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The Demographic Changes

Discuss about the Challenges with an Ageing Population.

The rapid increase in the ageing population has become a cause for concern for many nations that are presently grappling with such a situation. Many countries are having a large ageing population and this is invariably having a negative impact on their economy. An ageing population contributes to a decline in the working age population which leads to a shortage of qualified workers who can contribute to a nation’s growth and prosperity (Bloom, et al., 2015). It creates a rise in the healthcare costs as the demand for healthcare invariably rises with age thereby forcing the government to allocate and spend more money and resources on their public healthcare systems. Ageing population creates an increase in the dependency ratio as there is large elderly population which is dependent on the taxes paid by the smaller pool of workers for getting their pension benefits and other public funded facilities. This assignment will invariably discuss the rise in the ageing population in Japan and Singapore and how both the countries are trying to cope up with the challenges of managing the ageing population in their respective nations (Borji, 2016).

There are three factors which essentially affect the size and age of the population in Asia. These are the witnessed trend of continuous baby boom, the rapid reduction in the male and female fertility rates and the decline in the mortality rates creates an increased pressure on the healthcare services of any country.

In Singapore, the period of baby boom lasted nearly two decades from 1946 to 1965. The year 1965 is an important year for Singapore as the country became independent. The total yearly births remained 38,654 during the first year of baby boom and it steadily increased to 62,495 births in 1957. The number of births remained steady at around 60000 births until 1964 after which it steadily decreased to around 44,562 in 1969. After 1980, there was a marked increase in the number of live births and this trend continued till 1995. After 2000, the birth rate slowly decreased and this period after 2000 was marked by a low birth rate (Roy, 2014).  The fertility rate in Singapore remained at high level during the period between 1947 and 1957. It was 6.5 during this period. The baby boom transformed into a baby bust due to the rapid fall in the fertility rates among the Singaporean population during the early 1980s. The period between the late 1960s and the early 1970s were market by a temperamental shift in how the people perceived family planning and birth control (Ferraro & Shippee, 2009). Women had greater access to birth control techniques and the Government of Singapore introduced changes in their existing laws which went a long way in changing the perception and attitude of the general population towards women’s role in the society (Roy, 2014). Improved life expectancy along with declining fertility in recent years has contributed to a large ageing population in Singapore. During the year 2000, the life expectancy stood at an all time high of 80.4 years. The rise in living standards and improving nutrition levels combined with better education and awareness contributed mainly towards the low mortality rates during the first half of the 20th century contributed largely to the ageing population in Singapore.

The Policies


Japan’s population has increased during the post war period from about 93.4 million in 1960 to around 128 million in 2010. This shows an increase of 37% in the overall population. However, the main cause of concern for Japan is that the number of persons below the age of 15 years has been witnessing a steady decline till the 1980s after which there was a rapid decline till the present moment. The population size of persons below 15 years of age was only 16.8 million in 2010. This statistics indicate that the proportion of children in the overall population has shrunk down considerably from 30% in 1960 to 13% in 2010. Contrastingly the proportion of elderly population has risen continuously from 1960 to 2010. The number of people above the age of 65 years was 5.4 million in 1960 and this was 29 million in 2010 recording an increase of almost five and a half times (Tsuya, 2014). This rapid pace of ageing population is attributed as a major factor for the problems associated with population ageing which is being faced by Japan.  In terms of fertility rate, there was a sharp decline in the fertility rate in the period after the Second World War.  The Total fertility rate dropped down from 4.5 in 1947 to 2.0 in 1957. The fertility rate in Japan stabilised at the levels of 2.0 to 2.2 children per women till 1974 after which it recorded a decline again.

The developments and advancements made in the fields of healthcare services in both Singapore and Japan have played a vital role in bring down the mortality rates in both the nations. It has played a major role in increasing the life expectancy of the people in both the countries which has invariably contributed to the present problems associated with an ageing population in both the nations (Tamiya, et al., 2011).

The issue of the ageing population in Singapore has been on the national agenda since the 1980s and the Singaporean government has undertaken several high level committees to study the ageing trends in that country. Singapore is tackling the problem of ageing population with an inter-agency approach that takes into accounts inputs and feedbacks from the general population at the time of policy making. During the 1980s the government recognised the fact that the population was ageing rapid and thus they focused their efforts and attention on identifying and anticipating the needs of the elderly population (Goh, 2006).

The “Committee on the Problems of the Aged” was formed in 1982 and was chaired by the Minister for Health and their main purpose was to study the impacts of an ageing population on the country and provide solutions to tackle the challenges. During the 1990s, an Inter-Ministerial Committee on the Ageing Population (IMC) was set up for creating a coordinated national response to the challenges which emerged from an ageing society. It aimed at facilitating a successful ageing process by showcasing a high degree of preparedness for the challenges and opportunities which emerged from an ageing population (Sanderson & Scherbov, 2010).

The Singaporean Government has introduced holistic and affordable healthcare and eldercare which emphasises on disease prevention and health promotion. The government promotes personal responsibility for healthcare by encouraging the elderly population to maintain an active and healthy lifestyle in their respective communities for as long as possible. The Singapore government provides lifelong financial planning for their citizens. Under Singapore’s Central Provident Fund (CPF) system, the elderly population is responsible for planning and saving which would help to ensure their financial security in the old age. The government of Singapore has ensured that older people are employed for as long as possible which helps in ensuring that the elderly population are mentally and physically fit by leading an active lifestyle by enabling them to integrate with the society in an effective manner (Goh, 2006)


In Japan, the people above the age of 65 years presently comprise almost a quarter of the total Japanese population. This top heavy demographic aspect has created huge challenges for the Japanese government. In order to tackle this growing problem, the Japanese government is trying to implement innovative programs such as long term care and insurance to advanced robotics which would go a long way in helping Japan to mitigate the problems and challenges faced as a result of their ageing population. Japan is widely considered to be the oldest society on the planet and the worsening situation has compelled the Japanese government to take bold decisions to counter the challenges of an ageing population (Tsuya, 2014).

In the year 2000, the Japanese government has launched a long term care insurance which aims to totally change and transform the manner in which healthcare services are presently being delivered to the Japanese population. For revitalising the Japanese economy, the Japanese Prime Minister Mr. Shinzo Abe has launched a new set of reforms which are dubbed Abenomics". It aims to increase the proportion of women in the workforce by further increasing and expanding the inexpensive day-care centres for children and reforming the corporate governance laws in Japan (Marlow, 2015).

The Japanese government has chosen to supplement their national pension plans with the long-term-care insurance (LTCI) and this has result in the LTCI becoming one of the most generous long term care systems of the world as far as benefits and coverage are concerned. This has played a vital role in removing the anxiety and unpredictability associated with elderly care elsewhere. People are able to pay into the system while they are in their 40s and start obtaining the benefits once they reach the age of 65 years (Tamiya, et al., 2011). The LTCI system provides comprehensive coverage of upto $2,900 a month in services, as opposed to cash payment, and it does require "co-payments" from patients. The LTCI co-payments are capped or waived for patients coming from weak economic backgrounds. Japan is considered to be a global leader in advanced robotics and cutting edge technology. There is increasing research going on in Japan in order to ascertain whether the robots can replace the ageing workforce in the different industries of Japan (Marlow, 2015).

In the year 2002, the governments of 159 nations took part in the Madrid International Plan of Action on Ageing (MIPAA) along with representatives from civil society organisations. This was the first global agreement which aimed to recognise the contribution made by the older people to the development of their respective societies. The countries participating in this meeting pledged to consider ageing into all their future social and economic development policies which also includes their poverty reduction programmes (World Health Day 2012: ageing and health, 2012). These would help them to reach their Millennium Development Goals in 2018.

The culture of Singapore is extremely vibrant and it is considered to be a melting pot of different cultures. Looking at the cultural aspect of Singapore it can be safely stated that it is a combination of Asian and European cultures. The culture of Singapore is mainly influenced by Malay, South Asian (Indian), East Asian (Chinese) and Eurasian cultures and this is the main reason why Singapore is considered by many to be a country where the East meets West.

The Japanese culture on the other hand has evolved greatly over the years due to its growing interaction with western cultures. The Japanese culture has come a long way since the J?mon period where there was no interaction with the foreign cultures to the modern day contemporary culture which is largely the result of the global influences from Asia, Europe and North America.

Culture plays a very important role in determining the outcome of healthcare services. It shapes up the values and perceptions of the general population regarding health and well being and this can play a very important role in determining the health outcomes for the general population. The culture of a nation plays an essential role in determining their diets and food habits and this can have a detrimental impact on the overall health and well being of an individual. The doctor patient communication is another factor that is heavily influenced by the culture of an individual (Vilbig, 2017).  The language and literacy barrier is largely influenced by the socio-cultural norms under which an individual grows up and this can play a very important role in determining the outcome of healthcare services.

There is a growing need for culturally sensitive policies, solutions and recommendations in order to limit the impact of the ageing population. This would play a very important role in helping the ageing population to integrate with the mainstream society in an effective manner and this would eventually benefit the society as a whole because the young generation can learn from the experience and knowledge which is possessed by the elderly population.

Conclusion

This assignment has played an important role in helping us to understand the problems faced by Japan and Singapore as a result of their ageing population. We have also gained knowledge about the government policies and interventions which have been adopted by both the nations in order to tackle the problem of the ageing population. We have been able to understand the role of culture in determining the quality of healthcare support that is presently being provided to the ageing population in both the countries. The government of both the nations (Japan and Singapore) are playing a proactive role in tackling the challenges associated with an ageing population and these have played a vital role in helping them to effectively cater to the healthcare needs of their ageing population in an effective manner. 

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