How to Survive in Rapidly Aging Societies: Lessons learned from Japan

An woman carries a heavy load across a street in Tokyo, Japan.
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Image by Gideon.

By Shunichi Fukuhara, Dean, School of Public Health, Kyoto University

As is well known, Japan is experiencing a super-aging society which brings a lot of challenges and difficulties. Many initiatives have been taken and some have already shown positive outcomes.

The most recent cases will be presented at the World Health Summit Regional Meeting Asia, Kyoto 2015, hosted by Kyoto University and held April 13-14. Here are some key aspects to be discussed.

Better Healthcare for Super-Aging Societies: Japan’s Challenges & Opportunities
The population of Japan is aging faster than that of any other country in the world.  And while until about 20 years ago healthcare in the country appeared to be excellent, the system is becoming increasingly difficult to sustain in the face of significant demographic changes imposing a heavy burden on the dwindling number of younger members of society. Physical dependence and dementia of the “super-elderly” only aggravate this problem.

By the same token, Japan has been presented with a significant opportunity: Succeed in building a resilient healthcare system and social model, and become a world leader in overcoming challenges that many other societies will eventually face.

Setting Goals and Changing Habits
For many years Japan has been renowned for the length of its healthy life expectancy at birth, but to maintain this standard two goals have to be met: (1) premature death among the “young elderly” (ages 60–74) must be prevented in order that these largely healthy individuals can continue contributing to society, and (2) “old elderly” (74 and above) must be prevented from becoming disabled and dependent, such as by mitigating falls that result in debilitating bone fractures.

Of particular relevance to men in first category, while Japanese cuisine is considered worldwide as being “healthy,” largely due to its generally lower fat and calorie content compared with the rest of the developed world, salt intake and related health issues such as hypertension and stroke are serious concerns in Japan

High carbohydrate intake (mainly from highly polished rice) and a genetic predisposition to low insulin secretion also combine to result in the nation’s most common and serious non-communicable disease, diabetes. It is estimated that 21–27 percent of the adult population (both men and women) now have adult onset diabetes or glucose intolerance.

Changing dietary habits can be difficult, but this is a significant way in which levels of work productivity and social wellbeing can be kept high as the population grays.

High Tech and Smart Cities
For the “old elderly,” new solutions coming into view include applications of advanced robotics—which are viewed largely positively in Japan—and new concepts in urban design.

Japanese culture can thank a medical doctor, Osamu Tezuka, MD, whose “Astro boy” cartoon character lent a benign and beneficial image to robots. In the present day, the Tsukuba University lab of Dr. Yoshiyuki Sankai has developed a wide range of robotic technologies to assist and care for disabled and elderly citizens, and otherwise extend their productive lives.

Making cities more friendly for aging citizens is also key. For example, Mayor Masashi Mori of Toyama, a city of 400,000 on the Japan Sea coast, has made significant efforts to limit suburban sprawl and encourage elderly to move to the center in order to take advantage of improvements to public transportation and interact with a richer social fabric. Advanced wheeled walkers are also provided, encouraging mobility and community traditions that reinforce social cohesion.

Showcase in Kyoto
The World Health Summit Regional Meeting Asia, Kyoto 2015 will consider increasing society’s resilience by enhancing a sense of social responsibility among the medical profession. The aforementioned Dr. Sankai, as well as Mayor Mori will speak, along with numerous other leaders in the international community of health professionals. Details can be seen at <>.

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