To mark the occasion of Women’s Health Week (from March 1 to March 8), the Health and Global Policy Institute (HGPI) Women’s Health Project released the final report for “The Public Opinion Survey on Child-Rearing in Modern Japan.”

Since Japan’s total fertility rate fell to a record low of 1.57 births per woman in 1990, an event known as the “1.57 Shock,” the Government of Japan has worked to reverse the declining birthrate through various laws and measures. The “Outline of Measures for Society with Decreasing Birthrate” enacted by Cabinet Decision in May 2020 set a specific numeric target of 1.8 births per woman and included measures for reviewing child-rearing allowances and eliminating daycare waiting lists, improving working conditions for young people, and providing parental leave to men. However, statistics presented in June 2021 reported the total fertility rate for 2020 was 1.34, or 0.02 points lower than the previous year, making it the fifth consecutive year of decline. New measures to address the declining birthrate were implemented in response, including expanded subsidies for fertility treatments. Discussions on expanding insurance coverage for fertility treatments are currently underway, but many people feel these measures do not sufficiently reflect the needs of members of the generation who wish to conceive.

Given these circumstances, the HGPI Women’s Health Project conducted a nationwide online survey of 10,000 men and women ages 25 to 49 to identify and propose specific measures that will be important and effective for creating a society in which anyone who wants to conceive is able to do so.

The survey results showed there is room for improvement in health literacy for all of society regarding topics like fertility and infertility in men and women as well as women specific health concerns. Results also suggested factors that are related to having children among people who want them include: history of diagnosis and treatment for endometriosis, uterine fibroids, and polycystic ovary syndrome (PCOS); age of initial gynecological examination; annual income and employment status; and relationships in communities during childhood and relationships with nearby children later in life.

 

■ Key findings of the survey

(Health literacy)

• Almost half of women and over 60% of men did not know it is possible to treat symptoms experienced before or during menstruation.
• Almost half of women and over 60% of men did not know that amenorrhea or organic diseases like endometriosis and uterine fibroids can cause infertility if left untreated.

 (Gynecologic diseases)

• The proportion of respondents with a history of diagnosis or treatment for endometriosis, uterine fibroids, or PCOS was greater among those currently expecting their first child compared to those with children.

 (Socioeconomic activity)

• Among respondents who said “I have no income” or “My annual income is under 5 million yen” when asked about their annual income, there was a significant difference between men with children (37.4%) and men without children (63.9%).
• Among male respondents with full-time employment (including both full-time and temporary assignments), there was a significant difference between those with children (95.7%) and those without children (76.8%).
• When asked about what forms of support or systems are necessary to enable people who want to have children to be able to do so, many respondents said tax measures that reduce burdens on families with children, employment measures, and opportunities for stable employment.

(The surrounding environment)

• Respondents without children tended to have fewer opportunities to interact with children in everyday life than respondents with children had before becoming parents.

 

■ Four perspectives gathered from survey results

Perspective 1: Reinforce support to improve health literacy.

Perspective 2: Establish a system to improve access to gynecologists.

Perspective 3: Provide economic support to people who want to have children and advance work style reforms.

Perspective 4: Provide people with opportunities to interact with children and promote the creation of mechanisms for mutual support in communities.

*The English report will be posted as soon as the translation is complete.

■ Survey team organization

Survey team (Titles omitted; in no particular order)

• Yuko Imamura (Manager, HGPI)
• Yukiko Kawata (Senior Associate, HGPI)
• Maya Fujimura (Program Specialist, HGPI)
• Takashi Yano (Associate, HGPI)
• Noriko Miwa (Program Specialist, HGPI)
• Akiko Tamakoshi (Professor, Social Medicine Course, Department of Public Health, Faculty of Medicine, Hokkaido University)
• Takashi Kimura (Assistant Professor, Social Medicine Course, Department of Public Health, Faculty of Medicine, Hokkaido University)

Advisory board (Titles omitted; in alphabetical order)

<Special advisors>

• Makoto Atoh (Honorary Director-General, National Institute of Population and Social Security Research)
• Hitoshi Kikawada (Member, House of Representatives; Secretary-General, Japan Parliamentarians Federation for Population (JPFP))
• Tadashi Kimura (Professor, Department of Obstetrics and Gynecology, Graduate School of Medicine, Osaka University)
• Kunio Kitamura (President, Japan Family Planning Association)
• Kiyoshi Kurokawa (Chairman, HGPI)
• Junko Mihara (Member, House of Councillors)
• Seiko Noda (Member, House of Representatives)
• Yutaka Osuga (Professor, Department of Obstetrics and Gynecology, Graduate School of Medicine, University of Tokyo)
• Yoshiaki Wada (Member, House of Representatives)

<Advisory board members>

• Shinji Anzo (Professor, School of Political Science and Economics, Meiji University; Principal, Meiji University Meiji High School and Meiji Junior High School)
• Kazuko Fukuda (Representative, Nande Naino Project)
• Renge Jibu (Associate Professor, Institute for Liberal Arts, Tokyo Institute of Technology)
• Miho Konishi (Newscaster and Commentator, Nippon TV)
• Song Mihyon (Director, Marunouchi no Mori Ladies Clinic)
• Kaori Sasaki (President and Representative Director, ewoman, Inc.)
• Amina Sugimoto (CEO, fermata inc.)
• Sachiko Takahashi (Assistant Professor, Saitama Medical University)
• Masanori Yoshino (Senior Project Manager, Hitachi, Ltd.; Visiting Professor, Director, Hokkaido University Center of Innovation (COI))

Global coordination (Titles omitted; in alphabetical order)

<Members>

• Reiko Hayashi (Deputy Director-General, National Institute of Population and Social Security Research)
• Yumie Ikeda (School of Public Health, Doctoral Course in Health Informatics, Graduate School of Medicine and Faculty of Medicine, Kyoto University)
• Rintaro Mori (Regional Adviser for Population Ageing and Sustainable Development, United Nations Population Fund (UNFPA) at Asia-Pacific Office)
• Mariko Sato (Director, United Nations Population Fund (UNFPA) Representation Office in Japan)

Supporting companies and organizations

• Asahi Mutual Life Insurance Co
• Bayer Yakuhin, Ltd
• Fuji Pharma Co., Ltd.
• Hokkaido University

 

Please note that opinion exchanges were held with supporting companies and organizations when conducting the survey, but decisions regarding the reflection of opinions shared during those discussions in the survey were made independently by the survey team.

■ Inquiries

For inquiries regarding this survey, please contact Ms. Imamura or Ms. Kawata at HGPI.