The Elm

Age-Friendly University: Travel course to Japan offers lessons in aging, blending policy, culture, and innovation.

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The world is undergoing a significant demographic transformation, with the number of older adults growing faster than any other age group. Improved sanitation, declining birth rates, and advancements in technology, medicine, and public health are the primary contributors of this phenomenon. As a result, the United States has experienced a near 12-fold increase in the number of adults ages 65 and older between 1900 and 2000, and we are expected to be one of more than 30 super-aged societies by 2030. A society is defined as super-aged when more than 20 percent of its population is age 65 and older. In 2014, only three countries held this designation — Germany, Italy, and Japan.

Today, nearly 30 percent of Japan’s population is age 65 and over, and it has the second highest life expectancy in the world (84.85 years in 2024; for comparison, the United States ranks 48th in life expectancy at 79.46 years). Because Japan has been preparing for its aging society since the early 1980s, it serves as a compelling setting for students to broaden their understanding of how advancements in technology, medicine, and public health policy contribute to both life expectancy and quality of later life.

In June 2024, 11 students from the University of Maryland, Baltimore (UMB) and the University of Maryland, Baltimore County (UMBC) traveled to Kanagawa Prefecture, Japan, sister state of Maryland. The trip was part of the spring 2024 short-term study abroad course, GERO 710: Global Aging — Aging in Japan, led by Diane Martin, PhD, MA (UMB School of Graduate Studies), and Takashi Yamashita, PhD, MPH, MA (UMBC). Learners represented eight diverse disciplines, including gerontology, medicine, neuroscience, palliative care, public health, and social work. After orientation in April, participants spent two weeks exploring how cultural norms, social structures, and aging-related policies in contemporary Japan shape aging outcomes.

The trip raised awareness of how government policies, academic research, and private business can work together to advance technology and influence effective medical care. One such policy centered on the The ME-BYO（未病）Index, which was developed in 2017 and formally implemented by the Kanagawa Prefectural government in 2019 to comprehensively and numerically measure and visualize an individual’s current health status and future disease risk. Unlike traditional approaches focused on curing illness, the ME-BYO Index emphasizes personal responsibility for maintaining and promoting health across four domains: metabolic function, locomotor function (mobility), cognitive function, and mental resilience. This framework shifts the perspective from a binary “healthy” versus “sick” paradigm to a continuum, encouraging holistic health management throughout the life course.

The ME-BYO（未病）Index tool can supplement the global age-friendly movement with its known 4 Ms that influence care and outcomes for adults aging in their communities. As part of the age-friendly movement, both Japan and the United States recognize the importance of improving quality of life and reducing health care costs as people age. Both countries continue to find ways to quantify health status and identify modifiable factors essential for effective and individualized prevention of age-related conditions and for promoting health during aging. Students reflected on the visit in daily blog posts, and their reflections can be found at the following link.

The ME-BYO Index complements the "4 Ms" — what matters, medication, mentation, and mobility — of the age-friendly health system movement in the United States. Both Japan and the United States prioritize enhancing quality of life and reducing health care costs for aging populations. Tools like the ME-BYO Index support these goals by identifying modifiable health factors, promoting individualized prevention of age-related conditions, and advancing well-being in later life.

To learn more about student experiences and insights during their trip to Japan, read their blog posts found here. Interested in participating? Apply to enroll in GERO710 this spring. For more information and to apply, visit this website.

Disclaimer: Elm Voices & Opinions articles reflect the thoughts or opinions of their individual authors, and may not represent the thoughts or values of UMB as an institution.