Technology and Healthcare

How can technology and healthcare impact rural Japan?

By 2050, 40% of the Japanese population will be over 65 years old based on current projections. If young people continue to prefer big city life, rural areas will suffer from fewer people of working age, diminishing the tax base, which will inevitably lead to reduced services. What role can innovations in technology and healthcare play in alleviating this situation? Can these innovations produce long-term solutions for the Japanese countryside?

In the fourth part of our series on Japan’s rural revitalization, we will take a look at the role of technology and healthcare in deciding the fate of rural Japan.

This is the fourth article of a six-part series on Japan’s Rural Revitalization. Together with each article, we’re also discussing each topic on Japan Unleashed, Parthenon Japan’s new official podcast.

Technology and Rural Development

The impact of depopulation is clear: empty homes and buildings, depleted infrastructure, and fewer employment opportunities. In response, efforts are underway to better serve those living in rural communities, from more efficient transportation to improved healthcare availability. Even so, the current lack of young people interested in calling rural Japan home makes the situation more complicated. Changing this trend through attractive initiatives are at the core of any sustainable solutions. 

So, what can be done to entice new generations?

Let’s take a look at high-speed internet access, one of the prime issues preventing many young people from considering living in the Japanese countryside. Part of Prime Minister Kishida’s “Digital Garden City Nation” plan aims to provide 5G networks throughout Japan by 2030, in order to standardize internet access everywhere in Japan. However, not everyone is IT savvy, especially the aged population. Part of PM Kishida’s effort to provide fiber-optic networks to 99% of all Japanese homes is already well underway, but it is hindered by the fact that many younger people consider connectivity to be access to strong cell networks, which is more challenging.

Assuming this can be achieved, how will this impact rural living? Part of the answer lies in the “work-from-home” movement, a global trend many young Japanese increasingly prefer, although major Japanese firms are largely behind the ball. That said, Japanese organizations are getting better at accepting non-traditional ways of working. Japanese tech companies such as Paypay, Mercari and Moneytree are leading the pack in promoting this trend.

However, the challenge continues to be getting conservative Japanese companies to embrace hybrid work models, such as sharing work time both at home and face-to-face in the office, or even permitting 100% work-from-home as an option.  Admittedly, this is a work in progress. But as younger generations speak with their feet and leave employers that don’t embrace a flexible working environment, we suspect labor-strapped companies will start to get the message.

Universal acceptance of remote work will take time. As will the idea of a “digital nomad visa” for non-Japanese workers who want to call Japan home while working 100% remotely. To date, such a visa status has not been established, and there does not seem to be a serious discussion of introducing this type of visa.

Emerging Technologies

Can big data, artificial intelligence and other emerging technologies make rural living easier?  There are several industries in which technological innovations can be game changers.  Food production is perhaps the most crucial sector. By 2030, Japan’s agriculture industry is expected to lose up to one-third of its workforce as around 60% of Japan’s farmers will be 65 or older.

Smart farming could make a huge impact. Gaining in popularity for decades, machines increasingly plant and harvest crops. As of late, interest in drones for crop monitoring and fertilization has grown.  With a suite of agriculture technology known as “precision farming”, dispersion of fertilizer and pesticides can be completed in a fraction of the time and cost vs. doing it by hand.

Similarly, self-driving vehicles for farming with precision tools are under development. This can expand production and enhance delivery options, providing service to areas with limited access and eventually producing a profitable return on investment.  While widespread implementation and acceptance of innovative tech replacing people will be gradual, these are positive developments.

Change is needed on other fronts as well. Embracing new technological developments often necessitate updating the regulatory framework. Technology tends to progress faster than the rules of engagement.  As innovations in drones and other automated tech continue, laws are not being established or revised in sync with the pace of these developments. This is a missed opportunity as emerging technologies have immense potential for rural areas suffering from a lack of people and resources.

Rural Healthcare

Another area that requires more attention is healthcare: what happens when depopulation, a declining tax base, and urban plight merge together?

Stress associated with work can have a negative impact over time, whether living in an urban or rural environment. For city-dwellers faced with lengthy commutes and long hours at the office, country living has an immediate appeal.  But rural life has its own set of concerns, such as adequate health care with ease of access to facilities, staff-to-patient ratios, and medical professionals properly trained to use robotic technology.

We must not only consider simple daily needs and specialty, chronic, and emergency care, but also mental health support. Do rural areas have sufficient facilities with adequate staffing? How does a lack of access to the latest available technology impact support options?

Compared to cities like Tokyo and Osaka, many rural areas fall short in terms of facilities, such as assisted living or nursing homes, but also doctors, nurses, and caregivers. This is due not only to lack of funds due to tax revenue declines, which is exacerbated by the challenge of attracting qualified medical professionals. Highly skilled professionals often prefer the allure of big city life and higher pay – the very issues plaguing rural areas as a whole.

This is exactly where technology can help remedy the situation and Japan is leading the way in the medical device arena including artificial organ creation, which started in the 1960’s, and 3D printing for prosthetics, led by Japanese startups like Instalimb. Japanese technology shows promise in several sectors, including smart housing that provides energy-efficient heating/cooling, voice command living assistance tools, and water conservation appliances, e-commerce platforms to purchase and sell goods more efficiently, and clean energy innovations.

Continuous Efforts

“Build it and they will come.” This popular saying works some of the time in certain circumstances, but strong infrastructure lies at the core, and this is only part of the puzzle. Inquisitive young people tend to be more savvy than older folks, but older generations have more difficulty managing technology. What can be done to help them?

While national government programs intended to show people how to use new technology exist, they are sparse. Part of Prime Minister Kishida’s Digital Garden City Nation plan is to recruit 20,000 young people dedicated to help teach older people how to decipher cell phones, computers, and other devices. So far, this is still in the planning stages. Existing initiatives for older generations are largely done piecemeal at present, and mostly at the local level.

There are numerous issues that need more dedicated attention.  For example, sewage systems for rural areas. Currently many rural properties rely on septic tank systems for waste. This adds to the cost of rural living through annual cleaning requirements and makes daily use more difficult. Also needed are more nationally-supported, comprehensive waste and waste water programs encompassing state-of-the-art technology for overall water purification and leakage control. Doing so would make rural living more attractive and less expensive.

Fortunately, many retirees in Japan are in a good position to fund their own personal retirements due to individual investments and a high savings rate. However, finding qualified and willing people to act as caregivers poses a larger problem. This worker shortage impacts work-at-home family members who need to care for an elderly parent due to a lack of elder care assistance in their area.  Even elder care workers are often underpaid and not adequately trained. The need for technology is clear.

Another issue is community-building activities, such as assisting people who live alone to be more proactive members through communication and participation. Setting up and running such initiatives requires dedicated people.  Funding issues aside, it is easy to see how a well-intentioned program could quickly become overwhelmed.

Remaining Challenges

While the current situation encourages pessimism, good things are happening. There are literally hundreds of national and local projects aimed at making rural Japan more vibrant. Some are genuinely useful, while others appear aimed more at garnering support for politicians who depend on the rural vote to retain power.

While this may not be unique to Japan, the result of entrenched ties between rural leaders and national decision-makers may not fully serve the interests of rural residents.  What is needed is leadership based less on time spent getting re-elected and more on getting things done while in office.

If this trend continues on its current path, the outlook is relatively bleak. However, if technologies are implemented that provide new opportunities, we may see a turnaround. What is clear is that the private sector will need to step up to the plate in a much bigger way.  In the end, business can only contribute so much to resolving Japan’s many technological and health issues. Adding incentives and expanding public-private partnerships, which have been implemented but thus far unsuccessful in achieving the ultimate goal of rural revitalization, are key to generating meaningful change.