The city of Saku lies in a plain about 700 meters above sea level, practically in the middle of Japan. The Chikuma River flows through the middle of the city, Mount Asama rises up nearby, and the Yatsugatake mountain range can be seen far in the distance. This rural area of Nagano Prefecture is in a wonderful natural setting.

Winters are cold, with the thermometer dropping as low as −15 or −16°C. Until the 1960s, Saku had Japan's highest cerebral stroke death rate. This was said to be because of the cold winters and excess salt intake.

To reverse the trend, in 1971 the municipal government introduced a system to offer residents advice on staying healthy. Public health advocates, many of them housewives, are recruited for a two-year term. There is one advocate for around 30 to 50 households, and they work in the community to raise awareness of health issues. They have waged a number of campaigns, such as suggesting that homeowners keep at least one room warm during the cold months, and promoting a low-salt diet. The city's cerebral stroke death rate has now dropped below the national average. Disease prevention activities continue through the promotion of regular checkups, medical services, and advice on healthy living.

Thanks to the efforts of both residents and the municipal government, Saku now has the reputation of a place where people live long and healthy lives.

Ichikawa Chiyoko, who turns 83 this year, is known in the city for her exceptional health and energy. She owned a store selling stationery and electronic office equipment until she passed it on to her son. But even now she handles the cash register every workday from noon to 7 p.m. She remembers the prices of almost everything in the store, and quickly calculates how much customers owe.

She says with a grin, "Last year, I learned how to do the butterfly stroke. What a thrill that was!" When she started learning seven years ago, she could not swim a stroke, but now swimming a whole kilometer in the local pool does not faze her.