Karōshi: The Japanese Phenomenon Of "Death By Overwork" That's Quietly Becoming A Global Crisis

After World War Two, Japan rebuilt itself on a covenant between employee and employer: lifetime job security and prosperity were promised in exchange for loyalty, sacrifice, and total commitment. It was tough, but the deal paid off. From the 1950s to the early 1990s, Japan played the game of capitalism and globalization to near perfection, rapidly rising to become the second-largest economy in the world. It was a truly remarkable feat considering the country had been bombed to hell and back just a few decades before. 

The salaryman became a cultural archetype, a white-collar worker with a suit, tie, and sensible haircut. He arrived early at the office from the first commuter train. Regularly skipped his lunch break. He drank with his bosses until late, because the alternative was never getting that promotion. He slept for a few hours each night, before doing it all again, and again, and again. Quitting was never an option, lest you be met with enormous social stigma.

In the post-war era, the salaryman was promoted as something of a positive figure, like an unsung hero who helped drag Japan back from the brink. Then people started literally dying at their desks.

As early as 1969, Japan started to see cases of heart attacks and strokes tied to extreme overwork. Suicide linked to severe work-related stress and burnout, known as karojisatsu, was another major factor. Others died from malnutrition associated with intense stress. By the early 1980s, the problem had become widespread enough to earn its own term: karōshi. 

Even today, the scale of the problem is staggering. There were at least 1,304 documented cases of karōshi in 2024, according to data from Japan’s health ministry. Furthermore, it’s estimated (as of 2023) that 10.1 percent of men and 4.2 percent of women in Japan are working more than 60 hours a week (that’s 12-hour days, five days a week). For self-employed workers, it’s even higher, with 7.8 percent of women and 15.4 percent of men working more than 60 hours a week. And while the "salaryman" was historically a male stereotype, the data suggests that younger women are being pulled into a culture of overwork at an increasing rate.

In recent years, several high-profile controversies have pushed the uneasy topic of karōshi into the public imagination and put it in the firing line. One landmark case involved a 24-year-old woman, Matsuri Takahashi, who died by suicide in 2015. Thanks to the dogged efforts of her mother, the tragic story drew a huge amount of media attention in Japan and beyond. It transpired that she had worked more than 100 hours of overtime a month for some time before her death, at times sleeping as little as 10 hours a week. Her workplace, one of Japan's top advertising agencies, was eventually charged with her death.

In light of these national scandals, the Japanese government has attempted to reform workplace culture and impose stricter working-hour regulations, but progress has been slow and uneven. There are also fears that what little headway has been made could be reversed under the administration of Sanae Takaichi, who once said she slept just two hours a night.

But the problem is no longer Japan's alone. A landmark 2021 study by the World Health Organization (WHO) estimated that in 2016, approximately 745,000 people around the world died due to stroke and heart problems caused by long working hours. 

The WHO study went on to suggest that working 55 or more hours per week is associated with a 35 percent higher risk of a stroke and a 17 percent higher risk of dying from ischemic heart disease, compared to working 35 to 40 hours a week.

Men are disproportionately affected, accounting for 72 percent of those deaths. Southeast Asia and the Western Pacific were hardest hit, though the problem was prevalent across much of the Global South.

Even in Western Europe and North America, where labor protections are typically stronger, work culture is taking a worrying turn. The rise of electronic communications and always-on remote working has blurred the boundary between office and home, while the gig economy fosters the idea that people must "grind" around the clock. 

The old image of overwork might be a greying man falling asleep on a Tokyo subway at midnight in a rumpled suit, but the newly emerging figure is everywhere and hiding in plain sight. 

If you or someone you know is struggling, help and support are available in the US via the 988 Suicide & Crisis Lifeline which can be contacted by dialing 988. In the UK and Ireland, the Samaritans can be contacted on 116 123. International helplines can be found at SuicideStop.com.