The Tape Measure at the Company Health Check: Japan's "Metabo Law" — Epoche B1
1. Subject of this report Since April 2008, a tape measure has been part of the yearly health check offered to people in Japan aged 40 to 74, under a programme the newspapers named the "Metabo Law". This report sets out what the rule requires, of whom, and what is known about its effect. 2. What the rule requires The instrument is the Act on Assurance of Medical Care for Elderly People, revised in 2006. It places a duty on health insurers — company schemes and municipal ones — to offer each insured member in that age band a "specific health check": blood pressure, blood sugar, blood fats, and the waist measured at the navel. Those over the line who also show other risk signs are offered health guidance, meaning an interview, a plan and follow-up contact over some months. 3. Thresholds Men 85 cm or more Women 90 cm or more 4. Where the pressure falls This is the point most often misunderstood abroad. No individual is fined for a wide waist. The duty, and the money attached to it, sit on insurers and employers, whose contributions to the fund for elderly care can be adjusted according to their results. The cause was demographic: an ageing population and rising costs from lifestyle-related disease. The chosen remedy used a structure Japan already had, since the annual workplace check was an old habit. 5. Effect The evidence should be read carefully. Studies report modest average loss of weight and waist among people who complete the guidance, but effects on later illness are harder to demonstrate, and participation has often fallen short of official targets. 6. Conclusion Perhaps the quieter achievement is this: a national conversation about the body became routine, once a year, at a desk, without punishing anybody. References Act on Assurance of Medical Care for Elderly People (Act No. 80 of 1982, as amended 2006; specific health checks in force from April 2008). Government of Japan. Ministry of Health, Labour and Welfare, Japan. Standard Health Check-up and Health Guidance Programme. MHLW. Kohro, T. et al. (2008). The Japanese National Health Screening and Intervention Program Aimed at Preventing Worsening of the Metabolic Syndrome. International Heart Journal, 49(2), 193–203. Tsushita, K. et al. (2018). Rationale and Descriptive Analysis of Specific Health Guidance: the Nationwide Lifestyle Intervention Program Targeting Metabolic Syndrome in Japan. Journal of Atherosclerosis and Thrombosis, 25(4), 308–322.