TOKYO -- Deputy Prime Minister and Finance Minister Taro Aso has made headlines again, this time with his support for a comment that it is "ridiculous" to pay national health insurance premiums for "people who got sick by drinking too much and exercising too little."
Aso's remark at a press conference on Oct. 23 following a Cabinet meeting was apparently aimed at diabetes patients and follows up on a series of similar statements he had made in the past.
But is Aso right to suggest that people with diabetes only have themselves to blame for their ailment? Multiple medical doctors question the wisdom of the No. 2 person in Prime Minister Shinzo Abe's Cabinet, as data shows that poor people tend to get diabetes.
"More and more younger people are suffering from severe diabetes. I think it's serious," said Yasushi Azami, a diabetes specialist running a clinic in the city of Kanazawa in the central Japan prefecture of Ishikawa.
The trend began to emerge after the 2008 global economic meltdown triggered by the collapse of the U.S. investment banking giant Lehman Brothers. One after another, young patients came to see Azami with serious diabetic complications such as kidney problems that may require dialysis if left unattended, or retina issues that could lead to a loss of eyesight. These conditions occur long after a patient develops diabetes.
Most patients have type 2 diabetes that is often related to a lack of exercise, obesity, stress and other factors after puberty, although there are those with type 1 diabetes that tends to develop at a young age.
A nationwide survey of 782 patients aged between 20 and 40 in 2011 and 2012 showed 57.4 percent of them belonged to households with an annual income of less than 2 million yen, according to a survey conducted by the Japan Federation of Democratic Medical Institutions.
Typical type 2 diabetic patients "become obese because of dietary imbalances starting at early ages, or are forced to be non-regular workers and work long hours in adulthood," explains Azami. "They develop diabetes as they get fat because of irregular eating patterns and stress, and their symptoms become severe because they cannot receive health checkups."
According to professor Katsunori Kondo of Chiba University's Center for Preventive Medical Sciences, a social epidemiology specialist, a number of studies indicating a growing disparity in physical health between the rich and the poor have come out in foreign countries since the 1990s. In a Canadian study published in 2010, low-income women were 2.9 times more likely to have diabetes than their rich counterparts. The figure was 1.41 for men.
"It's common sense in advanced countries that low-income earners have higher risks of getting diabetes than rich people," said professor Kondo, indicating that a large body of studies have denied that diabetic patients "are responsible for their own illnesses" or "deserve what they have."
"Non-regular workers tend to receive health checkups less often. Saying they deserve their illnesses is unfair because they need to give up a day's salary to receive a health checkup," pointed out Kondo. "The preconditions for health management are not fair. Improving public health requires efforts to make up for societal and economic disparities."
Azami echoed Kondo in his critical view of Aso's remarks. "Poor people with deteriorating health must feel unfairness when they cannot be blamed for their condition. Diabetes is linked closely with social problems, and resolving them is a politician's job."
(Japanese original by Hiroyuki Wada, General Digital News Center)