Today, rural communities in Japan are on the brink of a ruin, and the rapidly deteriorating social conditions there have exerted a harmful influence on the health of farmers.
During the work for protecting health of the inhabitants in a village of Ehime Prefecture, it was noticed that a considerably low level of community health has reflected on the high frequency of anemia.
It is noteworthy that most of the anemic cases result from overwork and unbalanced nutrition caused by poverty.
In our last investigation on 1389 inhabitants, anemia was found in 28.0% of the male adults, 25.7% of the female adults, 40% of the old people. The mean hemoglobin level was 14.58±1.63 in the male adults, and 12.57±1.51 in the female adults.
It is urgently necessary to take effective measures to correct the situation.
As causal factors, we can enumerate distorted dietary life, overwork, and physiological phenomena peculiar to women, such as pregnancy and delivery, in the case of women; and overwork, a general decline of bone marrow functions, and the secondary anemia caused by other diseases in the case of old people. The establishment of a system of community health control is needed more than anything else.

An examination of anemia has been carried out for 466 pupils of Aiji Elementary School and Aiji Lower Secondary School in Hiromicho, Ehime Prefecture.
The cases of anemia became more and more frequent as the age of the pupils advanced, and this, we think, is closely connected with the distorted dietary life which is forced upon the people in rural areas in Japan by the repid change of living conditions there.
For measures to counter the frequent occurrence of anemia among pupils it is most important to establish a close cooperation between the school health protection and the community health protection and to pursue the community program of health protection.

Today, many villages in Japan are rapidly declining as a result of the policy of the Japanese government aiming at the growth of monopoly capital.
Shimo-Ono is one of such villages, with 184 houses and 731 inhabitants. We would report the progress of the regional examinations carried out in this village for these nine years and discuss about the necessity of the communal system of health protection, the actual state of health destruction and the countermeasures to be taken against this, and the problems imposed upon future regional examinations.

Based on previous anther's obsarbations of pseudocholinesterase (PCE) activity correlated with total cholesterol, fluctuation of this enzyme was epidemiologically studied in connection with changes of serum lipids on 225 sprayers of pesticides in citrut fruit area, and results are as follows;
1. PCE activity was slightly correlated with serum triglyceride (γ=0.277) and total cholesterol (γ=0.431) in females but not correlated in males.
2. PCE activity was significantly higher (P<0.05) in hyperlipemic subjects than normolipemic, and obviously higher (P<0.001) in hyperlipemic over weight subjects than hyperlipemic normal weight.
3. The enzyme activity was significantly higher (P<0.05) in hypertriglyceridemic subjects than in normolipemic, and highest (P<0.01) in subjects with hypertriglyceridemia and hypercholesteremia.
4. Serum triglyceride values in males and serum cholesterol values in females were obviously higher (P<0.05) in the high level group of PCE activity than in the low level group.
5. PCE activity was exhibited a tendency of elevation in hypertensive females than in normal blood pressure, and slightly correlated with systoric blood pressure (γ=0.286) and diastoric blood pressure (γ=0.358) in females.
6. PCE activity was found to be lower (P<0.05) in arterioslerotic subjects than nonsclerotic subjects with ocular funduscopic findings.
These epidemiological findings suggested that PCE might play a role in lipid metabolism and reduction of this enzyme might cause disturbances of lipid metabolism.

For the purpose of studying the systematization of community health care in the rural district, we made health examinations and investigations into labor conditions and daily life of women working in grape farms.
The health conditions of the women working in grape farms were considerably unfavorable. They were compelled extremely busy lives including agricultural labor, households, childcare and nursing of the elderly who were lying ill in bed.
The health examinations revealed the high prevalence of cervicobrachial disorder, lumbago, fatigue of the sensory-nervous system and some health hazards by agricultural chemicals, in addition to anemia and hypertention which show generally higher prevalence among farmers in Japan. Taking into account that the new technical know-how and agricultural chemicals will be more and more introduced to the intensive agricultural system, it will become important to raise the health level both through approaches of the community health and through industrial hygiene.
The cooperative activities which we carried out with the Agricultural Cooperative Association, Municipality, Health Center, the Agricultural Mutual Benefit Association and the Agricultural Guide Center, improved the health condition, health care delivery system and participation of workers in the activities. These effects also proved the necessity of improving living conditions in parallel with the promotion of the comprehensive health care system.

The activities for protecting health of inhabitants in the southern part of Ehime Prefecture (people call this part of the prefecture “Nan'yo”) has been developed by the Center of Rural Medicine, since it was established in November, 1965 as an auxiliary organization of the Ehime Prefectural Kitauwa Hospital.
Nan'yo covers an area of 1, 790.3 km² and has 348, 065 population (1970).It consists of two cities, nineteen towns and two villages, and has five Health Centers.
The phenomenon called “over-sparseness of population”, which is one of the manifestations of the contradiction inevitable to the capitalism in Japan is also observed more and more conspicuously in Nan'yo.
In this situation the Center of Rural Medicine pursues the activities of health protection based on the need of inhabitants as a part of the communal program for establishing health protection system, which is pushed forward in cooperation with the Health Centers, the Medical Association of Ehime Prefecture, Tottori University and the agricultural cooperative association.
The main features of the activities for protecting health of inhabitants are as follows.
1) To gain a closer cooperation of the administration of the prefecture
2) To establish a communal system of health protection in cooperation with various medical organizations
3) To establish hospitals based on the need of inhabitants
4) To urge the more substantial medical policy of the communities
5) To contribute to the deepening of understanding in social medicine of medical and paramedical students