‘By ELLEN ENDO
Part II of a two-part series.
The impact of global aging trends was examined by experts from both the U.S. and Japan during the Healthy Aging Summit held April 12 at the University of Southern California’s Ethel Percy Andrus Gerontology Center.
The summit, open to the public, brought together leading gerontologists, representatives from the Japanese American community as well as a public policy expert from Japan. The Institute for Healthy Aging at Keiro presented the event in partnership with the USC Davis School of Gerontology with the support of Consul General Junichi Ihara.
Sponsors included the American Association of Retired Persons (AARP) and the Aratani Foundation.
Some 21.5 percent of Japanese Americans, about one in five, are over age 65, a rate that is slightly higher than Japan’s 19.5 percent but significantly greater than the United States’ overall 12.5 percent, or about one in eight.
The U.S. is gradually but steadily approaching the older population levels found in Japan and among America’s Nikkei.
Eileen Crimmins, Ph.D., AARP Chair of Gerontology at USC, stated that, as life expectancy increases and the post-World War II Baby Boomers (those born between 1946-1964) pass through, the U.S.’ older population will rise at an unprecedented rate. She pointed to advances in scientific research, widespread education about health, and fewer births as key factors in the rise in the number of older adults.
As the U.S. population ages, the retirement age will have to be raised, Dr. Crimmins added. “We will keep people in the work force longer.”
Simultaneously, summit participants discussed the increased need for a sustainable health and long-term care system for older adults. But, Dr. Crimmins says, “The health of Americans is not good.” Prevalence of heart disease among men over 65 in the U.S. is about 37 percent in males and 28 percent in females. In Japan, about 16 percent of males over 65 report the prevalence of heart disease, with Japanese women slightly higher at approximately 18 percent.
Diabetes is also more prevalent among older adults in the U.S., with 22 percent reported among males and 17 percent among females. Whereas, according to studies, the diabetes occurrence in Japanese men is around 10 percent, and about 8 percent in women.
Research shows that prostate cancer is rare in Japan, while 16.7 percent of males in the U.S. will be diagnosed with the disease sometime in their lives.
However, strokes occur more often in males in Japan (12 percent) than in American men (9 percent). Women in Japan fared better than American women — 7 percent versus 8.5 percent.
The breast cancer rate in the U.S. is approximately three times higher than Japan, but the rate of survival — 81 percent versus Japan’s 65 percent — is greater in America, according to a 2002 study.
A contributing factor to America’s poor health statistics is obesity. Dr. Crimmins notes that the rate of obesity is the highest in the world (37.5 percent). In Japan, obesity is rare (about 2.5 percent), the lowest of any developed country.
When it comes to blood pressure, however, Americans fare better. Japanese males are more likely to have high blood pressure (66 percent) than American males (38 percent), studies indicate.
An overview of how Japan supports its social security system, comprehensive community care, accountability, and long-term care was presented by Professor Taichi Ono of the Graduate School of Public Policy with the University of Tokyo. Ono, who received his MBA from UC Berkeley, represented the Japan Ministry of Health, Labor and Welfare (MHLW).
With the longest life expectancy — 79.59 for men and 86.44 for women — Japan is the “frontrunner” in terms of global aging, Ono stated. Its population is aging at a rapid rate, and the birthrate is low, causing the population to start to decrease. Among other issues, this means that the tax revenue is decreasing while the need for long-term care and health services is increasing.
Traditional family-support function is diminishing, but many family members are still the primary caregivers. According to Ono, about half of those caregivers are over 60, and more elderly are living alone.
Japan began to offer universal health care and public pension (similar to Social Security in the U.S.) in 1961. Focusing on sustainability, the government reformed its system in the mid-1980s and by 2002 had increased individual co-payments to 30 percent.
Each municipality becomes the insurer and sets its own premium rates, using its residence (income) tax revenue as a guide. Efforts to reform senior care with more emphasis on preventive services began in 2005. There is also a move to regionalize care with the goal of establishing comprehensive community-based support centers in each junior high district, said Ono.
As for the state of senior care in America, summit speaker Kathleen Wilber, Ph.D., the Mary Pickford Foundation Professor of Gerontology, declared that the U.S. “is woefully unprepared for aging Baby Boomers.”
According to an AARP survey published in 2997, 87 percent of older adults are assisted by unpaid caregivers such as family members. Typically, they may receive only about half of the care that is recommended by medical professionals.
Keiro Senior HealthCare President and CEO Shawn Miyake echoed Dr. Wilber’s concerns, adding, “Our community is challenged with a large aging population. What is happening in our community foreshadows what will happen in the greater population.”
The summit, held in conjunction with Keiro’s 50th anniversary, was organized to shine a light the complexity of issues facing the U.S. by taking a closer look at how Japan and the JA community are tackling the burgeoning senior numbers. Paradigm shifts have occurred while Keiro and similar senior care facilities strive to serve as a model for a healthy community.
Miyake predicts that the needs of the elderly will double by 2050. Education about and the practice of healthy living are the best way to ensure that our systems are not overburdened, he advises.
“Historically, Japan has learned from the U.S.,” Miyake pointed out, “but both the U.S. and Japan could and should lead the world together to help realize a safe, healthy, and content life for the elderly.”