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Children's Health in a Multi-ethnic and Multi-cultural Society

I would like to report on our study of health of children particularly of foreign children, in Japan in the 21st century, although the title "children's health in multi-ethnic and multi-cultural society" may suggest that this paper addresses the United States or the United Kingdom.

While morphological methodology was used to determine the origins of the Japanese people, namely. The facial and skeletal features, in the past, current studies are conducted at the level of genetics by genetic analysis of blood types, enzyme types, human leukocyte antigens, mitochondria DNA and chromosomes. Studies have revealed three origins of the contemporary Japanese people, namely Siberia-Sakhalin, Korea and Okinawa. In other words, Japan has never been a mono-ethnic nation from the anthropological point of view.

As such facts surface, there are now about two million foreign people or non-Japanese living in Japan whose society has undergone rapid internationalization. It is not unusual to see one or two non-Japanese in each compartment during rush hour. The number of the Japanese marrying non-Japanese has also soared as indicated by the fact that 4.5% of the total or one out of 22 marriages takes place between a Japanese and the non-Japanese. In some areas, the number is more than double of this figure.

The total number of "children whose parent(s) is/are non-Japanese" was approximately 400,000 during the period from 1987 to 2000, indicating that children of diverse roots are growing up in our society. The number will continue to increase in the 21st century. The challenge faced by us is how symbiosis may be realized in the Japanese society by people of different nationalities, cultures, languages and religions while respecting the cultures and communities of various ethnic origins. Japan will soon be regarded as a multi-ethnic and multi-cultural society.

The ever-increasing non-Japanese population supports the Japanese economy, and improving their quality of life will contribute to prosperity of Japan. With the declining birthrate becoming a growing social problem, symbiosis of multiple cultures is an essential challenge that should be met, and this could be described as the first new era of people exchange since the era of Jomon/Yayoi culture.

Our study group is conducting research to propose better maternal and child health (MCH) within the framework of a multi-ethnic and multi-cultural society. Our project involves mainly 1) research to contribute to improved MCH and medical administration at a time of internationalization; 2) survey on MCH and medical service needs of non-Japanese women and small children; 3) research on birth, growth and educational environment of children; 4) analytical research of vital statistics and administrative statistics of population; 5) fact-finding studies of MCH services in multi-ethnic societies in various countries; and 6) diffusion of MCH-related information through the mass media. Our proposal for a better society will be based on these studies and researches. I would like to discuss some of the topics.

The main reason for rise in the non-Japanese population is the increase in second- and third-generation Japanese from Brazil and Peru and in Philippines and Thailand ("newcomers") under the amended Immigration Law of 1984-1985. Our group conducts studies of children of the "newcomers" living in Ota City (Gunma Pref.), Hamamatsu City (Shizuoka Pref.), Anjo City and Nishio City (Aichi Pref.) and examines the medical and educational services for these children in order to present proposals to the national government or to improve local administrative services.

The medical problems of children are ultimately related to education. To become aware of the need for inoculation and receive vaccination, for example, a person must be able to read, write and speak the language in order to obtain information about inoculation, visit the hospital, and receive vaccination. Furthermore, when children drop out of school because they are unable to keep up with their peers and withdraw from society, their health also deteriorates. It is thus necessary to conduct a survey on medical service and education.

In the field of perinatal medicine, pregnancy, parturition and infant health screening can cause great deal of stress to mothers. Because of inadequate knowledge of health and medical services, they fail to join the health insurance program, do not receive prenatal medical checks, rush to the hospital for delivery without prior screening or reservation, and do not receive post-natal medical checks for both mother and child. Inadequate language skills and poverty are the underlying problems.

As for the problem of communication, there may not be interpreters stationed at medical institutions and their translation skills may be less than adequate. Development of mechanical translation may be needed because of the difficulty in securing translators. A positive attitude on the part of government and non-government organs and better access to their services are essential. People who can take the initiative and those who can support such activities are urgently needed.

For further information on our activities, please access our home page (http://square.umin.ac.jp/boshiken/). Information about symposia and study meetings, project reports of the study group, and items of support services are posted. We hope to expand our efforts in this area.

Understanding other cultures is said to start from a misunderstanding of such cultures. Being an island country, Japan had relatively little contact with people of other countries for many centuries, and received little information due to the fact that we are non-English speaking. However, with more rapid and frequent communication and exchanges, Japan will head toward further internationalization and become a more multi-ethnic society. Efforts to eliminate misunderstandings are essential. To make Japan a more vigorous society, we should improve the health and education of all the children currently residing in Japan. This will certainly lead to peace and prosperity in the world.

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