Aging is a process that many people experience in their lifetime, though no person experiences it in the exact same way. Our experience is shaped by when and where we are born, the places we grow up, major historical and personal events, our family, friends, and our choices. Certain aspects of aging, such as perceptions of aging, healthcare, long-term care, and retirement, vary greatly across cultures. In South Korea, this is no exception, and as we discussed in class, there are many differences and similarities among these factors when compared to the United States.
One factor that significantly impacts growing older in South Korea is the health characteristics of the country, such as life expectancy, causes of death, and obesity. South Korea’s life expectancy is one of the highest in the world at 81 years from birth (“Republic of Korea: WHO statistical profile”). When compared to the global average, this higher life expectancy implies a more developed country, which tends to better support aging compared to a developing country.
In my opinion, the top causes of death are the most significant of all health characteristics, as they can signal more deep-rooted issues in a society. In the top causes of death in South Korea, nearly half of the top ten are noncommunicable diseases, which is also indicative of a developed society. The top three, all noncommunicable, are cancer, heart disease, and cerebrovascular disease, but perhaps the most noteworthy cause of death is number four: intentional self-harm (Shin et al).
Intentional self-harm resulting in death has been on the rise since 1990 (Lim et al). Analyzing by gender, this trend impacts men more than women, as it is the number four cause of death for men but down to the sixth cause of death for women (Shin et al). This increase in suicide rates brings to light the underlying mental health crisis that many South Korean adults are facing today.
Obesity trends can also represent underlying health factors in a society, such as diet and physical activity. South Korean obesity rates are very low compared to rest of the world. Though they have been on the rise since 1975, only 6.9% of men and 7.7% of women age twenty and older in Korea are considered obese (“Republic of Korea: WHO statistical profile”). This is slightly over half of the global obesity rate of about 13% of adults (“Obesity and Overweight”). Primarily this is the result of a natural based Korean diet centered around vegetables, fish, and rice. However, it is not necessarily attributed to a focus on physical activity in adults. In fact, physical activity rates among obese adults have decreased in recent years as Korea moves towards a more sedentary society (“Major Results: Health Behavior”). On the contrary however, over half of South Koreans met the physical activity recommendations, a rate that is above the average when compared to other countries (Cho).
Life expectancy measures, causes of death, obesity rates, and other health characteristics of a country can provide insight into certain health problems citizens in that country may encounter as they age and suggest areas where reforms should be made. For example, the increase in intentional self-harm deaths in South Korea since 1990 shows that adults in South Korea are experiencing mental health problems and are not receiving adequate support. Additionally, increasing obesity rates with lower physical activity can lead to related health problems like diabetes. Being personally aware of the risks involved with mental health problems and increasing obesity rates allows individuals the opportunity to educate themselves on preventative measures so that they can attempt to avoid the associated health problems later in life.
Another factor that impacts the aging experience in South Korea is the available long-term care options and the traditions and attitudes associated with long-term care. Recently, there has been a shift in the long-term care system in South Korea, with a new system put in place in 2008. In the past, there has been a predominant belief that families are responsible for taking care of their aging relatives who are no longer able to independently care for themselves. Specifically, women in the family held that responsibility; but as more women entered the workforce, the structure of families changed, and the women became less able to care for their older relatives (Jeon and Kwon).
This change in family structure combined with a rapidly aging population led to a need for a long-term care system to be put in place. In 2008 South Korea implemented a universal long-term care insurance system to help ease this transition. The system is based on the neediness of the individual, which is determined by a test of the individuals physical and mental abilities. It provides coverage for both nursing homes and in-home care. Over time, coverage has been extended to include more and more individuals, and citizens are beginning to fully utilize the benefits available through this system (Jeon and Kwon).
It is important to note, however, that though the universal long-term care insurance is available to everyone, it is not entirely free to individuals. Individual’s copayments are a decent portion (20% of institutional care and 15% of home-based care) of the financing of this system, in combination with the premiums paid through health insurance and taxes. Though the program is separate from health insurance, those who pay into health insurance also pay into long-term care insurance (Jeon and Kwon).
Long-term care is a very important part of the aging experience. It impacts where and how an individual lives leading up to their final days. Overall, South Korea’s universal long-term care insurance system improves the quality of life for citizens during this time. This new system shows how important it is for someone to be able to afford the proper care necessary. Compared to the rest of the world, Korea is in the minority in providing this comfort to its citizens. As we discussed in class, only 6% of the world has this long-term care protection. Long-term care can place a heavy financial burden on an individual, and without support from the government or careful financial planning, it can lead to inadequate care or a poor institutional experience. Not only does this affect the person in need of care, but the impact spreads through to their family, as they become responsible for providing informal care to bridge the gaps between their loved one’s needs and the needs met by the long-term care they can afford. It is worth mentioning, however, that though it is diminishing with the existence of universal coverage in South Korea, informal care roles are still present among close relatives and friends.
An aspect of the South Korean focus on their aging population that would benefit the United States as well is the social infrastructure from the age-friendly initiatives in Seoul. This includes the variety of entertainment for older adults as a part of Seoul’s action plan for a more age-friendly city. By providing older adults with social settings to interact with others and a means to get to these social settings, they would become more actively engaged in the community. This would lead to a greater sense of purpose among older adults in the United States.
In the video shown in class, “South Korea’s Ageing Population” by The Economist, they discuss several activities targeted towards older adults, including cinemas screening older movies and cafes playing nostalgic music and serving traditional lunches. There are also “daytime discos” popping up in South Korea where older adults can enjoy the company of others while enjoying themselves on the dance floor (Kim). While this might not be the typical form of “elderly-targeted entertainment”, it allows them to do things they actually enjoy. Like every other age group, not all older adults are interested in the same things, so having a wide variety of options helps cater to the desires of all individuals. This gives greater opportunity for social engagement, which is not only beneficial for the mental health of the population but also is one of the key themes of successful aging, as identified in our class discussion.
Social engagement and entertainment are especially important during older adulthood, as there is less opportunity to interact with your peers and work no longer occupies the majority of the day upon entering retirement. After my grandmother retired and my grandfather passed away, my grandmother spent the majority of her time at home by herself. She enjoyed being able to go to different activities, and I know when I enter that stage in life I would like to have many different opportunities to choose from. By adapting this South Korean view towards social activities, the United States can promote more well-rounded society for all generations.
In summary, the aging experience in South Korea is in some ways similar to that in the United States, but is vastly different in many others. We see very close life expectancy measures and similar leading causes of death with a majority stemming from noncommunicable diseases, but other health characteristics such as obesity rates, are on opposite ends of the spectrum. Long-term care also looks very different in South Korea, with universal long-term care insurance available to all citizens. Another difference stems from certain age-friendly initiatives in which the United States could benefit from adapting. Though I would expect such differences when comparing aging in a developed country to aging in a developing country, I did not expect that there would be so few similarities when comparing aging in South Korea to the United States. However, this is why it is important to study aging in other countries. It provides insight into possible solutions to our own problems based on what has been successful in other counties, and we can learn from initiatives that have been unsuccessful in other countries.