Health and occupational environment of Japanese expatriates in the United States: medical interview analysis using text mining

Objectives: While the health issues of expatriates have predominantly been investigated in the context of assignments to developing countries, there is a paucity of research addressing Japanese expatriates stationed in the United States, which is a developed country. Methods: This study employed quantitative content analysis, using the text mining software KH Coder 3 on records obtained from 17 Japanese expatriates who participated in interviews with an occupational physician during a US medical tour in May 2025. Results: The interview records comprised 7856 words and 440 sentences. Co-occurrence network analysis extracted 6 factors: The following subjects were examined: “Family life and daily challenges,” “Extended working hours and meetings between Japan and the United States,” “Comprehensive health checkups (Ningen Dock) and patterns of health care utilization,” “Health checkups and test results,” “Workload and stress,” and “Physical inactivity and weight gain.” Among these, the factor with the highest frequency of constituent terms was “Extended working hours and meetings between Japan and the United States.” Conclusions: Japanese expatriates encounter considerable health challenges, including difficulties in daily life, limited access to medical care, insufficient physical activity, and the substantial burden of work and meetings that extend late into the night owing to time differences. Global companies should ensure appropriate management of health- and work-related issues, even in assignments to developed countries, with particular attention to support systems, such as adjusting meeting schedules and providing family support.