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In 2022 SPICE launched the Stanford e-Fukuoka program, a new online course offered to high school students across Fukuoka Prefecture in Japan. Stanford e-Fukuoka’s main themes revolve around U.S.–Japan relations, the UN Sustainable Development Goals, and entrepreneurship. In the course, students engage in discussions with speakers on topics such as Japanese immigration to the United States, the historical preservation of cultural sites, and media representations of ethnicity.

Stanford e-Fukuoka is the latest of SPICE’s growing number of local student programs in Japan, which include other regional programs such as Stanford e-Hiroshima, Stanford e-Kawasaki, Stanford e-Kobe, Stanford e-Oita, and Stanford e-Tottori. These online courses are a collaboration between SPICE and local government and school officials in Japan and challenge students to think critically about global themes related to U.S. society and culture and U.S.–Japan relations.

The inaugural session of Stanford e-Fukuoka recently came to a close, and two students have been selected to be recognized as honorees for their outstanding performance in the course. Congratulations to the 2022 Stanford e-Fukuoka honorees on their excellent academic achievement!

Student Honoree: Kasane Horiuchi
School:  Tochiku High School
Project Title: Research on Plastic Bottle Recycling

Student Honoree: Mihiro Tomomatsu
School:  Hakata Seisho High School
Project Title: Break Invisible Barriers. Create the World that Everyone Needs

These students will be honored at a virtual event hosted by SPICE, Stanford University, this week. During the ceremony they will also make a formal presentation to members of the Stanford community, the Consulate General of Japan in San Francisco, and the Japanese community in the San Francisco Bay Area.


SPICE also offers national online courses to Japanese high school students (Stanford e-Japan), to Chinese high school students (Stanford e-China), and to U.S. high school students on Japan (Reischauer Scholars Program), China (China Scholars Program), and Korea (Sejong Korea Scholars Program).

To stay informed of SPICE news, join our email list and follow us on Facebook, Twitter, and Instagram.

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Announcing the Honorees of SPICE’s 2021–22 Regional Programs in Japan

Congratulations to the ten student honorees from Hiroshima Prefecture, Kawasaki City, Kobe City, Oita Prefecture, and Tottori Prefecture.
Announcing the Honorees of SPICE’s 2021–22 Regional Programs in Japan
Principal Officer John C. Taylor and Governor Seitaro Hattori with students
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Opening Ceremony for Stanford e-Fukuoka

Governor Seitaro Hattori, Ambassador Rahm Emanuel, and Principal Officer John C. Taylor congratulate students in inaugural class.
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SPICE Honors Top Students from 2020–2021 Regional Programs in Japan

Congratulations to the eight student honorees from Hiroshima Prefecture, Kawasaki City, Oita Prefecture, and Tottori Prefecture.
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Kasane Horiuchi and Mihiro Tomomatsu, 2022 Stanford e-Fukuoka honorees
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Congratulations to student honorees Kasane Horiuchi and Mihiro Tomomatsu.

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Published in Shoji Homu, the leading business law journal in Japan, this article analyzes problematic aspects of a recent, controversial Japanese Supreme Court decision on the approval by a vote of the majority-of-the-minority shareholders (known as "MoM") of a "poison pill" defense against an activist shareholder. The coauthors point out that MoM was borrowed from Delaware corporate law, where it is used in a very different context, and highlight MoM's potential for abuse by target company management in Japan’s prevailing corporate governance environment.

They conclude by proposing a new form of a poison pill for Japanese companies that protects shareholders against structurally coercive bids and is consistent with existing Japanese judicial doctrine requiring shareholder approval of defensive measures, while simultaneously promoting all cash, all shares tender offers to improve economic returns to shareholders.

Title in Japanese: "Tokyo kikai seisakusho jiken ga teikishita mondai to shin J-Pill no teian"

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Curtis J. Milhaupt
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Applications opened recently for the Fall 2022 session of the Stanford University Scholars Program for Japanese High School Students (also known as “Stanford e-Japan”), which will run from the end of September 2022 through the end of February 2023. The deadline to apply is August 12, 2022.

Stanford e-Japan
Fall 2022 session (September 2022 to February 2023)
Application period: July 1 to August 12, 2022

All applications must be submitted at https://spicestanford.smapply.io/prog/stanford_e-japan/ via the SurveyMonkey Apply platform. Applicants and recommenders will need to create a SurveyMonkey Apply account to proceed. Students who are interested in applying to the online course are encouraged to begin their applications early.

Accepted applicants will engage in an intensive study of U.S. society and culture and U.S.–Japan relations. Government officials, top scholars, and experts from Stanford University and throughout the United States provide web-based lectures and engage students in live discussion sessions.

Through the course, I learned that people-to-people connections are important in international relations. I am forever grateful to the people I met in this program—like-minded friends who supported me through the course!
Mio Kobayashi
Fall 2021 Stanford e-Japan Honoree

Stanford e-Japan is offered by the Stanford Program on International and Cross-Cultural Education (SPICE), Stanford University. Stanford e-Japan is generously supported by the Yanai Tadashi Foundation, Tokyo, Japan.

For more information about Stanford e-Japan, please visit stanfordejapan.org.

To stay informed of news about Stanford e-Japan and SPICE’s other student programsjoin our email list or follow us on FacebookInstagram, and Twitter.


SPICE offers separate courses for U.S. high school students. For more information, please visit the Reischauer Scholars Program (online course about Japan), the Sejong Korea Scholars Program (online course about Korea), and the China Scholars Program (online course about China).

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Empowering the Next Generation of Japanese Leaders

Yanai Scholars, Stanford e-Japan alumni, and EducationUSA representatives highlight a special session for the Spring 2022 Stanford e-Japan students.
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Professor Yujin Yaguchi in front of the main library at University of Tokyo
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Professor Yujin Yaguchi, University of Tokyo, Offers Lecture on Pearl Harbor for Stanford e-Japan

Professor Yujin Yaguchi introduced diverse perspectives on Pearl Harbor to 27 high school students in Stanford e-Japan.
Professor Yujin Yaguchi, University of Tokyo, Offers Lecture on Pearl Harbor for Stanford e-Japan
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Stanford e-Japan alumna Mio Kobayashi, who will be studying at Minerva University as a Yanai Tadashi Foundation Scholar.
Stanford e-Japan alumna Mio Kobayashi, who will be studying at Minerva University as a Yanai Tadashi Foundation Scholar; photo courtesy Mio Kobayashi
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Interested students must apply by August 12, 2022.

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Kiyoteru Tsutsui
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At the APARC Japan Program, we are deeply saddened by the news of the assassination of Shinzo Abe, former prime minister of Japan and still an influential political figure domestically and globally. We strongly condemn this senseless act of violence. We also sincerely hope that we will all strive to stop the 21st-century world from conjuring the memories of a pre-World War II days, bringing back the invasion of a sovereign nation for no reason (Russia’s invasion of Ukraine), violent attack on democracy based on disinformation (the January 6 uprising in the United States), and assassination of an influential leader of a stable democracy (the death of Abe). Having served longer than any other prime minister in Japanese history, Abe had his admirers and detractors. Regardless of one’s evaluation of his legacy, however, this act of violence needs to be condemned in no uncertain terms, and every effort should be made to prevent similar acts of terror.

Abe was one of the most transformative political leaders in modern Japanese history, whose foreign policy accomplishments made him a leading protector of the liberal international order at a time when China’s authoritarian model and the U.S.’s isolationist tendencies began to threaten the rules-based international order. He consolidated U.S.-Japan relations by deftly handling the polar opposite personalities of Presidents Obama and Trump during his second term. He made lasting contributions to international politics, having invented new influential concepts such as Free and Open Indo-Pacific and Data Free Flow with Trust, which were later embraced by many democratic allies in the region, most notably by the United States.

Abe's passing will change Japanese politics in a number of ways. Most immediately, internal politics within the ruling Liberal Democratic Party will be shaken up.

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Abe's diplomatic prowess was predicated on his domestic power base, evidenced by six straight victories in national elections during his second term. Even after stepping down as Prime Minister, he wielded powerful influence in national politics, particularly in defense and foreign affairs. His passing will change Japanese politics in a number of ways.

Most immediately, internal politics within the ruling Liberal Democratic Party (LDP) will be shaken up. The LDP was poised to win the Upper House election held on Sunday, July 10, but the margin of victory likely grew because of national sympathy for Abe’s death. With this victory, Prime Minister Kishida now has “the Golden Three Years” in which he does not need to hold any national election. This puts him in a position to execute his policy agenda.

In the economic realm, Prime Minister Kishida no longer has to go out of his way to defend Abenomics and emphasize that his economic policy is an extension of Abe’s. He also does not face the same level of internal pressure to increase the defense budget, take a strong stance against China, and work toward a constitutional revision. At the same time, with Abe no longer uniting the conservative constituencies for Kishida, they might become more critical of Kishida, pushing him to pursue Abe’s policy agenda such as constitutional revision.

Prime Minister Kishida will likely be emboldened to shake up the cabinet and bring in people he finds useful. He no longer needs to consider Abe’s preferences, which he did to a certain extent in forming his first cabinet.

Abe’s faction is the largest in the LDP, and it will have to find a successor who can keep it together and exert influence within the LDP. Prime Minister Kishida will likely be emboldened to shake up the cabinet and bring in people he finds useful. He no longer needs to consider Abe’s preferences, which he did to a certain extent in forming his first cabinet. This will likely lead to surprising appointments in the next cabinet shuffle such as a long-term partner of Abe’s becoming Kishida’s close ally.

The U.S.-Japan alliance will remain strong, and Americans should not expect any major changes that would impact them directly in the short term. A stable leadership in an important ally is always welcome, and somebody like Kishida who is sensible and careful, if not dynamic, makes for a reliable partner. Abe’s interpersonal skills are hard to replicate but the geopolitical environments will continue to push American and Japanese leaders to work closely and remain friendly.

One concern for Japan is that a copycat event is common after a violent incident like this. The fact that the gun used in the assassination was made by the perpetrator speaks to the efficacy of gun control measures in Japan but it also serves as a warning that others with similar skills and intentions could use hand-made guns for other acts of violence. Japan experienced a wave of political violence in the period leading up to World War II, and the political instability provided fertile ground for the destructive military expansion that resulted in the devastating defeat in 1945. It might seem too early to worry about such dire outcomes, but we can never be too careful in working to preserve our precious democracy. The United States is learning this lesson the hard way, as it has had to deal with all the demagogies and disinformation that seem to persist with no end in sight.

Shinzo Abe was killed while on a campaign trail in the last few days of the Upper House election period. While the assassin’s motivation was more personal than political, it is still alarming that election campaigns were the site of this violent attack. If this can happen in Japan, widely viewed as the least likely place for violence in general and gun violence in particular, then it could happen anywhere to undermine democracy. To honor Abe’s legacy, we all need to reassert our resolve to protect our democracy in Japan, the United States, and all over the world.

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Kiyoteru Tsutsui

Henri H. and Tomoye Takahashi Professor of Japanese Studies, Professor of Sociology, Director of the Japan Program and Deputy Director at APARC, Senior Fellow at the Freeman Spogli Institute for International Studies, Stanford University
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Shinzo Abe speaking at Stanford University in 2015.
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Abe was one of the most transformative political leaders in modern Japanese history, and his passing will change Japanese politics in a number of ways, most immediately shaking up internal politics within the ruling Liberal Democratic Party. To honor Abe’s legacy, we all need to reassert our resolve to protect our democracy in Japan, the United States, and all over the world.

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In March 2022, SPICE released Introduction to Issues in International Security, an online lecture series that was developed in consultation with the Center for International Security and Cooperation (CISAC). Four CISAC scholars are featured in accessible video lectures that aim to introduce high school students to various global security issues.

Dr. Ignacio Ornelas Rodriguez, high school educator, historian, and researcher, was an advisor to the first cohort of high school students to engage with the lectures. Ornelas guided students from San Jose and Salinas through the video lectures and accompanying curriculum. Students took the initiative to complete the series and assignments on top of their regular schoolwork.

Ornelas’s efforts culminated in the inaugural International Security Symposium that was held on May 26, 2022. The four CISAC scholars gathered online with the first cohort of students. The objectives of the symposium were to offer students a chance to interact with leading scholars in the field of international security and to learn from the scholars about careers in the field.

The scholars, who are featured in the lecture series and who were present during the symposium, are:

Dr. Martha Crenshaw, Senior Fellow, Freeman Spogli Institute for International Studies (Terrorism and Counterterrorism)

The Honorable Rose Gottemoeller, former Deputy Secretary General of NATO and Frank E. and Arthur W. Payne Distinguished Lecturer at Freeman Spogli Institute for International Studies (International Security and North Korea’s Nuclear Program)

Dr. Norman Naimark, Professor of History and Senior Fellow, Hoover Institution and the Freeman Spogli Institute for International Studies (Ethnic Cleansing and Genocide)

Dr. Megan J. Palmer, Executive Director of Bio Policy and Leadership Initiatives at Stanford University, Adjunct Professor in the department of Bioengineering, and Affiliate of the Center for International Security and Cooperation (Biosecurity)

During the symposium, the scholars shared key turning points in their careers and how they came to be in their fields of expertise. This was followed by student presentations in breakout sessions, where the students were given the opportunity to present on one of the four topics covered in Introduction to Issues in International Security.

In the breakout session on ethnic cleansing and genocide, Professor Naimark was impressed by how the students had absorbed the most important lessons of the material on mass atrocities: 1) that ethnic cleansing and genocide are an important part of human history, and 2) that these are phenomena that need to be studied and understood in order to prevent them from repeating in the future.

The student participants from Salinas were recently featured in an article in The Salinas Californian. Alisal High School student Ashley Corral commented that the series “brought awareness to COVID, mass atrocities and weapons,” and “it was really helpful that students from Salinas Valley could have that opportunity.” Another student, Bilha Piceno said, “It lets me see if this is something that I’m interested in."

The lecture series encourages students to think about international security not only on a broader level, but also how they can contribute to the safety of the world as global citizens starting with their own communities. Given the success of the first symposium, CISAC and SPICE hope to expand on the lecture series, which is part of their DEI-focused efforts, and reach more underrepresented minority students.

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CISAC Scholars Martha Crenshaw, Rose Gottemoeller, Norman Naimark, Megan Palmer; photos courtesy CISAC
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Dr. Ignacio Ornelas Rodriguez speaks with Salinas students; photo courtesy Jocelyn Ortega/The Salinas Californian
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High school students from San Jose and Salinas Valley met online with scholars from Stanford's Center for International Security and Cooperation for the inaugural International Security Symposium.

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Jonas Edman
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SPICE continues to expand its regional programs for high school students in Japan. This year marked the launch of the Stanford e-Kobe program, which joins the previously established programs, Stanford e-Hiroshima, Stanford e-Kawasaki, Stanford e-Oita, and Stanford e-Tottori.

These online courses are a collaboration between SPICE and local government and school officials in Japan and challenge students to think critically about global themes related to U.S. society and culture and U.S.–Japan relations.

All five courses have now finished their 2021–2022 term. This summer, two top students from each program will present their final research projects and be honored at a virtual event hosted by SPICE, Stanford University. Congratulations to the ten honorees below on their excellent academic achievement!

Stanford e-Hiroshima (Instructor Rylan Sekiguchi)

Student Honoree: Minori Imai
School: Hiroshima Prefectural Kuremitsuta High School
Project Title: All Lives Are Important

Student Honoree: Yui Miyake
School: Hiroshima Prefectural Hiroshima High School
Project Title: U.S. Prison System: How the Country’s History of Racial Inequality Drives the High Rate of Incarceration in America

Stanford e-Kawasaki (Instructor Maiko Tamagawa Bacha)

Student Honoree: Sayaka Kiyotomo
School: Kawasaki High School
Project Title: How Can We Improve Junior and Senior High School English Education in Japan?

Student Honoree: Anne Fukushima
School: Tachibana High School
Project Title: How Are Invisible Disorders Accepted in the United States and Japan?

Stanford e-Kobe (Instructor Alison Harsch)

Student Honoree: Nonoha Toji
School: Kobe University Secondary School
Project Title: How to Foster Entrepreneurship in School Days: Between U.S. and Japan

Student Honoree: Cullen Hiroki Morita
School: Kobe Municipal Fukiai High School
Project Title: The Different Work-Life Balance in Japan and America

Stanford e-Oita (Instructor Kasumi Yamashita)

Student Honoree: Rina Imai
School: Usa High School
Project Title: Learn About War and Peace Through the Naval Air Base Bunkers in Oita

Student Honoree: Yuki Nojiri
School: Hofu High School
Project Title: I Want to Live in the Second House of the Three Little Pigs

Stanford e-Tottori (Instructor Jonas Edman)

Student Honoree: Sakurako Kano
School: Tottori Keiai High School
Project Title: Being Proactive

Student Honoree: Yuki Yamane
School: Tottori Nishi High School
Project Title: The Effect of Collectivism and Individualism on Education

The SPICE staff is looking forward to honoring these ten students in a virtual ceremony on August 9, 2022 (August 10 in Japan). Each student will be given the opportunity to make a formal presentation to members of the Stanford community, the Consulate General of Japan in San Francisco, and the Japanese community in the San Francisco Bay Area.


SPICE also offers online courses to U.S. high school students on Japan (Reischauer Scholars Program), China (China Scholars Program), and Korea (Sejong Korea Scholars Program), and online courses to Chinese high school students on the United States (Stanford e-China) and to Japanese high school students on the United States and U.S.–Japan relations (Stanford e-Japan).

To stay informed of SPICE news, join our email list and follow us on FacebookTwitter, and Instagram.

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Encina Hall, Stanford University, home of SPICE; photo courtesy Irene Bryant
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Congratulations to the ten student honorees from Hiroshima Prefecture, Kawasaki City, Kobe City, Oita Prefecture, and Tottori Prefecture.

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Gary Mukai
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In 2015, SPICE launched Stanford e-Japan, an online course for high school students in Japan that is generously supported by the Yanai Tadashi Foundation, Tokyo, Japan. The two key objectives of Stanford e-Japan are to introduce the students to U.S.–Japan relations and to also encourage the students to consider studying in the United States. Since then, many Stanford e-Japan alumni have spent time or are spending time studying at U.S. colleges as exchange students and as four-year undergraduates. The two Stanford e-Japan instructors are Waka Brown (spring course) and Meiko Kotani (fall course). On May 13, 2022, Brown organized and facilitated a session that introduced her students to opportunities to study abroad.

The session began with comments by Chizuru Sasada, Senior EducationUSA Advisor of Fulbright Japan; Vincent Flores, EducationUSA Regional Educational Advising Coordinator for Northeast Asia and the Pacific; and Kaede Ishidate, an intern at EducationUSA and student at Harvard University. EducationUSA is a U.S. Department of State network of international student advising centers in many countries and territories that provides free advice and comprehensive information to prospective students wishing to study at U.S. colleges and universities. Sasada and Flores offered advice on studying abroad and noted, “There’s nothing like ‘being there!’” and fielded questions from the Stanford e-Japan students on topics such as college application essays, balancing extracurricular activities, and letters of recommendation.

After the comments by Sasada, Flores, and Ishidate, the Stanford e-Japan students were offered the opportunity to meet with Japanese students who are currently studying at colleges abroad in breakout groups. The breakout groups were led by the following college students:

  • Ryusei Best Hayashi (University of California, Berkeley) is majoring in Business Administration and Political Science and was a participant in the Stanford e-Japan Spring 2020 course. He is half-Mexican and half-Japanese, and was born in Mexico. He studied at Aoba-Japan International School, Tokyo.
  • Anna Matsumoto (Stanford University) is studying Mechanical Engineering. She is a Yanai Tadashi Scholar and is from Tokushima, Japan. She attended Tokushima Bunri High School, Tokushima. The New York Times featured her in an article in 2021.
  • Ayano Shirakawa (University of British Columbia, Canada) participated in the Stanford e-Japan Spring 2019 course and is studying at UBC Sauder School of Business majoring in Commerce and minoring in Law & Society. She was born and raised in Kobe, Japan, and attended the Canadian Academy.
  • Keilyn Tai (Brigham Young University) grew up in Hong Kong before moving to Japan to attend high school at Shibuya Makuhari Senior High School, Chiba, Japan. She participated in the Stanford e-Japan Fall 2020 course. She is considering Computer Science as a major.
  • Hannah Tauchi (University of California, San Diego) is majoring in Bioengineering with a focus on biotechnology. She participated in the Stanford e-Japan Spring 2017 course and was a student at Futaba High School, Tokyo. She is a Yanai Tadashi Scholar.
     

Reflecting on the breakout sessions, the Stanford e-Japan students shared takeaways from their discussions about the college admission process. These included:

In closing, Brown underscored the importance of the takeaways, encouraged her students to explore new opportunities, and also reassured them that it is okay if they as high school students do not yet know what they want to do in their lives. She also noted the importance of a good “college fit.” Reflecting upon the session, she noted, “I am so grateful to Sasada-san, Vincent, Kaede, the Yanai Scholars, and Stanford e-Japan alumni for the insight that they provided my students. I wish that I had such invaluable advice when I was a high school student.”

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Reflecting on the session, Ishidate noted, “I was very impressed by the students from the Stanford e-Japan program who were all highly motivated and eager to ask questions about study abroad opportunities in the U.S. It was encouraging to see that they have access to the right resources and even more, that they have the mindset to expand their horizons and pursue their goals. While I was only able to speak with them for a short amount of time, I myself felt inspired by the students to continue my own academic journey!”

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Participating students (clockwise from top left): Ryusei Best Hayashi, Anna Matsumoto, Ayano Shirakawa, Keilyn Tai, Hannah Tauchi
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Yanai Scholars, Stanford e-Japan alumni, and EducationUSA representatives highlight a special session for the Spring 2022 Stanford e-Japan students.

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This press release was originally published by the University of Tokyo. It discusses a new study, published by Lancet Public Health and co-authored by researchers from the University of Tokyo along with FSI Senior Fellow Karen Eggleston, director of the Asia Health Policy Program at APARC, and Jay Bhattacharya, Professor of Health Policy and director of the Center for Demography and Economics of Health and Aging at Stanford.


A new detailed microsimulation, using a database of 40 million people, has examined the future of Japan’s aging population up to 2043. It projects that more people will live longer, and that overall years spent living with dementia will decrease. However, the model highlighted the diversity of impacts on different segments of the population, as Japanese women with a less than high school education aged 75 and over may be disproportionately affected by both dementia and frailty. Better understanding where health gaps like this exist can help inform public health planning, to minimize future economic costs and support those most in need.

Taking care of the older members of society is a common concern around the world. Japan is famous for its long-lived residents, the number of which continues to rise. In 2020, almost 30% of the Japanese population was aged 65 years or older, and this age group is not projected to peak until 2034. Caring for people with age-related ailments, such as dementia and frailty, poses a challenge both to individuals and public health care systems.

Microsimulation models, which are computer models that can provide detailed analysis on an individual basis, are currently used to project future population health in some countries, such as the U.K. and the U.S. Professor Hideki Hashimoto and researchers at the University of Tokyo, along with researchers from Stanford University in the U.S., wanted to create a new microsimulation model for Japan, which would take into account more diverse conditions than had been considered before.

“We developed a new Japanese microsimulation model that accounts for 13 chronic conditions (including heart disease, stroke, diabetes, depression and dependency), as well as frailty and dementia,” explained Hashimoto. “Using an ultralarge data system, we were able to ‘follow’ a virtual cohort of more than 40 million people aged 60 and over from 2016 to 2043.”

According to Hashimoto, projections of aging in Japan usually rely on the “average” status of older people and so don’t consider the diversity of the population. “I believe that problems of aging are a matter of health gaps over the course of people’s lives,” he said. “Our projection brings attention to a widening health gap among older people. It highlighted that women with a less than high school education aged 75 or over are more likely to be affected.”

Identifying where health gaps like this exist could be used to better inform public policy, not only about health care but other influential aspects of life. “Japan’s case may suggest that improvement in educational attainment, as well as population health, could be a key to making a healthier and more manageable aging society,” said Hashimoto.

Positively, this study shows hope for a future where many people live longer and more healthy lives. “People might believe that an increase in cases of dementia is inescapable, given population aging. However, in this study we found that in Japan, despite an aging population, the number of people with dementia is expected to decrease over the next two decades,” said Hashimoto. “Population aging does not necessarily mean an increase of social burden for care, but it does bring a diversity of problems that requires careful study and science-based policy attention, to close the health gap.”

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Karen Eggleston

Senior Fellow at FSI and Director of the Asia Health Policy Program, Shorenstein APARC
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A new microsimulation projects that over the next 20 years, Japanese people will live longer without dementia, but older women with a less than high school education will benefit less than men.

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Background

Dementia and frailty often accompany one another in older age, requiring complex care and resources. Available projections provide little information on their joint impact on future health-care need from different segments of society and the associated costs. Using a newly developed microsimulation model, we forecast this situation in Japan as its population ages and decreases in size.

 

Methods

In this microsimulation modelling study, we built a model that simulates an individual's status transition across 11 chronic diseases (including diabetes, coronary heart disease, and stroke) as well as depression, functional status, and self-reported health, by age, sex, and educational strata (less than high school, high school, and college and higher), on the basis of nationally representative health surveys and existing cohort studies. Using the simulation results, we projected the prevalence of dementia and frailty, life expectancy with these conditions, and the economic cost for formal and informal care over the period 2016–43 in the population of Japan aged 60 years and older.

 

Findings

Between 2016 and 2043, life expectancy at age 65 years will increase from 23·7 years to 24·9 years in women and from 18·7 years to 19·9 years in men. Years spent with dementia will decrease from 4·7 to 3·9 years in women and 2·2 to 1·4 years in men. By contrast, years spent with frailty will increase from 3·7 to 4·0 years for women and 1·9 to 2·1 for men, and across all educational groups. By 2043, approximately 29% of women aged 75 years and older with a less than high school education are estimated to have both dementia and frailty, and so will require complex care. The expected need for health care and formal long-term care is anticipated to reach costs of US$125 billion for dementia and $97 billion for frailty per annum in 2043 for the country.

 

Interpretation

Japan's Government and policy makers should consider the potential social challenges in caring for a sizable population of older people with frailty and dementia, and a widening disparity in the burden of those conditions by sex and by educational status. The future burden of dementia and frailty should be countered not only by curative and preventive technology innovation, but also by social policies to mitigate the health gap.

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A Microsimulation Modelling Study

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The Lancet Public Health
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Karen Eggleston
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Gary Mukai
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Mayor Norihiko Fukuda of Kawasaki City—the sixth most populous city in Japan—spoke during the closing ceremony of Stanford e-Kawasaki on March 29, 2022. The ceremony marked the end of the third-year offering of Stanford e-Kawasaki, which is taught by Instructor Maiko Tamagawa Bacha. Nineteen students representing Kawasaki High School and Tachibana High School successfully completed the course and each received a certificate from Mayor Fukuda as Bacha announced each student’s name.

Stanford e-Kawasaki focuses on two themes, entrepreneurship and diversity. In Mayor Fukuda’s comments to students, he noted that with people coming from across and outside of Japan to Kawasaki, the city has developed to become a city of 1.54 million people and one of the most diverse cities in Japan. Given this, Fukuda underscored the importance of having students value diversity, and stated, “I want young people in Kawasaki to appreciate this core value.” He continued,

I also want students to foster entrepreneurial mindsets as they pursue their future careers… With the English and critical-thinking skills that they have gained in this program, they have taken off from a starting line to make their way into the world.

This year’s course featured a diverse group of speakers, including a panel of Japan Exchange and Teaching (JET) Program alumni who spoke about diversity in the United States. The panelists included Jeffrey Fleischman, Cerell Rivera, and Kai Wiesner-Hanks, who spoke on topics such as ethnic diversity, gender equality and identity, religious diversity, and cultural diversity. Bacha is a former Advisor for Educational Affairs at the Consulate General of Japan in San Francisco and one of her major responsibilities was overseeing the JET Program. She commented, “It was particularly gratifying for me to provide a platform for JET alumni to continue to offer their support to students in Japan.” Other sessions were led by Dr. Stephen Murphy-Shigematsu who addressed the central question, “What is diversity?,” and also discussed diversity issues in Japan, and Stanford graduate student Alinea Tucker, who spoke on “Black Lives Matter.”

In the area of entrepreneurship, Miwa Seki, General Partner, M Power Partners, provided perspectives as an investor, and Sukemasa Kabayama, Founder and CEO of Uplift Labs, shared his journey as an entrepreneur in Japan and in the United States.

A highlight of the closing ceremony was the announcement of the two honorees of Stanford e-Kawasaki. They are Sayaka Kiyotomo from Kawasaki High School and Anne Fukushima from Tachibana High School.

Reflecting on the three years of teaching the course, Bacha noted, “Since the inception of Stanford e-Kawasaki, Mayor Fukuda’s unwavering commitment has without a doubt contributed greatly to the success of the course. The students and I have always felt his support.” After the ceremony, Mayor Fukuda brought the students to one of his meeting rooms and engaged them in informal discussions. His formal and informal comments were very inspirational to the students.

I am most grateful to Mayor Norihiko Fukuda for his vision and for making this course possible. I would also like to express my appreciation to Mr. Nihei and Mr. Katsurayama from the Kawasaki Board of Education; and Mr. Abe, Mr. Tanaka, Mr. Kawato, and especially Mr. Inoue from Kawasaki City for their unwavering support. Importantly, I would like to express my appreciation to Principal Iwaki and his staff of Kawasaki High School and Principal Takai and his staff from Tachibana High School for their engagement with Stanford e-Kawasaki. An article in Japanese about the closing ceremony that was published by Kawasaki City can be found here.

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Maiko Tamagawa Bacha

Instructor, Stanford e-Kawasaki
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Students with Mayor Fukuda; photo courtesy Kawasaki City
Students with Mayor Fukuda; photo courtesy Kawasaki City
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Stanford e-Kawasaki closing ceremony held.

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