Its low-tech but clever approach could serve as a model for countries like China and South Korea facing a similar situation
An elderly Japanese woman (left) exercises at a day care facility for senior citizens in Tokyo on April 6, 2022. (Photo: AFP)
For decades Japan has been facing a demographic crisis that is unprecedented in modern times. So much so that countries like China, which is also facing a significant demographic challenge as its population ages and its birth rate declines, are closely observing its efforts to address this pressing issue.
With a rapidly aging population and a plummeting birth rate, Japan’s economic, social, and infrastructure stability has been threatened. This dire situation has captured the attention of politicians and media alike around the world, including tech entrepreneur Elon Musk, who famously remarked that "aging demographics are the single biggest problem facing developed economies like Japan."
According to a recent estimate by the National Institute of Population and Social Security Research, Japan's population will dip below 100 million people in 2056. By 2070, the national population is expected to shrink 30 percent from current levels to 87 million. These are alarming statistics.
To combat the problem, the Japanese government has implemented several policies and initiatives aimed at promoting childbirth but also at supporting the elderly population. For example, the government has introduced subsidies for families with children and expanded the availability of childcare facilities. Additionally, the government has increased funding for healthcare and eldercare services to support the growing aging population.
But one innovative solution to support the elderly population is the use of technology to provide remote healthcare services. In Nagasaki prefecture an innovative system has been recently developed that allows doctors to remotely monitor the health of elderly patients using an online platform.
Nagasaki is the province with the most Catholics in Japan (60,000) after Tokyo but by far the highest in percentage. The percentage of Catholics in the whole of Japan is a mere 0.34 percent.
"Being 'too bothersome' was one of the most common reasons for not attending health check-ups"
This system enables patients to receive medical care without leaving their homes and has helped to reduce the burden on healthcare facilities. This is especially true in the many remote islands, like the Goto Islands, a group of five main islands located on the outer southern edge of the Sea of Japan also notorious for being the place where the kakurekirishitan (hidden Christian) would find refuge from religious persecution. But the Goto Islands are not the only ones.
When we think of Japan we mostly think of the main Honshu island. We rarely contemplate that Japan is indeed an archipelago comprised of over 6,800 islands, but only around 400 of them are currently inhabited. Of these inhabited islands, many have a very small population, with some having less than 50 residents. These remote islands often face unique challenges in terms of access to resources, healthcare, and education, and are a key focus of Japan's regional development policies.
One of the main problems with living in a remote location is the difficulties associated with attending regular hospital visits.
As it happens the attendance rate of health check-ups under the Municipal National Health Insurance in Nagasaki Prefecture was found to be very low at only 39.6 percent in 2018. To investigate this issue, a self-administered questionnaire was conducted in August 2020 in three municipalities of Nagasaki prefecture.
The questionnaire included socio-demographic questions about daily lifestyle habits, current medical treatment, self-rated health, and health check-up-related questions. Statistical analyses were done on two age groups: 40−59 and 60−74 years.
Results showed that being "too bothersome" was one of the most common reasons for not attending health check-ups among respondents who did not undergo one in the year prior to the study. This is especially due to the fact that many residents lived in remote locations where access to hospitals was indeed inconvenient. In some places on Goto Island, residents have to drive almost an hour to get to the closest hospital. Others needed to take a boat.
It was found that the most vulnerable were middle-aged and older men, such as those living alone and with low economic status. They were found to be less likely to undergo health check-ups. To address this problem in a traditional way, that is with public health nurses who could make home visits to increase awareness of individual health conditions, was not feasible, either due to the lack of workforce and also the long distance to be covered.
This is how the new mobile clinic project started in January this year, using a multi-tasking vehicle equipped with medical devices and with a specialized nurse on board.
The vehicles are sent to patients' homes, primarily those who have trouble getting to medical facilities, and the patients receive online consultations from doctors at the medical facilities. The patient can see the doctor face to face through a monitor inside the vehicle.
The mobile clinic project is a feasible solution to increase awareness of individual health conditions, especially for those who are socioeconomically disadvantaged and living in remote locations. This low-tech but clever approach could surely serve as a model for other countries — not only China but also South Korea — that are now facing similar demographic problems.
*The views expressed in this article are those of the author and do not necessarily reflect the official editorial position of UCA News.
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