Integrated Long-Term Care ‘Neighbourhoods’ to Support Older Populations: Evolving Strategies in Japan and England

Ala Szczepura, Harue Masaki, Deidre Wild, Toshio Nomura, Mark Collinson, Rosie Kneafsey

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Western countries are currently facing the public health challenge of a rapidly aging population and the associated challenge of providing long-term care services to meet its needs with a reduced working age population. As people age, they will increasingly require both health and social care services to maintain their quality of life and these will need to be integrated to provide cost-effective long-term care. The World Health Organization recommended in 2020 that all countries should have integrated long-term care strategies to better support their older populations. Japan, with the most rapidly ageing society in the world, started to address this challenge in the 1990s. In 2017, it introduced a national policy for integrated long-term health and social care services at a local geographical level for older people. England has recently embarked on its first plan aiming for the integration of services for older people. In this article, we compare these approaches to the integration of long-term care systems, including the strengths of each. The paper also considers the effects of historical, cultural and organizational factors and the emerging role of technology. Finally, we identify critical lessons that can inform strategy development in other countries, and highlight the need to provide more international comparisons.
Original languageEnglish
Article number6352
Number of pages13
JournalInternational Journal of Environmental Research and Public Health
Issue number14
Early online date12 Jul 2023
Publication statusPublished - Jul 2023

Bibliographical note

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (


This research received no external funding. The views expressed are those of the authors.


  • integrated health and social care
  • national strategy
  • older people
  • aging in place
  • international comparison
  • Japan
  • family carers
  • digital technology
  • community-based care
  • COVID-19


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