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| 教 育 專 題 深 入 報 導《2007-04-20》 |
| 本期內容 | |
| ◎國際專題：別讓長輩一個人走！日本正在努力Japan's age-old problem | |
| ◎美連鎖速食進攻 日本健康亮紅燈Health fears as Japan falls for fast food | |
| 國際專題：別讓長輩一個人走！日本正在努力Japan's age-old problem | |
| 策劃、編譯■唐澄暐、侯美如 | |
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眼前房舍剝落、侵蝕的外觀和破爛的設施，讓人很難想像這片「常盤平住宅區」在1960年代初期打造的時候，還被認為是郊區名宅的標準。同時，在東京東北方松戶市的便宜低層套房，開始被那群帶動日本經濟奇蹟的年輕家庭所佔據。但在過了50年之後，常盤平住宅區已不再是個典範，而是當下日本人的警訊。 離開了樹蔭成列、井然有序的日本印象街道，就會看見越來越多缺乏照顧的獨居老年人，在日本進步並成為全球最年長社會的過程中，獨自生存並死亡。在日語中，他們的慘況被稱為「孤獨死」。 在1960年代，常盤平住宅區的居民沒有一個在65歲以上，但其人口統計就像全日本一樣在快速改變。現在，5,360位居民中有1／3是老年人，10年內就會變成40％。 「這樣的改變在不知不覺中就形成了」，當地援助居民的自助會領導者阪井豐表示。「常盤平住宅區已經變成一個讓老人獨居的便宜地方。當他們退休，發現自己無法發展人際關係的時候，就搬到了這裡。很多案例中，他們在幾年內就會過世。」 他表示，與鄰居斷絕往來的退休男性，是最容易發生危險的一群。「在他們過世後進入他們的房間，你很快就會發現，這些人都沒辦法烹飪、打掃或洗衣。他們甚至連垃圾都不丟。他們完全無法照顧自己。」許多人離婚後，就與孩子斷絕了往來，多數出現酗酒問題。「當他們身邊無人依靠，酒精就成了他們的好友。」常盤平住宅區自治會的主席中澤卓實表示。 中澤對於當地生活的描述，讓日本社會緊密聯繫的傳統形象整個鬆動。在這裡，獨居銀髮族的出現被認為是大家庭分解、農業人口驟減和中高年離婚率升高所造成的後果。 而日漸年老的日本社會，更讓這樣的情形雪上加霜。日本已經比世界其他國家都要來得年老，其平均壽命為男性79歲、女性85歲。政府統計顯示，超過65歲的人在總人口中佔了21％，超越了之前的冠軍義大利。現在，380萬日本老年人獨居，根據統計未來35年將達到630萬人。沒有國家統計過多少人獨自老死，但松戶在2004年的統計是95人，其中男性佔了總數的3／4。 5年前，常盤平住宅區的居民發現一位男性死在家中，屍體在那邊放了3年還沒人知道。從此他們便展開了各種行動；他們設立了「免費關心熱線」，讓察覺不對的鄰居可以立即通報；他們也和當地郵差簽署合作，當郵差發現信箱一直沒人收信時就立即通報。 當常盤平住宅區於2003年第一次統計的時候，獨自死亡的人數是15人，2004年是21人，去年掉到只剩6人。「目前還沒辦法達到零，但至少現在已經沒有人死了幾個月還沒被發現了。」中澤表示。 中澤的努力促使東京和其他地方政府也展開嘗試，包括監視年長者瓦斯與電表活動是否突然停止，以關注老年居民的安全。而全日本面臨的老化，也激發出不少可讓家中有老年人的家屬可以方便關心的小工具，包括一旦開啟就會送出3封e-mail的「線上水壺」，或是可以將冰箱門、浴室地毯等日常家具與網路連線的感應器。阪井承認，如果實在沒辦法說服多數老年男性參加更多社區生活，這樣有監控功能的小工具確實可以挽救不少生命。 然而，也有其他常盤平住宅區的老年居民拒絕孤獨度過餘生。81歲的離婚婦女益岡雅子依然能勝任清掃志工，並為她的鄰居們煮飯。她認為，她們那個年代的人有種寧願死也要保有隱私權的文化，這也是造成老年孤獨的原因之一。「獨自死去的人都有他們自己的個別問題」，她說。「他們完全不想要融入任何人，所以當他們生病或覺得生活出了問題，沒有人能幫他們。我有朋友，所以就好多了。」 常盤平住宅區現在的目標寫在社區四處可見的標語上：要將獨自死亡的人數降到零。中澤希望這樣的目標也能在日本各個銀髮社區努力。「幾十年來我們對於日本的社會福利都很熟悉，但那都是由上而下的政策。我們認為，政府不應該只關心人們怎麼活著，也該關心他們的生命是怎樣結束的。」 With their flaking, battered exteriors and weatherworn amenities, it is hard to imagine that the concrete flats of Tokiwadaira were considered the height of suburban chic when they were built in the early 1960s. Then, the dozens of low-rent, low-rise tenements in Matsudo city, north-east of Tokyo, were snapped up by young families leading Japan's rapid flight from postwar austerity towards a future of unprecedented wealth. But almost 50 years on, Tokiwadaira is not so much a model as a warning to the rest of Japan. Away from the pleasant, tree-lined streets the price of Japan's transformation into the world's greyest society is being paid by a growing number of people who live, and die, in complete isolation. In 1960 not a single Tokiwadaira resident was aged over 65, but its demographics, like Japan's, are changing fast. Now, almost a third of the 5,360 residents are elderly; in 10 years they will make up around 40%. "It has changed beyond recognition," says Yutaka Sakai, head of a local group that reaches out to at-risk residents. "Tokiwadaira has become a cheap place for old people who live alone. They move here when they retire and find it difficult to make friends. In many cases they're dead within a few years." Men, he says, are the greatest risk of living out their retirement cut off from their neighbours. "Go into their homes after they die and you can see straight away that most can't cook, clean or do laundry. They don't even throw out their rubbish. They have no idea how to look after themselves." Many are divorced and have lost touch with their children or have developed problems with drink. "When they have no one, alcohol naturally becomes their best friend," says Takumi Nakazawa, head of the local residents' association. Tokiwadaira residents were spurred into action five years ago after the decayed corpse of an elderly man was found inside his flat three years after his death. They formed a taskforce to put in place a range of measures that include free counselling, a hotline for concerned neighbours and an agreement from newspaper-delivery workers to alert them when papers remain uncollected from mailboxes. Mr Nakazawa's description of life in his neighbourhood sits uncomfortably with the traditional image of tightly knit Japanese communities. Here, the rise of the grey singleton is blamed on the breakup of the extended family, rural depopulation and the rising divorce rate among middle-aged and retired couples. The rapidly ageing society will only make matters worse. Japan is already greyer than any other nation on earth, with an average life expectancy of 79 for men and 85 for women. Government figures show that the number of people aged 65 or over stands at 21% of the total population, surpassing the previous record-holder, Italy. Around 3.8 million elderly Japanese live alone, and the number is expected to rise to 6.3 million in the next 35 years, according to estimates. No national records are kept of the number of people who die alone, but in Matsudo in 2004 the number was 95, with men accounting for almost three-quarters of the total. Tokiwadaira's death toll had fallen to six last year, compared with a record 21 two years earlier and 15 in 2003, when records were first kept. "It's not zero yet, but at least we no longer have people lying dead for months," Mr Nakazawa said. His talent for generating publicity has prompted Tokyo and other local governments to experiment with checks on the wellbeing of elderly residents by monitoring their gas and electricity meters for signs of sudden inactivity. The greying of Japan has also inspired an array of gadgets for people who are worried about elderly relatives. They include an "online" kettle that automatically sends emails to up to three recipients when it is switched on, and internet-linked sensors that can be attached to everyday items such as fridge doors and bathroom mats. Gadgets like these could save many lives, particularly if, as Mr Sakai admits, many elderly men will never be persuaded to play a more active part in community life. Other elderly Tokiwadaira residents, however, refuse to live out their remaining years in isolation. Masako Masuoka, an 81-year-old divorcee, is still fit enough to work as a volunteer cleaner and cook for her elderly neighbours. She says a cultural tendency among her contemporaries to protect their privacy at all costs was partly to blame for their loneliness. "People who die alone have their own special problems," she said. "They don't even attempt to mix, so if they feel ill or something is going wrong in their lives, no one can do anything for them. I've got friends. That helps." Tokiwadaira's aim, emblazoned on dozens of banners around the neighbourhood, to bring the number of deaths in isolation down to zero, is one Mr Nakazawa says should be repeated in greying neighbourhoods across Japan. "We've been familiar with the idea of social welfare in Japan for decades, but it's always been from the top down," he said. "We think the government should be concerned not just about how people live, but about how they die as well." http://www.guardian.co.uk/japan/story/0,,2059047,00.html |
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| 美連鎖速食進攻 日本健康亮紅燈Health fears as Japan falls for fast food | |
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英國《衛報》指出，隨著美式速食連鎖店大舉入侵，素以清淡生魚片、醋飯海苔壽司聞名的長壽之國日本，也開始淪陷，追逐高糖高熱量的下一代飲食男女，將付出他們的青春年華為肥胖及青春痘奮戰。 近日才在新宿新開張的香脆奶油甜甜圈店，正象徵了美式速食聯鎖店登陸日本大成功的例子，首賣當日，大批群眾為了一嚐知名甜甜圈的滋味，不惜排上一個多小時的隊伍，接下來的3天內並估計共有1萬人次入店消費。 其他來自美國的速食鉅子，如冷石乳製品專賣店Cold Stone Creamery，上個月才在日本開了3間新分店，為饕客提供香濃冰淇淋、配上酸酸甜甜的新鮮水果、榛果和小脆餅，大受好評，計畫這個月還會增開兩家分店；漢堡王也不落人後，將在近期推出新計畫，二度衝擊日本速食市場；而身為龍頭的麥當勞成果豐碩更不消說，光是3月份銷售量就達到430億日圓（約120億新台幣），創下進駐日本市場36年來最高紀錄，甚至4天內就能賣出170萬個超大麥克堡（夾著4片牛肉餡的超大漢堡）。 然而，就在左一口漢堡右一匙冰淇淋的誘惑下，日本新世代也不知不覺吞下了足以毀滅健康的危險因子。4月初一份研究報告指出，日本5到12歲的兒童中每5人中就有1人是胖小子，在成長過程中就必須面對發展障礙、代謝症候群等問題，小小年紀就可能大腹便便，報告進一步發表，若這些孩子未接受適當治療，肥胖甚至可能在未來導致中風及心血管疾病等嚴重後果。日本舉國上下，2千3百萬兒童的健康都亮起紅燈。 而雖然日本直到近幾年才出現罹患第2型糖尿病（起因肥胖或遺傳的糖尿病）病例，且好發者多為年屆半百的上班族，研究也指出，患者年齡有下降趨勢，目前最年輕的病例甚至年僅9歲，專家表示，背後元兇便是販賣高熱量食品的美國速食連鎖店。 而促成這樁「好事」的幫兇便是父母，「最需要為孩子的飲食負責的自是父母，但問題是，他們自己的飲食習慣也很差。」國家健康與營養研究院研究員林文指出，父母根本就沒有作好榜樣。 現在，一波波隨著肥胖襲擊而來的疾病將更迅速、更猛烈地向日本叩關，浩大攻勢甚至遠超過任何西方國家曾經歷過的。「當生活習慣急速改變，最糟的健康問題就隨之而來。」國際肥胖專案小組亞太地區協調員吉爾指出，突然轉向高糖油膩食品的日本，無異是盲目投向代謝毛病的懷抱，中風、糖尿病及高血壓罹患率將戲劇性高攀，「這可能是場健康的浩劫」。 由於缺乏政府規範，速食廣告得以恣意縱橫日本電視媒體，著眼兒童消費者的文宣五花八門，速食工業在這裡贏得前所未有的勝利。成就無數肥胖歐美孩童的元兇，現在正貪婪地將大手伸向亞洲這塊炙手可熱的大餅。 但是青少年還想不到那麼遠，現在他們的眼裡只有鮮嫩多汁的大麥克，還有熱呼呼的脆皮奶油甜甜圈。「脆皮奶油甜甜圈是把最高熱量塞進最小容積食物裡的最佳典範。」吉爾表示。 此外，亞太肥胖外科學會指出，日本地區共有1千3百人為減重、移除脂肪而進行外科手術。速食旋風來襲，樂了外來連鎖店和整形醫師，卻苦了日本的新世代，如何在傳統健康飲食及高膽固醇速食中取得平衡，是日本即將面臨的難題。 Japan, the home of sushi, seaweed cuisine and the world's longest life expectancy, is rearing a generation of young sugar addicts who are destined to spend their adolescence fighting obesity and acne, according to a report that paints a devastating picture of the country's health crisis. In Tokyo, the fast food of choice is a towering concoction of four hamburger patties, with all the trimmings, crammed into a single bun and children happily line-up around the block for a calorie-laden doughnut. But while the queues outside the Krispy Kreme doughnuts in the Shinjuku area of the capital, which opened recently, point to an extraordinary Japanese success story for the fast-food industry, they also symbolise a health disaster in the making for consumers. Up to a fifth of Japanese children aged from five to 12 who are overweight suffer, or are at risk of developing, metabolic syndrome, a range of symptoms including high cholesterol and large waistlines, according to a study released last week. Left untreated, it can lead to serious illnesses such as strokes and heart disease. Nationwide, the condition afflicts an estimated 23 million Japanese, the health ministry warns. Although middle-aged 'salarymen' are at greatest risk, children as young as nine are now suffering from type-2 diabetes, a phenomenon unheard of in Japan only a few years ago. Experts say the looming health crisis is being fomented by a surge in demand for highly calorific food sold by the top US food chains. When Krispy Kreme opened people waited more than an hour to sample its doughnuts - some of which pack several hundred calories each. An estimated 10,000 people visited the restaurant in the first three days. Cold Stone Creamery, which serves up portions of ice cream mixed with fruit, nuts and biscuits, opened three new outlets in Japan last month and plans to open two more this month, while Burger King is about to launch its second assault on the Japanese market. Last week McDonald's in Japan reported monthly sales of just over 43bn yen (about ￡183m), the highest in its 36 years in the country. The US chain sold 1.7 million Mega Macs - four burger patties in a bun - in four days in Japan, as outlets struggled to keep up with demand. Experts blame adults for setting a poor example. 'Ultimately it is up to parents to take greater responsibility for what their children eat,' says Fumi Hayashi, a researcher at the National Institute of Health and Nutrition. 'The problem is that they are just as guilty of bad habits rather than eating a balanced diet.' Now diseases associated with obesity will strike Japan faster, and with greater ferocity, than anything seen in the West. 'When you have rapid transformations in lifestyles, that's when you see the worst health outcomes,' says Tim Gill, Asia-Pacific regional co-ordinator for the International Obesity Task Force. The rapid changes taking place in the Japanese diet, combined with a greater susceptibility to metabolic illness, will lead to dramatic rises in strokes, diabetes and hypertension, he warned. 'The potential is there for a disaster.' In the absence of government intervention - limiting TV advertising aimed at children, or banning special promotions - the fast-food industry is enjoying unprecedented success in Japan. Held responsible for contributing to health problems of American and British children, the same firms are setting their sights on a lucrative market in Asia, the world's most populous region. Krispy Kreme's marketing machine, combined with the mouth-watering sight of freshly made doughnuts emerging on a conveyor belt, is proving irresistible to Japanese teens. 'Krispy Kreme is the epitome of how to cram maximum calories into the smallest amount of food,' Gill says. 'All you can do with doughnuts is to point out what crap they are.' More than 1,300 people across the region have had weight reduction surgery since the beginning of last year, according to the Asia Pacific Bariatric [Obesity] Surgical Society. http://www.guardian.co.uk/japan/story/0,,2052583,00.html |
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