With Korea’s population declining in earnest, the problem of regional depopulation is intensifying. Depopulation is especially severe in areas considered at risk of “fading away,” where more than half of the population consists of individuals aged 65 and over, many of whom, as their functional abilities in daily life continue to deteriorate, may well soon be added to the list of eldercare recipients. Given the low residential mobility rates among older adults, eldercare needs look set to only grow over time in these local areas. A lack of human resources, shortages of provider agencies, and less-than-convenient transportation networks further compound the issue. These declining areas are typical sites where “spatial mismatch” becomes especially pronounced, as available resources increasingly fail to meet local demands. This situation may work against aging in place (AIP) for older adults and is likely to undermine their quality of life.
Over the years, the government has steadily strengthened the eldercare system by expanding long-term care insurance, tailored care, and the availability of dementia care centers. There are a wide variety of services on offer. However, as the national population declines and regional contraction accelerates, it has become evident that existing services―particularly in their supply and delivery―fall short, in many respects, of meeting local eldercare needs. There is thus a growing need to move beyond the centrally managed, standardized service provision toward more flexible approaches that are tailored to local conditions. It is in this recognition that we put together this month’s Health and Welfare Forum and look into the structural limitations of Korea’s eldercare in terms of the spatial mismatch between demand and supply, service infrastructure, and central-government eldercare policies as well as the policies aimed at addressing local decline from the eldercare perspective. Cases of community-originated endeavors are also taken up. I hope readers will find our discussion an opportunity to reflect on how local eldercare might be reconfigured in the current social context of structural transformation driven by population aging and regional decline.
With Korea’s population declining in earnest, the problem of regional depopulation is intensifying. Depopulation is especially severe in areas considered at risk of “fading away,” where more than half of the population consists of individuals aged 65 and over, many of whom, as their functional abilities in daily life continue to deteriorate, may well soon be added to the list of eldercare recipients. Given the low residential mobility rates among older adults, eldercare needs look set to only grow over time in these local areas. A lack of human resources, shortages of provider agencies, and less-than-convenient transportation networks further compound the issue. These declining areas are typical sites where “spatial mismatch” becomes especially pronounced, as available resources increasingly fail to meet local demands. This situation may work against aging in place (AIP) for older adults and is likely to undermine their quality of life.
Over the years, the government has steadily strengthened the eldercare system by expanding long-term care insurance, tailored care, and the availability of dementia care centers. There are a wide variety of services on offer. However, as the national population declines and regional contraction accelerates, it has become evident that existing services―particularly in their supply and delivery―fall short, in many respects, of meeting local eldercare needs. There is thus a growing need to move beyond the centrally managed, standardized service provision toward more flexible approaches that are tailored to local conditions. It is in this recognition that we put together this month’s Health and Welfare Forum and look into the structural limitations of Korea’s eldercare in terms of the spatial mismatch between demand and supply, service infrastructure, and central-government eldercare policies as well as the policies aimed at addressing local decline from the eldercare perspective. Cases of community-originated endeavors are also taken up. I hope readers will find our discussion an opportunity to reflect on how local eldercare might be reconfigured in the current social context of structural transformation driven by population aging and regional decline.
This article presents an analysis of the problem of spatial mismatch between demand and supply for eldercare resources in Korea, where rapid population aging coincides with local depopulation. Using high-resolution demographic data, this spatial accessibility analysis finds that for regions with declining populations, often characterized by a high proportion of residents aged 65 and older and dispersed settlement patterns, accessibility to eldercare facilities is substantially lower than suggested by administrative data. Moreover, the proportion of older adults for whom care services are available within walking distance declines sharply when estimated with real road network distances taken into account, indicating that existing locality-specific statistics do not adequately represent gaps in eldercare provision in local areas. These findings suggest that addressing the stated problem should involve not only increasing the provision of eldercare facilities, but also a major policy shift in the direction of promoting adaptive reuse of non-eldercare facilities and expanding outreach services in order to improve the spatial availability of local eldercare and better assist individuals with mobility limitations.
In this article, I first examine whether and to what extent national-government policies concerning population and eldercare bear on aging in place (AIP) and the right to receive care for older adults in a growing number of rapidly depopulating localities, and then suggest ways to improve the eldercare system and related programs so that these seniors can continue living in their own communities with assured access to the care services they need. The present analysis of two categories of relevant policies―those addressing local depopulation (including master plans responding to demographic change and policies for balanced regional development) and those concerning health and care for older adults (such as health management, medical care, long-term care, and assistance with daily living activities)―shows that these policies, while each having been implemented with its distinct objective, exhibit various limitations in advancing AIP and guaranteeing the right of older adults in depopulating areas to receive adequate eldercare. In an attempt to address these limitations, this article discusses improvements needed for existing eldercare policies in order to further AIP for older adults living in depopulating areas.
Korea’s population is on the decline, a problem to which the central government has responded with various administrative and fiscal interventions. Notwithstanding these efforts, rapid demographic shifts have led to regional disparities in guaranteeing fundamental rights, most notably the right to receive adequate eldercare.
In this context, the present study analyzes three regions facing depopulation that have been regarded as proactive in addressing eldercare challenges, identifying their specific contextual factors and examining their concrete policy instruments and implementation strategies.
Based on this comparative assessment, the study offers several key policy implications. To build a sustainable and stable eldercare system, it is vital to: (1) develop multifunctional, community-based care infrastructures; (2) reinforce mechanisms to meet the essential needs of local residents; and (3) establish models for the recruitment and retention of the local care workforce.
This study examined whether information online about the Community Social Service Investment Program, a key source of local social services, was provided in sufficient quantity and in an easy-to-understand format. The analysis covered digital outlets such as websites and social media platforms operated by various organizations, including service providers, government-related agencies, and local authorities. Only 15.5 percent of all provider organizations maintained their own online platforms, and the information provided scored low in timeliness, variety, and vividness. These platforms were also limited in interactive functionality, that is, in terms of the extent to which they enable users to make individual requests for information or share their own feedback. Overall, social service providers offer only limited information access on their online platforms, an issue that calls for the attention and support of central and local governments. The same problem also applies to many online platforms operated by local and central government agencies. From these findings I draw policy recommendations for improving user access to information about social services.
In the last two decades, Korea has made continued efforts to expand out-of-school-hours care (OSHC) for primary school children, with the Ministry of Education, the Ministry of Health and Welfare, and the Ministry of Gender Equality and Family leading the way. Still, the point at which children begin primary education often marks a second career break for their mothers. To reduce the childcare burden on families, the government has woven after school education and out-of-school-hours care into Neulbom School, a system integrating in-school programs with community-based services outside school. However, a tailored-to-needs program as part of this system, while having in effect extended school release time for children in the first and second grades, has been pointed out to be unsustainable due to a lack of human resources, space, and operational capability. Against this backdrop, the Ministry of Education is set to shift the policy focus to what is known as the On-Dongnae Care Initiative. This article surveys the current state of OSHC for primary school children and offers several points for consideration that may be of use in policymaking toward community-based afterschool care.
