Since 2011, the WHO Kobe Centre (WKC) has been collaborating with the Centre for Well-being and Society of Nihon Fukushi University in Nagoya, Japan, to improve metrics for evidence-based policy-making on ageing and health in Japan.
The Centre for Well-being and Society received funding from the Ministry of Health, Labour and Welfare, Japan, to develop a benchmark system to evaluate the long-term care insurance policy which has been in effect since 2000. WKC is providing technical assistance to this effort, especially to develop a tool for policy makers in Japan to assess and respond to health inequities among the older population which would be harmonized with WHO’s Urban Health Equity Assessment and Response Tool (Urban HEART).
The development of the benchmark system utilizes data from the Aichi Gerontological Evaluation Study (AGES), which began in 1999, and the Japan Gerontological Evaluation Study (JAGES). Thirty-one municipalities from all over Japan participated in the 2010/11 JAGES survey, providing information on the social and health status of over 100,000 older adults. The survey sample is designed to allow for sub-city analysis of health inequalities.
Of special note is that major cities like Kobe and Nagoya were added to the 2010/11 survey. This shows the cities’ commitment to use sound evidence to inform its decisions on how to better protect and promote the health of its elderly population.
Kondo K. (ed.) Health inequalities in Japan: an empirical study of older people. Melbourne, Trans Pacific Press, 2010.
Twenty-five municipalities have agreed to take part in the next JAGES survey. This includes the participation of the big cities of Kobe and Nagoya for their second time; the new addition of two other large cities, Yokohama and Niigata; as well as some rural municipalities with very aged populations. These locations span across Japan from the northern prefecture of Hokkaido to the southern prefecture of Kyushu. In addition to the survey data, there are also plans to pool other relevant sources of data across these municipalities to allow for further comparative analyses. This project has been recently designated as a pilot study for the Cabinet-approved programme on “Visualization of Information on Health and Long-term Care” (unofficial English translation), and is funded in part by the participating municipal governments and by grants from the Ministry of Health, Labour and Welfare and the Ministry of Education, Culture, Sports, Science and Technology (MEXT), Japan.
The objectives of JAGES 2013 are: 1) to conduct a standardized survey on risk factors and social determinants of health and frailty (i.e. need for long-term care) among elderly people for comparisons and benchmarking across municipalities, allowing for a “visualization” of priority issues; 2) to generate policy-guiding evidence on the association between frailty risk and social determinants of health based on a longitudinal analysis of data on over 100,000 elderly; 3) to evaluate the effects of frailty prevention strategies implemented by the municipalities during 2010-2013 by comparing 2010 and 2013 results; and 4) to identify good practices and the determinants of their effectiveness.