Health

Two in three international students fall ill in Japan. One in seven of them just waits it out.

Buried at the back of JASSO's survey is a single table nobody quotes. It asks whether students have been ill or injured since they enrolled, and what they did about it. 68.0% have. And the share who went to neither a doctor nor a pharmacy has climbed in every round since 2019 — from 11.8% of the ill to 15.1%.

Almost every guide to studying in Japan tells you about health insurance in the abstract. Almost none tells you what students actually do when they get sick, because until you read the survey there is nothing to say. There is one table, it has six rows, and it is more revealing than its size suggests.

Start with the base rate. Of 7,867 students, 2,521 — 32.0% — say they have not been ill or injured since enrolling. Everyone else has. So the population we care about is the other 5,346.

Two-thirds saw a doctor. Just over half treated themselves at a pharmacy — in Japan a great deal is available over the counter, and this is a normal, sensible thing to do for a cold.

Then there is the third bar. 808 students report that they went to neither a hospital nor a pharmacy and endured it. That is one in every seven students who got ill.

The trend is the story, not the level

A single figure invites shrugging — perhaps these were minor illnesses. What is harder to shrug off is that JASSO prints the same question from 2019 and 2021, and every line moves the same way.

Over four years, seeing a doctor fell by nearly ten percentage points. Using the school's health office fell by a third. Self-treatment at a pharmacy did not move. And the share who did nothing rose in both intervals.

Meanwhile the share of students who were ill at all rose from 58.3% to 68.0%. More people getting ill, fewer of them seeing a doctor.

The school health office is the part you can check in advance

Of the five things a student can do when ill, exactly one is a feature of the institution you are choosing: whether it has a health office, and whether it is any use. Usage of it has fallen from 23.7% to 14.6% of ill students in four years.

The survey does not tell us whether that is because fewer schools have one, because the ones that exist are harder to reach, or because more students are enrolled at the kinds of school that never had one. But it does mean the assumption "my school will look after me if something happens" is being made by a shrinking minority — and it is a question with a factual answer you can get before you enrol.

It also sits oddly beside what students say about their schools elsewhere in the same survey: 19.4% name support with everyday life, including health, as something they are satisfied with, against 7.4% who name it as a complaint. The schools are not being condemned here. They are just being used less.

What to take from this

• Expect to need this. 68.0% of students report being ill or injured since enrolling, and the figure has risen in each of the last two surveys.
• The pharmacy is a real answer, not a fallback. 57.5% of ill students used one, and that has been steady across all three rounds.
• Ask whether your school has a health office before you enrol, and what hours it keeps. It is the only line in this table that is a property of the school rather than of you.
• If you find yourself deciding not to go, you are in a group that is growing, and nobody has yet established why. That is a reason to check your assumptions about cost and coverage early rather than during a fever.
• We do not know why the trend exists. Anyone who tells you confidently — including us — is going beyond what this data supports.

Sources. Japan Student Services Organization (JASSO), FY2023 Survey on Living Conditions of Privately Financed International Students. Table 11-1 (illness or injury since enrolment and what students did, with 2019 and 2021 comparisons), Tables 4-6 and 4-7 (satisfaction and dissatisfaction with school support for everyday life). Survey PDF (Japanese). On the calculation. JASSO publishes every row of Table 11-1 as a share of all 7,867 respondents — so "waited it out" appears as 10.3%, not 15.1%. Since 32.0% of respondents report never having been ill, we have rebased each row onto the 5,346 students who were, for each of the three survey years in turn. The published figures are 6.9%, 8.3% and 10.3% for "waited it out" and 41.7%, 36.1% and 32.0% for "never ill"; the rebased trend, 11.8% → 13.0% → 15.1%, is ours. It rises on either basis. On the question format. Students may give more than one answer, since the question covers every illness since enrolment rather than a single episode. A student who went to a hospital once and endured something else another time appears in both rows. What this article is not. Nothing here is medical or insurance advice. It is a description of what a survey recorded.