Japan is searching for the secrets to healthy old age

Most people lucky enough to get old will have at least some unhealthy years in later life. The global gap between life expectancy and healthy life expectancy , a measure of how long a person lives without health problems that impede everyday activity, is nearly ten years, according to the World Health Organisation.

That is bad enough for individuals and their families but it is also concerning for ageing countries where large elderly populations can drain public finances. In Japan, the world’s oldest country, men live an average of 81.6 years and women an average of 87.7 years. But in 2019, the last year for which data are available, the healthy parts of those lives were on average nine years shorter for men and around 12 years shorter for women.

Shrinking that gap has thus become an important goal for the Japanese government. Staying healthy for longer, the thinking goes, will make people happier—and put less strain on medical systems, and on the government’s budget. “For a long time [Japan] made a collective effort to extend life expectancy,” says Akiyama Hiroko of the University of Tokyo’s Institute of Gerontology.

But those with the longest healthy lives are not necessarily those with the longest lives overall. Many conditions that crimp the quality of life are not fatal, such as back pain, eye disease or mental-health problems. Helping people stay healthy, rather than simply alive, involves looking at broader social and environmental considerations. Jobs are essential. Working longer keeps people physically and mentally active, but also keeps them connected to others.

Social networks—the real-world kind—play a big role, too. Strong ties with friends, family and neighbours make for better mental health, more active lifestyles and better support. Investments such as upgrading cultural facilities or creating mobile libraries to serve remote communities may not appear to be health-related, but can benefit public health, says Kondo Naoki of the University of Tokyo.

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