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MEETING WITH THE REPRESENTATIVES OF LOCAL GOVERNMENTS COLLABORATING IN JSTAR SURVEY

On 8 March 2019 we organized a meeting with the representatives of cities and wards that have collaborated with us in implementing the Japanese Study on Aging and Retirement (JSTAR).

The meeting was held at Hongo Campus at a lecture room belonging to the Graduate School of Public Policy (GraSPP).

Its main purpose was to inform the representatives of local governments about the results our project has obtained from JSTAR, and to offer them suggestions for possible policy improvements, based on the empirical data gathered through the survey, by pointing out the problems JSTAR data indicate in their communities and on the country level. Another important objective was to hear about the needs and issues in health and social welfare that these local governments experience and tackle with daily.

The first part of the meeting consisted of presentations by our principal coinvestigator Prof. Hidehiko Ichimura, Project Professor Naohiro Ogawa and co-investigators professors Yasuhiko Sawada, Emiko Usui and Hideki Hashimoto, as well as our researcher Taiyo Fukai. Aside from the recapitulation of the characteristics of JSTAR and its potential for policy recommendations, the presenters addressed different aspects of population aging, such as its impact on health systems, the rise in the number of cases of dementia and its causes, or the untapped work potential by the elderly in Japan.

The second part consisted of presentations by the representatives of the local governments, mostly focusing on their initiatives regarding health and public hygiene and care for the elderly. This was followed by a frank and open discussion about issues in the provision of medical and care services that could and should be addressed at the community level, and the problems local governments would like to have researchers examine in the future.

Out of the ten local governments that have participated in JSTAR in the past several years, eight attended our meeting: Naha, Tosu, Tondabayashi, Hiroshima, Shirakawa, Adachi, Sendai and Takikawa.

 

PRESENTATION AT THE CHOFU CITY HALL

On October 26 project leader Prof. Hidehiko Ichimura delivered a presentation at the Chofu City Hall.
Chofu City is an administrative unit within the Tokyo Metropolitan Area. It is one of the ten areas where our project is implementing the Japanese Study on Aging and Retirement (JSTAR).
Prof. Ichimura informed the attending local government officials about the historical background of JSTAR and the economic and social benefits it brings by collecting panel data on the elderly, and presented survey findings on the wealth, social participation, health condition and health expenditure of the Japanese elderly, with a focus on Chofu City residents.
As regards health, JSTAR collects data on activities in daily life, instrumental activities in daily life, depression, blood pressure, incidence of diabetes, whether the respondent requires nursing care or not, and health expenditure. Thus, in addition to wealth and social participation, Prof. Ichimura's presentation compared findings from the previous survey round on the above-mentioned indicators of health for Chofu with other administrative units while analyzing the link between the health condition and the family composition of the respondents, thus offering Chofu officials clues that could help them tailor city services so that they better fit the needs of the local elderly population.

 

SEMINAR AND LECTURES BY DR. IQBAL H. SHAH FROM THE HARVARD T.H. CHAN SCHOOL OF PUBLIC HEALTH

On 6 October 2016 Dr. Iqbal Shah, Principal Research Scientist with the Harvard University T. H. Chan School of Public Helath, gave a seminar at our graduate school entitled "Abortion and Contraception Following Liberalization of Abortion Laws".The presentation briefly covered the known world history of abortion, key concepts regarding abortion, data sources and their limitations, levels and trends in induced abortion, contraception and births, and then turned the focus to the main theme indicated in the title, surveying data and previous studies.
Dr. Shah pointed out that abortion and contraception are two alternative means of regulating fertility, and that past research indicates that although the abortion rates do rise initially after the legalization of abortion, they also tend to decline over time as the use of modern contraceptives increases. So far, evidence suggests that the prevalence of modern contraceptive methods continues to rise or stays constant at high levels after the legalization of abortion.
At the end of his presentation Dr. Shah called for further study of abortions after legalization and deeper examination of the interactions between contraceptive and abortion rates under different conditions and at different levels. He also suggested the need for additional studies to better understand causal pathways leading to the decline of abortion rates after liberalization of abortion laws. 
In addition, Dr. Shah gave a lecture on postpartum family planning that illustrates the content of work in the project he leads at Harvard University: "Postpartum Family Planning in Low- and Middle-income Countries". Based on a review of literature supplemented by an analysis of Demographic and Health Survey data (DHS) for 16 countries, Dr. Shah covered terms and definitions, measurement of the unmet need for family planning and addressed the following four key points: (1) is the postpartum unmet need for family planning particularly high or higher than at other times; (2) do women await for the return of menses before initiating contraception: 3) is breastfeeding a deterrent to using modern contraceptive methods; and 4) what are the program implications.
The data Dr. Shah presented suggest that: 1) the unmet need in postpartum is not higher than at other times once amenorrhea and abstinence is taken into account, but that health consequences of pregnancy are greater; 2) the return of menses is a powerful signal for contraceptive adoption, but appreciable minorities adopt contraceptives before the return of menses, particularly sterilization in some countries; and 3) among menstruating women breastfeeding has little influence on the use or method choice, except on oral contraceptives in some countries. In terms of policy implications, promoting early uptake of contraception in countries where lactational protection lasts for three or four months is recommended. In countries where lactational amenorrhea typically extends throughout the first 12 months after birth, as in sub-Saharan African countries and India, promoting early uptake of long-acting reversible methods or giving advice on using a modern method of contraception at six months postpartum is recommended.
Dr. Shah pointed out the importance of learning women's perspectives on the timing of initiating contraceptive use, on the link between the return of menses and the risk of pregnancy as well as on the contraceptive protective effect of breastfeeding. He concluded his presentation by indicating that postpartum contraception is important in rich countries as well.  
Furthermore, on the same day Dr.Shah delivered a third presentation entitled: "Changing Profile of Reproductive Health in Europe", in which he provided an overview of trends in reproductive health in countries of North, West, East and South Europe.
In Europe fertility transition to low levels preceded the advent of modern methods of contraception. With few exceptions, the total fertility rate in European countries in 2014 was lower than in 1980. A trend in terms of increased childlessness, increased divorce rates, and increased number of births outside marriage was noted. Marriage rates in Europe have fallen and the age at first birth has increased. Dr. Shah pointed out that factors influencing these patterns are contextually determined and needed to be better studied to make informed policy decisions and interventions.

 

SEMINAR: "An Analysis of the Policies for the Equalization of Intergenerational Economic Burden, Using Health and Long-term Care Insurances Model"

On August 4, our project member Professor Yasushi Iwamoto made a presentation entitled "An Analysis of the Policies for the Equalization of Intergenerational Economic Burden, Using Health and Long-term Care Insurances Model". At the seminar held at the Economics Research Building Prof. Iwamoto presented the work he has done in cooperation with Prof. Tadashi Fukui from Kyoto Sangyo University.
Burgeoning social security costs present a major threat for the viability of the Japanese society, which faces rapid population aging and population decline. According to Iwamoto and Fukui, in assessing future social security costs, previous studies have tended to emphasize public pensions, although the largest increase in public cost will, in fact, come from health care and the utilization of the government scheme for nursing care, known as Long-term Care (LTC). Their analysis covers the period of 95 years and focuses on intergenerational differences in lifetime burden. Iwamoto and Fukui find that large intergenerational differences will exist between future generations in Japan, and that significant increases in expenditure on health and nursing cannot be avoided, but their simulations of different future scenarios also show that it is possible to alleviate the situation by reducing the peak of life time burden.

 

SEMINAR: "Work, Family and Health: Current Research, Future Questions"

On March the 22nd and 23rd we welcomed Prof. Lyndall Strazdins from the National Centre for Epidemiology and Population Health, Australian National University.

Prof. Strazdins is a psychologist whose research focuses on contemporary predicaments of work and care and their health and equity consequences. Recently, she has been developing a theory on time as a social determinant of health, that includes the attempt to understand time as a resource that not only structures power and gender relations but also people’s capacity to be healthy. She is an author of more than 100 publications.

On March the 23rd Prof. Strazdins delivered a broad and informative lecture on the relationship between work, family and health in Australia that looked at issues such as the effects of population aging, longevity, globalization and gender relations on the labor market in Australia, the time men and women spend at work and at home caring for children, and the impact of the work-family conflict on parents’ mental health, the quality of child care they provide and their children’s health. Aside from analyzing the current situation in Australia, with brief comparisons to Japan, the lecture offered clear suggestions as to how and to what extent women should be included in the labor market, about the need to encourage fathers to spend more time caring for children and about how work-family conflict should be addressed in future policies on labor and fertility, while paying attention to gender equality and mental health of both parents and children.

On both days of her stay, our project members held consultation with Prof. Strazdins about the inclusion of psychological measures of parent and child health in the next rounds of the National Survey of Work and Family we are scheduled to conduct, and on possible venues of future joint, comparative research.

 

LECTURE: "About NTA Estimation: Income"

On 14 April 2016 at the Economics Research Bld. Assistant Professor Rikiya Matsukura from Nihon University, a co-investigator in our project, held a lecture for postgraduate students and researchers on estimation that utilizes the methodology of the National Transfer Accounts (NTA).
The lecture taught concrete estimation methods based on the data gathered by the National Survey of Family Income and Expenditure, such as an estimation of age profiles and smoothing, and reestimation after population data have been introduced to the age profiles.