Age-friendly Communities Development in Northern Thailand : Hua-Ngum’s Experience and Implementation in Other Sub-districts Rungnapa Thepparp A dissertation submitted in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY in Social Welfare Japan College of Social Work Graduate School of Social Welfare 2017 Abstract The study of “age-friendly community development in northern Thailand: Hua- Ngum’s experience and implementation in other sub-districts,” makes a research assumption that the age-friendly community concept has the potential to be a model for sustainable rural development. It aims: 1) to conduct a needs assessment to analyze the Thai aging situation; 2) to construct an age-friendly community (AFC) development model from a good practices (GP) study; and 3) to generalize the AFC development model into guidelines to develop an AFC. The study mainly adopts qualitative research as the main methodology, however, both qualitative and quantitative methods are used to investigate the empirical evidence. The study is conducted in rural communities in northern Thailand by focusing on Hua-Ngum sub- district and four other selected sub-districts in the northern region. The results of the good practice study (GP) of Hua-Ngum sub-district and four other selected sub-districts in northern Thailand can be summarized through three models, including: 1) the logic model of age-friendly community development, which aims to explain the assumed causal connections of input, output, and outcome of age-friendly community development; 2) the process model of age-friendly community development at the community level as a model to explain the stage of development of the age-friendly community. This depicts the stages of development of an age-friendly community that is divided into three stages, including: the beginning stage; the stage of establishing core values and community spirit; and the stage of focusing on age-friendliness; and 3) the process model to develop age-related activities, which aims to explain the process of developing age-related activities based on the community development cycle (community assessment, planning, implementation, and evaluation). Moreover, key factors contributing to the success of age- friendly communities are proposed, including: 1) good leadership - both formal and informal leaders; 2) strong partnerships; 3) concordance with religion and local culture; and 4) participation of the elderly. According to the models, importance is paid to the elderly as the “center” of community development, with the realization and reflection that the elderly have potential and they are also powerful resources that can drive community development. Furthermore, the lessons learned based on GP study indicate the importance of the power of local communities to tackle their own aged societies with regards to the social capital and social participation of all community members. i Acknowledgement I would like to express my warmest regards to my great Professors at the Japan College of Social Work (JCSW), Prof. Hideharu Uemura, Prof. Iwao Oshima, Prof. Eiji Kitajima, Prof. Hisao Sato, Prof. Kurumi Saito, and Prof. Koki Tsuruoka, for the continuous support of my Ph.D study and research, for their patience, encouragement, enthusiasm, and invaluable knowledge and advice. Without their immense knowledge and guidance, I could not have completed this dissertation. I am thankful indeed. Moreover, I am deeply grateful to Phrakhru Sujina Kunlayanadham, the administrators and staff of Hua-Ngum SAO, the Director of the Hua-Ngum THPH, the schoolteachers of Padeang Wittaya School, the elderly residents of Hua-Ngum, community leaders, and the Hua-Ngum people that provided great learning opportunities in my life. Furthermore, I would like to express my regards and thanks to all research participants in the other four sub-districts - Banmaipattana, Donfai, Nanokkok, and Bansiao, and to the ten Thai experts for their kindness, support, data, and knowledge. Additionally, I would like to express my sincere gratitude to my great Professors at Thammasat University (Thailand), Prof. Decha Sungkawan, Prof. Pornchai Tarkulwaranont, Prof. Julaporn Euarukskul, and Prof. Saifon Suindramedhi for inspiring my studies in Japan. My warmest regards also go to Thammasat University and Mr. Boonchoo Treethong for my Ph. D scholarship. I am deeply appreciative because it has led me to gain new ideas, invaluable knowledge, and life experience. My sincere thanks also go to my wonderful and lovely Japanese and Korean friends in JCSW, especially my friends in the seminar classes of Prof. Uemura, Prof. Oshima, Prof. Tsuruoka, and the friends who work in the JCSW Research Institute. I am very glad to have met and become friends with all of you. Thank you very much for all of your support and friendship. All of you have made my days in Japan meaningful. Finally, I would like to thank my family - my parents and my younger brother - for everything they have done for me, particularly their spiritual support throughout my life. Without my family, I could not overcome the obstacles I have faced. ii Table of Contents Page Abstract ………………………………………………………………………….. i Acknowledgments ………………………………………..……………………... ii Table of Contents………………………………………………………………... iii List of Tables……………………………………………………………………. viii List of Figures…………………………………………………………………… x List of Photos……………………………………………………………………. xi List of Charts…………………………………………………………………….. xi Chapter 1 Introduction 1. Background of the Study……………………………………………………… 1 1.1 Global aging and the age-friendly city movement………………………… 1 1.2 Thai aging situation ……………………………………………………..... 2 1.3 Focusing on age-friendly community, social participation domain……….. 3 1.4 Need of age-friendly community in rural context and Thai academic……. 4 1.5 Why focus on rural area and northern Thailand………………………….. 4 1.6 Age-friendly community development in rural northern Thailand is needed………………………………………………………………………….... 6 2. Objectives of the Study……………………………………………………….. 6 3. Research Question…………………………………………………………….. 7 4. The Definition of Terms………………………………………………………. 7 5. Significance of the Study……………………………………………………… 7 6. Structure of the Dissertation…………………………………………………... 8 Chapter 2 Literature Review 1. The Age-friendly Community: Definition and the Shift of Paradigm……….. 9 2. The Age-friendly Community: Concept and Characteristics………………… 9 2.1 Age-friendly community based on the lifespan and developmental psychology perspective………………………………………………………….. 10 2.2 Age-friendly community based approaches identified……………………. 10 2.3 Age-friendly community based on ecological perspective……………….. 10 3. Age-friendly Community Development: Models, Processes, and Principles… 12 3.1 Community development concept…………………………………………. 12 3.2 Age-friendly community development ……………………………………. 15 4. Social Participation of the Older Persons and Age-friendly Community…….. 19 4.1 Social participation of older people: the definition and characteristics…… 19 4.2 Factors and conditions related to social participation of the older people… 20 5. Conceptual Framework……………………………………………………….. 21 Chapter 3 Research Methodology 1. The Overview of Research Process………………………………………..…. 22 2. Research Field: Why Select Hua-Ngum Sub-district?....................................... 23 3. Data Collection Procedures…………………………………………………… 26 3.1 Phase of preparation………………………………………………………. 26 3.2 Phase of getting in…………………………………………………………. 27 3.3 Phase of data collection……………………………………………………. 28 3.4 Phase of withdrawal……………………………………………………….. 28 iii Table of Contents (continued) Page 4. Research Process and Method for Data Collection…………………………… 29 4.1 The 1st step: The study on the concept of AFC and Hua-Ngum’s experiences on age-friendly community………………………………………… 29 4.2 The 2nd step: Possibility study on the implementation of the model of age- friendly community development ……………………………………………….. 31 5. Research Instruments…………………………………………………………. 34 6. Ethical Considerations………………………………………………………… 35 7. Data Analysis…………………………………………………………………. 35 Chapter 4 Thai Aging Society and Introduction of Hua-Ngum Sub-district 1. Introduction of the Chapter ………………………………………………….. 36 1.1 Objective of the Chapter…………………………………………………... 36 1.2 Data collection……………………………………………………………. 36 2. Overview of Thai Aging Society ……………………………………………. 36 2.1 Change of Thai population structure……………………………………… 36 2.2 Trends of Thai aging population ………………………………………….. 40 2.3 Thai aging and gender issue……………………………………………….. 41 2.4 Thai aging index…………………………………………………………… 42 2.5 Particular characteristics of Thai older people…………………………… 43 3. The Responses of Thai Government to Population Aging …………………... 43 3.1 Overall reaction…………………………………………………………… 43 3.2 Social service and long-term care…………………………………………. 45 3.3 Health service……………………………………………………………… 46 3.4 Old age allowance………………………………………………………… 48 3.5 Pension and retirement benefits…………………………………………… 48 3.6 The elderly clubs………………………………………………………….. 49 3.7 Sub-district Administrative Organizations (SAO) and the role for improving quality of life of Thai elderly in rural areas………………………….. 49 4. Introduction of Hua-Ngum sub-district ……………………………………… 53 4.1 Size, location, geography, and climate………………………………….. 53 4.2 Population and population structure……………………………………… 55 4.3 Education………………………………………………………………….. 56 4.4 Occupation, income and expenses of Hua-Ngum people………………… 57 4.5 Religion, tradition and culture…………………………………………….. 60 4.6 Health status and primary health