Abstract
Sweden and Japan are developed welfare countries facing serious societal and public health challenges due to demographic ageing. The objective of the present study was to provide a background to environmental challenges in the home, related to demographic ageing. Specific aims were to compare: 1) demography and household composition 2) physical housing stocks 3) indoor accidents and 4) housing adaptations between the two countries. Descriptive analyses were conducted using secondary data sources. Demographic ageing is projected to accelerate faster in Japan compared to Sweden, with overall lower fertility rates expected in Japan. In 2050, 39% of the Japanese population is projected to be aged 65 years or older, compared to 23% of the Swedish population. The Swedish ordinary housing stock was markedly older than the Japanese housing stock, with almost 80% of the dwellings built before 1980, while in Japan about 65% were built after 1980. High occurrences of fatal indoor accidents were noted in both countries, but for different reasons. In Sweden, falls was the dominant cause of fatal accidents among older people, while in Japan, in addition to falls, drowning and suffocation caused most of the fatal accidents. Housing adaptations were less frequent in Japan compared to Sweden, and the procedure for evaluating, granting and carrying out housing adaptations appeared to be more complicated in Japan. To decrease the occurrence of indoor accidents, identifying and removing “risk barriers” could be instrumental. In both countries, large-scale efforts are imperative to improve the housing situation for the ageing population.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ahrentzen, S., & Tural, E. (2015). The role of building design and interiors in ageing actively at home. Building Research and Information, 43(5), 582–601.
Annear, M., Keeling, S., Wilkinson, T., Cushman, G., Gidlow, B., & Hopkins, H. (2014). Environmental influences on healthy and active ageing: A systematic review. Ageing and Society, 34(4), 590–622.
Boverket. (2011). Building Regulations BFS 2011: 26 BBR19 [Boverkets byggregler BFS 2011: 26 BBR19]. Retrieved from http://www.boverket.se/sv/lag%2D%2Dratt/forfattningssamling/gallande/bbr%2D%2D-bfs-20116/. Accessed 20 June 2017.
Boverket (2015). What is housing adaptation? [Vad är bostadsanpassningsbidrag?]. Retrieved from http://www.boverket.se/sv/bab-handboken/Om-bostadsanpassning/bostadsanpassningsbidrag/. Accessed 5 June 2017.
Boverket (2016). Housing Adaptations 2015 [Bostadsanpassningsbidragen 2015]. Retrieved from http://www.boverket.se/globalassets/publikationer/dokument/2016/bostadsanpassningsbidragen-2015.pdf. Accessed 5 June 2017.
Cabinet office, Goverment of Japan (2015). The 7th International Comparative Survey on the Life and recoginision of the Elderly people [Dai7kai Koureisyano seikatsuto ishikinikansuru kokusai hikaku tyousa]. Retrieved from http://www8.cao.go.jp/kourei/ishiki/h27/zentai/. Accessed 5 June 2017.
Cabinet office, Government of Japan. (2016). White Paper 2016: Chapter6 Living Environment for older people [Heisei28nen Koureisyakaihakusyo (Zentaiban) 6. Koureisyano seikatsukankyou]. Retrieved from https://www8.cao.go.jp/kourei/whitepaper/w-2016/html/zenbun/s1_2_6.html. Accessed 14 May 2019.
Civil Protection and Emergency Agency. (2015). Statistic database: Causes of death - personal injuries from the Death Crime Register, 1972–2015, National Board of Health and Welfare [Dödsorsaker personskador från Dödsorsaksregistret, 1972–2015, Socialstyrelsen]. Retrieved from https://ida.msb.se/ida2#page=a0145. Accessed 5 June 2017.
Clapham, D. (2015). Accommodating difference evaluating supported housing for vulnerable people. Bristol: Policy Press.
Consumer Affairs Agency, Government of Japan (2018). The current situation of the accidents by older poeple [Koureisyano jikono joukyounitsuite]. Retrieved from https://www.caa.go.jp/policies/policy/consumer_safety/caution/caution_009/pdf/caution_009_181226_0001.pdf. Accessed 14 May 2019.
Emanuelsson, R. (2015). Supply of housing in Sweden. Sveriges Riksbank Economic Review, 2, 47–75.
Gitlin, N. L., Mann, W., Tomit, M., & Marcus, M. S. (2001). Factors associated with home environmental problems among community-living older people. Disability and Rehabilitation, 23(17), 777–787.
Granbom, M., Iwarsson, S., Kylberg, M., Pettersson, C., & Slaug, B. (2016). A public health perspective to environmental barriers and accessibility problems for senior citizens living in ordinary housing. BMC Public Health, 16(1), 772.
Hantrais, L. (2009). International comparative research theory, methods and practice. Basingstoke: Palgrave Macmillan.
International Council for Building Research Studies and Documentation. (1965). Towards industrialised building. Copenhagen: Proceedings of the third CIB Congress.
Kanda, K., Ohnaka, T., Tochihara, Y., Tsuzuki, K., Shodai, Y., & Nakamura, K. (1996). Effects of the thermal conditions of the dressing room and bathroom on physiological responses during bathing. Journal of Physiological Anthropology, 15(1), 19–24.
Kido, M., Hitosugi, M., Yokoyama, T., & Tokudome, S. (2005). [sudden death while bathing]. Nihon Rinsho. Japanese Journal of Clinical Medicine, 63(7), 1239–1242.
Komatsu, Y. (2008). Life time estimations of Japanese BUildings and houses at the years of 1997 and 2005. Journal of Architecture and Planning, 73(632), 2197–2205.
Kylberg, M., Löfqvist, C., Tomsone, S., Phillips, J., Liepina, Z., & Iwarsson, S. (2015). A European perspective on the service delivery Systems for Assistive Technology ? Differences and similarities between Latvia and Sweden. Journal of Cross-Cultural Gerontology, 30(1), 51–67.
Lawton, M. P. (1986). Environment and Aging. (Center for the Study of aging, Ed.). Albany, NY: Brooks/Cole publishing company.
Lin, C.-Y., Wang, Y.-F., Lu, T.-H., & Kawachi, I. (2015). Unintentional drowning mortality, by age and body of water: An analysis of 60 countries. Injury Prevention, 21, e43–e50.
Lipsitz, L. A., Nakajima, I., Gagnon, M., Hirayama, T., Connelly, C. M., Izumo, H., & Hirayama, T. (1994). Muscle strength and fall rates among residents of Japanese and American nursing homes: An international cross-cultural study. Journal of the American Geriatrics Society, 42(9), 953–959.
Liu, S., & Lapane, K. (2009). Residential modifications and decline in physical function among community-dwelling older adults. The Gerontologist, 49(3), 344–354.
Lux, M., & Sunega, P. (2014). Public housing in the post-socialist states of central and Eastern Europe: Decline and an open future. Housing Studies, 29(4), 501–519.
Ministry of Health, Labour and Welfare (2000a). Housing adaptation in Long-term Care Insurance [Kaigo hokenni okeru juutaku kaisyu]. Retrieved from http://www.mhlw.go.jp/general/seido/toukatsu/suishin/dl/07.pdf. Accessed 5 June 2017.
Ministry of Health, Labour and Welfare (2013). International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) [Shippei syoubyou oyobi shiinno toukeibunrui]. Retrieved from https://www.mhlw.go.jp/toukei/sippei/dl/naiyou20.pdf. Accessed 14 May 2019.
Ministry of Health, Labour and Welfare (2015). International Statistical Classification of Diseases and Related Health Problems-External causes of morbidity and mortality (V01-Y98)- [Syoubyou oyobi shibouno gaiin (V01-Y98)]. Retrieved from http://www.mhlw.go.jp/toukei/sippei/. Accessed 5 June 2017.
Ministry of Health, Labour and Welfare (2000b). Long-term care Q&A vol. 2 [Kaigohoken Q&A dai2han]. Retrieved from http://www.keieikyo.gr.jp/data/old/d122.pdf. Accessed 31 May 2017.
Ministry of Health, Labour and Welfare (2014a). e-Stat: Fact-finding Survey on Project of Long-term Care 2014 [Kaigojigyou joukyou houkoku]. Retrieved from http://www.e-stat.go.jp/SG1/estat/List.do?lid=000001153596. Accessed 5 June 2017.
Ministry of Health, Labour and Welfare (2014b). The 102nd Social Welfare Meeting of Long-term care: Special housing for older people. Retrieved from https://www.mhlw.go.jp/file/05-Shingikai-12601000-Seisakutoukatsukan-Sanjikanshitsu_Shakaihoshoutantou/0000048000.pdf. Accessed 20 Apr 2017.
Ministry of Health, Labour and Welfare (2016b). e-Stat: Survey Institutions and Establishments for Long-term Care 2015 [Kaigosa-bisu shisetu/jigyousyo tyousa 2015]. Retrieved from http://www.e-stat.go.jp/SG1/estat/NewList.do?tid=000001029805. Accessed 5 June 2017.
Ministry of Health, Labour and Welfare (2017). e-Stat: Vital Statistics 2015: Mortality Classification by Causes of death, Sex and Age [Jinkou doutai tyousa 2015]. Retrieved from http://www.e-stat.go.jp/SG1/estat/List.do?lid=000001158057. Accessed 5 June 2017.
Ministry of Internal Affairs and Communications (2006). e-Gov: Act on Promotion of Smooth Transportation, etc. of Elderly Persons, Disabled Persons, etc. No. 91 of June 21 2006 [koureisya syougaisya touno idoutouno enkatsukano sokushinnikansuru houritsu]. Retrieved from https://elaws.e-gov.go.jp/search/elawsSearch/elaws_search/lsg0500/detail?lawId=418AC0000000091_20181101_430AC0000000032&openerCode=1. Accessed 14 May 2019.
Ministry of Internal Affairs and Communications (2007). e-Gov: Long-Term Care Insurance Act No. 123 of December 17 1997 [Kaigo hoken hou]. Retrieved from http://law.e-gov.go.jp/htmldata/H09/H09HO123.html. Accessed 5 June 2017.
Ministry of Internal Affairs and Communications (2015a). e-Stat: The housing and Land survey, 2013 [Heisei25nen Juutaku/tochi toukei tyousa]. Retrieved from http://www.e-stat.go.jp/SG1/estat/List.do?bid=000001068458. Accessed 5 June 2017.
Ministry of Internal Affairs and Communications (2016a). e-Stat: Comprehensive Survey of Living Conditions, Table01: The number of households by household type, and year [Kokumin seikatsu kiso tyousa]. Retrieved from https://www.e-stat.go.jp/stat-search/files?page=1&layout=datalist&toukei=00450061&kikan=00450&tstat=000001114975&cycle=7&tclass1=000001114976&tclass2=000001114977&tclass3=000001114978&result_page=1&second=1&second2=1. Accessed 19 Apr 2019.
Ministry of Internal Affairs and Communications (2016b). e-Stat: Comprehensive Survey of Living Conditions, Table015: The number of households at least one person 65 years or older by household type, and year [Kokumin seikatsu kiso tyousa]. Retrieved from https://www.e-stat.go.jp/stat-search/files?page=1&layout=datalist&toukei=00450061&kikan=00450&tstat=000001114975&cycle=7&tclass1=000001114976&tclass2=000001114977&tclass3=000001114978&result_page=1&second=1&second2=1. Accessed 19 Apr 2019.
Ministry of Internal Affairs and Communications (2016c). e-Stat: Population Census, Population by age and sex in 2015 [Jinkou suikei]. Retrieved from http://www.e-stat.go.jp/SG1/estat/GL08020103.do?_toGL08020103_&listID=000001163203&disp=Other&requestSender=estat. Accessed 5 June 2017.
Ministry of Internal Affairs and Communications (2016d). e-Stat: Population Census, Population by age and sex in 2016 [Jinkou suikei]. Retrieved from http://www.e-stat.go.jp/SG1/estat/List.do?lid=000001177743. Accessed 5 June 2017.
Ministry of Internal Affairs and Communications (2017). e-Stat: Population Census, Table01 Population by sex, year [Jinkou suikei tyouki jikeiretsu de-ta]. Retrieved from https://www.e-stat.go.jp/stat-search/files?page=1&layout=datalist&toukei=00200524&tstat=000000090001&cycle=0&tclass1=000000090004&tclass2=000001051180&second2=1. Accessed 18 Apr 2019.
Mitoku, K., & Shimanouchi, S. (2014). Home modification and prevention of frailty progression in older adults: A Japanese prospective cohort study. Journal of Gerontological Nursing, 40(8), 40–47.
Mizumura, Y. (2014). Design to keep staying in society in Sweden [Sumitsuzukeru syakai no dezain]. Tokyo, Japan: Syokokusya.
Newman, A., & Cauley, J. A. (Eds.). (2012). The epidemiology of ageing. Dordrecht, Netherlands: Springer Netherlands.
Nomura, K., & Hashimoto, M. (2012). Theory of housing adaptation by occupational therapists and physiotherapists (2nd ed.). Tokyo, Japan: Mitsuwa Shoten.
OECD (n.d.). OECD.Stat international migration database. Retrieved from https://stats.oecd.org/Index.aspx?DataSetCode=MIG. Accessed 15 Apr 2019.
Pettersson, C., Slaug, B., Granbom, M., Kylberg, M., & Iwarsson, S. (2018). Housing accessibility for senior citizens in Sweden: Estimation of the effects of targeted elimination of environmental barriers. Scandinavian Journal of Occupational Therapy, 25(6), 407–418.
Prideaux, S., & Roulstone, A. (2009). Good practice for providing disabled people with reasonable access to the built environment. International Journal of Law in the Built Environment, 1(1), 59–81.
Rantakokko, M., Törmäkangas, T., Rantanen, T., Haak, M., & Iwarsson, S. (2013). Environmental barriers, person-environment fit and mortality among community-dwelling very old people. BMC Public Health, 13, 783.
Romli, M. H., Mackenzie, L., Lovarini, M., Tan, M. P., & Clemson, L. (2016). The Clinimetric properties of instruments measuring home hazards for older people at risk of falling. Evaluation & the Health Professions, 1–47.
Sattin, R. W., Rodriguez, J. G., DeVito, C. A., & Wingo, P. A. (1998). Home environmental hazards and the risk of fall injury events among community-dwelling older persons. Journal of the American Geriatrics Society, 46(6), 669–676.
SCB. (2010). Statistics Sweden: Housing and Building Statistics Yearbook 2010 [Bostads-och byggnadsstatistisk årsbok 2010]. Retrieved from http://www.scb.se/statistik/_publikationer/bo0801_2010a01_br_bo01br1001.pdf. Accessed 5 June 2017.
SCB. (2015). Statistic database: Population by age and sex. Year 1860–2016. Retrieved from http://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__BE__BE0101__BE0101A/BefolkningR1860/?rxid=9693c161-6689-4919-95d1-403bb8dc8fad. Accessed 5 June 2017.
SCB. (2016a). Statistic database: Number of dwellings by region, type of building and period of construction. Year 2013–2016. Retrieved from http://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__BO__BO0104/BO0104T02/?rxid=9693c161-6689-4919-95d1-403bb8dc8fad. Accessed 5 June 2017.
SCB. (2016b). Statistic database: Number of dwellings by region, type of building and type of ownership (including special housing). Year, 2013–2016 Retrieved from http://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__BO__BO0104/BO0104T03/?rxid=b2e45969-6925-4342-ac56-78bef2170ec2. Accessed 5 June 2017.
SCB. (2016c). Statistic database: Number of dwellings by region, type of building and useful floor space. Year, 2013–2016 Retrieved from http://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__BO__BO0104/BO0104T5/?rxid=9693c161-6689-4919-95d1-403bb8dc8fad. Accessed 5 June 2017.
SCB. (2016d). Statistic Database: Number of persons by region, age, year and household status in2013. Retrieved from http://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__BE__BE0101__BE0101S/HushallT08/?rxid=c915d75a-e96b-4a5e-9758-73f874969444. Accessed 19 Apr 2019.
SCB. (2016e). Statistic database: Population by age and sex. Year, 2015–2110 Retrieved from http://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__BE__BE0401__BE0401B/BefolkprognRev2015/table/tableViewLayout1/?rxid=9693c161-6689-4919-95d1-403bb8dc8fad. Accessed 29 May 2017.
SCB. (2016f). Statistical database: Number of households and persons by region, type of household and number of children. Year, 2011–2018 Retrieved from http://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__BE__BE0101__BE0101S/HushallT05/?rxid=c915d75a-e96b-4a5e-9758-73f874969444. Accessed 17 June 2019.
SCB. (2019). Statistic database: Population by age and sex. Year, 1860–2018 Retrieved from http://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__BE__BE0101__BE0101A/BefolkningR1860/?rxid=3d106d33-a737-49ed-a952-8ddb250029b5. Accessed 18 Apr 2019.
Sekiguchi, Y., Kato, T., Honda, K., Kanetaka, H., & Izumi, S.-I. (2017). Effects of grab bar on utilized friction and dynamic stability when elderly people enter the bathtub. Clinical biomechanics, 47, 7–13.
Shimizu, T., & Yoshitani, K. (2019). Impact-reduction effect of tatami floor mat made of nonwoven fabric for head injuries in fall accidents. Journal of Building Engineering, 24, 100728.
Slaug, B., Chiatti, C., Oswald, F., Kaspar, R., & Schmidt, S. (2017). Improved housing accessibility for older people in Sweden and Germany: Short term costs and long-term gains. International Journal of Environmental Research and Public Health, 14(9), 964–977.
Suzuki, T., Yoshida, H., Hashimoto, T., Yoshimura, N., Fujiwara, S., Fukunaga, M., Nakamura, T., Yoh, K., Inoue, T., Hosoi, T., & Orimo, H. (1997). Case-control study of risk factors for hip fractures in the Japanese elderly by a Mediterranean osteoporosis study (MEDOS) questionnaire. Bone, 21(5), 461–467.
Suzuki, H., Hikiji, W., Tanifuji, T., Abe, N., & Fukunaga, T. (2015). Characteristics of sudden bath-related death investigated by medical examiners in Tokyo, Japan. Journal of Epidemiology, 25(2), 126–132.
Svensk Författningssamling (1992). Swedish Act on Housing Adaptation Grants, etc [Lag (1992:1574) om bostadsanpassningsbidrag m. m. Svensk författningssamling 1992:1992:1574 t.o.m. SFS 2000:527]. Retrieved from https://www.riksdagen.se/sv/dokument-lagar/dokument/svensk-forfattningssamling/lag-19921574-om-bostadsanpassningsbidrag-m-m_sfs-1992-1574. Accessed 5 June 2017.
The National Board of Health and Welfare. (2015). Number of elderly residing in special housing in Sweden from 2007 to 2016. In Statista - the statistics portal. Retrieved from https://www.statista.com/statistics/531066/sweden-elderly-residing-in-special-housing/. Accessed 5 June 2017.
The National Board of Health and Welfare. (2016). Socialstyrelsen: Cause of Death. Retrieved from http://www.socialstyrelsen.se/statistics/statisticaldatabase/help/causeofdeath. Accessed 5 June 2017.
United Nations. (2015a). Cities - United Nations Sustainable Development Action, 2015 Retrieved from http://www.un.org/sustainabledevelopment/cities/. Accessed 16 June 2017.
United Nations. (2015b). World population prospects: The 2015 revision, key findings and advance tables. Working paper no. ESA/P/WP 241. Retrieved from https://esa.un.org/unpd/wpp/publications/files/key_findings_wpp_2015.pdf. Accessed 5 June 2017.
Wahl, H.-W., Fange, A., Oswald, F., Gitlin, L. N., & Iwarsson, S. (2009). The home environment and disability-related outcomes in aging individuals: What is the empirical evidence? The Gerontologist, 49(3), 355–367.
WHO. (2003). International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10). Retrieved from http://apps.who.int/classifications/apps/icd/icd10online2003/fr-icd.htm. Accessed 14 May 2019.
Acknowledgements
The authors are grateful to Professor Mitoku Kazuko for approving to use her results in this paper.
Funding
This study was supported by funding from the Scandinavia-Japan Sasakawa Foundation, the Ribbingska foundation in Lund, the Swedish Research Council and the Swedish Research Council for Health, Working Life and Welfare (Forte). The study was conducted within the context of the Centre for Ageing and Supportive Environments (CASE) at Lund University, Sweden.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors have no conflicting interests.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Appendices
Appendix 1
Appendix 2
Rights and permissions
About this article
Cite this article
Tsuchiya-Ito, R., Iwarsson, S. & Slaug, B. Environmental Challenges in the Home for Ageing Societies: a Comparison of Sweden and Japan. J Cross Cult Gerontol 34, 265–289 (2019). https://doi.org/10.1007/s10823-019-09384-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10823-019-09384-6