Healthcare Services

Healthcare Services

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Healthcare Services

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Healthcare Services

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Questions:
1. How will the culture affect the support provided for the aging population?
2. How will the two countries play out differently in managing the aging population? 
 
Answers:

Introduction
Asia is struggling with the issue of aging population. Population ageing is the shift in the distribution of countries population towards older age. This phenomenon is prevalent worldwide, but it is growing faster in less-developed areas. It means that more elderly person will be increasing in lower developed countries. The main reason for this is a sustained baby boom, hasty reduction in fertility and decline in mortality rate. It will have a severe impact on the rate of future economic growth, operation, and integrity of health care and well-being of the aging population. The issue of population aging has decreased considerably in Europe, but it will have a great impact in Asia. The article will identify two countries in Asia and compare and contrast the challenge faced by two countries in managing the ageing population. The study will critically analyze and look into various aspects related to issues of aging population.
Demographic changes in two countries of Asia
Japan and China are the two countries identified in Asia facing issues of aging population. Japan has the highest proportion of aging citizens. About 22% of the Japnaese population is greater than the age of 60. Over the past several years, Japan’s demographic has shifted a lot. The countries population began falling from 2004, and it is ageing faster than any other planet. It is estimated that by 2050 the countries population will decline from 128 million in 2007 to 95 million in 2050.  It has occurred due to low fertility rates, high life expectancy and decline of populations since 2011. The driving force for the change is advancement in health care, migration, and change in birth patterns. Japan had a history of low childbearing rate (Hanley & Yamamura, 2015). Since the 1950s, the birth rate in Japan has been below population replacement level. The birth rate has dropped almost every year. Analyzing this trend into the long-term projection, it is estimated that about 25% will never marry and about 38% will never have babies. In addition to the decline in birth rate, Japan’s population is also living longer. It has life-expectancy, and it is one of the healthiest countries in the world. Life-expectancy is expected to increase from 86 to 90 years for women and 79 to 84 years in men by 2055. Earlier there were six workers for every retiree but now it by 2025 it will be two workers for every retiree. It will have the impact on tax revenue, welfare and medical health of the population (Shirakawa 2012).
China is the country with the highest number of population in the world. Two major factors in determining population aging are declining fertility and increasing longevity. China has experienced the fastest decline in fertility reducing from 6 births per women in 1995 to 2 births in the 1990s.  By the year 2050, half of the population will be over 45 years of age and quarter of the population will be older than 65 years old. During the 19560s it, life expectancy was 50-60 years which increased to 72 in 2005. The impact of 1970s fertility decline was seen in 2005 histogram (Knox & Marston, 2014). The fertility rate was only 1.7 in 2005. In 1950 China had a pyramid shaped structure with base comprising of young people, 4% of the population was above 65. By 2005 the 65+ population increased to 8%, and it is projected to rise to about 16% by 2030.  To decrease the population they have adopted several strategies. One important policy is one child policy. China’s population is rapidly aging due to lower mortality rate, low birth rate, and one child policy. It will create a financial problem in the future, and the population will not be competitive in the future. The countries shift toward ageing population will have the huge impact on the economy and investment opportunities of countries. The Chinese government will then have to alter its budgetary policies (Scharping, 2013).  
 
Policies in two countries
The Japan Government has implemented various policies to check the issue of aging population. One was the angel plan of 19955-1999. It was executed by Ministry of Education, Health, Labour, and Construction. It proposed an improvement in child care centers and maternity medical care system. There was one ‘New Angel Policy’ in 2000-2004. It had a higher target than previous policies. Another gender equality policy was implemented in 2005-2009 called the ‘New New Angel Plan.’ Its focus was on the independence of youth, giving support to family and employment and support in child rearing. Other alternative policies were provided in the form of economic assistance. The Government gave expenditure for pregnancy, child care, housing, and education (Ezeh et al., 2012). Social Security benefits were provided in the form of pensions, medical care, and financial support. Workplace environment was adjusted by the increase in work flexibility, enforcing vacation time, changing gender equality policy in corporate culture and availability of child care services for part-time workers. Japan Government is developing policies to encourage fertility and engage more population particularly women and children in the workforce. They gave incentive for family formation by giving an opportunity for child care, new benefits for children and state sponsor service. There are policies for engaging more women in the workplace to include longer maternity leave and legal protection against pregnancy discrimination (Campbell, 2014). 
One of the famous policies of China to check population control was one-child policy. It was introduced in 1980 and phased out in 2015.  A significant amount of population was subjected to the strict one-child restriction. This system was exempted only for ethnic minorities. Only those couples were allowed to have a second child whose first child was a girl. They imposed fines for violation of the policy. They organized awareness programs and did inspection work to check violation. About 400 million births were prevented by this policy (Feng et al., 2013). The draconian law left an emotional, social and psychological scar on the population of the country and its citizens. The disparity in gender ratio is increased.  But after analyzing the growth in an aging population of China, the Communist Party of China changed the policy to two-child policy on 29 October 2015. The new law finally came into force on January 1, 2016, after it was passed by the Standing Committee of The National People’s Congress on 27 December 2015. This decision of China to lift one-child policy will be helpful in diversifying country aging population issue and increase the male population. The relaxed control system will resolve labor deficit and age population issue to some extent. Low birth rate also occurred due to personal choices. The United Nation has predicted older population by 2100. The population of major countries will be above the age of 65 (Gong et al., 2012).
The challenge for International Organization is to reorient policies to control ageing population in countries like Asia. The number of elder person in the less developed country is expected to rise to 690 million by 2030. As the elderly population will be at high risk of disease and disability, it will put immense pressure on the health-care system. Therefore, it will be a challenge for developing countries to reorient health sectors by managing diseases and health care needs of elderly. Therefore, two major steps by International Policymakers are shifting health sector priorities and investing in support for old age. Population aging will be accompanied by an epidemiological shift in infectious diseases. To prevent diseases, WHO has launched Innovative Care for Chronic Conditions. According to that framework, health care system should provide support to reduce the burden of disease. It advises prevention approach that can mitigate the problem and give better lifestyle to citizens.United Nations Population Fund (UNPA) also works to create awareness about population ageing and address the challenges for society. It supports data collection to provide foundation for creating policies and integrating ageing issues in national development programs. Its primary focus is on policy creation, data collection, research, and advocacy. It supports development of evidence-based strategies that look after issues related to population ageing (Moulaert & Biggs, 2013). 
 
Culture
Japan has a multi-layered culture which is developing and transforming with time. It has aa history of deep tradition practice, but its society is always changing with increasing population, change in lifestyle and technology developments. Japanese people appear to be socially homogenous people. The country lies on the eastern coast of the Asian continent. It consists of five islands namely Hokkaido, Honshu, Shikoku, Kyushu, and Okinawa. The country is highly urbanized and has high population density. Two major religions are Shinto and Buddhism. Japanese follow Shinto and Buddhist rituals in their life. They have a very tolerant attitude towards religion. Kimono is the famous traditional dress worn by Japanese people. Its staple food includes rice, baked fish, vegetables, etc. They use a large amount of alcohol in their diet. It is a tolerant country for drunken people. They have their form of entertainment (Fujita et al., 2013).
China is a country known for the high population in the world. It is a multi-racial country with 55 ethnic groups. The Chinese culture is influenced by its long history and diverse ethnic groups. These groups have different customs and tradition which varies from town to cities. Different religion is practiced here, but it is mainly dominated by a Confucian value system. Different religions are Buddhism, Islam, Taoism, Christianity and other religions. Confucianism is nothing but quasi-religion.  This value is present in China since its foundation by Confucius 2000 years ago. Confucianism values lay stress on self-restraint, maintaining the proper relationship with other and social harmony. It respects hierarchy and emphasizes loyalty in family relations and friend. It encourages human to be the perfect gentleman. These values are embedded in Chinese culture and behavior. Some people give great importance to developing the personal relationship in business. Dining and drinking are the best ways for Chinese to build relationship and business connections (Atchley et al., 2014).
The diversity of the population is a challenge for health care system, its providers and policy makers. They have a challenge in delivering culturally competent services. This objective is achieved when health care services meet the social, cultural and linguistic needs of patients. The culture of different countries and its citizens have an impact on health service outcomes. A culturally competent health care system leads to the elimination of racial and ethnic disparities. It can be achieved by giving medical staff training on cultural competence and how to address cross-cultural issues in patients. The policies created for this purpose further reduces cultural and linguistic barriers in treating patients. The racial and ethnic group has a higher rate of morbidity and mortality due to illness. Therefore, health services should give more priority to improving conditions of the ethnic population (Barrera et al., 2013).
Therefore from the overall report on the issue of aging population, it is recommended that culturally sensitive policies should be implemented that reduces the impact of ageing population. The primary purpose of health care system should be the improvement in safety, effectiveness, efficiency, equity and patient-centered care. Equity in health delivery will ensure that each and every individual receive quality care. The quality of care should not discriminate by race, ethnicity and personal characteristics of the patient. Quality care will be delivered by ensuring the safety of patients and taking care to avoid injuries. Timeliness should be maintained by minimizing delay in the treatment procedure. Patient-centered care should be provided that looks after individual patient needs and preference for treatment. Health care organizations can arrange for programs that create understanding of cultural competence in health care staff. A cultural competence assessment should be prepared, and changes should be implemented based on that assessment (Purnell, 2014).   
 
Conclusion
From the detailed report above, it can be summarized that it was valuable information on the issue of population ageing worldwide and in countries in Asia. It mainly addresses the problem of population ageing in Japan and China. It described the challenges faced by the world in an increase of aging population. Based on the two countries, it gave the report on demographic changes since the last fifty years and what steps Government has taken to curb population ageing. It discusses the policies made by the country for addressing the issue of an aging population. It explained how the culture of different countries could affect health care service and cope with an ageing population. It gave recommendations on how health care services can develop culturally competent strategies in health care and mitigate the problem face in the good outcome of health care. 
 
Reference
Atchley, P., Shi, J., & Yamamoto, T. (2014). Cultural foundations of safety culture: A comparison of traffic safety culture in China, Japan and the United States. Transportation research part F: traffic psychology and behaviour, 26, 317-325.
Barrera Jr, M., Castro, F. G., Strycker, L. A., & Toobert, D. J. (2013). Cultural adaptations of behavioral health interventions: A progress report. Journal of Consulting and Clinical Psychology, 81(2), 196.
Campbell, J. C. (2014). How policies change: The Japanese government and the aging society. Princeton University Press.
Ezeh, A. C., Bongaarts, J., & Mberu, B. (2012). Global population trends and policy options. The Lancet, 380(9837), 142-148.
Feng, W., Cai, Y., & Gu, B. (2013). Population, Policy, and Politics: How Will History Judge China’s One‐Child Policy?. PoPulation and develoPment review, 38(s1), 115-129.
Fujita, S., Seto, K., Ito, S., Wu, Y., Huang, C. C., & Hasegawa, T. (2013). The characteristics of patient safety culture in Japan, Taiwan and the United States. BMC health services research, 13(1), 1.
Gong, P., Liang, S., Carlton, E. J., Jiang, Q., Wu, J., Wang, L., & Remais, J. V. (2012). Urbanisation and health in China. The Lancet, 379(9818), 843-852.
Hanley, S. B., & Yamamura, K. (2015). Economic and demographic change in preindustrial Japan, 1600-1868. Princeton University Press.
Knox, P. L., & Marston, S. A. (2014). Human geography: Places and regions in global context. Pearson.
Moulaert, T., & Biggs, S. (2013). International and European policy on work and retirement: Reinventing critical perspectives on active ageing and mature subjectivity. Human Relations, 66(1), 23-43.
Purnell, L. D. (2014). Guide to culturally competent health care. FA Davis.
Scharping, T. (2013). Birth Control in China 1949-2000: Population policy and demographic development. Routledge.
Shirakawa, M. (2012). Demographic changes and macroeconomic performance: Japanese experiences. Opening Remark at.

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