The 130th Annual Meeting of APHA

Abstract #47973

Gabriel Montero, Robert F. Wagner Graduate School of Public Service, New York University, 4 Washington Square North, room 42, New York, NY 10003, 212-998-7564, gabriel.montero@wagner.nyu.edu and Keiko Honda, MPH, International Longivity center-USA (New York University), 60 E. 86th St., New York, NY 10021.

This paper examines the supply of long-term care in Tokyo and New York City. Both of these cities have been deeply affected by declining birth rates and a rise in the share of older persons. In fact, New York City and Tokyo have areas in which the percent of older persons over 65 years approximates the 20 percent figure projected for the United States in 2020. What services exist in these cities to respond to the problems created by a growing population of older persons? What are the major differences between these service systems? What accounts for these differences? Both cities are characterized by important variation within their urban cores, as well as between these cores and their surrounding regions. Distinguishing the urban cores of these cities from their peripheries, we compare the organization of long-term care—both nursing homes and home care—for older persons in New York City and Tokyo. When compared to their respective surrounding regions, both Tokyo and New York City have higher rates of older persons living alone, lower nursing home utilization and higher rates of home care. However, a comparison of New York City and Tokyo reveals that the latter has far fewer nursing homes, lower rates of older persons who live alone as well as lower rates of nursing home care. This paper explores how different cultural values, institutional arrangements and policies result in these contrasting living arrangements and long-term care systems.

Learning Objectives:

• 1)Identify key features of the long-term care systems of Tokyo and New York City.
• 2)Define inter- and intra-city differences among the older populations of New York City and Tokyo.
• 3)Analyze differences among long-term care utilization rates in these two cities.
• 4)Evaluate the cultural and institutional factors that contribute to differences in urban long-term care systems.

Keywords: Long-Term Care, International

Related Web page: www.ilcusa.org

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: I do not have any significant financial interest/arrangement or affiliation with any organizaion/institution whose products or services are being discussed in this session or paper
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.