Junk food is easy, cheap, and not good for you. Vegetables are good for you and, increasingly, expensive. Does money buy health? Let’s put it this way, says Josei Seven (Oct 31): Yes – but the rich have their characteristic health problems too, and as to the shrinking middle class, its position between the proverbial rock and the hard place is in some ways the unhealthiest of all.
Postwar Japan prided itself on its wide and expanding middle class. Everyone could, and before long everyone would, belong to it. Gaping inequality would be a thing of the past – as it proved to be; but it was also, unexpectedly, a thing of the future, which is now present. Today’s rich and poor, growing wider and wider apart, eat differently, are educated differently, and live and work differently. Health is measured in many ways, and different measurements can contradict each other, but this one, courtesy of Chiba University medical professor Katsunori Kondo, is striking if not conclusive: the death rate among low-income people, those below 2 million yen a year, is two to three times higher than that among those earning 6 million or more.
Key to health is a balanced diet – but “a balanced diet costs money,” says Kondo. It also takes time, and who has it, nowadays? The rich have more of it, but even they are career-driven and leisure-deprived. At least they can afford quality food, which the poor often can’t. The instant substitutes – instant noodles, snack cakes and the like – lead to obesity, with its attendant risks of high blood pressure, diabetes, cerebral hemorrhage and bowel cancer.
Vegetables, which mean so much to the body and its organs, are increasingly absent from the plates of the poor. Disastrous weather has shrunk harvests and raised prices. To say nothing of typhoons – this summer’s relatively scanty sunshine in the Kanto region caused the humble cucumber to double in price. The rich can shrug that off. The poor can’t.
There are other aspects of the rich-poor health gap. A low income generates high anxiety – particularly if you’re over 65 and living on a pension. The low-income elderly suffer alarming rates of insomnia, Kondo tells Josei Seven. (Insomnia is prevalent even among higher-income elderly: 49 percent of them suffer from greater or lesser intensities of it, vs 60 percent of low-income elderly.)
Depression is also linked to poverty, though the rich are far from immune to it, as we shall see in a moment. Clinical depression is serious – it’s a factor in 60 percent of suicides; also in cancer, heart attacks and strokes. Low-income elderly are 5 times more likely to suffer from depression than higher-income elderly.
If we turn to the younger and financially better-off, who among them is most vulnerable to depression? Mid-level managers, Josei Seven hears from International University of Health and Welfare Professor Koji Wada. They are arguably the most stressed people in the nation – in the world in fact, says Wada, citing Finland and Denmark as running Japan close seconds in that regard. Many of them are managers in name only, saddled with impossible quotas and exempt from overtime pay, though not from overtime labor. Women managers, says Wada – even high-income ones – are at heightened risk of breast cancer.
Middle-income earners enjoy at least the advantage of regular company medical checkups. Generally speaking, too, they can afford a balanced diet, though whether their work allows them the leisure for it is another question. Their biggest health challenge, Josei Seven finds, is immobility. The rich can exercise at sports clubs. Blue-collar workers work with their bodies – refreshing them, in effect, by physically exhausting them. The mid-level office worker, for hours on end, is chained to a desk, glued to a screen. Health-wise, everybody knows where that leads.© Japan Today