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Disability Statistics in Japan
Eiko Okuno
Associate Professor, Rehabilitation Course
Tsukuba University Graduate School


Abstract Japan has made a great progress in measures and welfare services for persons with disabilities since the International Year of Disabled Persons of 1981 with the international incentives especially by the United Nations and Rehabilitation International. Our services have been also promoted upon the data of persons with disabilities collected through the surveys.
The first survey on physically disabled persons was conducted in Japan in 1951. Since then, the Survey has been conducted almost regularly every five years. This paper tries to state briefly the basic concepts and the history of welfare services for people with disabilities in Japan. Also, the definitions of disabled persons in Japan will be addressed clearly in order to avoid confusing. Finally, the total number of disabled people will be drawn after analyzing the surveys conducted in Japan.

Basic Concepts of Welfare Services for Persons With Disabilities in Japan

Our measures are promoted based on the following 4 basic concepts.

  1. Rehabilitation
  2. Equalization of Opportunities
  3. Normalization
  4. Full Participation and Equality

History of Welfare Services for Persons with Disabilities in Japan

The welfare services for persons with disabilities were started by the enactment of the Law for the Welfare of Physically Disabled Persons of 1949. Since then many laws were enacted and the government have formulated many programs and plans to promoted the measures for disabled persons, and those are as follows.

1943 Child Welfare Law
1949 Law for the Welfare of Physically Disabled Persons
1960 Law for the Welfare of Mentally Retarded Persons
1960 Law for Employment Promotion etc. of the Disabled (Rev. 1976)
1981 Headquarters for Promoting IYDP (at the Prime Minister's Office)
1982 Headquarters for Promoting the Welfare of Disabled Persons
1983-1992 Long-Term Program for Government Measures for Disabled Persons
1993 Disabled Persons' Fundamental Law
1993-2002 New Long-Term Program for Government Measures for Disabled Persons
1993 Annual Report on Government Measures for Persons with Disabilities
1993 Law concerning the Promoting of Research, Development and Diffusion of Social Welfare Equipments
1993 Law for Promoting Business that Facilitate the Use of Communications and Broadcast Services by the Physically Disabled to Make These Services More Convenient and More Accessible to Disabled Persons
1994 The Act on Buildings Accessible and Usable for the Elderly and Physically Disabled
1995 Mental Health and Welfare Law of Mentally Disabled Persons
1996-2003 The Government Action Plan for Persons with Disabilities - A Seven Year Normalization Strategy
1996 Department of Health and Welfare for Persons with Disabilities reorganised and integrated in Ministry of Health and Welfare

Definition of Disabled Persons in Japan

According to the Article 2 of Disabled Persons' Fundamental Law which came into effect on 3 December 1993, "Disabled Persons" means persons whose daily life in society is substantially limited over the long term due to a physical disability, mental retardation or mental disability. This is a rough or comprehensive definition in Japan.

Besides this definition by the Disabled Persons' Fundamental Law, other laws have their own definition to provide the services for eligible persons.

1.Physically Disabled Persons
According to the Article 4 of Law for the Welfare of Physically Disabled Persons, "Physically Disabled Person as used in this Law shall mean a person over 18 years of age who has physical disability which comes under one of those enumerated in the attached list, and who has received a Physical Disabled Person's Certificate from the governor of a local public body." (Refer the Attached List of Degrees of Physical Disability.)
2. Mentally Retarded Persons
In the Law for the Welfare of the Mentally Retarded Persons, the purpose of the Law is written as "to help mentally retarded persons in their rehabilitation to give them necessary care, and thus to promote the welfare of mentally retarded persons." No clear definition of mentally retarded persons is given in the Law. But there is an operational definition to be used for the Survey on the Mentally Retarded Persons, and it is as follows.
"A Person with mental retardation is a person who has an intellectual disability manifested during the developmental period (birth to 18 years of age) and displays functional deficits in skills for daily life which require supportive services."
3. Mentally Disabled Persons
In the Article 5 of Mental Health and Welfare Law of Mentally Disabled Persons, "Under this Law, Mentally Disabled Persons shall mean those with schizophrenia, psychotic disorders due to psychoactive substance use, mental retardation, personality disorders, and/or other mental disorders."

The Survey on Disabled Persons in Japan

1. Physically Disabled Persons
The Survey of Actual Status of Physically Disabled Persons was started in 1951 by the Ministry of Health and Welfare, and since then the Survey is conducted almost every five years. The recent survey was conducted on November 1, 1996, and this is the 9th Survey of Physically Disabled Persons in Japan.

The purpose of the survey is to get the basic data which are required to promote measures for physically disabled persons, by asking them about the kinds and degree of disabilities, disability causes, the real situation of daily life, whether using the community services such as home helpers, day services, and other services as assistive devices and prosthetic appliances, disability pension or other allowances, housing conditions and welfare and social services needs, etc.

The area decided at random is 1/360 in the area which has been set at the National Census of 1995. The questionnaires are brought in by the census staff with interview at disabled person's home, and explain how to fill the questionnaire. The filled questionnaire are sent to local government by disabled persons. 88 percent of the questionnaire were collected in 1996.


2. Mentally Retarded Persons
The purpose of the survey is to obtain the basic data on the daily living situation and services needs of individuals with mental retardation in order to establish well prepared public policies for mentally retarded persons.

Census staff visit every household in the specific area and explain the purpose of the survey and to determine if they meet the sampling criteria. Once the eligible samples are identified, the staff hand in "the Notification of the Welfare Administration's Basic Survey of Adults and Children with Mental Retardation" and "the Questionnaire". The filled questionnaire are sent back to Ministry of Health and Welfare directly for keeping privacy.


3. Mentally Disabled Persons
As for the mentally disabled persons, the Ministry of Health and Welfare has not conducted the survey, and we have data on the patients who are hospitalized in various hospitals through the Survey on Patients in Japan.
The Association of Families of Mentally Disabled Persons is a voluntary agency, and it is actively working for mentally disabled persons in Japan. The Association conducts the survey to know the real situation of living and service need of mentally disabled persons. The Mentally Disabled Persons' Certificate System was started in 1995, but the persons to apply for the Certificate are so small in number, partly because of the prejudice on mental disability, and partly because of the services for mentally disabled persons are not yet enough or varied, so they think that there is no big merit to have certificate which usually used as an eligibility for receiving services in Japan.


The Number of Disabled Persons in Japan (as of November 1996)

According the Survey on Physically Disabled Persons of 1996, the Survey on Mentally Retarded Persons of 1995 and the Survey on Mentally Disabled Patients, the total number of disabled persons in Japan is estimated as follows.

1. Estimated Number of Disabled Persons
Total Number 5,136,500 (about 4.3% of total Japanese Population)
Physically disabled persons 3,176,500
Mentally retarded persons 390,000
Mentally disabled persons 1,570,000

2. Number of Physically Disabled Persons and Children
- under 18 over 18 Total
Living in Institution 7,900 154,000 161,900
Living in Community 81,600 2,933,000 3,014,600
- 89,500 3,087,000 3,176,500


3. Categories of Physical Disabilities and Numbers of Physically Disabled Persons over 18 Years Living in Community
Motor dysfunction (limb and body) 1,657,000 (56,5%)
Visual disability 305,000 (10,4%)
Hearing and speech disability 350,000 (11.9%)
Internal organ disorder 621,000 (21,2%)
Total 2,933,000


4. Recent Trend of Result of the Survey
The characteristics of the situation of disabled persons in Japan are explained in "New Developments in Measures for People with Disabilities in Japan".

Attached List of Degrees of Physical Disability

- Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7
Visual Impairment Visual acquity less than 0.01 with correction on International Vision Test Chart 1. Visual acquity less than 0.04 (bilateral)
2. Visual field diameter 10 or less of both eyes and binocular visual field loss more than 95%
1. Visual acquity less than 0.08 (bilateral)
2. Visual field diameter 10 or less of both eyes and binocular visual field loss more than 90%
1. Visual acquity less than 0.12 (bilateral)
2. Visual field diameter 10 or less of both eyes
1. Visual acquity less than 0.2 (bilateral)
2. Visual field defect more than 50%
Visual acquity less than 0.2 (bilateral), acquity of worse eye less than 0.02 and acquity of better eye less than 0.6 -
Hearing Impairment - More than 100 dBHL in each ear More than 90 dBHL in each ear 1. More than 80 dBHL in each ear
2. Less than 50% on hearing intelligibility
- 1. More than 70 dBHL in each ear
2. One ear more than 90 dBHL, the other more than 50 dHBL
-
Para-equilibrium - - Difficulty of gait Difficulty of voicing, speech or language Difficulty of gait under eye mask - -
Voice, Speech and Language Disorders - - No voice, no speech or no language - - - -
Upper Limb Impairment 1. Total function loss, bilateral
2. Amputation above wrist, bilateral
1. Severe function loss, bilateral
2. Amputation of five fingers, bilateral
3. Amputation above half length of humorous, unilateral
4. Total function loss, unilateral
1. Amputation of thumb and index finger, bilateral
2. Complete function loss of thumb & index finger, bilateral
3. Severe function loss, unilateral
4. Amputation of five fingers, unilateral
5. Complete function loss of five fingers, unilateral
1. Amputation of thumb, bilateral
2. Complete function loss of thumb, bilateral
3. Complete function loss of one of shoulder, elbow or wrist joint, unilateral
4. Amputation of thumb or index finger, unilateral
5. Complete function loss of thumb and index finger, unilateral
6. Amputation of three fingers including thumb or index finger, unilateral
7. Complete function loss of three fingers including
8. Severe function loss of four fingers including
1. Severe function loss of thumb, bilateral
2. Severe function loss of one of shoulder, elbow or wrist joint, unilateral
3. Amputation of thumb, unilateral
4. Complete function loss of thumb, unilateral
5. Severe function loss of thumb and index finger, unilateral
6. Severe function loss of three finger including thumb or index finger, unilateral
1. Severe function loss of thumb, unilateral
2. Amputation of two fingers including index finger, unilateral
3. Complete function loss of two fingers including index finger, unilateral
1. Mild function loss, unilateral
2. Mild function loss of one of shoulder, elbow or wrist joint, unilateral
3. Mild function loss of hand and fingers, unilateral
4. Severe function loss of two fingers including index finger, unilateral
5. Amputation of middle, third and little fingers, unilateral
6. Complete function loss of middle, third and little fingers, unilateral
Lower Limb Impairment 1. Total function loss, bilateral
2. Amputation above half length of thigh, bilateral
1. Severe function loss, bilateral
2. Amputation above half length of tibia, bilateral
1. Amputation above Chopart joint, bilateral
2. Amputation above half length of thigh, unilateral
3. Complete function loss, unilateral
1. Amputation of five toes, bilateral
2. Complete function loss of five toes, bilateral
3. Amputation above half length of tibia, unilateral
4. Severe function loss, unilateral
5. Complete function loss of hip or knee joint, unilateral
6. Abnormally shortness of one leg more than 10cm or 10%, unilateral
1. Severe functions loss of hip or knee joint, unilateral
2. Complete function loss of ankle, unilateral
3. Abnormally shortness of one leg more than 5cm or 6.7%, unilateral
1. Amputation above Lisfranc joint, unilateral
2. Severe function loss of ankle unilateral
1. Severe function loss of five toes, bilateral
2. Mild function loss, unilateral
3. Mild function loss of one of hip, knee or wrist joint, unilateral
4. Amputation of five toes, unilateral
5. Complete function loss of five toes, unilateral
6. Abnormality shortness of one leg more than 3cm or 5%, unilateral
Bodily Dysfunction No sitting balance 1. Difficulty of sitting or standing position
2. Difficulty of standing up movement
Difficulty of 100 m gait - Difficulty of 200m gait - -
Cardiac Disorders Limitation of daily living (living on bed) - Limitation of daily living (in-door living) Limitation of out-door activities (Notes)
1. In case a person has two impairments listed in the same grade, his grade is to be one grade severer, except that two impairments are specifically described as double impairments.
2. In the categories of upper and lower limb, the person who has two impairments in grade 7 is considered as grade 6.
3. In case a person has two impairments in different grades, his grade is to be decided.
4. "Amputation of finger" means amputation above IP joint of thumb, and above PIP joint of other fingers.
5. "Function loss of finger" means the impairment below MP joint, and in case of thumb, opponent motion is included.
6. The length of amputated stump is the practical length measured from underarm in upper limb, and from sciatic tuberous in lower limb.
7. The length of lower limb is to be measured from spine iliaca anterior superior to medical maleolus.
Renal Disorders Limitation of daily living (living on bed) - Limitation of daily living (in-door living) Limitation of out-door activities
Respiratory Disorders Limitation of daily living (living on bed) - Limitation of daily living (in-door living) Limitation of out-door activities
Bladder or Rectal Disorders Limitation of daily living (living on bed) - Limitation of daily living (in-door living) Limitation of out-door activities
Small Intestinal Disorders Limitation of daily living (living on bed) - Limitation of daily living (in-door living) Limitation of out-door activities

Mrs. Karen Ngai
Executive Editor
c/o Division of Social Studies
City University of Hong Kong
Tat Chee Avenue
Kowloon
Hong Kong
Tel: (852) 2788 8834
Fax: (852) 2788 7709
E-mail: scngai@cityu.edu.hk

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