Successful Aging in Japan: The Role of the Government Yasuhiko - - PowerPoint PPT Presentation

Successful Aging in Japan: The Role of the Government

Yasuhiko Saito Nihon University, Tokyo, Japan Presented at AASSREC Conference on "Ageing in Asia-Pacific: Balancing the state and the family" held on April 4-5 in Cebu, Philippines

• This presentation is based on collaborative

work with Dr. Vanessa Yong and Dr. Yuka Minagawa.

Overview of the Presentation

• Successful Aging
• Individual Level Determinants of Successful

Aging

• Concept of Health
• Macro Level Factors for Successful Aging

– 4 Areas of Concern

• Critical view of Successful Aging

Successful Aging

• The term successful aging was first introduced

in 1961 in an article published in The Gerontologist.

Definition of Successful Aging

• by Rowe and Kahn (The Gerontologist,

37(4):433-440, 1997) 1) avoidance of disease and disability 2) maintenance of high physical and cognitive function 3) sustained engagement in social and productive activities

Determinants of Successful Aging

• Studies on successful aging centered around

individual level determinants of healthy aging such as –behavioral predictor of healthy aging –psychosocial predictors of health aging –in particular lifestyle factors

• diet, exercise, smoking

Concept of HEALTH

• Very important factor for Successful Aging
• How to define "HEALTH?"
• What is "healthy aging?"
• One way of realizing Successful Aging may be

"Pin Pin Korori"

Definition of Health

• WHO: Health is a state of complete physical,

mental and social well-being and not merely the absence of disease or infirmity.

5 Aspects of Health

• Healthy
• Diseases, Conditions, and Impairments:

– stroke, heart disease, pain, loss of vision

• Functioning:

– walking, kneeling, grasping

• Disability:

– ability to perform personal activities, independent living, work

• Death

Transition among Health States

Diseases Conditions Impairments Functioning Loss Disability Death

HEALTHY

Pin Pin Korori

• Phrase used in a campaign in Japan to

promote healthy aging about 30 years ago

• “Pin Pin” is to keep healthy, bouncing and

dynamic, “Korori” is to roll over and die.

• Meaning of the phrase: to live a long life

without illness and when the time is up simply die peacefully

2 concepts to be considered

• Longer life

– For a society: aging (increase in life expectancy) – For an individual: longevity (reaching every member of a society to maximum life span)

• Healthy life

– For a society: active aging (increase in healthy life expectancy – For a individual: longevity without unhealthy period

Life Expectancy

• Average length of expected life for a

population

• Summary measure of age-specific mortality

rates

• Life expectancy goes up if mortality rates go

down

• Life expectancy can be computed at any age

Longevity (Life Span)

• Biological limit for human being exists?

– We don’t know exactly yet. – Probably around 120 years? (Bible, Koran)

• Longest life human being ever lived?

– French woman: Jeanne Calment – With proof: died in August 1997, at the age of 122 years and 164 days

Health Expectancy: Definition

Summary measure of both mortality and morbidity Life Expectancy = Healthy Life Expectancy + Unhealthy Life Expectancy 86 Years of Life = 82 Years of Healthy Years + 4 Years of Unhealthy Years 4 years of unhealthy years do not mean the last 4 consecutive years of life.

Survival curves for morbidity, disability, and mortality: Percentages surviving to given age without the event

10 20 30 40 50 60 70 80 90 100 10 20 30 40 50 60 70 80 90 100 110 Age Mortality Disability Morbidity

10 20 30 40 50 60 70 80 90 100 10 20 30 40 50 60 70 80 90 100 110 Age

Pin Pin Korori: Rectangularization of survival curves

Definition of Successful Aging

• Definition has been revised and broadened.

– life satisfaction – subjective well-being – social interaction – consider age, gender and cross-cultural differenced

Role of Government in Successful Aging

• shift focus from individual level factors to

macro level factors which could help successful aging for individual

Samantha Bennett, Health Promotion Board, Singapore, presentation at Healthy Ageing in Asia, held from March 4-5, Singapore

The Japanese Context

• Total population: 127 million
• Known for homogenous, egalitarian and

cohesive society (?)

• Fertility 1.37
• Life Expectancy at Birth

– F 86.4, M 79.64 in 2010

• 2 characteristics of population aging in Japan

– speed and aging among older population

Changes in Proportion of Aged 65+

Country 7% 14% 21% Years from 7% to 14% Years from 14% to 21% Japan 1970 1994 2005 24 11 France 1862 1979 2021 115 42 Sweden 1887 1972 2018 85 46 UK 1929 1976 2019 47 43 USA 1942 2014 2050 72 36

Proportion of Aged 75+ in Aged 65+

Country 2000 2025 Difference Japan 40.7% 59.1% 18.4 France 46.2% 48.5% 2.4 Sweden 51.3% 52.2% 0.9 UK 46.9% 48.6% 1.7 USA 47.3% 42.2%

• 5.1

4 Areas of Concern

• Healthcare for Older Adults
• Employment and Re-employment of Older

Workers

• Social Participation and Active Aging
• Aging-in-Place: Housing and Transportation

Policies

• (Pension)

Healthcare

• Universal Health Insurance Coverage
• The Gold Plan
• National Long-Term Care Insurance
• Care Prevention Program
• Healthy Japan 21 and 2nd Healthy Japan 21

Employment and Re-employment

• Rising the Retirement Age and Promoting

Continued Employment

• Re-employment of Older Workers
• Temporary and Short-term Employment

(Silver Human Resource Centers)

Social Participation and Active Aging

• Age-Less Life Practitioners and Groups Award
• Life-Long Learning
• Educational Supporter System
• JICA Senior Volunteer
• Senior Citizens' Clubs: Rojin Clubs
• Japan Association of Second-life Service
• Programs of Free Reduced Fare for Public

Transportation

Aging-in Place: Housing and Transportation Policies

• To enable older Japanese to age-in-place and

continue to live within their community in a familiar environment rather than to move to institutional living, over the past few decades the Japanese government has formulated and implemented various housing and transportation policies for older Japanese.

Housing

• Housing Plan for Senior Citizens in the Local

Regions: This policy mandated every local government to establish a plan for housing

• lder people.
• Housing loans at low-interest rates
• Silver Housing program: subsides for the

construction of senior housing for both widowed elderly and elderly couples.

• Design Guidelines of Dwelling for an Ageing

Society: universal design for all ages

Transportation

• Transportation Accessibility Improvement

Law: To ensure that older as well as disabled Japanese lead a self-reliant life to the greatest extent possible.

• The key objective is to ensure complete

barrier-free accessibility at railway stations, streetcar stops, bus terminals, ferry terminals and airport passenger terminals.

Successful Aging: for WHAT?

• Successful Aging should be means to the end

and not end in itself.

• Happiness?
• Satisfaction?
• Well-being?
• Feeling of Achievement?

IKIGAI: Japanese Word

• Successful Aging for IKIGAI (Sagaza, 2013)
• a reason for living, make life worth living,

purpose of life, etc.

• Think about the work in your own language.