Abstract
The demographic situation and disease structures are very influential for medical services delivery system and its finance. A rapid ageing is on goimg in Japan. The population of aged more than 65 yr old accounts for 22% and Total Fertility Rate (TFR) was 1.37 in 2008. The total population is decreasing since 2006. This demographic change means the increase in users of social and health services and the decrease of tax payers, which requires the Japanese government to re-organize its social security system. The mortality has been also dramatically decreased during the past 50 decades. It is considered that this improvement in health status was caused by the following factors; improvement of general hygiene, medical system and nutrition, relatively small incidence of violence, relatively moderate climate and so on. On the other hand, the ageing and westernization of the lifestyle have changed the disease structure from the acute to chronic diseases dominant patterns. For example, diabetes mellitus and mental disorders have become new health threats for the Japanese population. Because of this dramatic change in demography and disease structures, we face to a fundamental problem concerning how to make our social system sustainable.
