Our first day back from Hakone is also our first properly rainy day in Kanagawa. Everyone is in rain ponchos or holding umbrellas, and we hit the subway to head to our first stop, the University of Tokyo, Hongo campus. It was the most crowded we’ve seen it on the subway!
On to Tokyo. We had an incredible session at the University of Tokyo, Hongo Campus. Taka informed me that this university is the best in Japan, so I was excited for the session. We heard from a few professors and graduate students at the school. There is too much to discuss so I’ll just bring up a few especially interesting points. While we heard about a diverse range of topics, they all centered around improving and learning about the lives of the aging population in Japan.
First we heard from a professor who discussed how to design buildings and communities from an architectural perspective to improve “aging in place”. He suggested two improvements: to create layouts that are functional for older people and foster community, and to create environments and green spaces that are pleasant. I asked him whether architecture can be designed around people with dementia, and he said the key is to design such that people do not need to move from where they have lived, as it is an agitating and confusing experience to move. If they do need to move, being somewhere nearby where they lived to maintain their surroundings and community as much as possible is important. He also said that older people like to watch the children play, so providing a community center where kids can play while the older people have an area to watch is mutually beneficial. He also discussed the Everybody’s chair project which encourages people to leave out chairs around the neighborhood so people can rest. This is done in a super aged community where around 40% of residents are aged 65 and older!
We then heard from a professor who discussed his work on frailty in the older population and how their health habits in three central domains impact frailty. The most surprising thing I saw was that the split mainly came between people who were low in all three domains versus someone who were high in at least one domain. It made less of a difference if you had a high score in 1 or 3 of the domains. I asked him about this and he said he’s particularly interested in this population, particularly how other factors may cluster in this group such as certain economic statuses.
We then heard from a woman who had done ethnography work in the Ojika Islands which are in the west of Japan. I was surprised that mental health status did not differ among high and low social grouñs. She said that the participants don’t think much about their mental health so they had trouble answering, even though the questionnaire was designed for people in Japan. It’s a good reminder that the biases we bring into our study can affect the results.
There is so much more I could write about but there were too many interesting things to fit in one blog post. In the afternoon we met with Dr. Haruka Sakamoto, who is a former WHO representative. She was basically like Google, as she knew the answers to all of our questions, so naturally we grilled her for two hours. Just a few main points as she covered so much in her time.
She discussed the age friendly cities and communities initiative with us, and went over the long-term care insurance scheme that you pay into over the age of 40. She mentioned that the government sets prices for health services, meaning the basic care price is the same wherever you go in Japan. Japan is increasing the insurance premium which primarily affects younger people, as costs are increasing. Natural delivery is subsidized by the government as it’s not covered by insurance, and IVF was also not covered until 2020.
Overall it was an extremely educational day! I learned more today more than any other day so far.
Abigail Vigderman
University of Maryland, Baltimore School of Medicine