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An evaluation of fertility- and migration-based policy responses to Japan's ageing population.

ABSTRACT: Japan's ongoing struggle with rapid ageing is well known. Fertility and migration policies have both been proposed as solutions to Japan's ageing population. We used stock flow population models to estimate the impact of hypothetical fertility and migration policy interventions on measures of aging in Japan from 2015 to 2050. We evaluated policy models based on the Old Age Dependency Ratio (OADR) they produced at the specified end date. Start dates ranged from 2020 to 2030 to assess the time horizons of individual policies. Fertility policies were found to be highly time dependent and only slowed the rate of increase of OADR. It would require a Total Fertility Rate far above replacement levels to compensate for Japan's already aged demography. Migration policy was less time dependent. However, such measures would require unprecedented, and ultimately unrealistic, volumes of migration over coming decades in order to reduce Japan's OADR. Our results suggest that fertility and migration based policy responses will be unable to significantly reduce Japan's OADR or reverse Japan's ageing population within the next few decades. Japan should focus on activating its human capital through the prolongation of working lives, increasing participation, and improving productivity within the Japanese labour force to mitigate and adapt to the inevitable effects of ageing populations.

SUBMITTER: Parsons AJQ

PROVIDER: S-EPMC6300274 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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An evaluation of fertility- and migration-based policy responses to Japan's ageing population.

Parsons Alexander J Q AJQ Gilmour Stuart S

PloS one 20181219 12

Japan's ongoing struggle with rapid ageing is well known. Fertility and migration policies have both been proposed as solutions to Japan's ageing population. We used stock flow population models to estimate the impact of hypothetical fertility and migration policy interventions on measures of aging in Japan from 2015 to 2050. We evaluated policy models based on the Old Age Dependency Ratio (OADR) they produced at the specified end date. Start dates ranged from 2020 to 2030 to assess the time hor ...[more]

PMID: 30566513

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Project description:IntroductionIt is essential to establish appropriate medical quality metrics and make improvements to safely and efficiently deliver optimum emergency medical services. The Ministry of Health, Labor and Welfare (MHLW) recommends prefectures to establish numerical quality metrics in their regional healthcare plans (RHCP). The 7th RHCP was issued by the MHLW in 2017 along with a notice of planning in covering the six-year period from 2018 to 2023. In this descriptive study, the emergency medicine policies in the 7th RHCP of each prefecture were analyzed from a quality improvement perspective.MethodThe authors examined the chapters on emergency medicine in the RHCPs of 47 prefectural governments for the overall structure, cost-benefits, and connection to community-based integrated care systems. The type and number of clinical measures listed as numerical metrics and their classification methods were emphasized.ResultRegarding the overall plan structure, 40 prefectural governments began their description with an analysis of current surroundings. In total, 24 prefectural governments mentioned community-based integrated care systems but none mentioned cost-benefit analysis. Altogether, only 43 of 47 prefectural governments (91%) indicated numerical metrics. The maximum number of numerical targets for quality measures by prefecture was 19, the minimum was 0, and the median was 4 (IQR: 3-6.5); there were 220 metrics in total, with 82 structural, 96 process, and 42 outcome measures. Additionally, 13 prefectures (28%) classified quality measures according to the MHLW's guidance, 6 (13%) used their own classification manner, while the others did not classify their measures.ConclusionsThere were significant differences in emergency medicine policies and quality metrics among the prefectural governments. Further research is needed to develop and establish more comprehensive and appropriate metrics based on a common methodology to improve the quality of emergency medicine.

Project description:BackgroundHealthy ageing is a complex construct which involves multiple dimensions. Previous studies of healthy ageing have focused only on measuring the intrinsic capacity of the older person. The objectives of this study were to design a multidimensional model of healthy ageing and to identify its determinants from national data in Ecuador.MethodsA cross-sectional analytical study was carried out from the National Survey of Health and Well-being of the Older Adult, 2010. Sample was 1797 adults aged 65 years or more. A multidimensional model was designed based on the World Health Organization's concept of healthy ageing. For the analysis, two groups were created: a healthy ageing and a less healthy ageing group. Bivariate and multivariate logistic regressions were performed to analyze the probability of belonging to the healthy group according to sex, age, area of residence, level of education, perceived health status, perceived life satisfaction, and poverty by income level.ResultsThe 53.15% of the sample was classified in the healthy ageing group. Women and the poorest older adults were less likely to be in the healthy ageing group (OR 0.58; 95% CI 0.464-0.737; OR 0.44; 95% CI 0.343-0.564). Older adults with secondary education or higher, who considered their health as excellent and who were satisfied with their life, had a greater probability of being in healthy ageing group (OR 2.61; 95% CI 1.586-4.309; OR 28.49; 95% CI 3.623-224.02; OR 0.23; 95% CI 0.165-0.341).ConclusionsThis study contributes with a multidimensional approach to healthy ageing. It proposes to evaluate the intrinsic capacity of the individual, the social and political environment and the interaction with it, through indicators that discriminate who are ageing in a healthy way and who are not. By using this model, it was identified that gender and economic situation seem to play an important role on heathy ageing of the Ecuadorian population. Public policies are necessary to promote healthy ageing, especially focused on improving socioeconomic conditions and gender equity.

Project description:BackgroundMajor haemoglobinopathies (MH), such as thalassaemia syndromes (Thal) and sickle cell disorders (SCD), are genetic defects associated with chronic anaemia and other complications. In Europe, MH are rare diseases (RD) but their prevalence is significantly growing in many countries due to mobility and migration flows. This creates a growing health problem in the EU that has not yet been effectively addressed by Member States (MS) authorities. The present study has been conducted with the aim of: (i) providing an overview of policies for MH in 10 EU member states (MS) (ii) analysing the challenges linked to these RD due to growing requirements imposed by population, mobility and migration trends and (iii) identifying gaps, proposing improvements on existing policies, or developing new ones to fit the identified needs.MethodsThe study has been undertaken by a group of members of the European Network for Rare and Congenital Anaemias (ENERCA) and the Thalassaemia International Federation (TIF), in collaboration with the public affairs firm Burson-Marsteller Brussels. Data from 10 EU countries have been gathered using targeted desk research and one-to-one interviews with local stakeholders, including healthcare professionals, patients and public health officers/providers.Results1. MH are the most common RD in all the 10 countries, 2. Data on prevalence, overall burden, trends, and clinical follow up costs are lacking in most countries. 3. Neonatal screening practices show a wide variation across and within countries. 4. Awareness on MH and their related complications is very low, exception made of Italy, Greece, Cyprus and UK, 5. No disaggregated data is available to understand the impact of mobility and migration on the prevalence of haemoglobinopathies, and how healthcare delivery systems should adapt to respond to this situation. 6. Targeted policy measures and/or actions are generally lacking and/or delayed.ConclusionsTen policy recommendations have been drawn from this study, building on 2006 WHO recommendations for MH to include haemoglobinopathies in National Plans of Actions for Rare Diseases.

Dataset Information

An evaluation of fertility- and migration-based policy responses to Japan's ageing population.

Publications

An evaluation of fertility- and migration-based policy responses to Japan's ageing population.

Similar Datasets

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