アフターコロナでニーズ高まるヘルス、ウェルネス、ウェルビーイングについて関係性の整理をはじめておこない、最新のウェルネス定義、ウェルネスツーリズムの定義を発表する琉球大学ウェルネス研究分野の研究講演英語版を公開します。
成長著しいウェルネス産業市場規模の最新データや、世界が注目する日本のウェルネス（JAPAN Wellness）とは、そして持続可能の発展形として海外で登場しつつあるリジェネラティブツーリズム（Regenerative tourism；再生観光）についても解説しています。
ウェルネスツーリズムがようやく日本の観光分野や地域自治体でも本格化するなかで、ウェルネスツーリズムの本質（上位概念にあるウェルネス、ウェルビーイングの理解を果たしたうえでのツーリズム）を説明できない日本の大学者、団体がいることに混乱を招いています。ウェルネスツーリズム開発、ウェルネスツーリズム人材育成と謳いながら、蓋を開けてみると健康目的型のヘルスツーリズムである場合が見受けられ、かつて地域活性の一環にニューツーリズムともてはやされ全国で取り組まれたものの、補助事業など支援が終わればすべて消えていったヘルスツーリズムとの混同、二の舞になりかねません。
健康（ヘルス）は重要ですが基盤であり、身体の健康、精神の健康、環境の健康、社会の健康を基盤に、輝く人生を志向するウェルビーイングに向かうさまざまなアクションがウェルネスであり、世界で巨大なウェルネス市場を形成しています。そうしたウェルネスコンテンツをコアにしつつ多業種、多職種、異業種連携によるアライアンスで創意工夫のもとにあらゆる地域資源をウェルネス資源として新しい価値を生み出していく、旅先滞在でウェルビーイングを手に入れるウェルネスを提供していくことが、日本から世界に発信する最新のウェルネスツーリズムです。従来の観光概念を超えて、新しい視点でさまざまなプレーヤーの参入を促し日本全体を活性化する、ウェルネス、ウェルビーイング大国日本となっていくことを期待します。
＊先端観光科学研究所(FITS）第1回研究カンファレンス（2023年12月4日、金沢大学）にて基調講演した英語プレゼン資料を基に一部修正
＊本サイトページ内容の引用は自由ですが、引用元として
サイトリンク：https://health-tourism.skr.u-ryukyu.ac.jp/ 琉球大学国際地域創造学部ウェルネス研究分野
論文引用元の記載の場合は
荒川雅志. アフターコロナの旅と健康～ウェルビーイングを達成する新しいウェルネス、ウェルネスツーリズムの定義、Precision Medicine. 6(2), 59-62 2023.
を必ず記載ください。
Dr. Arakawa was born in Fukushima Prefecture in 1972, moved to Okinawa in 1999.
He graduated from Graduate School of Medicine in Fukuoka University.
His research expertise is epidemiology and title of doctoral dissertation is “The Relationship between Hypertension and Stroke in Centenarians Okinawa Japan” (Cerebrovasc Dis. 2005; 233-238) . His research centered on the lifestyles of centenarians in Okinawa, one of the world’s five “ Blue Zones” known for longevity.
He translated and supervised the U.S. business bestseller, “THE BLUE ZONE, 2ND EDITION: Learning Health and Longevity from the World’s Centenarians The Nine Rules.”
He also conducted pioneer research on wellness tourism at Japanese universities.
“TSUNAGARI” (in Japanese, meaning connection or tie). He has studied longevity from the perspective of social capital – connections with nature, with people, and with the community – and has applied this concept to wellness menus at hotels and developed many menus.
Dr. Hulbert Dunn introduced the wellness concept 60 years ago in the United States. Wellness is a holistic view of health encompassing more than just the physical aspect. Since then, researchers worldwide have refined and expanded upon the concept. It has evolved as people’s lifestyles, and values have changed in different countries, social situations, and eras. Researchers from various backgrounds, including race, ethnicity, gender, sexual orientation, religion, and language, have contributed to the concept of wellness. Recognizing that wellness is not fixed and will continue to evolve is essential.
What is Wellness?
The concept of wellness has a long history. Still, it was in 1959 that Dr. Dunn first introduced the term “high-level wellness” to conceptualize positive health and a holistic approach to promoting well-being. In 1961, wellness was defined in modern usage as follows:
An integrated method of functioning that is oriented towards maximizing the potential of which the individual is capable within the environment in which the individual is capable within the environment in which he is functioning. (Dunn H, 1961)
Dr. Dunn initially emphasized four dimensions of wellness: mental, emotional, physical, and spiritual. Since then, various American scholars, including Ardell (1977), Benson and Stuart (1992), and Greenberg and Dintiman (1997), have contributed to the definition of wellness. The concept of wellness is understood differently in different cultures and countries. The German Wellness Association identified four common elements in the various definitions of wellness proposed by American scholars: “the importance of lifestyle,” “individual responsibility for health,” “multifactorial health,” and “potential development for the quality of life.” Croatian scholar Koncul (2012) described wellness as a result of awareness of positive health, well-being, and happiness.7 Hamed (2015) from Egypt defined wellness as “a state of health that involves overall well-being including body, mind and spirit,” similar to the definitions proposed by American scholars.
The concept of wellness has a more extended history and decisive influence than health in China, compared to the West and other Asian countries. In Chinese, wellness is most closely translated as regimen, often described as “Youjou” in Japanese. The leading Taoist and influential thinker, Zhuangzi, advocated the concept of Youjou. Since ancient times, wellness has been integrated into people’s lives in China as a way to rest and prevent disease actively. Huang and Xu (2014) describe Youjou as achieving optimal well-being through internal and external forces to promote self-healing. Mueller and Kaufmann (2001), German scholars, proposed an extended model of the wellness concept that consists of “self-responsibility” at the center of a circle, with “mind: mental, education,” “body: fitness, beauty,” “relaxation: rest, meditation,” and “health: nutrition, food regimen” around it. Among others, “environment” and “society” are in the outer circle for the first time.
The expansion of the wellness definition
The development of wellness theory and programs has evolved significantly in the United States, leading to the establishment of wellness centers nationwide and the emergence of the Wellness Movement. Research and popular awareness, mainly from the medical community and fields such as health, education, social, physical education, and physical fitness, have emphasized the spiritual component of wellness, albeit in a broad sense from a health perspective.
Since 2000, the term wellness has been interpreted broadly, encompassing the relationship with the environment and society, the original holistic approach, and the lifestyle. It has become widely used as a marketing term in business, leading to attention and participation from various industries, including the lifestyle and leisure sectors. The Global Wellness Institute (GWI), a non-profit think tank of researchers and practitioners that studies and reports on global trends in health and wellness, defines wellness as follows:
The active pursuit of activities, choices, and lifestyles that lead to a state of holistic health. (The Global Wellness Institute, 2010)
The GWI acknowledges various definitions and regional differences in the concept of wellness, but it has identified several common themes. Wellness is multidimensional; it changes over time; it is personal and influenced by the environment and requires self-responsibility. According to the GWI, there are at least six dimensions of wellness (up to 12): physical, mental, emotional, spiritual, social, and environmental. The University of Michigan and the National Wellness Institute (NWI) have divided the elements of wellness into eight dimensions: physical, spiritual, social, occupational, financial, emotional, environmental, and intellectual.
The difference between wellness and health
Wellness is a concept that has emerged in the search for a more realistic view of health that goes beyond the absence of illness. The English word “wellness” comes from the word “well,” meaning “energetic” or “invigorating,” as opposed to “illness,” which means “disease.” While health has traditionally been used to describe the absence of illness, wellness is a concept that encompasses a healthy lifestyle and positive health actions.
The World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” (1946). It is well-known among researchers and health professionals as a comprehensive concept that includes social aspects and the previously body-centric view of health. However, this interpretation may not be as widely recognized by the general public. When people hear “health” or “wellness,” they often focus on their physical or mental aspects and determine whether they are healthy or unhealthy based on medical or quantitative criteria, such as the results of health checkups. If diagnostic criteria and standards change, people previously considered healthy may be sick.
The difference between wellness and health can be understood in the context of Maslow’s hierarchy of needs. Health is a foundational need that includes safety and security. In contrast, wellness encompasses all higher-level needs, such as the need for love, approval, and self-actualization, while also including foundational requirements. Public safety, sanitation, and medical infrastructure have improved in many developed countries. The basic needs of Maslow’s five-step theory are being met, leading people to focus on higher-level needs such as approval and self-actualization. Physical and mental health form the foundation, and wellness aims to achieve a life of abundance and excellence based on that health. When we are fully engaged in something that helps us reach self-actualization, when we find our purpose in life and are passionate about it, we experience a fulfilling life, and that process is also wellness. It is healthier for us to focus on our purpose in life rather than being driven by the current health craze.
A New Definition of Wellness
The concept of wellness changes as people’s values, social conditions, and the times transform lifestyles. With the COVID-19 pandemic, the need for wellness will increase even further. These times, we need a new definition of wellness suitable for the dawn of the wellness lifestyle era, allowing people with diverse aspirations and backgrounds to participate. The most recent definition of wellness, from 2017, defines it as “designing a lifestyle” that involves “creating a radiant life based on physical health, mental health, environmental health, social health, and self-actualization.”16 This definition suggests a new era of wellness in which all fields and businesses can participate.
Designing a radiant life and self-actualization based on a foundation of physical health, mental health, environmental health, and social health. (Arakawa M, 2017)
The relationship between wellness and well-being
Wellness is sometimes confused with well-being and health. While there is no global consensus on the definition of well-being, ontologists generally agree that it includes a state of positive affect or mood (feeling satisfied or happy). It is often synonymous with happiness and translated as well-being. In China, well-being is translated as happiness. Researchers worldwide have studied various aspects of well-being, including economic well-being, social well-being, psychological well-being, and life satisfaction. GWI chair Susie Ellis has stated that wellness will increasingly be associated with health and prevention to avoid confusion, while well-being will be more closely linked with happiness.
The main difference between wellness and well-being is that wellness is an active, action-focused dimension (dynamic). In contrast, well-being, also known as happiness, is a perceived state of being (static). Wellness is achieving well-being through physical, mental, social, and environmental health. The various practices and policy actions related to wellness, such as physical, mental, emotional, spiritual, social, and environmental wellness, are the results of achieving well-being. This understanding helps to clarify the distinction between the two concepts.
Recently, the United Nations World Happiness Report and other measures of well-being have gained attention. However, it’s important to note that countries with high well-being rankings may not necessarily have high levels of health, and countries with high levels of health may not necessarily have increased well-being rankings. Health, wellness, and well-being are closely related and play complementary roles. Wellness, which includes multiple aspects of health, contributes to overall well-being. On the other hand, striving for well-being can often lead to specific habits that promote wellness. In short, these three concepts are interconnected and interdependent.
New demographics seeking wellness
According to a 15-year follow-up study of 150,000 people in the United States by sociologist Paul Ray and psychologist Shelley Anderson, a rising demographic is focused on sustainability and practices environmentally and health-conscious consumption behaviors. The study predicts that this group will soon become a significant portion of the US population. It is estimated that 26% (85 million) of the US population and 35% (150 million) of the EU population will belong to this demographic.
This demographic, which values slow living, eco-symbiosis, organic products, yoga, mindfulness, clean energy, locally-sourced products, and ethical consumption, has driven the growth of significant markets in these areas. They are known as “cultural creatives” or the next generation of lifestyle creators. This group is also susceptible to the Sustainable Development Goals (SDGs), which are targeted for achieving by 2030. This population segment prioritizes sustainability as an ideal and an integral part of modern economic and consumption practices. It aligns with the goals of Socially Responsible Investing (SRI) and Environmental, Social, and Governance Investing (ESG). As a result, the wellness industry will likely continue growing in popularity.
In contrast, the healthcare industry is a “disease industry” and a “passive” one, as people only become customers when they suffer from a specific symptom or disease or have a physical or mental health condition. In other words, no one wants to be a healthcare industry customer. In contrast, people are willing to become customers of the wellness industry, which offers a lifestyle that promotes health, beauty, and overall well-being rather than just addressing specific symptoms or diseases. In today’s world, with a high prevalence of chronic diseases and a shift towards healthier lifestyles, the wellness industry has the potential to appeal to people of all ages, races, genders, religions, and nationalities.
According to the Global Wellness Institute (GWI), the wellness economy grew at an annual rate of 5.8% between 2013 and 2017, about five times faster than the overall global economy, which grew at 1.2% per year. In 2017, the wellness economy was estimated to be worth $4.3 trillion, and it was expected to reach $4.9 trillion by 2019, a growth of 6.6%. However, the spread of COVID-19 in 2020 significantly slowed the development of the wellness economy, which declined by 11.0% to $4.4 trillion.
The wellness economy includes industries that allow consumers to incorporate wellness activities and lifestyles into their daily lives and comprises 11 sectors. In terms of market size, the personal care, beauty, and anti-aging industry are valued at $955.2 billion; the healthy eating, nutrition, and diet industry at $945.5 billion; the fitness industry at $738.1 billion; the wellness tourism industry at $435.7 billion; the complementary and alternative medicine industry at $412.7 billion; the public health, prevention, and personalized medicine industry at $375.4 billion; the wellness real estate industry at $275.1 billion; the mental wellness industry at $131.2 billion; the spa industry at $68 billion; the workplace wellness industry at $48.5 billion; and the hot springs and mineral springs industry at $39.1 billion. The wellness tourism market, which includes overall travel, has been stagnant due to the restrictions on travel caused by the COVID-19 pandemic but is expected to recover significantly in the post-COVID period.
Definition of wellness tourism
Wellness tourism is a high-value-added type of tourism that can achieve high levels of customer satisfaction by bringing together professional human resources from various industries, occupations, and fields. It is also to meet the diverse needs of travelers in an age where people are re-evaluating their work and lifestyle choices. As values and lifestyles continue to evolve, the concept of wellness is also changing, and the definition of wellness tourism will likely adapt over time.
Researchers have proposed various definitions of wellness tourism.
For example, Wolfgang Nahrstedt (2004) defined wellness tourism as “tourism that consists of health care, treatment and recovery, relaxation, diet, exercise, skin care, and beauty during leisure time,” providing specific examples of the types of activities that may be included.
In a 2018 report, the World Tourism Organization (UNWTO) defined wellness tourism in a public statement as follows:
A type of tourism activity that aims to improve and balance all of the main domains of human life, including physical, mental, emotional, occupational, intellectual, and spiritual. The primary motivation for the wellness tourist is to engage in preventive, proactive, lifestyle-enhancing activities such as fitness, healthy eating, relaxation, pampering and healing treatments. The primary motivation for the wellness tourist is to engage in preventive, proactive, lifestyle-enhancing activities such as fitness, healthy eating, relaxation, pampering and healing treatments.
GWI (2018) defines wellness tourism as
Travel associated with the pursuit of maintaining or enhancing one’s personal well-being.
Defining the new wellness tourism
While yoga, spas, meditation, and other healthy activities are often used as examples to illustrate wellness tourism, it is essential to remember that this concept is not limited to these specific experiences. The definition of wellness tourism will evolve as the concept and values of wellness change over time. The World Tourism Organization (UNWTO) has defined wellness tourism in a 2018 report, but the author believes that the value provided beyond these experiences is more important. In 2017, the author proposed a new definition of wellness tourism that reflects these values and cites specific examples. Government agencies, research journals, companies, and communities in Japan have widely cited this definition.20, 27
The COVID-19 pandemic has significantly impacted society and the travel and tourism industry worldwide. In the pre and post-pandemic periods, there has been a shift in the way people value travel. The prolonged period during which people could not travel has increased the desire for meaningful travel, meaning a willingness to discover more profound forms of traveling, explore the world with more purpose, and enrich the lives of oneself and the people in the visited region some way. This shift can involve interacting with locals, learning about different cultures, and being responsible tourists. As travelers become more experienced, affluent, and knowledgeable, they will likely emphasize authentic experiences, nature, and local cultures and seek travel that brings unique experiences, interaction, inspiration, and empathy. The demand for this type of travel is expected to grow worldwide.
The post-COVID period marks a significant turning point for tourism, and it is essential to promote the wellness tourism of the new era. Wellness tourism is changing to align with the values of the times. The author suggests that the common denominator of wellness tourism should be something meaningful, something that allows for unique experiences, exchanges, emotions, and empathy, and a journey that enhances the lives and lifestyles of both the visitor and the destination. The author believes this to be the wellness tourism of the new era.
/A journey of awareness of mental and physical health, exposure to local resources.
/Fostering special experiences, emotions, interactions, empathy, and a journey that accompanies the lives and lifestyles of both the visitor and the destination.
/A journey of new discovery and self-development, a return to our roots.
/A journey to refresh and energize you for tomorrow.
Japan Wellness Tourism
In addition to these natural resources, Japan’s regions have a rich history and cultural heritage, including traditional performing arts and stylistic beauty passed down through the generations. Japan also has a spirituality centered on Zen and Taoism, which can be utilized as wellness resources. Recognizing these potentials, pursuing Japanese sensibilities and aesthetics, and emphasizing “WA” (Japanese spirit) are all considered necessary for the overall wellness of Japan.
Japan has “safety and security value,” such as its high standards of sanitary management and use of advanced technology, the “functional value” of its materials and commercial products, and the “emotional value” of the stories and thoughts behind them. By leveraging them, we can create unique, memorable experiences that allow people to encounter Japanese ingredients linked to the secret of Japan’s longest life expectancy and experience the wisdom of longevity. By offering these unique, immersive experiences, Japan can become a world-class wellness destination, with each region offering its unique charm and appeal.
Japan has the longest life expectancy in the world
Wellness tourism is predicted to be the fastest-growing form of tourism in the future worldwide. As a result, the Japanese government has identified wellness tourism as an area of focus. For designing booming wellness tourism, it is essential to consider a country’s unique wellness resources and what it can offer that other countries cannot. What value can Japan provide in a unique way to the world? There is a growing movement to discuss Japan’s unique wellness offerings and establish a globally accepted Japan Wellness brand.
The ultimate goal for all humans is to stay healthy and achieve longevity. According to the latest statistics from the World Health Organization (WHO), the average life expectancy for Japanese people is 84.3 years, making Japan the country with the longest life expectancy of over 20 years. By examining the natural and social environmental factors, food culture, spiritual culture, and lifestyle in Japan, it is possible to create high-quality wellness content that showcases the country’s longevity as a brand. Establishing “Japan Wellness,” which capitalizes on Japan’s world-leading life expectancy, could give Japan a competitive advantage in the global wellness market.
Four key factors make a destination appealing to travelers: climate, nature, food, and culture. Japan is known for its temperate and mild climate, diverse natural beauty that changes with the seasons, abundant hot springs (27,970), and unique regional food ingredients. The country’s fermentation techniques, known as “HAKKOU,” are highly regarded by top chefs worldwide. Japan also boasts a rich traditional culture, making it a destination with excellent potential. Overall, Japan is well-equipped with the necessary conditions to attract visitors.
New wellness tourism is regenerative
The new definition of wellness in the post-Corona era is “Inside Out,” which focuses on maintaining the health of the internal environment as part of the overall environment and creating a sustainable lifestyle that is in harmony with the external natural environment, community and society. The author proposed this new wellness definition, called the “Inside Out” SDGs.
Environmental destruction often begins with people. When solving global and worldwide problems, we must first examine the nature within us. If there is some imbalance within, we must first address the challenges of our internal environment. In recent years, there has been a movement, particularly in Europe and the United States, to not only think about conventional “conservation” and “maintenance” of sustainability but also about “regeneration” and “creation” beyond that. American environmentalist and entrepreneur Paul Hawken emphasizes the importance of centering all actions and decisions around life, including people. He believes the next wave of sustainability should involve creating jobs that restore the natural environment, energize people, provide livelihoods, and contribute to well-being. This holistic worldview sees humans, other life forms, the natural environment, and the Earth as autonomous systems. When “the will of all life” circulates throughout this system, it leads to growth and prosperity. Japan’s “Satoyama” and “Satoyamasatoumi” cultures provide examples of preserving nature by being used and modified in harmony with the people’s lives and livelihoods.
After the disaster of the novel coronavirus, it is essential for humanity to move forward and not remain stagnant. We must go beyond the mindset of conservation and maintenance and take action from the perspective of a living community that sees people, organisms, the environment, and the entire planet as a system. We should also consider the view of the local communities where we live our daily lives and make a living to create a new future.
There are three levels of regeneration: the individual, organizational, and global. We must first regenerate ourselves personally or “regenerate” our internal environment to change the world. We can work on renewing acquaintances and communities from there. It is important to note that this process must be sustainable. Without sustainable individuals, it is impossible to create a sustainable society.
I propose a new type of wellness tourism from Japan to the world that promotes meaningful travel, memorable experiences, interaction, inspiration, and empathy. This new type of wellness tourism encourages a recycling-oriented, symbiotic society from the individual to the organizational and global levels.
- A journey to experience the destination’s resources, relax and rebalance the mind and body. (Relaxation)
- A journey to “return” to one’s true self by experiencing the destination’s resources. (Reset)
- A journey to connect with nature, people, and the local community. (Relation)
