Age-friendly city and Age-friendly PHC from the health co-operative point of view -

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Age-friendly city and Age-friendly PHC from the health co-operative point of view - Mr.Eisaku Yamada Vice General Secretary HCA-JCCU Health Co-operative Association of Japanese Consumers Co-operative Union

We are health co-op, we create health Number Number of beds Local co-ops 117 Hospital 81 12,875 Clinics 351 Institute of nursing care 18 1,443 Group home 20 Home visiting nurse station 222 Home visiting helper station 185 Visiting nursing care units 143 Home stay nursing care support unit 333 Other business units 369 Total 1,758

Health Co-op Slogan Create health, Create peace

2.62million associate members

2,223 branches for member s active participation

Japanese society and aging Productive Population Elder population Youth population

30000 people committee suicide for a decade!

Compression of social security strikes peoples life Aging is advancing, and people need more medical and nursing care however government compress social security budget Number of doctor and nurse is in short, there is crisis of medical system such as OB/GYM, Pediatrics and ER Nursing care givers are also in shortage due t the low nursing care rewards and hard working situation Social environment becomes hard and it is difficult for aging people to live comfortably Peoples anger and discontent were came out and it made change of government in August 09, the politics is changing dramatically

Building town and health with Dream map Health Co-op has theme deliver, foster and passing away and develop to health and society creation where children and elder people live comfortably Associate member use Dream map in branch and Han-group as main role. They check their town and increasing partners and do their active attempts.

Example of town scenery map (Dream map) Decide the area and making plan within small group Having map, camera and pens, go to town and start town scenery check/ exploration Contents of exploration are summerized in paper, we call it Town Scenery map / Dream map

Group Town Scenery Exploration Let s go to the town scenery exploration!!

Results of exploration will be included to Dream map Reality of investigation will be confirmed by participants and they go to the map.

And it is summarized

Discussion with local authority and expansion of own activities To improve town, we start to discuss with local authority and suggest our findings We expand local people s dream such as meals with aging people, feeding service, creation of gathering spot and preparation for aging people s house.

Everyone s will become real, one by one Making lunch box and delivering to aging people Health and anti-fall exercise

4 7 World Health day s activities run all over the country every year

WHO Age-friendly City and PHC Project WHO s 3 documents 1.Global Age-friendly Cities; A Guide 2.Towards Age-friendly Primary Health Care 3. Age-friendly PHC centres Toolkit were translated and published by HCA-JCCU

Age Friendly Primary Healthcare Center Aging advance rapidly with global level However aging is fact with social development Society aging people live actively Age friendly Primary health care is important Create toolkit and implement around the world HCA-JCCU contributes for implementation in Japan

AFPHC pilot project Term:June 2009~March 2010 System:11clinics 3 blocks Schedule 17 May 2009 1 st meeting 10 Oct. 2009 Evaluation meeting Finish workshop 6, up to Feb. 2010 14 Mar. 2010 Final meeting AFPHC Basic authentication

Some attempts in Japanese AFPHC Creating promotion video 10 min screening at aging people consultation Publication ~ news letter Working with nursing care workers and PT Simulated patient Role play

Model survey of Age Friendly City in 11 Japanese cities 1.Aomori 2.Tokyo 3.Niigata 4.Toyama 5.Nagoya 6.Osaka 7.Amagasaki 8.Himeji 9.Okayama 10.Tottori 11.Miyazaki

AFC Example of Jujo area Tokyo Outside, Traffic:Narrow roads however heavy traffic and no pedestrian path, also it is difficult to see traffic sign Housing:Public apartment is far from station, it is inconvenient, also many aging people move out from their hometown due to expensive rent Social participation:we have a few public facilities to use with cheap prices, we would like to use space such as vacant classroom of school Respect and solicitude:the political attitude of respects to aging people and vulnerability become worse, Good points of Japanese culture is disappearing trending towards nuclear family Citizen participation and employment:even young people do not have job, aging people are harder

Example of Miyazaki city Outside, Traffic:Parks and public places are good however pedestrian path is jaggy and it is difficult for wheel chair Traffic:A bus in a hour, very inconvenient for user Housing:Most are houses, not many apartment Social participation:events and gathering are different timing, Facilities are far from bus stop Employment:No work place for aging people and not prepared.

Future issues and foresight Local activities are expanding by associate members of health co-op At the same time we ask to join to local authorities and neighborhood association We respects the demand and needs of local people and associate members, do advocacy to central government to improve the aging people life

Thank you for your listening Your questions are always welcome