Aging 150 Year Old Japanese in Abundance – Health Secrets and Population Issues

If you want to live forever, try moving to Japan and living like the Japanese.  More than 77,000 missing Japanese residents are at least 120 years old according to government records.  In an eye-opening case of bureaucratic oversight, Japan’s Justice Ministry recently announced that more than 234,000 people age 100 or older in government records were actually missing and probably no longer living.  In many cases, relatives were continuing to collect pensions on behalf of the deceased.

Secrets to Japan’s Long Life Expectancy | Diet, Lifestyle, and Health | Tough Work Conditions | Effective Healthcare | Demographics | Dramatic Population Shift | Policy Recommendations

Secrets to Japan’s Long Life Expectancy

Japan is well known for having the world’s longest life expectancy at more than 82 years.  According to the handy 2010 Economist Pocket World in Figures, one of GS’ favorite resources, Japan leads the world in population aged 80 and over (6.1% of Japan’s roughly 128 million people), population aged 60 and over (29.7%), and median age (44.4 years).  The recent government revelation makes one wonder a bit about the precision of some of these data, though GS honestly isn’t familiar with the actual accounting or any verification procedures.

Japanese Diet, Lifestyle, and Health

Fish and Soy

Japan’s long life expectancy is frequently attributed to a healthy diet rich in fish and soy protein and low in fast food and processed snacks.  Japanese annually consume about 80 percent of the world’s catch of Atlantic and Pacific bluefin tuna.  In 2001, a giant 440-pound tuna brought a record $220,000 at auction at Tokyo’s massive Tsukiji seafood market.

Portion Control

In addition to Japan’s love affair with fish, relatively small portions tend to characterize a healthy Japanese diet. According to Naomi Moriyama, co-author of Japanese Women Don’t Get Old or Fat: Secrets of My Mother’s Tokyo Kitchen, the average Japanese person eats about 25 percent fewer calories per day than the average American. Japanese are among the many nationalities that have a hard time overcoming their surprise at the generosity of typical U.S. serving sizes.

Food Costs

The high cost of food in Japan is one factor behind the inclination to portion control.  A pair of highly coveted Yubari melons from the northern island of Hokkaido sold for a record $26,000 at auction in 2008.  The price of more everyday fruits has traditionally been driven up by highly demanding consumers and equally creative growers.  Japanese shoppers long expected pristine specimens with perfect proportions and no blemishes.  Japanese farmers were willing to oblige by painstakingly wrapping individual fruits still on the tree in protective nets and concocting exotic growing techniques, like spraying fruit with homemade elixirs to achieve a more desirable flavor.

On the other hand, the Japanese diet is not all about sushi and tofu and dainty portions.  Common Japanese dishes include fine fried fare like tonkatsu (deep-fried cutlets or fillets) and cream-filled korokke (croquettes).  All-you-can-eat restaurants and specials are easy to find.  An endless array of cooking shows in the food-crazed nation regularly glorifies the virtues of fat through close-ups of succulent, dripping pieces of grilling meat.

Okinawa Diet and Fast Food

Over time, fast food and other less healthy choices have also come to account for a growing portion of many Japanese’s diets.  In a 2004 NYT article, Norimitsu Onishi wrote about the relationship between Okinawans’ growing waistlines and the influence of adopting American eating habits from the large U.S. military presence.  The prefecture’s fall from grace as the Japanese region with the longest life expectancy to the 26th spot in the ranking was considered serious enough to prompt “The Great Citizens Campaign to Lose Three Kilograms”.  Many of Onishi’s subjects openly attested to falling hard for the allure of American-style fast food.  McDonalds opened its first company-owned, Japanese franchise in Okinawa in 1976.  At the time of the article, “residents of Naha, Okinawa’s capital, spent 46 percent more of their household budgets on hamburgers than residents of Japan’s other prefectural capitals, 60 percent more on bacon, three times more on processed meat, and 4.5 times more on canned foods.  They spent 49 percent less on salad and 71 percent less on sushi.”

Okinawa’s weight issues cannot be solely blamed on American-influenced dietary habits.  Many Okinawans are less active than other Japanese because they mostly get around by car due to the lack of an extensive public transport network found in most major Japanese cities.  Despite Japan’s limited interest in fitness and gym memberships, most Japanese who rely on public transportation get more exercise than those who use cars as their primary mode of transport.

Low Obesity by World Standards

One clear upside of a healthy diet and active lifestyle is a strikingly low obesity rate.  Only 3.6 percent of Japanese are obese versus 32 percent of Americans.  While the U.S. is an outlier, Japan’s rate also compares very favorably with other countries, including: Australia (19.3 percent for men and 22.2 percent for women), Argentina (19.5 percent for men), England (23.6 percent for men and 24.4 percent for women), and Germany (21.0 percent for men).

Japan’s Tough Work Conditions

It’s worth noting that Japan’s long lifespans come in the face of a number of cultural obstacles to healthy living.  The country has some of the longest working hours in the world.  In many cases, work obligations continue after leaving the office in the form of nearly obligatory outings (tsukiai) with co-workers that frequently involve generous quantities of alcohol.  The Japanese language has a word, karoshi, that identifies dying from over-working.  Japan also has one of the world’s highest suicide rates.  It doesn’t seem surprising that Japan comes in 16th in the Economist’s world ranking of most smokers, with per capita daily consumption averaging 5.3 cigarettes.  By comparison, Spain is the only advanced western country to crack the top 20 at 6.0 cigarettes per person per day.

Due to ongoing struggles and structural changes in Japan’s economy, many Japanese are also being forced to burn the candle at both ends by taking on two or three jobs to make ends meet.  These jobs are often contract or temporary positions that do not come with the same benefits as regular full-time jobs.  On the upside, some people are finding a way to make these circumstances work for them by starting side businesses that could help facilitate the transition to a more flexible, dynamic economy.

Effective, Universal Healthcare

One reason Japanese life expectancy seems to hold up so well in spite of such strains is the country’s highly effective, universal, private health care system.  Newsweek recently ranked Japan number one on its list of the ten top countries for healthcare in a feature about the best countries in the world.  Japan leads world rankings in avoidable mortality with the best recovery rates form nearly all major diseases.

Moreover, these results come from a universal, private system that spends about $3,500 per person on annual medical costs, less than half of the $7,400 the U.S. spends annually to cover a significantly smaller percentage of the population.  Despite achieving lower costs, Japan allows longer hospital stays and leads the world in the highest number of hospital beds per 1,000 people at 14.0 beds.  All other countries, including those with socialized healthcare come in far lower, such as: Finland (6.8 beds), France (7.3 beds), Germany (8.3 beds), and Russia (9.7 beds).

Japan’s Demographics

Other than a long life expectancy, the two other main reasons Japan’s population isn’t getting any younger are the country’s low fertility and immigration rates.

Low Fertility Rates

Japan’s fertility rate is estimated to stand at about 1.21 in 2010 (versus 1.37 in 2008).  This level is far below the replacement fertility level of 2.1 that is needed to maintain a stable population.  A number of other countries are also grappling with fertility rates that contribute to a shrinking population, including: Austria (1.39), Italy (1.31), Portugal (1.49), and Spain (1.31), among others.  The U.S. is close to replacement level at 2.05.

As this international comparison shows, Japan’s low birth rate is part of a broader global trend that comes both with improved standards of living and as a consequence of having an advanced economy.  However, the problem is exacerbated in Japan by abnormally low net migration, among other factors.

Insular Immigration

Japan’s net migration rate and low percentage of foreign-born residents and citizens attest to its insularity.  Net migration refers to the difference between residents migrating to and from a country.  A positive number indicates more people are entering than leaving leading to a corresponding increase in population.  Net migration in Japan is near zero.  By comparison, net migration is significantly positive in other economically advanced nations, including: Australia (6.23), Canada (5.63), Germany (2.19), Italy (2.06), Netherlands (2.46), Spain (0.99), the U.K. (2.16), and the U.S. (4.32).  The registered foreign population in Japan accounts for less than 2% of Japan’s total population, with nearly everyone else being native born of Japanese ancestry, other than the sticky issue of residents of Korean descent.

Dramatic Population Shift

A dramatic population decline is predicted to be the critical culmination of Japan’s large elderly population, low birth rate, and limited immigration.  The Economist predicts Japan’s population will decline by an average of 0.3% per year over the period 2010 to 2015.  While this might not sound like a lot, the long-term effects of this trend and its consequences are staggering.  Japan’s economy is forecasted to contract by more than 25% from about 128 million today to 95 million in 2050.  The chart below from the Economist illustrates this contraction and the remarkable aging of Japanese society from 1950 to 2050.

This population shift places an onerous burden on Japan’s economy and society.  The number of workers to support each social security recipient has fallen from ten in 1950 to four in 2000 and is projected to further decline to two by 2025.

Policy Recommendations

On the population front in Japan, Japan needs to take any steps it can to address the mismatch in the age distribution and negative implications for domestic demand and economic growth.  One approach could involve expanding incentives and fostering social conditions and attitudes that make having more children more desirable and feasible.  Another long overdue action would make the country more open and friendly to immigration and foreign workers by, for example, loosening residency and citizenship requirements and providing more equal access to the benefits enjoyed by native Japanese citizens.  The country also badly needs to find a more market-based approach to generating a reasonable return on the trillions of dollars in individuals’ postal savings accounts that have earned near-zero interest for decades.  On the upside, Japan’s effective healthcare system, legacy of long-term employment, and high savings rate should help it deal with aging issues in the near term.

On the health front in Japan, the government could think about taking action to promote a healthy lifestyle.  It could run a public health campaign extolling the virtues of a traditional Japanese diet high in fish and soy protein, which could also help preserve the culture in the process.  On the other hand, the campaign would need to be careful not to cross the fine line into exclusionary, nationalistic territory.  It could also promote an interest in fitness through promotional and educational efforts and offer tax incentives for meeting public health goals, such as not smoking and exercising.

For other countries, including the U.S., the challenge of promoting healthy eating habits seems more difficult and, at the same time, more important.  Public education needs to do as much as possible to teach and ingrain the fundamentals and benefits of leading a healthy lifestyle.  Health and gym classes and student programs should provide engaging instruction on healthy eating and exercise that get young peoples’ attention and lead to lasting lifestyle habits.

In the U.S. and elsewhere, it would also be worthwhile to take a page from the Japanese healthcare system by ensuring universal coverage and trying to put some limits on the quick service, in-and-out nature of excessively bureaucratic and paternal managed care systems.

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Sources:

The Economist.  Cloud, or Silver Linings? July 26, 2007;  Go Forth and Multiply a Lot Less.  October 29, 2009; A Slow-burning Fuse.  June 25, 2009.

Kashiwazaki, Chikako and Tsuneo Akaha.  Japanese Immigration Policy: Responding to Conflicting Pressures.  Migration Information Source.  November, 2006.

Kato, Mariko.  Experts Say Japan Must Change How It Is Handling Low Birth Rate.  The Japan Times Online.  January 5, 2010.

Kingston, Jeff. Contemporary Japan: History, Politics, and Social Change since the 1980s (Blackwell History of the Contemporary World).  Wiley-Blackwell.  328 pages. August 23, 2010.

Onishi, Norimitsu.  On U.S. Fast Food, More Okinawans Grow Super-Sized.  New York Times.  March 30, 2004.

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