A Review for Promoting Evidence-based Healthcare and Welfare Policies for People with Disabilities-A Proposed “Definition of Health” for a Care-focused Mature Society

Objectives: What the review set out to determine “health” in a care-focused mature society. Design: Review on the evidence-based public health policies in Japan. Data Sources: Ministry of Health, Labour, and Welfare in Japan. Eligibility Criteria: Next Generation Healthcare Foundation Law Results: In Japan, evidence-based public health is promoted for lifestyle diseases, and evidence such as survival rates of cancer is useful not only for healthcare providers and policymakers but also for cancer patients in executing the right to self-determination in promoting health. Meanwhile, evidence about long-term outcomes of trauma in Japan is overwhelmingly lacking, although the incidence of trauma is estimated to be comparable to that of neoplasms in the 2014 national patient survey. We have proposed reviewing health and welfare policies for people with disabilities from the viewpoint of longitudinal epidemiological studies that understand disease conditions from the perspectives of ordinary citizens by redefining the prognoses of trauma as “the outcomes of acquired disability.” To realize this review in a care-focused society we focus on the Clinical Efficacy database of patients visiting medical institutions, and intend to develop a disability registry toward the additional definition of “health” in a matured society, that is, including “health of the people with disabilities.” Conclusions: In care-focused mature societies, considering the disease burden and various other social, physical, and psychological problems, maintaining the patient's quality of life, enabling his/her control over his/her own life, offering opportunity for independent functioning, and fostering his/her self-actualization should be included in the definition of health.