Health Checks in Japan

TW: This article talks about body fluids and health exams. Disclaimer: This information is based on my personal experience. Your experience will likely be different. Every hospital and medical facility does their health exam a little differently.

If you work for a large to medium-sized company in Japan, you must undergo a yearly health check or physical. According to Japan’s Health department, it is required by law that all employees undergo an annual health exam. However, health checks are for employees and all residents insured under the national health insurance system. They receive a free health check yearly at their local clinic or hospital.

Many things go into a health check. I want to share what I have experienced in hopes that you are better prepared. The health check usually includes height, weight, blood pressure, chest X-ray, and blood tests for anemia, lipids, glucose, and liver disease. Depending on your age and gender, you may also need to do some additional tests such as a barium swallow test, mammography, or prostate examination. The process can take one to three hours, depending on the number and type of tests you must do.

The health check is standardized and regulated by the government and the companies, so you can expect the same procedure and results no matter where you go. The results are graded by letters from A to F, indicating the level of health risk in each category. For example, A means no risk, B means low risk, C means moderate risk, D means high risk, E means very high risk, and F means urgent threat. You will receive a report with your grades and advice on improving your health.

The health check aims to prevent and detect diseases early and promote healthy lifestyles among the population. However, some people may have concerns about the health check, such as privacy issues, unnecessary testing, or cultural bias. For example, some people may feel uncomfortable sharing personal information with their employer or insurance provider. Some may think some tests are too invasive or irrelevant for their condition. Some may also feel that the health check does not consider their preferences or circumstances.

Therefore, it is crucial to understand what the health check entails and what it means for you. You can always ask questions or decline any test you do not want. You can also seek a second opinion or consult a specialist if you have doubts or worries about your results. The health check is a tool to help you monitor and improve your health, but they are not the only ones. It would help if you also cared for your diet, exercise, sleep, and mental well-being daily.

Forms

Before the health check, you must prepare some information and samples. You will receive a form from your company or city hall asking general questions about your health and medical history. Answering them honestly and accurately would be best, as they will help the doctors assess your health condition. You will also receive some vials for collecting your urine and fecal samples. Please follow the instructions carefully, as they may require you to take samples on different days or at specific times. It would help to keep the vials in a cool and dry place until you are ready to bring them to the health check. Don’t forget to bring everything with you on the day of the health check.

Before the health check

The health check is usually done in the morning, and most of the time, you won’t have to pay for it. However, you must bring your health insurance card, as it will identify your company or insurance provider. If you forget your health insurance card, you may have to pay for the health check yourself. You should also bring your ID card and the form you filled out with your health and family history.

You will be asked to fast for 10 to 12 hours the day before your health check. This means you should not eat or drink anything except water after a particular time in the evening. This ensures that your blood test results are accurate and not affected by your food intake.

The morning of the Health Check

On the morning of your health check, you will be asked to do a urine and, in some cases, a fecal sample. You should collect these samples at home and bring them to the health check in the vials provided to you. You should also avoid drinking too much water before the health check, as it may dilute your urine sample.

Pro tip: On the night before your exam. Add any vials you need to fill near your toilet. That way, you won’t have to search for them frantically in the morning.

If you are 35 or older, you may undergo a more comprehensive health check, including an electrocardiogram, abdominal ultrasound, and colonoscopy. These tests may take longer and be more uncomfortable, so you should take a half day or full day off work to recover fully. You may already have the rest of the day off, depending on when your appointment is scheduled. Some companies may allow you to take paid leave after completing the health check.

During the health check

The health check involves various tests and procedures that may differ depending on the place and the person. Here is what you can expect when you arrive and go through the health check.

First, you will be asked for your health insurance card, which will identify your company or insurance provider. You should also bring your ID card and the form you filled out with your health and family history.

Next, you may be asked to change your clothes into a hospital outfit that resembles pajamas. It usually consists of a shirt and pants that are easy to wear and take off. You should remove any jewelry, bras, and camisoles that may interfere with the tests. Underwear bottoms are generally ok.

Then, you will start the tests, which may vary in order and duration. Some of the standard tests are:

- Vision and hearing tests: You will be asked to read letters or numbers on a chart or screen or listen to sounds or words through headphones.

- Height and weight measurements: You will be asked to stand on a scale or device that automatically measures your height and weight.

- Waist circumference measurement: You will be asked to wrap a tape measure around your stomach at the level of your navel.

- Blood pressure measurement: You will be asked to sit on a chair and put your arm on a device that inflates a cuff around your upper arm and measures your blood pressure.

- Blood test: You will be asked to extend your arm, and a nurse will insert a needle into your vein and draw some blood samples. Blood samples will be used to test for anemia, lipids, glucose, liver disease, and other conditions.

- Chest X-ray: You will be asked to stand before a machine that takes an X-ray image of your chest. During the process, you may have to hold your breath for a few seconds.

- Electrocardiogram: You will be asked to lie on a bed and attach some electrodes to your chest, arms, and legs. The electrodes will record the electrical activity of your heart.

- Abdominal ultrasound: You will be asked to lie on a bed and expose your abdomen. A doctor will apply gel on your stomach and move a sound wave device. The sound waves create an image of your internal organs on a screen.

- Barium swallow test: This is one of the last tests you may have to do. It is used to examine your esophagus, stomach, and small intestine. You will be given some liquids or tablets containing barium, a contrast agent that makes your digestive tract visible on X-rays.

You will have to drink or swallow them slowly and carefully. You are not allowed to burp for the entire duration of the test. You will be asked to lie on a movable medical table, tilting in different directions. A machine will take X-ray images of your digestive tract as the barium moves through it.

After the test, the doctor must remove the barium from your body. You will be given a strong laxative on the spot and additional laxatives to take home. The laxatives will help you pass the barium through your stool.

You should expect to spend one to three hours at the health check, depending on the number and type of tests you must do. You may also have to wait between tests, so bring something to read or do. After you finish all the tests, you may be able to leave or have to wait for some results or advice from the doctors.

After the health check

You will likely feel exhausted and hungry after the exam. If you can take time off, you should eat a balanced meal and relax for the rest of the day. If you must go back to work, ensure you eat something before you go. Have patience with yourself; your body has been through a lot today. If you are on a laxative, stay hydrated throughout the day.

In conclusion, while Japanese people are relatively healthy, significant health concerns exist here. More people get diagnosed with cancer, diabetes, and heart disease every year. Most people don’t have much free time to see a doctor, which is a significant reason for the federal requirement.

Smaller companies may not require health checks, but if you are on national health insurance, your city might offer it for free or at a discount. You should get checked occasionally if you have lived in Japan for a while. Unless you have a specific health condition, seeing a regular doctor isn’t commonplace in Japan.

References

Health checks according to Japanese law: https://www.japaneselawtranslation.go.jp/en/laws/view/3440#je_ch7at6

Information about Barium swallow test.

(1) Japan Health Check: What You Need to Know About This Service. https://www.japanlivingguide.com/health-and-safety/health/health-check/.
(2) The Kenko Shindan/Health Check-In Japan: Is It Mandatory? https://www.city-cost.com/blogs/Tomuu/zDR0w.
(3) Annual Health Check in Japan: What is Needed? https://www.smileswallet.com/japan/annual-health-check-in-japan-what-is-needed/.

Additional Information

• Japan Health Check: What You Need to Know About This Service: This is a comprehensive guide that explains who can receive an annual health check in Japan, what’s included in it, how to make an appointment, and how to get the results. It also provides some tips on preparing for the health check and what to do if you have any health issues.
• The Kenko Shindan/Health Check-In Japan: Is It Mandatory?: This blog post discusses the legal aspects of the health check in Japan and whether it is mandatory. It also explores why people may be reluctant or resistant to undergo the health check and some variations among different companies and insurance programs.
• Annual Health Check in Japan: What is Needed?: This is a brief article that summarizes the main components of the standard health check in Japan and why it is essential to have one. It also gives information on how to find a suitable medical facility and pay for the health check.
• Persons entering or returning to Japan must submit a questionnaire on which they have filled in information on their travel history and health condition: This is a PDF document that shows the sample questionnaire that all persons entering or returning to Japan must submit to the quarantine officer as part of the COVID-19 prevention measures. It also explains how to access the online version of the questionnaire and what to do after submitting it.