan-culture/gender-roles-women-modern-japan.

Scroope, C. (2021). Japanese Culture. Retrieved from https://culturalatlas.sbs.com.au/japaneseculture/japanese-culture-family#japanese-culture-family

Skolnik, R. (2021). Global Health 101 (4th ed.). Burlington, MA: Jones & Bartlett Learning.