Psychosomatic medicine treats patients as a whole including psycho-social-environmental aspects. Social epidemiology is a discipline to explore social determinants of health, which bring “health gap society”, using epidemiological approaches. It means that social epidemiology is a part of “psychosomatic medicine” in a broad sense. In this paper, firstly, we review achievements which have been clarified about the process of generating health gap. Secondly, we overview countermeasures which could be used as “prescriptions for health gap society”. Thirdly, we introduce methods and effectiveness of community building, and social prescribing which is expected to be used widely.

Many medical interview or medical consultation textbooks describe the utility and effectiveness of various medical interview or consultation methods or skills. But are these recommendations valid under all circumstances, everywhere in the world? Here, we discuss the results of several epidemiological investigations regarding the effectiveness of various medical interview skills across a variety of contexts to see patients with psychosomatic problems.

The perinatal period is associated with a large physical and psychosocial burden, and it is a high-risk period for the onset of mood disturbances. Perinatal depression has a great influence on child development and family life in general, thus it is important to elucidate its etiology and to establish an effective treatment method. We have been conducting prospective cohort studies of pregnant women since 2004, and we got a number of findings. In this article we introduce our research results leading to the understanding of depressed women and their support.

In the highlands of Himalaya-Ladakh, the five-color Buddhist prayer flag flutters everywhere in the village, and everyday life is colored by Tibetan Buddhism. People’s lives are far from abundant, but are filled with smiles and vibrancy. Residents’ well-being is high, and in response to the question “When is the happiest time for you?”, many residents answer “When I pray.”

With Japan’s advanced aging society, the number of elderly people who have to live by themselves has increased with the progress in the nuclear family structure and young people move to urban areas. In the city center, elderly people who are neglected will be conspicuous without being supported by their families and society. Tragically, if there is little support for the elderly, they may spend the remainder of their lives feeling thankful despite having to lead solitary lives while facing the possibility of a lonely death in their homes. It seems that hints to age happily exist in the lifestyle of elderly residents in high-altitude regions.

Japan is standing at the forefront in the trend of progressing aging society on a global scale. It is not only urgent to act on the aging of society in the country, it may be required to present and share the knowledge and experience to the world. We have promoted the program of community-based medical care for the elderly in Bhutan in cooperation with local villagers and the central government. In Bhutan, there is an idea that harmony with all living things is a source of longevity. There were conditions that we cannot provide adequate medical care for diseases which are treatable in our country. On the other hand, there were the handicapped cared by families, relatives, and neighbors in the rich nature of the village. Grasping the current situation of Bhutan’s elderly people is important for knowing what we gained and lost. It must be significant for the both countries to seek the elderly care in line with the regions while sharing issues and possibilities, and symphonizing each other.

With the revision of Japan’s Long-Term Care Insurance Act in 2015, the government built community-based comprehensive care systems. It relies on reciprocity among local residents to provide some of the assistance the elderly need to avoid having to be moved into care facilities. Facilities providing support services have been required to arrange for places of social activities to be held and to create roles for elderly residents in the hope of increasing their participation in the community.

The person-to-person and person-to-community ties that created during these types of activities involving reciprocity among local residents can be understood as the concept of social capital (SC). SC is based on trust, shared norms, and networking. We have already shown in a study of the association between elderly people’s mental health and SC that people with deep relationships of trust with others, many friends, and those who participate in community activities are psychologically healthier.

In this study, we use SC to discuss the effects of person-to-person and person-to-community ties on mental and physical health based on contrasts between the cases of A and B, whom we encountered while working at a community-based comprehensive support center. They lived in the same community, but case A had no contact with any local organizations and refusing public assistance, ended up isolated and dying alone. In contrast, case B lived independently, had ties to the community and to volunteers, participated in a variety of activities, had a role in the community, and something to live for. These two contrasting cases are used to illustrate topics related to social services for the elderly in Japan and what our future objectives should be. In addition, we use the example of “Daredemo Shokudou” (“Everyone’s Diner” events held by local organizations that provide an inexpensive meal and activities for community members) to show the importance of providing independent living assistance for the elderly so that they may create ties with the community and build relationships of trust through community-based activities.

The purpose of this article is to evaluate the value of field medicine from the view point of medical anthropology. Medical anthropology is one of the branches of social and cultural anthropology which explores the socio-cultural understanding in health care field. The word “cultural competence” is the most important concept. This idea has largely resulted from increasing cultural and ethnic diversity of the population, and the need to improve communication with minority and immigrant groups, and improve the quality of their medical care (Cecil G. Helman, 2007). In Japan, medical anthropology was designated as one of the required subjects of “core curriculum model of medical education” by the Ministry of Education, Culture, Sports, Science and Technology (MEXT) in 2017.

Field medicine aims to investigate the back ground of health problems in the population rather than hospital situations. Field medicine tries to evaluate the whole life style including social-cultural-environmental and also religious behavior. In order to conduct filed medicine, the concept of cultural competence is essential. All the presenters of this symposium are the forerunners of this field, reporting the holistic evaluation of health status in Bhutan, Ladakh, and some regions in Japan. The original findings of these presenters are that learning from the population is more important than providing advanced medical treatment.

As the essential matters of ethical issues in performing field researches in any society, whether urban or rural, Western or non-Western, diverse or not, Cecil G. Helman emphasized the following four instructive questions :

1. What possible benefit will such research bring to the research subjects, their families and their communities?

2. Will the research be exploited by others, to the detriment of the subjects, and their community?

3. What might be the psychological effects, both positive and negative, of the research project on the subjects, and on those around them?

4. Will the research findings be fed back to the community, and if so, to whom and by whom?

This paper focuses on the experiences of mothers who have had difficulties and experienced physical symptoms, such as fatigue, during childrearing and reports on cases where these feelings have been alleviated through various approaches to the physical symptoms. Several results were obtained through working with mothers who attended prearranged childrearing consultations. First, in cases where mothers engaged in childrearing while experiencing physical symptoms, it can be said that sympathetic support led to some relief. At the same time, when a mother shifted her attention from childrearing to her own body, it had the effect of producing an awareness that it is okay for her to tend to herself. Secondly, results showed that dealing with the physical symptoms themselves generated a positive effect. When physical symptoms are alleviated, one’s mental state also improves, which in turn has a positive effect on childrearing.