Advancing universal health coverage through knowledge translation for healthy ageing Lessons learnt from the Japan Gerontological Evaluation Study Edited by Katsunori Kondo and Megumi Rosenberg Advancing universal health coverage through knowledge translation for healthy ageing: lessons learnt from the Japan Gerontological Evaluation Study/Katsunori Kondo, Megumi Rosenberg, editors. ISBN 978–92–4–151456–9 © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. 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Advancing universal health coverage through knowledge translation for healthy ageing Lessons learnt from the Japan Gerontological Evaluation Study Edited by Katsunori Kondo and Megumi Rosenberg Contents © Taketoyo Town, Aichi, Japan Foreword iv Chapter 1: What is JAGES? 9 Acknowledgments vi 1.1 Overview of the JAGES initiative 9 List of abbreviations viii 1.2 Collaborative research with Executive summary 1 municipalities across Japan 13 Introduction 5 1.3 Creation and accumulation of scientific knowledge 14 1.4 Contribution to national health policy reform 19 1.5 Summary 24 © JAGES © MrHicks46 Chapter 2: Knowledge translation Chapter 3: Implementing in JAGES 27 knowledge translation for healthy ageing and UHC 54 2.1 Knowledge translation 27 3.1 JAGES’ driving factors for KT 2.2 Ageing in Japan: background and on ageing and health can also context 29 be key to realizing KT in 2.3 Key driving factors for JAGES’ KT 29 other countries 55 2.4 Case studies 44 3.2 Lessons learnt from the JAGES case study: promoting KT on ageing and 2.5 Summary 52 health in other countries 57 3.3 Conclusion 66 Glossary 70 Annex 1: Background and context in Japan 75 Annex 2: Development process of JAGES 86 Annex 3: List of publications by JAGES (as of March 2018) 104 Foreword Japan’s steadily increasing longevity has long been a global reference point for the highest attainable standard of health. Japan has the highest proportion of older people in the world, including nearly 68 000 centenarians. Countries around the world are keen to learn Japan’s approach to ensuring access to affordable, quality health services and extending life expectancy. This knowledge has direct implications for these countries’ ability to achieve the Sustainable Development Goals (SDGs), specifically Target 3, to ensure healthy lives and promote well-being for all ages through universal health coverage (UHC). This monograph not only demonstrates one of the ways that Japan has managed to apply evidence-based policy to extend healthy life expectancy, but also shows that even one of longevity’s success stories still has work to do. Specifically, it describes a major initiative where researchers generate scientific evidence of the determinants of health, well-being and equity in older age, which they then interpret and apply towards co-designing interventions and evaluating these interventions with community stakeholders. This collaborative process of knowledge generation and translation is one of the keys to developing policies, systems and programmes that are relevant, effective, acceptable and sustainable for ensuring UHC and healthy lives for all. The Japan Gerontological Evaluation Study (JAGES) provides an illustrative example for other countries that are seeking to build national capacity for research, evidence-informed planning and intervention design for healthy ageing. This case study describes the evolution of this cutting-edge research initiative, which involves both basic epidemiological research and implementation research. Its findings underscore the importance of prevention and health promotion for healthy ageing, as well as effective strategies for communication and collaboration between researchers and public officials to facilitate knowledge translation. Elements of the various strategies employed by the JAGES team are adaptable to different health issues as well as to diverse resource environments including low- and middle-income contexts. This document is a resource for the global community as it seeks new insights and innovative approaches that can catapult countries towards UHC and the SDGs. Dr Sarah Louise Barber Director World Health Organization Centre for Health Development (WHO Kobe Centre – WKC) Kobe, Japan iv Advancing universal health coverage through knowledge translation for healthy ageing Foreword Foreword The Japan Gerontological Evaluation Study (JAGES) is a longitudinal cohort study about ageing established in 2010, following its antecedent, the Aichi Gerontological Evaluation Study (AGES), which started in 1999. Its aim is to build a scientific backbone illustrating the role of preventive medicine in a healthy ageing society. Since 2017, we have been collaborating with more than 40 municipalities all over Japan to investigate the living conditions of approximately 300 000 adults aged 65 and above. More than 30 researchers from colleges, universities and national institutions in Japan are currently conducting a wide variety of studies using our data. JAGES has been collaborating with the WHO Kobe Centre (WKC) since 2011 to improve metrics for evidence-based policy-making on ageing and health in Japan. The Ministry of Health, Labour and Welfare, Japan, funded us to develop a benchmark system to evaluate the long-term care insurance policy. As part of this project, WKC provided technical support to develop a tool with which policy- makers can assess and take actions against health inequalities, especially among older people, and which can be harmonized with the WHO Urban Health Equity Assessment and Response Tool (Urban HEART). Most epidemiological research, in general, collects a large amount of data and presents scientific evidence. It is less likely, however, that those findings have been applied to policies and practices. One of the most outstanding achievements of JAGES is that we have been successful at translating research findings into action, especially policy reform. This monograph, which is the result of another collaboration with the WKC, features good practices from JAGES in knowledge translation for healthy ageing so that other countries, especially those in the Asia Pacific region that face population ageing in the near future, can