The Japanese school health system was established at about the same time as the modern Japanese educational system and thus has a history of more than a century. In the middle of the 19th century (1866), Dr. Hermann Cohn, professor of Ophthalmology at the University of Breslau, Germany, proposed allocating doctors to schools to provide inspection and guidance in the hygienic and environmental conditions of the school, since the incidence of myopia was particularly high among school attendees. Consequently, the need for management and guidance of hygiene in schools was advocated in Europe at the time. Following the European lead, Japan formulated a system to manage the health of children in school and to facilitate their growth and development.
Before the end of World War II, the system was called the school hygiene system, but it was later known as the school health system. There was also a transition in the activities required to maintain school health from the periods of Meiji (1868–1912) to Taisho (1912–1926), Showa (1926–1989), and Heisei (1989–). This paper outlines the background and process of establishment of the school health system in Japan, discusses new issues of school health currently occurring in the school system, and introduces activities being carried out by JMA to solve such issues.