Welfare state building during wartime: maternal health and local governments

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K03573
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Politics
• Research Institution: Kwansei Gakuin University
• Principal Investigator: Somae Kiyosada 関西学院大学, 総合政策学部, 准教授 (50325825)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 医療制度 / 公衆衛生 / 近代史

Outline of Final Research Achievements

This research tries to clarify how Japan’s health environment had been dramatically improved for this 100 years and the main factor for the change is found out that local governments in Japan had great abilities to implement health care policies.
After Meiji Restoration, local governments had been small and distal bodies of government. Management of resident registration, elementary education, and military recruitment were their main tasks. Since the Sino-Japanese and other following wars militarized the whole country, maternal health care was focused for more babies to be tougher soldiers. During the post-war Showa era, more resources such as newly national-licensed Public Health Nurses and Public Health Stations were put on this policy area.Voters now expected local governments as solution of health care problems and community health care activities have continued to this day at high levels to realize a nation in great health.

Free Research Field

政治学

Academic Significance and Societal Importance of the Research Achievements

日本の周産期衛生状態は世界最高水準にあるが、ほんの70年前まではそれほどよい状態ではなかった。しかもわが国の対GDP費医療支出はそれほど高くなく、いわば「安くて良い」医療がなぜ実現したのかは大きな謎であった。
本研究は、それが戦時体制とはいえ、地方政府に政策執行責任を負わせ、憲法体制が変化した戦後においてもそれが継続した点にあることを、社会科学分野（少なくとも政治学・公共政策学分野）では初めて明示した。歴史的経路依存で成立した制度なので、今後の制度変更は細心の注意を払って設計すべきであることを暗示した。