Hoping for Government for Solutions? First, Consider the Contradictions

I usually start my day scanning the headlines of the online English edition of the avowedly leftist newspaper, the Asahi Shimbun. I'm not necessarily looking for news or government pronouncements. I look to the Asahi to learn what is socially and politically acceptable today. 

On November 29, 2023, the Asahi published a story that caught my attention. It states that school children are increasingly becoming myopic, or near-sighted, over time. The Asahi article reports on the Ministry of Education, Culture, Sports, Science and Technology's (MEXT) annual health survey of all Japanese students. It covers children from preschool through high school. 

In 2022, over 70% of high school students were myopic, compared to about 52% in 1985. Myopia also appears to have increased in young children. In 1981, about 15% of kindergarteners were myopic, rising to almost one-quarter of kindergarteners in 2022. 

The Asahi attributes the rise in myopia to "more time spent using smartphones and tablet devices." Never mind that myopia has been rising since 1979, well before the invention of "smartphones and tablets devices". 

Misplacing the Government at the Center of All Problems

Toward the bottom of the Asahi myopia article, we read that in 2018 MEXT promised, for the sake of equity and equality, "one mobile device per [primary and secondary] student … nationwide." And in 2021, MEXT fulfilled its promise. As a result, the Asahi article implies that the government has ruined the eyesight of Japanese youths.

MEXT did offer guidance on using mobile devices to relieve eye stress during the rollout of its free devices. The ministry is also currently conducting a study on elementary and junior high school students to ascertain the effects of its free gifts on their vision. Its results are due in 2024.

Myopia is in fact a "major public health concern." Left untreated, myopia could lead to other ocular disorders such as glaucoma, retinal detachment, and eventually blindness.

But is the Japanese government to blame for what happens outside of Japan, too? Myopia appears to be growing faster in developed East and Southeast Asian countries compared to Europe and underdeveloped countries. Countries with "intense educational pressures," including Japan, China, and South Korea, appear to have the highest incidence of myopia. 

The association between using smartphones and myopia is not as clear-cut as the Asahi and MEXT suggest. Why blame the Japanese government, almost instinctively, for problems that are likely to be much more complex in origin and cause?

Government Should Not Be An Excuse to Ignore Complexity

An aggregate review of 15 individual studies involving a total of almost 50,000 children was unable to uncover a significant association between long periods spent on digital devices, including handheld devices, and myopia. One cross-sectional study of a small number of third graders in Kagoshima uncovered an association between time spent on computers and smartphones and myopia.  

However, when other factors were taken into consideration, such as sex, body weight, and concurrence of parental myopia, the association was not statistically significant. In fact, the authors of the Kagoshima study found that "Westernized dietary habits" were significantly associated with myopia. Perhaps MEXT will ban Western-style lunches in school cafeterias?

As with other biological functions, genes play a role in the development of myopia. Several gene variants have been found based on population-wide studies. 

Studies searching for genes associated with myopia have usually been performed with adult European subjects. The results suggest the cumulative effect of education and potential risk factors such as time spent on close work and genes over time. 

For example, it appears that a high level of educational attainment (e.g., college degree) is associated with myopia. Should MEXT ban university education? As myopia develops in childhood, it will be key to determine the extent of the interaction between genes and risk factors in Japanese children, to determine effective preventative measures, if any.

The Asahi's Short-sighted Views on Myopia

The Asahi article highlighted myopia in MEXT's health survey but skipped over other trends. Excessive viewing of mobile devices could lead to other health problems besides myopia. Children who spend too much time on their tablets or phones could develop eating disorders, obesity, suicidal behavior (from cyberbullying), and delayed or impaired social and language skills. 

Indeed, the MEXT survey points out a rise in the number of overweight students. Compared to 1977, the percentages of 11- and 14-year-old males who are overweight in 2022 have doubled. There were more overweight 11- and 14-year-old females over the same period as well, though the increases were not as dramatic as that of males. 

Oddly, at the same time, more male and female students in 2022 were underweight compared to previous years. Clearly something more complicated than a one-to-one smartphone-myopia causal link is occurring.

Government Creates Problems When It Tries Solving Problems

Also unreported by the Asahi is a small but persistent minority of male high school students with a speech disorder.  

The last time the survey found no speech disorders in male high school students was in 2001. Since 2008, the year iPhones were introduced in Japan, the percentage of male high school students with a speech disorder has ranged between 0.02% and 0.08%. (The latter number is the figure for 2022.)

Interestingly, within this same period, the percentage of female high school students with a speech disorder ranged from 0.01% to 0.03%. Japanese females appear to spend more time on their phones than their male counterparts. Therefore, factors other than, or in addition to, smartphones could be underlying speech disorders in male students. 

Leave it to the government to create more problems while attempting to solve a problem. "If all you have is a hammer, everything looks like a nail." 

Government Won't Solve the Population Problem, Either

Two articles were unfortunately juxtaposed on the Asahi home page on November 29, 2023. One laments Tokyo's ranking at the "bottom among Japan's 47 prefectures in total fertility rate, the number of children a woman is expected to give birth to during her lifetime." 

In response to Tokyo's population woes, an "official at the Tokyo Metropolitan Government's Bureau of Public Health" blandly stated, "We would like to continue our efforts to support those who wish to get married and have children." What those efforts are were not elaborated.

Prime Minister Fumio Kishida has made a number of promises in the Japanese government's fight to stop population decline. Kishida promised monthly allowances to parents with children up to high school age. He promised expanded maternity care and paternity leave. Furthermore, he promised to do all this without raising taxes. 

At the same time, the Ministry of Health, Labour and Welfare has allowed, as a trial run, the sale of the so-called "morning after pill," levonorgestrel. This so-called "emergency contraception" will be available over the counter, without a physician's prescription. Helpfully, the Asahi linked to a website showing pharmacies participating in the distribution of levonorgestrel. 

By contrast, the Asahi did not link to MEXT's health survey of school children. One can draw one's own conclusion from this.

More Government 'Solutions' in Japan

Levonorgestrel is intended to prevent unwanted pregnancies following unplanned sexual activity, including rape. It is "not intended for routine use as a contraceptive."  

However, compared to American women without multiple partners, women in the United States with multiple partners appear to be more likely to repeatedly (three to five times in the past year) or extensively (six or more times in the past year) use levonorgestrel. Those who use levonorgestrel appear to believe that it is greater than 90%, even 100%, effective in preventing pregnancy.

The manufacturers of levonorgestrel warn that it is not as effective as routine contraception. What Japanese women think about levonorgestrel is not well known. It seems the Japanese government was not at great pains to find out.

It is mystifying that the Asahi chose to place two divergent stories next to each other. On the one hand, the Asahi highlighted increasing reproductive rights without the responsibility of raising children. On the other hand, the Asahi highlighted the shrinking fertility rate in Tokyo.

Incredibly, the Japanese government is working hard in both conflicting directions. The Asahi, through a possibly unintended juxtaposing of two diverging articles, shows that the Government of Japan is fighting itself.

RELATED:

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• Reversing Depopulation: Why Japan Used to Be a 'Children's Paradise'
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• EDITORIAL | Non-Japanese Children Missing School Will Be Detrimental to Society
  
  

Author: Dr Aldric Hama
Find other book reviews, reports, and analyses by Dr Hama on JAPAN Forward.