Guidance

Japan: migrant health guide

Advice and guidance on the health needs of migrant patients from Japan for healthcare practitioners.

Main messages

If the patient is new to the UK:

  • explain to them how the NHS works
  • discuss how this compares to the healthcare system they’ve been used to

Ensure that all patients are up-to-date with the UK immunisation schedule.

Ascertain any risk factors for hepatitis B infection that may indicate the need for screening, because Japan has a low prevalence.

Consider screening for hepatitis C, because Japan has a considerably higher prevalence than the UK.

Ask opportunistically about any travel plans the patient may have to visit friends and relatives in their country of origin, and see National Travel Health Network and Centre (NaTHNaC), or the Health Protection Scotland websites (TRAVAX and fitfortravel), for travel advice.

Infectious diseases

Immunisation

Ensure that all patients, especially children, are up-to-date with the UK immunisation schedule. See Immunisation collection with complete schedules.

Tuberculosis

There is a low incidence of TB in Japan (< 40 cases per 100,000), so:

  • routine screening is not required
  • consider testing in patients (including children) who show signs and symptoms
  • be aware that TB is a notifiable disease

Sexually transmitted infections and HIV

Take a sexual history, and:

  • screen for STIs and HIV according to risk as specified in the UK national standards and guidelines
  • test all sexually active patients under the age of 25 for chlamydia

Japan has a low rate of HIV (≤1%), so:

  • offer and recommend an HIV test if the patient:
    • falls into a high risk group
    • is newly registering in a high prevalence area
  • be advised that national guidelines do not recommend routine consideration of HIV testing of infants and children who have recently arrived in the UK

Hepatitis B

Japan has a low prevalence of hepatitis B, so:

  • offer screening for hepatitis B to all pregnant women during each pregnancy
  • immunise appropriately babies born to mothers who are hepatitis B positive, and follow-up accordingly
  • be aware that the UK has a selective immunisation programme for hepatitis B

Hepatitis C

Japan has a considerably higher prevalence of hepatitis C than the UK, so consider screening for hepatitis C if other risk factors apply.

Travel plans and advice

Ask opportunistically about any travel plans the patient may have to visit friends and relatives in their country of origin, and see National Travel Health Network and Centre (NaTHNaC), or the Health Protection Scotland websites (TRAVAX and fitfortravel), for travel advice.

Women’s health

Reproductive health indicators

Reproductive health indicator UK Japan
Number of children per woman¹ 2 1
Use of contraception² 82% 52%
Breast examination or mammography³ 75% 3%
Cervical cancer screening⁴ 70% 24%

¹lifetime average; ²by woman of reproductive age or partner; ³women aged 50 to 69 years; ⁴women aged 20 to 69 years

Nutritional and metabolic concerns

Anaemia

There is a moderate risk of anaemia in adults (estimated prevalence in non-pregnant women is 20-40%) and low risk in pre-school children (estimated prevalence is 5-20%), so:

  • be alert to the possibility of anaemia in recently arrived migrants, particularly women and pre-school children
  • test as clinically indicated

Vitamin D

Consider the possibility of vitamin D deficiency in people who may be at risk due to:

  • covering their body for cultural or religious reasons (lack of sunlight)
  • skin colour
  • diet (vegan or vegetarian)

Country profile

Health indicators and health care

WHO Global Health Observatory has a summary of health indicators and health care in Japan.

Culture, politics and history

BBC News and The World Factbook provide background information on the culture, politics and history of Japan.

Languages

The main language used in Japan is:

  • Japanese (official)

Source: The World Factbook.

Religions

Religion Population (%)¹
Shintoism 79.2
Buddhism 66.8
Christianity 1.5
Other 7.1

¹Total exceeds 100% because many people practice both Shintoism and Buddhism

Source: The World Factbook.

Migration to the UK

There were almost 36,000 people from Japan living in England and Wales at the time of the 2011 Census.

Source: Office for National Statistics

Published 31 July 2014