My research on rural health began in 1953 when I was involved in a survey of the actual living environment and health conditions of residents where there were no practicing physicians. From the findings of subsequent surveys, I noticed how badly poor living environments in rural areas can affect the health of the residents. In 1962, I engaged in a study of environmental pollution in rural areas caused by industrial development and contributed to significant achievements of mine ; namely, I was the first person in the world to discover that not only does air pollution due to fluoride destroy plants, but also fluoride can accumulate in crops causes fluorosis when ingested by animals and humans. For this work, I received The Kiyoshi Saito Award from the Japan Society of Air Pollution in 1976. Next, Our research began with occupational health in dairy farming. We were able to establish a labor management system which is acceptable to all dairy farmers. R ecently, I surveyed changes of the physical constitution of pupils in a farming village which occurred over the last 40 years. In the last forty years, in pupils in the rural area, the thorax has flattened, the head has become rounded and the face has elongated. I can only attribute this change to the significant improvement in the diet and living environment of the children in the rural area. The medical technologies used in my research on rural health were not necessarily advanced ; rather I tried to used an approach which guaranteed the reproducibility of data even if the method was old. I hope my stance toward medical research will be of some help to young member of this society studying rural medicine.
In the 20th century, the form of agricultural management was greatly changed in rural areas in Japan. Many farmers became part-time farmers and began to have a side business. With the spread of cars, roads were paved with asphalt and traffic system to local cities was improved, Moreover, living conveniences such as electric installation and telephone were improved and thier living became very convenient. In the 21st century, the time of information will come, including the infrastructural develiopment, and rural areas will have good living conditions with the increase of urban people who intend to live in rural areas. On the other hand, however, environmental issues are coming out. Thinking of new rural areas, this paper presents rural vision towards the 21st century and proposes medical services based on the vision. Rural vision of ‘Cultural Residence Sphere’ in the 21st century will design the development of rural areas in about 20-30 km sphere as a unit of sphere (this unit is also for that of environmental conservation). In the sphere, resources will cycle and rural environment will be conserved not only by rural people but also by urban people. Following three proposals will be given for medical services in rural areas. 1) To make systematic medical service in the cultural residence sphere. 2) To make a community center for aged people in each agricultural settlement. 3) To make traveling medical services.