Japan is the only super-ageing nation in the world. At the same time, it is a comparatively healthy country. What can the UK learn from Japan, and vice versa? And how can we leverage the opportunity of Japan’s upcoming G7 presidency? This slide deck is part of a webinar by ILC-UK and the National Graduate Institute for Policy Studies, Tokyo, on Thursday, 9 February 2023. Speakers include: • Dr Taichi Ono, National Graduate Institute for Policy Studies, Tokyo • Professor Yoko Matsuoka, Tokyo Kasei University • Arunima Himawan, Senior Health Research Lead, ILC-UK • Professor Judith Phillips, Deputy Principal (Research) at the University of Stirling and Professor of Gerontology

1. Getting to grips with ageing:
Can Japan and the UK learn from
each other?

2. Getting to grips with ageing: Can Japan
and the UK learn from each other?
Chair: Lily Parsey
@LilyParsey
@ILCUK
Dr Taichi Ono
@GRIPS_Info
Prof. Yoko Matsuoka
Tokyo Kasei University
Arunima Himawan
@arunimahimawan
@ILCUK
Judith Phillips
@JudithEleri
@StirUni
@ilcuk
#DeliveringPrevention
Thursday, 9 February 2023
9.00am – 10.30am GMT
Virtual

3. Welcome
Lily Parsey, Head of Projects, ILC-UK
Join the conversation: @ilcuk
#DeliveringPrevention

4. Join the conversation: @ilcuk
#DeliveringPrevention
Welcome Chair: Lily Parsey, Head of Projects, ILC-UK
Active Aging in Japan
from a Historic Perspective
Dr Taichi Ono, National Graduate Institute for Policy
Studies (GRIPS), Tokyo
Active Ageing Initiatives in Japan Professor Yoko Matsuoka, Tokyo Kasei University
Healthy Ageing and Prevention Index:
Driving government action
Arunima Himawan, Senior Health Research Lead, ILC-
UK
Healthy Ageing in the UK Discussion
Professor Judith Phillips, Deputy Principal (Research),
University of Stirling and Professor of Gerontology
Q&A All
Closing remarks Chair: Lily Parsey, Head of Projects, ILC-UK
Agenda

5. Active Aging in Japan
from Historic Perspective
Dr Taichi Ono, National Graduate Institute
for Policy Studies (GRIPS), Tokyo
Join the conversation: @ilcuk
#DeliveringPrevention

6. 2021,
29.8
2021,
18.9
0
5
10
15
20
25
30
35
40
45
1950
1956
1962
1968
1974
1980
1986
1992
1998
2004
2010
2016
2022
2028
2034
2040
2046
2052
2058
2064
2070
2076
2082
2088
2094
2100
65+ as of total population (1950-2021, 2022-
2100 (estimate))
Japan UK
2021,
15.8
2021,
8.9
0
5
10
15
20
25
30
35
40
45
1950
1956
1962
1968
1974
1980
1986
1992
1998
2004
2010
2016
2022
2028
2034
2040
2046
2052
2058
2064
2070
2076
2082
2088
2094
2100
75+ as of total population (1950-2021, 2022-
2100 (estimate))
Japan UK
6
Source: World Population Prospects, 2022 (United Nations)

7. 7
https://www.populationpyramid.net/

8. 8
https://data.london.gov.uk/dataset/londons-population
-
100
200
300
400
500
600
700
0～4 5～9 10～14 15～19 20～24 25～29 30～34 35～39 40～44 45～49 50～54 55～59 60～64 65～69 70～74 75～79 80～84 85～89 90～94 95～99 100+
Age Structure, Jan. 2022 Tokyo (in thousands)
Male Female
-
100
200
300
400
500
600
700
0～4 5～9 10～14 15～19 20～24 25～29 30～34 35～39 40～44 45～49 50～54 55～59 60～64 65～69 70～74 75～79 80～84 85～89 90～94 95～99 100+
Age Structure, Jan. 2022 Tokyo (in thousands)
Male Female

9. 0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
0
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
GDP dependency ratio
Dependency ratio
(% of population
GDP (nominal)
100 million yen
Source: Population Statistic of Japan (2019), and The Financial Statistics of Social Security in Japan (2019), IPSS
Age of baby boomers
15 30 50 65

10. 10
Age of baby boomers
15 (1962) 30(1977) 50 (1997) 65(2012) 75(2022)

11. 11
“Anyone will experience aging. It is
unavoidable. (omitted)
What lies ahead of us is not only the issues
related to material wealth, money or service
provision, but also spiritual matters how we will
let our elderly people live fulfilled life. It is one
of the issues that we Japanese need to tackle
how we will challenge these problems (related
to the aging) that the humanity has never
experienced.
(White Paper on Health and Welfare,
1970)

12. “On social security that need to be addressed to
coming ageing society”
・We need to pay more attention to
the measures for social participation
not only from the perspective of
earning money but also reflecting the
increase of elderly isolated from
workplace or family due to the
progress of industrialization, etc..
Excerpts from Recommendations of Advisory Council on Social
Security (Chairperson: Kazuo Okochi)
12
(1975.12.1)

13. Introduction of public Long-term Care
Insurance system (2000)
Universal health care and pension coverage by
social insurance (1961)
Act on the welfare for the elderly (1963)
“The Gold Plan” (1989)
“The New Gold Plan” (1994)
“Free medical care for the elderly” (in 1973)
Issue of “social hospitalization” (1980’s)

14. 14
Public Long-Term Care Insurance provides services (in-home,
community, residential (facility) for the elderly with certain level
of senility/disability).
PLUS subsidizes various types of “Community Support Project”
designed and operated by municipality government.
By such mechanism, establishment of community-wide network
of mutual help for supporting daily life (see next page) is
aggressively promoted by the municipality government.

15. 15
Private
Companies Volunteers
ＮＰＯ
Cooperative
Associations
Social Welfare
Corporations
Support for
chores
Safety
Confirmation
Grocery Delivery
Truck-Marts
Meal Delivery and
Observation
Community
Association
Level
Elementary
School
Level
Municipality
Level
Social Exchange
Saloon
Say Hello
Community Cafe
Rights Advocacy
Outing support
Image of “Community Support Project
Supporting the
family carer
Conducting
Bodies
Participation of elderly themselves as provider of services is desired;
as participation would keep them active and prevent loneliness and
loss of will to live, thus lead to the prevention of care need and keep
their psychological health.

16. 16
Now we are expecting the “era of 100-years life period”.
Friday, September 16th, 2022
45,141 elderly will receive “Centenarian Award 2022”
There are 90,526 people aged 100 and over nationwide.

17. 17
Throughout the development of social policy, Japan has
learned, and is learning, a lot from the United Kingdom.
Beveridge
Report
National Health
Service
Social
Work
Normalization
Community
Care Reform
Care
Management
Social
Prescription
Minister for
Loneliness
Reablement
Aging is the challenge for any humanity, yet aging is also an
achievement by the humanity, and is providing further opportunity to
the humanity.
It is exciting that UK and Japan could disseminate positive messages
toward the aging in various occasions to the global society, that include
not only the already-aged, economically-advanced countries but also

18. 18

19. Active Ageing Initiatives in Japan
1) Ikeda-cho 2) Hagi-city 3) Hofu-city
Professor Yoko Matsuoka,
Tokyo Kasei University
Join the conversation: @ilcuk
#DeliveringPrevention

20. 20
 Social welfare Council (SWC) required older people to attend the lecture on
demographic crisis, the public service situation, the meaning of the CS project.
 Tree pillars:
• Salons for social participation and long-term prevention
• Daily life support
• Transportation support
Ikeda-cho(6,800, 43.6%, 2019)
＜Crisis＞
 The 65+ rate will exceed the productive generation rate
by 2025.
 The LTCI payment has been skyrocketing so fast that the
municipality was convinced that it could not keep people’ s health and
well-being only with LTCI.

21. Step exercise
s.
E. Recycle s.
Blow gun s.
Mahjong s. Calculating s.
News reading s.
1: Salon for social participation 2: Daily life support 3: Transportation support
13000 participants at 53 salons
Remarkable outcome: 48% reduction of LTCI payment and
36% reduction of users of LTCI during 4 years (2012-2016).
• Supporters must
attend the lecture
on CS project and
mutual aid.
• Community bus (2014)
is going around in town.
• Elderly helps elderly.
Three pillars of Community Support Project in Ikeda-cho

22. 22
District Population Ageing rate Population
dencity
Total 47,513 41.9% 68.0
① Hagi 36,896 38.9% 266.8
② Kawakami 835 50.8% 9.0
③ Tamagawa 2,606 50.8% 33.4
④ Mutsumi 1,419 55.9% 20.2
⑤ Susa 2,481 52.0% 28.5
⑥ Asahi 1,575 52.3% 11.8
⑦ Fukuei 1,701 53.7% 17.3
Hagi City(47,000 population, 41.9%, 2019) Hiroshima
●
＜Crisis & strategy＞
 the primary schools and middle schools have been closed due to the
decrease in the birthrate in the past ten years. The activity salons
were closed due to the population aging.
 The slogan of Hagi city was ‘Let promote the community
building/development through CS project!’ They held more
than 200 times’ community meetings during 3 years (2015-
2017).

23. Mutsumi vigorous Supporters club
23
• Mutsumi district: Inhabitants 1,419, 65+ =780 (55%)
• Salon
• Three salons was born after 2015 in Mutsumi district.
• Daily life support
• €0.7/30ｍ（light bulb replacement, petroleum refueling, shopping
support)
• €33（house cleaning, clearing away snow, garbage ）
• 50 volunteers (from 30s to 90s (median: 70s)
• Transportation support:
• for going clinic/hospital with a car the municipality loans out for
free.
Life
Sup
port
City
SWC
Community menbers

24. 24
 Policy maker in the municipality talked with community members
 The integrated project of prevention and shopping support
• Community members: calling the participants and support
• Shopping center firm: providing the room for exercise
• Care provider: professionals for exercise
• SW Corporation: pick-up bus
＜Crisis＞
 High premium of LTCI ＝ €42＞€40/ｍ
 Highest usage rate of day service in Japan
 This did not lead to users’ improvement
but made a change for the worse.
(Few nursing homes, many day services from outside of city）
Hofu City(116,000, 30.1%)
Hiroshima
●

25. Integrated project of prevention and shopping!
Supporters (community members)
support all the process.
10：00 €4
Pick-up bus
10：45
Exercise for prevention
Shoppoing
12：00
Lunch at shopping center
14：00
Get back to the home
• MUKO Island（1,300）in Hofu
city
• They have 4 places for exercise
全過程を住民が見守ります
介護予防と
買物支援を
一体的に提供！

26. Findings: the elements of successful initiatives
for CS project and Active Ageing
1. Recognition of demographic risk and ineffectiveness of
LTCI services
2. The passionate leading of municipalities and
community members’ initiative
3. Understanding that CS project if Community
development
4. Full participation in the community; care providers,
profitable firms, residence association, commissioned
volunteer, and so on)
26
（Matsuoka, Y., Hattori, S., 2022)

27. ‘CS project if Community development’
Older persons are
taking and enjoying
actions as the subject
of the
society/community.
They participate equally
with the professionals.
This is the state of
‘Doing WITH’.

28. Healthy Ageing and
Prevention Index
Arunima Himawan, Senior Health
Research Lead, ILC-UK
Join the conversation: @ilcuk
#DeliveringPrevention

29. Our programme of work
“The UK has also provided international leadership in the ageing
agenda, with the International Longevity Centre UK (ILC) provoking
discussions and pioneering solutions around the globe.”
- DIT, Healthy Ageing report, November 2021

30. We’ve engaged with stakeholders across the
world

31. Despite repeated commitments to prioritise prevention
action continues to lag
But across the OECD alone, countries only spend
on average 2.8% of their health budgets on
prevention.
If we increase preventative health spend by just 0.1
percentage points it could unlock an additional 9% of
spending every year by people aged 60 or over.

32. The Healthy Ageing and Prevention Index
• The Healthy Ageing and Prevention Index is a global Index that holds
governments to account on healthy ageing and prevention.
• The Index measures and ranks 121 countries on six healthy ageing and
prevention indicators including life span, health span, work span, income, the
environment and happiness.
• For the first time, this Index brings together health, wealth and societal metrics
to give us a comprehensive picture of how sustainable countries are in the
context of longer lives, and the extent to which governments are investing in
efforts to prevent ill-health.
• Aside from ranking individual countries on their performance, the Index also
ranks political and/or economic country blocs, such as G20,
EU and OECD.

33. The six indicators
• Health and Life span: these are measured at birth using life expectancy and healthy life
expectancy measures (expressed in years) respectively. Data is obtained from the WHO.
• Work span: is defined as the expected number of years spent between being economically active
and retirement (ages 15-65). Work span is expressed in years and data to calculate this metric is
obtained from the World Bank and the International Labour Organisation.
• Income: is measured by GDP/per capita using purchasing power parity with data obtained from
the World Bank.
• Environment: is measured using the Yale Environmental Performance Index (EPI) which positions
countries on a scale of 0 to 100 (100=best). The top five countries on the EPI scale are Denmark
(82.5), Luxembourg (82.3), Switzerland (81.5), the UK (81.3) and France (80).
• Happiness: positions countries on a scale of 0-10. 0-4 are interpreted “suffering”, 5-7
“struggling”, 8-10 “thriving”. Data are taken from the annual Gallup World Poll which
asks respondents to think of a ladder and asked to rate their own current lives on
the 0-10 scale. Data is obtained from the UN.

34. Developing the Index
Step 1: Countries are categorised from ‘best’ to ‘worst’ for each
individual metric.
Step 2: Once each country is categorised on all six indicators, we then
assign these indicators a numerical rank value.
Country Step 1: Life span (life
expectancy at birth,
expressed in years
Step 2: Rank
Country Y 83.4 2
Country X 82.3 14

35. Developing the Index
Step 3: Once we have the ranked values, we take the sum of these ranks
for each country to generate a country score.
• Country
Country Life span Health
span
Work
span
Income Environment Happiness Country
score
Country Y 2 4 25 4 3 3 41
Country X 14 9 11 9 17 5 65

36. Developing the Index
Step 4: Aggregated scores are then assigned a further and final rank. The
smaller the total score, the higher the rank.
Country Life
span
Health
span
Work
span
Income Environment Happiness Country
score
Rank
Country
Y
2 4 25 4 3 3 41 1
Country
X
14 9 11 9 17 5 65 2

39. Bloc Life span
Health
span Work span
Income
GDP/head
ppp $ 000s Environment Happiness Global Rank
Scandinavia 82.0 71.4 31.5 58.1 79.3 7.5 1
G7 80.9 69.5 30.5 55.3 64.7 6.8 2
EU 81.2 70.7 28.6 46.5 72.8 6.7 3
The Organisation for
Economic Co-operation
and Development 80.4 69.4 30.4 46.3 63.0 6.5 4
Americas 77.2 66.3 31.3 34.1 50.6 6.4 5
Asia-Pacific Economic
Cooperation 76.9 67.4 33.2 24.9 43.5 5.7 6
The Association of
Southeast Asian
Nations 72.2 63.6 33.4 12.8 37.6 5.4 7
G20 75.4 65.4 30.1 21.4 41.4 5.2 8
African Union 66.2 57.6 29.5 5.2 34.3 4.7 9

40. Environment and Income
1
2
3
4
5
6
7
8
9
10
11
12
0
10
20
30
40
50
60
70
80
90
0 10 20 30 40 50 60 70 80 90
Environmental
performance
(EPI)
GDP/head ppp $000s
Japan/UK

41. Happiness and Income
1
2
3
4
5
6
7
8
9
10
11
12
0
1
2
3
4
5
6
7
8
9
10
0 10 20 30 40 50 60 70 80 90
Happiness
GDP/ head ppp $000s
Japan/UK

42. Healthy Ageing and Prevention Index
• Hold Governments to account by tracking progress on prevention
through the production and launch of the digital Healthy Ageing and
Prevention Index in May alongside the 76th World Health Assembly.
• Engage global health leaders to move from commitment to action
on preventative health.
• Build strong relationships with 20 leading organisations to form a
Healthy Ageing and Prevention Coalition to demand action and hold
governments to account on preventative health.

43. Professor Judith Phillips
Deputy Principal (Research) at the University
of Stirling and Professor of Gerontology
Join the conversation: @ilcuk
#DeliveringPrevention

44. Getting to grips with ageing: Can Japan and the UK learn
from each other?
ILC-UK-Japan
Prof. Judith Phillips
The Heathy Ageing Challenge:
Social, Behavioural and Design Research Programme

45. Healthy Ageing Challenge
Healthy Ageing Challenge
Vision
To enable businesses, including social
enterprises, to develop and deliver products,
services and business models that will be
adopted at scale which support people as they
age.
This will allow people to remain active,
productive, independent and socially connected
across generations for as long as possible.

46. Healthy Ageing Challenge
£98 MILLION
total Challenge investment
121PROJECTS
funded from 572 applications
7 investor partners
Including a first with charities
£46m
co-investment from
industry
31
universities
engaged
1st ISCF challenge
to appoint an external
research director
Our story so far
AUKRI-030822-OurStorySoFarHACImpactReport2022.pdfat:
https://www.ukri.org/publications/publications-our-story-so-far-

47. A Healthy Ageing innovation pipeline supported
by research and a community of practice
Healthy Ageing Challenge
Research
Social, Behavioural and Design Research Projects
with a focus on supporting businesses to improve their impact
Community of Practice
Supporting active learning and linking to over 40 UK research centres with an interest in ageing including
The National Innovation Centre for Ageing and the DesignAge Institute
Catalyst
Awards
Helping
entrepreneurial
researchers develop
spin-outs –
particularly from the
arts, humanities &
social sciences
Social Ventures
SBRI
100% investment in
solutions developed by
social enterprises to
scale up
Designed for
Ageing
Supporting business
innovations focused
on user-centred
design
Trailblazers
Larger ‘service
integration’ collaborations
aiming for impact at scale
Investment
Partnerships
Working with private
and third sector
investors to support
SMEs
Covid-19 Fast Response
Rapid innovation for impact

48. Research with a focus on translation to enable
business impact
• DesHCA - Designing Homes for healthy Cognitive Ageing: co-
production for impact and scale (Stirling University)
• ENLIVEN - Extending active life for older people with cognitive
impairment and their families through innovation in the visitor
economy of the natural environment (Exeter University)
• SPACE - addressing cognitive health inequality by investigating
the impacts, and possible mechanistic pathways, of urban
environments on healthy ageing and cognitive health, and on
diverse individuals and communities. (Queens University
Belfast)
Social Behavioural Design Research Programme
@Ageing_SBDRP

49. Living environments for people with dementia:
Why a Scotland/UK – Japan design for ageing network?
Shared challenges re increasing numbers of people living with dementia
UK has at least 850,000 people living with dementia, projected to increase to 2m+ by 2051
Japan has 4.6m, projected to increase to 7.3m by 2025 (the world’s most rapidly ageing population)
Shared policy focus
National and local dementia strategies in the UK: Prime Minister's challenge in England (the best place to live with
dementia, doing the best research) ; Scotland’s National Dementia Strategy (x3)
Japan: Orange Plan from Japanese Government highlights support resources, drug development, home care and
family care support
Emphasis on living better with dementia, staying at home as long as possible, support for carers, focus
on the person living with dementia and their quality of life and integration into communities
Japan 2005 Dementia Friends programme (UK 2013), changing attitudes
UK focus on designing built/outside environments (DSDC work in Japan has helped promote interest, and these
issues now attracting increasing attention)

50. Partners:
• University of Stirling (lead)
• Keio University
• Shizuoka University
• Tokyo Metropolitan Institute of Gerontology
• Mediva Japan
• Health and Global Policy Institute Japan
• Scottish Care
• Generations Working Together

51. Our questions:
• What environmental design principles can enable people living with dementia to live the lives they
wish, at home, in care facilities, in communities and public spaces?
• What are the outcomes of improved environmental design?
• Can improved design mitigate some of the economic and social costs of supporting people with
dementia?
• What are the socio-economic, cultural and policy similarities and differences between the UK and
Japanese contexts?
• What are the internationally relevant lessons offered by the UK-Japan contexts and the comparisons
between them?

52. View of
development

53. ‘Gran Creer’ Residences, Setagaya, Tokyo
• Masterplan development in
Nakamachi – a suburb of Tokyo
• 255 General apartments
• 172 Independent Senior Residences
• 72 Bed Care Centre
• 24hour respite care centre
• Kindergarten
• Community café, facilities

54. THANK YOU
If you’d like more information on the Social Behavioural &
Design Research Programme please contact: Prof. Judith
Phillips, Research Director: Judith.Phillips@stir.ac.uk
@Ageing_SBDRP
Social Behavioural Design Research Programme

55. Discussion
Lily Parsey, Head of Projects, ILC-UK
Join the conversation: @ilcuk
#DeliveringPrevention

56. Closing remarks
Lily Parsey, Head of Projects, ILC-UK
Join the conversation: @ilcuk
#DeliveringPrevention