Migration of elderly residents

Ideas to promote the migration of elderly residents from large metropolitan areas to other parts of the country are gaining attention as a way to address an anticipated crisis in welfare services for senior citizens in and around Tokyo.

The Abe administration has begun studying ways for rural areas to attract senior citizens to their communities, following the release last December of the government’s comprehensive strategy for regional revitalization. A private think tank has come up with a more concrete — and controversial — proposal for promoting the migration of residents aged 75 and up in the greater Tokyo area to 41 areas in 26 prefectures that are deemed to have surplus capacity to provide medical and nursing care for such people.

Although such a proposal may seem to make sense at a first glance, its feasibility and desirability need to be closely examined. Some people may find it an attractive option, but mass migration should not be considered a panacea for the various problems associated with the sharp rise in the elderly population and associated medical and nursing-care requirements.

Behind the calls for the migration of elderly residents is the demographic pressure of postwar baby boomers on the nation’s medical and nursing-care systems. Citing a forecast by the National Institute of Population and Social Security Research, the think tank Japan Policy Council says that the greater Tokyo area — the capital and the adjacent prefectures of Kanagawa, Chiba and Saitama — will see its population of residents aged 75 or older increase by some 1.75 million to 5.72 million within 10 years. This figure accounts for about one-third of the nationwide increase in the number of people in that age bracket.

The group says that as demand rises for medical and nursing-care services for elderly people, the area will suffer from an acute shortage of nursing-care facilities and residences for the elderly that offer nursing-care services. An additional 800,000 to 900,000 medical and nursing-care service personnel will be needed by 2025. But recruiting such a large number of medical and nursing-care personnel to the greater Tokyo area could further accelerate the population flight from rural regions, and the metropolitan area may not have enough land space available to build new nursing-care facilities.

Therefore the group proposes encouraging the migration of the elderly population from the greater Tokyo area to other parts of the country that, due to their own depopulation trends, should have enough surplus facilities and manpower to provide medical and nursing-care services for the elderly newcomers at cheaper costs. The 41 areas that the think tank identified as candidates for resettlement included Obihiro and Hakodate in Hokkaido, Akita, Toyama, Okayama, Kochi, as well as the city of Beppu in Oita Prefecture.

The group also proposes that the municipalities that opt to accommodate elderly migrants should provide not only medical and nursing-care services but also comprehensive social services for the new residents, including opportunities for lifelong learning. This is in line with the concept of continuing care retirement communities (CCRC), which are popular in the United States. Some retired people resettle in such communities while they’re still healthy and continue to live there even after they start to require regular medical and nursing-care services. The government is pushing for this model to be adopted here.

The Japan Policy Council, comprising scholars and representatives from various business sectors, released an alarming report last year warning that nearly half of the nation’s municipalities face the risk of disappearing in the future due to a steep fall in the population of women of child-bearing age. This directed public attention to the population issue and led the Abe administration to put regional revitalization on its political agenda. The latest proposal also drew a quick response from the government, with Chief Cabinet Secretary Yoshihide Suga saying that the migration of elderly people away from the capital area would contribute to solving the demographic woes in rural regions by generating demand and creating jobs outside of Tokyo.

Pushing CCRC projects may in fact provide a chance for depopulated rural areas to create jobs and sustain local economies, while urban municipalities can expect to reduce financial costs associated with building medical and nursing-care facilities for their elderly residents. So far, 202 local governments across Japan have expressed an interest in pursuing such projects. The national government reportedly plans to offer new types of grants — introduced as part of the regional revitalization efforts — to local governments to promote the migration of senior residents. Some local governments hope to use the grants to help pay to develop and improve their facilities for medical and nursing-care services.

Still, the governors of prefectures named in the think tank proposal as candidates for accepting elderly migrants are more cautious and even negative about the idea due to concern that accepting large numbers of senior citizens requiring medical and nursing-care services would impose a heavy financial burden on local government coffers. In addition, some local governments dispute the estimates stating that they have a surplus care-service capacity to accommodate elderly migrants.

Governors in the greater Tokyo area also voiced skepticism toward the proposal, with Kanagawa Gov. Yuji Kuroiwa saying he has doubts about pushing for the migration of elderly residents who may not wish to leave their hometowns. It’s unpredictable how much of the elderly population would indeed want to move from the capital area to rural parts of the country when they start requiring medical and nursing care. In addition to the cost of moving to unfamiliar places, it’s likely that most elderly people would want to live close to relatives and friends.

The think tank’s proposal serves as a reminder of the severe challenges that lie ahead for meeting the welfare needs of the nation’s growing population of senior citizens — even in the Tokyo metropolitan area, which seems to attract resources from all other parts of the country. But policymakers should avoid the illusion of elderly migration serving as a cure-all solution. It may help to provide support for those elderly people who see migration as an attractive option, but whether migration should be promoted as a policy to address the welfare needs of elderly people should be carefully considered.