Who Will Care for the Rural Elderly? Taiwan's Version of "Local Extinction" Sounds the Alarm

General News Jan 1, 1970By Emily Carter 0 views

In 2014, Masuda Hiroya, a former Japanese Minister of Internal Affairs and Communications and a visiting professor at the University of Tokyo, published a book titled "Local Extinction," which described how population within Japan is concentrating in the three major metropolitan areas, including Tokyo, while aging and declining birthrates intensify in other regions. By 2040, 896 municipalities across Japan (equivalent to 49.8% of the total number of local autonomous bodies in Japan) will face extinction.

Among them, the challenges are especially severe in central and eastern Hokkaido, Japan's most important agricultural region. It is estimated that by 2040, the female population aged 20 to 40 in dozens of rural villages will decline by 50%, or even as much as 87%, compared with 2010. About 40% of the rural population will be 65 or older, which not only raises the question of who will cultivate Japan's most fertile agricultural region, but also makes the challenge of elder care even more severe.

Although statistics show that people aged 65 and over account for one quarter of Japan's total population, making it a "super-aged nation," while in Taiwan, China, the elderly account for less than one fifth of the total population, and the degree of aging is far lower than in Japan. However, circumstances similar to those in Japan's "Local Extinction" have long been playing out in Taiwan, China. The population outflow, declining birthrate and aging triggered by the decline of rural industry are even catching up with Japan in speed.

A 2010 survey by the Ministry of Health and Welfare found that the disability rate in agricultural counties is clearly much more serious than in cities (purple areas) (provided by Lin Jinli)
When Japan's Toyama City planned long-term care, it used bus and light rail scheduling to drive urban development, so that elderly people could also walk to take public transport to seek medical care and for leisure. (provided by Lin Jinli)

In addition, we should also think about how to narrow the urban-rural distance within Yunlin County through public transport planning, rather than falling into the thinking that "a small population means there is no public transport benefit" and "fewer passengers means transport frequency should be reduced."

"Improve transport conditions, and people will be willing to move back, which can then drive community recovery and allow long-term care services to be sustained," Lin Jinli believes. This is easier to achieve than attracting people back to their hometowns by building industrial zones.

Rural Areas Need Multifunctional Comprehensive Care Centers

To solve the problem of rural aging, in addition to thinking about how to improve public transport to narrow the urban-rural distance, when planning long-term care centers, it is also possible to combine the needs of community residents with care or child care for older adults, young children or people with physical and mental disabilities, so as to achieve the goals of serving the community, balancing revenue and expenditure, and sustainable operation.

However, using existing rural resources to plan multipurpose care centers may face legal constraints. Some commentators suggest converting idle school buildings in remote rural primary schools, or local "mosquito halls" [white elephant buildings], into day care centers, but in practice, according to land and building-related regulations, education and social welfare affairs fall under different competent authorities, which creates the situation of "changing school land into social welfare land, leading to the disappearance of schools." Education authorities are therefore not highly willing, and successful cases are extremely rare.

Lin Jinli pointed out that Japan also encountered this problem in the early days. The solution was to compare the building standards for schools, disability facilities or child care sites, and adopt the strictest requirements as the review standard, resolving the situation of being at a loss under multiple regulatory authorities. Taiwan, China, may perhaps refer to Japan's experience and have the central competent authority begin revising regulations, so as to facilitate the revitalization of idle school buildings or mosquito halls into multifunctional care institutions, achieving multiple benefits at once.

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Who Will Care for the Rural Elderly? Taiwan's Version of "Local Extinction" Sounds the Alarm

Rural Areas Need Multifunctional Comprehensive Care Centers

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