Portal de Periódicos da CAPES

The ‘8050 issue’ of social withdrawal and poverty in Japan’s super‐aged society

2020; Wiley; Volume: 76; Issue: 8 Linguagem: Inglês

10.1111/jan.14372

1365-2648

Kyoko Yoshioka‐Maeda,

Migration, Aging, and Tourism Studies

Japan is now a super-aged society, and the older population is estimated to reach 39.9% in 2060 (Cabinet Office, 2016). Long-term care insurance was launched in 2000 to support the older population in community settings. Presently, many parents in their 80s who are receiving pensions are supporting their single children in their 50s who have experienced social withdrawal and been unemployed since their youth. This situation, commonly called the '8050 issue', is increasing in Japan (Ministry of Health, Labour, & Welfare, 2019). Unmarried and unemployed persons in their 40s and 50s living with their parents have gradually become more dependent on them for their primary living needs (Nishi, 2017). This article explores new community health needs relating to the '8050 issue' in Japan. Since 2006, municipalities have developed and operated community-based integrated care centres (CICCs) in their junior high school districts to support older people (Mitsubishi Research Institute, 2015). Local healthcare systems monitor single-person households with residents 65 and older and older couple households to prevent social isolation. However, older-with-single-child households—'single' meaning unmarried, adult children—were not covered, assuming that the adult children could support older people. However, the poverty of such children, hidden by the financial support of the parents receiving pensions, is gradually being revealed as parental care needs are increasing (Kasuga, 2010). Staff of CICCs have found a parallel between these elder patients with health issues and their children having ongoing unsolved issues including mental disorders, school refusal, long-term unemployment and/or job turnover that began in their teens and 20s and remains unresolved. In Japan, the national government has defined social withdrawal as an issue only affecting people under the age of 40. However, a nationwide survey estimated that 613,000 people between the ages of 40–64 have withdrawn and are economically dependent on their parents, suggesting that withdrawal is prolonged as people age (Cabinet Office, 2019). Based on the culture of shame in Japan, parents of withdrawn children have tried to resolve the problems themselves. A recent survey revealed that 80% of the CICCs had provided support to older-with-single-child households. Among 220 such households, 104 parents had economic distress (47.2%), and 92 cases had experiences of social isolation (41.8%) with dementia and required care support to continue to live in the community (NPO houjin KHJ Zenkoku hikikomori kazoku kai rengou kai, 2019). The results suggest that many older-with-single-child households have experienced social deprivation (Marmot, 2017). This survey also showed that 153 of their children had withdrawn (69.5%), 125 had economic distress (56.8%), 124 had mental illnesses (56.4%), and 99 had abused their parents (45.0%) (NPO houjin KHJ Zenkoku hikikomori kazoku kai rengou kai, 2019). People with mental illnesses often experience chronic poverty and significant deprivation (Sylvestre, Notten, Kerman, Polillo, & Czechowki, 2018). Other reports indicated more than 70% of families with a child with mental illness had experienced psychological and physical violence (Kageyama et al., 2018), and family dysfunction causes domestic violence and abuse (Chan, Chen, & Chen, 2019). Additionally, Japan has the highest number of psychiatric care beds and still has inadequate healthcare systems for community-dwelling people with mental illnesses (Organization for Economic Co-operation & Development, 2013). Healthcare professionals, especially nurses, should treat each family member to save lives and develop needs-oriented mental health programs in community settings. This study focused on the growing 8050 issues in Japan: increasing numbers of older-with-single-child households with social withdrawal, mental illness, and economic distress. The findings could inform significant revisions to the healthcare systems and policies supporting older-with-single-child households in their communities and recognizing disability in the adult children before they reach middle age. The need is urgent, considering the changing age dynamics of the Japanese population.