Structure and roles of public health centers (hokenjo) in Japan

Public health centers (PHCs, hokenjo in Japanese) are local government authorities responsible for public health in Japan. As of 2010, 494 centers were operating under the Ministry of Health, Labour and Welfare of Japan. While the general rule is that one PHC covers 300,000 inhabitants, several centers cover a population of more than 1 million. The roles of PHCs described in the Community Health Act include 1) propagation and improvement of information on community health, 2) vital statistics and other statistics on community health, 3) improvement of dietary conditions and food sanitation, 4) environmental sanitation including housing, water supply, sewage, waste disposal and public cleaning, 5) medical and pharmaceutical affairs, 6) matters involving public health nurses, 7) promotion and improvement of public medical services, 8) maternal, child, and elderly health, 9) dental health, 10) psychiatric health, 11) health of patients under long-term care due to incurable diseases, 12) prevention of infectious diseases, 13) laboratory tests on sanitation/environment, and 14) other functions needed to maintain/promote health in the community. Among those many roles, infectious disease controls are one of the most important. Concerning tuberculosis control, PHCs are responsible for the isolation of patients, health check-ups of those in close contact with infectious TB patients, and public subsidy of medical expenses for tuberculosis treatments. Food poisoning controls are also an important responsibility of PHCs, as are the conduct of surveys to trace suspicious foods and laboratory testing of samples from patients. To make these many measures effective, sufficient numbers of public health professionals are required.