Shuttered shopping streets have become known as a symbol of a declining regional economy. During the period of high growth, these shopping districts were regarded as the centers of the respective cities or towns, where a plethora of lively activities took place. Now, they are seeing customer and visitor numbers gradually fall due to the trends of the times such as the opening of large-scale commercial malls, changes in lifestyles and business customs, and the aging population along with the low birthrate, as well as the burst of the bubble economy. It is not just a local phenomenon that is occurring in some shopping streets, but an ongoing issue that may result in the real decline of municipalities. According to a survey on the actual situations of shopping streets conducted nationwide by the Small and Medium Enterprise Agency in 2012, ... [Read more]

The issue of “shuttered shopping streets” is a symbolic phenomenon of a declining regional economy, one of the greatest challenges for Japan, which is suffering from a shrinking population. It refers to a situation in which a shopping district that had previously been prospering changes into a depopulated area where the shutters are kept pulled down even during the daytime, as the number of closing shops increases due to customer situations or aging shop owners. These towns will become desolate if nothing is done. However, people have started to take on efforts to revitalize them in many parts of Japan. In this volume, No. 30, the significant achievements of such efforts are featured in “New Plan for Reforming... [Read more]

The Demise of the Regions and the Elderly Population Crisis in Tokyo Is One and the Same Problem
Masuda: In June, the Japan Policy Council published a strategy for avoiding a crisis in the elderly population in the Tokyo area. In the future, the elderly population in the Tokyo metropolitan area (Tokyo, and Saitama, Chiba and Kanagawa Prefectures) is expected to increase rapidly. I must apologize for repeating things that the governor is already well aware of, but the population aged 75 and older is expected to increase by 1.75 million in the next ten years up to 2025. This would hammer the medical and nursing care field. The shortage of facilities for medical and nursing care would assume more serious proportions, but this problem is actually not limited to the Tokyo metropolitan area because any strengthening of the medical ... [Read more]

Buying goods from foodstuffs to daily necessities at a convenience store close to our home seems a matter of course when we get used to living in an urban area. In reality, however, “people with a shopping handicap” who experience inconveniences in day-to-day shopping are growing in population segments centered on elderly persons. According to the Report by the Study Group on the Role of Distribution Systems in Community Infrastructure put together in 2010 by a research team at the Ministry of Economy, Trade, and Industry, there were about 6 million people with a shopping handicap aged 60 or older across Japan. These persons lived primarily in two areas – rural districts where depopulation has advanced and the outskirts of urban communities where former “new towns” and the like are located. According ... [Read more]

There is currently an atmosphere in and around Japanese universities of innocently agreeing to what is termed the “globalization” of universities. Since even someone as obtuse as myself can manage to sense it, I think that this atmosphere must be totally pervasive. Certainly, if you pay a little attention and take a look around you can see that, in the spaces where discourse on the role of universities takes place, the problem of globalization is being raised repeatedly. Unfortunately, however, you rarely come across an opinion that’s worth listening to. On one hand, when views on globalization are communicated from within a university, in most cases it is either by the people that represent that university, or by those responsible for its globalization. Naturally, there is no way that messages issued by people in these kinds of positions are going... [Read more]

The era of multiple deaths is coming in Japan. There were around 1.2 million deaths in 2014, but 2025 is projected to see annual deaths of 1.6 million. Cancer, which comes at the top of the rankings of causes of death, is said to be a national disease, and 50% of Japanese nationals suffer from it. Currently, one in three people die of cancer, but the percentage is anticipated to reach 50% going forward. ... [Read more]

One of major issues concerning end-of-life care for severely frail elderly is what to do when they can no longer eat even with assistance. The major trend in Japan in the 1990s was the use of feeding tubes when severely frail elderly could no longer eat. For example, there was a hospital that created a policy of “choosing natural death when severely frail, bed-bound elderly with advanced dementia can no longer eat.” The hospital came in for some harsh criticism, saying that the hospital was practicing a policy of“passive euthanasia” by withholding tube-feeding that could enable elderly people to continue to live. Today, nearly twenty years later, there have been an increasing number of media reports in recent years claiming quite the opposite of what newspapers argued in the 1990s. These reports present skeptical views about the utilization of artificial feeding, such as the gastrostomy, in elderly people living the final phase of their lives, saying that although such treatments could enable the elderly to continue to live for some more time in some cases, they could undermine their dignity as human beings. In particular, PEG tube-feeding has advantages over other types of artificial hydration and nutrition (AHN), and a dramatically increasing number of people have been using this treatment. ... [Read more]

With the world’s highest average life expectancy, Japan is facing population aging. In this situation, the entire society is bewildered by this rapid change. Population aging inevitably leads to changes in medical care. The issue of death just ahead of that is considered to be a sacred cow, and if people attempt to discuss the issue, they face a barrage of different views and are unable to make progress with their arguments. If this issue is left unsolved, however, things will get even worse. Japan is the world’s largest population-aging country. The major indexes for aging society are the percentage of population aging, the average life expectancy and the rapidity of population aging, and Japan is number one in the world in all these indexes. Japan has reached over 25% in terms of percentage of population aging. ... [Read more]

Now that Japan has become a major country of longevity in the world, social security system reform has long been one of the most important national administrative issues. The Council for the Promotion of Social Security System Reform is currently holding a broad range of discussions from a cross-disciplinary perspective with a focus on 2025, when the baby boomers will reach the age of more than 75 years. However, it is the issue of terminal care that is still left behind when medical and nursing care issues are being considered. Japan’s average life expectancy is the highest in the world, and the percentage of population aging (the ratio of the population aged 65 or over to the entire national population) is over 25%. The number of deaths is also increasing along with this trend, with about 1.2 ... [Read more]

Mark Twain said with humor, “The only two certainties in life are death and taxes.” However, few people attempt to look straight at this undoubted reality, especially the latter. With the technological development of life-prolonging medicine, only “life prolongation” comes to the fore, and it is said that old people are abused in terms of terminal medicine in the name of medicine. I had the opportunity to listen to reports about terminal medicine from two experts on medicine for the elderly at a trustees’ meeting of the Japan Productivity Center that was held in late September 2015. The trustees who attended the meeting showed keen interest in their vivid explanations about reality. The lecturers were Hokkaido Chuo Rosai Hospital Director Miyamoto Kenji and Sakuradai Koujinkai Hospital ... [Read more]