As I’ve been thinking about the theory that stress has a great effect on health, obesity and longevity, one point has nagged at me. The Japanese are fairly healthy, suffer low rates of obesity (around 3% compared to our 35%) and have the longest lifespan on the planet. Nonetheless, my general sense of the Japanese is of a group of people who are pretty stressed. We always hear of the long hours the Japanese worker must endure. And any time you watch an old samurai film there’s always a scene where a character walks up and says (subtitled), “The fact that I was late to dinner three times last week has brought dishonor to my family. Therefore I will now commit suicide via our traditional method of hari kiri. As I dig this blade into my intestines, I will suffer greatly and hopefully my agony will appease the spirits of my ancestors.”

If that’s not enough, check out this article: Japanese office stress at record levels.

So, if the Japanese are so stressed, how do they maintain their health? I’ve been reading an interesting book on the history of mind-body medicine — it’s called “The Cure Within” — and it touches on this. It reports on a study conducted in the 1960s that tracked the health of Japanese people who integrated into Western culture, specifically migrants who moved to Hawaii and California. The presumption was that Japanese migrants who adapted the high-fat Western diet would suffer ill health. And, at first, that seem to be the case. But an interesting thing was noted (from page 182):

It turned out… that the “most traditional” Japanese-Americans living in California had coronary heart disease prevalence no higher than what had been observed in Japan. In contrast, “the group that was most acculturated to Western culture had a three- to five-fold excess in CHD prevalence.”

What did traditional Japanese culture offer that might account for these health benefits? Marmot’s answer was “a close knit community, that is, a community to provide its members with a great deal of stress reducing emotional and social support…. It began to look as if the Japanese lived longer than any other group on the planet not just because they ate a healthy diet but because they, perhaps more systematically than other countries, had developed a culture that had learned to exploit the power of healing ties.”

So the idea is, yes, the Japanese have stress, but they also have effective means of handling stress. In a sense, this notion of “loyalty to family” (which I openly mocked in my samurai example above) is actually part of the explanation of their health and longevity.

However, as the book continues, the picture gets a bit muddled. As research went on, it began to look like it wasn’t so much a lack of community ties that caused stress, but rather being on the low end of a hierarchical structure (such as any corporation or the military or family etc.) A famous study in England noted that British civil servants on the low end of the organizational hierarchy where “more than 2.5 times” likelier to die of a heart attack. (Interestingly, I’ve seen reports on studies of monkeys that make the same point. The lower you are on the monkey hierarchy, the more stressed your heart is.)

Well, everyone knows that the Japanese culture (especially the professional culture) is very hierarchical. (As a former student of Japanese language, I can note that the grammar of the language itself changes depending on whether you’re speaking to someone whose status is higher or lower than yours.) So wouldn’t this oppressive hierarchy again damage their health?

Maybe… but let’s consider the possibility that there are different kinds of hierarchy. The book notes that the Japanese people…

… lived in communities where everyone was provided with a clear and secure social role, where overt displays of status were discouraged, and where conformity was encouraged…. Adults might spend their entire lives working for the same corporation and follow a very predictable career trajectory. In the United States, in contrast, much of life is organized around a goal of continuing upward mobility, with resulting competitiveness, discontent, and stress.

So the idea here — and this is my analysis, not directly taken from the book — is that while the Japanese might live in a hierarchy, it’s a relatively fair hierarchy. If you work for the same company for 50 years, you will be treated well and climb up the ladder*. That’s a completely different experience than living in an unfair hierarchy where the monkey with the biggest pecs gets to beat everyone up and have sex with all the chicks.

This also gets an idea which is anathema to both the individualistic and egalitarian sides of Western culture. It’s the idea that being a lowly, put down upon scrub isn’t so bad if you accept your lot in life. And, if you don’t torment yourself by comparing what you have to those around you, you can be content. (It’s the whole Buddhist, “get rid of the wanting,” concept.) Frankly, it’s a pretty controversial idea, and I’m not sure I can accept it, but it does make some intuitive sense.

* As opposed to more Western models where companies aren’t particularly loyal to their employees, and employees often jump ship for a higher salary.