Background Health advocacy, as performed by physicians, is an important global agenda for tackling health inequities, especially in the primary care area. However, few physicians are trained be able to perform health advocacy in Japan. This descriptive preliminary study aimed to clarify the current situation regarding health advocacy among Japanese physicians and propose specific strategies for its dissemination.Methods A questionnaire survey was distributed to 1,296 medical institutions in Kagoshima Prefecture to clarify Japanese physicians’ awareness of, practical experiences in, and education need for health advocacy.Results Physicians strongly perceived the need for health advocacy on the micro, meso, and macro levels (95.3%, 82.4%, and 77.7%, respectively). However, about 90% of the physicians did not actually put meso- and macro-level health advocacy into practice. Overall, specific social issues were less recognized as targets of health advocacy as its range of actions broadened from the micro to the meso and to the macro levels. And even given that overall trend, different trends in awareness of the need for and actual practice in health advocacy were observed among each social issue. In total, 73.6% of the physicians had never heard the term “health advocacy”, and 45.9% did not think it was their responsibility. However, 69.6% of the physicians showed a positive attitude toward participating in health advocacy education. Over 62% of the physicians supported undergraduate and lifelong medical education as effective dissemination measures of health advocacy among Japanese physicians. Notably, however, the physicians who were more likely to be rooted in primary care expressed less willingness to participate in lifelong educational opportunities.Conclusions The findings of this study suggest that feasible lifelong medical education is needed for Japanese physicians to acquire the knowledge, attitudes, and practical skills necessary to perform health advocacy on the meso and macro levels. Furthermore, the introduction of health advocacy as a theme of undergraduate medical education in Japan is needed. To develop both general theoretical research and practical educational strategies research is required that can lead to effective health advocacy solutions for health inequities.
