Award Information

Abe Fellowship 2006
Institutional Affiliation (at time of award):
Assistant Professor, Sociology and Social Work, University of North Carolina / North Carolina Agricultural and Technical State University
Comparative Study of Senior Housing with Long-Term Care Options for Japanese and American Middle Class

The establishment of public, mandatory Long-Term Care Insurance (LTCI) in 1997 was a giant step towards addressing long-range social security needs in Japan. After the program' s successful launch in 2000 and some growing pains since, the Japanese long-term care insurance program has become the largest social insurance program for long-term care in the world. Today, over 15 percent of the population age 65 and older in Japan receives benefits provided by this insurance program . This figure is remarkable when compared with, for example, Germany, another country with a publicly-mandated long-term care program, where a substantially smaller proportion receives benefits under its long-term care insurance program . Much attention has been paid in Japan to the enormous impact of LTCI on home and community-based care and on traditional institutional care such as nursing homes. What most interests me, however, is that the LTCI program has spurred private- sector development in the senior housing industry and is helping make housing with care options affordable for the middle class. At this juncture, a comparison of senior housing options with the U.S., where there is a much longer experience with housing for frail older adults would be of great interest to the Japanese. In particular , the Continuing Care Retirement Community (CCRC) model deserves attention, as there are only very limited options in Japan that meet the needs of people from independence through heavy care. In the U.S., a major concern is that CCRCs are still very costly and out of reach for most Americans . Learning from the Japanese experience about how a new national program (i.e., LTCI) has impacted and energized the senior housing field would be very instructive for Americans .I propose to conduct an in-depth comparative study examining both contrasting and similar trends in senior housing options in the U.S. and Japan. A focal point of the study will be a series of case studies at several selected facilities in both countries. In particular, I will pay close attention to innovative programs that present promising opportunities. Investigating the factors that help or hinder these innovations from getting off the ground is another important focus for the study.