Introduction: ageing in place in the Western Asia-Pacific

Abstract

Population ageing is an international phenomenon (United Nations Department of Economic and Social Affairs [UN], 2017) with profound social and economic implications (Harper, 2014; Rouzet et al., 2019; World Health Organization [WHO], 2015) and the nature of the built environment at various scales is critical to optimizing the social participation and well-being of older people, who increasingly comprise larger shares of the population. It is, however, occurring at different rates in different countries, eliciting policy responses reflecting local cultural, political and economic settings (UN, 2017). A common response of governments is to move toward policies that encourage ageing in place in one’s own home and community for as long as possible in order to reserve more costly institutional care for those with higher needs such as frailty and dementia (Philips, Ajrough and Hillcoat-Nallétamby, 2010). It is often seen as a win–win policy, favoured by governments because of the potential cost savings to counter increasing dependency ratios as well as by the majority of older people themselves who prefer to remain independent and engaged with their communities in their later years. It is also argued that remaining in one’s own home and maintaining active involvement in a familiar community can contribute to positive health and well-being in older age (WHO, 2015). However, successful ageing in place is only possible with access to appropriate care services and a supportive built environment. The focus of this book is on ageing-in-place policies and practice in the Western Asia-Pacific, particularly in relation to policies and practice regarding the built environment. This corresponds with the Western Pacific Region as defined by the World Health Organization (WHO, 2020a), which extends from Japan in the north to New Zealand in the south and from China in the west to the many small island nations in the western Pacific Ocean. Our particular focus is on Japan and China (including Hong Kong and Taiwan) in the northern hemisphere, and Australia and New Zealand in the southern hemisphere, both of which have increasingly been seen as part of Asia given their geographic location in the Western Pacific Region, the importance of trade relationships with East Asian countries, and increasing Asian immigration. There are a number of reasons for this focus on ageing in place in the Western Asia-Pacific. First, Asia includes the country with the most advanced ageing internationally (Japan), and another (China) with the highest total population that is on a very steep ageing trajectory, both requiring sustained policy responses in the face of a breakdown in family support and care traditions (Chang, 2014; Miyanaga, 1993; Rein, 2014). Second, the bulk of the existing