[Feature: Rethinking Japan's Living Environment] Roundtable Discussion: What Kind of Housing Allows for a Healthy Life in the Age of 100-Year Life Expectancy?

Today, I would like to discuss with everyone the idea of reviewing Japan's housing environment, primarily from the perspective of "health and longevity."

First, I would like to speak about the current situation. Recently, there was a national convention of the "National Network of Clinics and Citizens Supporting Home Care," where I spoke on the theme of "Prevention of Disease and Need for Nursing Care through Reviewing Housing and Lifestyles." However, at present, there is a lack of evidence-based data in Japan.

I believe that unless we collect data thoroughly and accumulate it at a level that can be published as medical papers, the element of "housing" will not be incorporated into Japan's health policies.

In particular, we are currently trying to support the elderly through community-based integrated care. The "housing and lifestyle" part is, so to speak, the flowerpot that serves as the foundation, but the current situation in Japan is that there are "cracks" in that important flowerpot.

Why are Japanese houses so cold? A passage from "Tsurezuregusa" (Essays in Idleness) is constantly cited: "A house should be built with the summer in mind. In winter, one can live anywhere." This is a story from the Kamakura period, saying that even if it is cold in winter, one can manage somehow. Even today, architects and housing providers use these words as a golden rule, citing them as a basis for arguing that insulation is unnecessary.

However, Tsurezuregusa was written in an era when life expectancy was 50 years, and it assumed temperate regions like Kyoto and Kamakura, without taking Tohoku or Hokkaido into account. But there is a problem in that this idea is widely circulated.

On the other hand, in the UK, the housing environment is now firmly positioned within health policy. I believe this is because Florence Nightingale showed a deep understanding of the housing environment in her book "Notes on Nursing" 160 years ago, and that has taken root.

Temperature standards have been set, and the public is told that an appropriate heating environment is 18°C or higher, and that a cold house leads to various illnesses. In fact, developed countries other than Japan have properly positioned the housing environment in their health policies, and based on this, the WHO issued guidelines three years ago with a strong recommendation for a "winter indoor temperature of 18°C or higher." However, Japan is not yet prepared to accept this.

The third revision of "Health Japan 21" has just begun. Through this review, we have reached a point where the housing environment is recognized as a health issue, but it is unclear whether it will ultimately be reflected.

Given this situation, I would first like to ask how you feel about the current problems with Japanese housing from your respective professional standpoints. Dr. Suzuki, from the perspective of emergency medicine, what are your thoughts?

To begin with, "housing" rarely comes up as an issue in emergency medicine. However, if you think about it, we spend 8 or 10 hours a day at home, so it goes without saying that the living environment there is important.

As I always say, emergency medicine is like the "end of the line." It's not a matter of feeling a bit unwell and going to a nearby hospital; it's the image of a condition becoming severe and requiring urgent attention.

Where are such people transported from? Of course, they are brought from places they are visiting or from work, but many are also brought from their homes. Recently in Japan, the role of emergency services as a so-called safety net has become very heavy. What this means is that there is a background where people called the vulnerable, or those in financial distress, are increasingly unable to visit hospitals normally.

The living and housing environments of these people have become quite terrible. There are many who have almost no interest in health and live desolate lives. It is extremely important to consider the environment of the housing where we spend much of our lives.

There is hypertension, cardiovascular disease, and in emergency medicine, there are also deaths while bathing. Furthermore, falls and injuries inside the home are becoming more frequent. Also, while high temperatures in summer due to climate change are attracting attention, I believe we must think more about how we are affected by weather and temperature within our living environments.

Furthermore, COVID-19 is currently repeating cycles of outbreaks and subsidence, but I actually suspect that waves occur when the environment necessitates the use of heating or cooling.

For example, during the beginning of the first wave, there were many infected people in Hokkaido. Since Hokkaido is a cold region, rooms are sealed to keep them warm. I think there is a high possibility of infection if people do not ventilate in a sealed state.

I also have the impression that the so-called fifth wave began to decrease around mid-August when it suddenly became cooler. Ventilating reduces the efficiency of heating and cooling, but I feel strongly that we have entered an era where we must think even about such things.

Ms. Nagata, please speak from the perspective of home nursing.

In home nursing, our position is to support patients so they can continue living as long as possible in their homes—the place they return to from the emergency room, or where they might be at risk of needing emergency care.

Elderly people and people with disabilities live in various types of houses while maintaining connections with people in their communities. Therefore, we want them to continue living in their current homes regardless of the environment, but we sometimes face cases where a person with a disability wants to continue living in a five-story apartment complex without an elevator.

Also, as mentioned, there are homes that are very cluttered, or what the media calls "hoarder houses." Even in such a state, they live there saying that the environment is fine for them. To the individual, it is never trash; it is all their important memories and treasures.

We must provide daily nursing care to fulfill the wishes of people in these various environments as much as possible, while ensuring they maintain their health and that their conditions do not worsen. It is easy to tidy up to prevent falls, but the items in the house are their property. If we tidy up without permission because it's "dangerous," the connection might be severed with them saying, "You don't need to come anymore."

To prevent that, we build a relationship of trust and patiently work on improving the environment little by little while gaining their consent, saying things like, "If we clear this area a bit, it will be harder to fall when you go to the bath." This is more of a current reality than a problem.

Regarding the climate, it is true that very low indoor temperatures in winter can worsen cardiovascular diseases, but what we often hear on the ground is about air conditioning in the summer.

The idea of "focusing on the summer" is actually still not being realized. Even though it is becoming increasingly hot and humid, and despite living in sealed apartment complexes or crowded housing that is different from the past, there are many elderly people who refuse to use air conditioning.

Just like before, we try to get them to use the air conditioner even a little, building trust while attempting to make the room temperature even slightly more comfortable.

Also, it might be slightly different from housing problems, but while the number of people who cannot live without care intervention is increasing, housing with advanced auto-locks and security is also increasing. That is very important, but it can also mean that outsiders cannot enter the house even if they try.

It would be fine if we could reach a relationship where they entrust us with a key, but if it doesn't go that far, we become unable to approach the home. In some cases, even when we need to get to the person quickly, it can become a wall that stands in the way.

We have heard about the current situation from two medical professionals. Next, I would like to hear from Mr. Ito, as a representative of a company that provides housing.

The housing problem I feel is, after all, the low insulation performance. Our company has raised insulation standards in line with government movements, but many houses built over 20 years ago do not meet current standards.

For such houses, we are focusing on renovation proposals for "insulation retrofitting." When a house is over 20 years old, children have often left the nest, and it has become a household of only an elderly couple. Therefore, rather than renovating the entire two-story house, we recommend starting with the area currently in use, focusing on insulation retrofitting for the LDK (Living, Dining, Kitchen).

Indoor temperature differences are also a concern. For example, we propose installing small air conditioners in areas that easily get cold, such as hallways and washrooms, to first regulate the temperature in the living area. While cost is a factor, the fact that renovations can be done while living in the house is a key point, and orders are increasing.

Furthermore, for new construction, we are promoting ZEH (Net Zero Energy House). A ZEH is a house that aims for zero annual energy expenditure by significantly increasing insulation performance, introducing energy-saving equipment, and also providing power generation equipment such as solar power and fuel cells. Last year, 91% of the detached houses sold by our company were ZEH.

Equipping a house with such performance at the time of new construction also has the advantage of reducing introduction costs. In addition to energy efficiency, comfort is also improved. For example, windows are generally the part where heat escapes most easily, but if the insulation performance of the windows is sufficiently high, it is possible to create an open space that connects with nature without being cold, even with large windows. This is our company's current approach to aligning energy-saving performance while making the living environment comfortable in both new construction and renovations.

Dr. Suzuki mentioned ventilation earlier, and in response to the spread of COVID-19, our company also released a product called "Smart-ECS" last year. This is a system that performs ventilation and air purification while maintaining room temperature using heat-exchange ventilation equipment and ceiling-mounted air purifiers. We also make proposals while simulating air flow during the design stage and checking the state of the indoor air.

Mr. Kawakubo, you are well-versed not only in large-scale house makers but also in the circumstances of small local builders who play a major role in building houses.

Buildings are an important life foundation and social infrastructure for us. In particular, modern people are said to spend 90% of their lives indoors, and housing especially protects our safety and provides a place to rest. It is also a place to raise descendants, so it is natural to value it. Additionally, recently, it has also become a place for remote work. Diverse purposes are required, and I believe we must consider the nature of housing from truly various perspectives.

Looking back slightly at our country's housing policy, at the end of the war in 1945, the land was scorched and there was a simple shortage of housing. It was an era of housing hardship, but thanks to the hard work of house makers and local builders nationwide to provide housing, the quantity gradually became sufficient. That lasted until around 1970.

Next, there was a shift from quantity to quality, and the direction became to gradually improve quality until around 2000. Along the way, sick house syndrome also became a major social issue, but from around the mid-2000s, a trend emerged toward forming high-quality stock, which leads to today's healthy housing.

Considering the state of hardship due to housing shortages, it is gratifying that housing is now generally available, but a frequently mentioned problem is the short lifespan of houses. Compared to other countries, the scrap-and-build cycle is frequent.

As a countermeasure, the Long-Life Quality Housing certification system has been proposed, but compared to other countries, further extending the lifespan of housing is necessary. In addition, we must link this to solving problems such as resource circulation and decarbonization.

In other words, we must consider what to do with housing as a social asset, and we must also improve environmental performance. However, since housing is both a social asset and the private property of individuals, we cannot forcibly modify it, and how to improve the quality of the housing stock in the market as a whole is a very difficult point.

SDGs appear everywhere recently, and Goal 12 is "Responsible Consumption and Production."

This is the most important thing for those in the construction industry: how to create high-quality things and use them over the long term. Furthermore, recently, it has been pointed out in the industry that "responsibility for closing" is also important. In other words, after use, not leaving vacant houses as they are, but taking responsibility through to demolition.

Currently, the perspective of resilience is being emphasized again in the housing industry. Especially since 3/11, the strengthening of safe and secure home building has been advocated.

In 1961, the WHO released "Four conditions for satisfying basic human life needs regarding the living environment." First is "Safety." Since housing is a place that holds people's lives, safety is paramount. Next is "Health." This is followed by "Convenience" and "Comfort."

Housing in our country is generally thought to be of high quality, but I believe we need to re-examine the basics of the four conditions mentioned by the WHO, such as earthquake resistance and health-related performance.

Next, I would like to consider what kind of housing is good for health. Dr. Suzuki, for example, what about housing that prevents bathing accidents?

When asked what kind of housing is good for health, from the perspective of an emergency physician, "not falling into extreme situations" is the first essential condition for protecting health.

For example, the room temperature reaching about 40°C in summer. Conversely, always dropping to 2 or 3°C in winter. It is easy to imagine that living in such an environment for a long time is not healthy.

We call them environmental disorders, but heatstroke and sunstroke in summer, and hypothermia in winter, occur very frequently among the elderly, and moreover, they often live in such environments.

Regarding baths, the most influential cause of bathing accidents we consider is so-called heatstroke caused by soaking in high-temperature water. Since heatstroke depends on the environmental temperature, the way to prevent it is to reduce the amount of heat received from the hot water around the body.

In short, it means lowering the water temperature or shortening the time spent in it. However, if you consider whether you can enter a 38°C bath in the middle of winter, the environmental temperature depends on weather conditions. Then, a direction such as what kind of housing is not greatly affected by weather conditions would be good for preventing bath accidents. So, as I said at the beginning, I think it is important not to reach extreme situations, such as being extremely cold or extremely hot.

On the other hand, is it really good for the indoor temperature to be constant at 24°C year-round? Humans need a certain amount of temperature fluctuation. Mild stress on the body should create the power for the body to respond to it, and eliminating that is conversely not good for the body. Therefore, I think it will be necessary to determine a certain range of margin for variation.

The word "health" in "good for health" is also quite deep. The WHO says that health is "a state of complete physical, mental, and social well-being," and as you said, physical health requires at least not falling into extreme situations as a basic foundation, and maintaining that properly is truly important.

Regarding housing and health, I think fall prevention and ease of movement are also important elements, but this cannot be generalized. It is not necessarily the case that a house that is completely barrier-free, flat, and without obstacles is best; as mentioned, there are cases where having some kind of stress is actually better.

Going up and down stairs can ensure daily exercise, and while small steps can easily lead to falls, a raised entryway (agari-kamachi) with a step requires lifting the feet firmly, so doing that daily can help maintain the body's range of motion.

Therefore, in terms of maintaining exercise volume and ensuring physical mobility, generally having a state where a certain amount of stress is applied leads to adapting to the house and maintaining athletic ability.

Social and mental health are also things we inevitably consider from a nursing perspective. Being shut-in is said to affect people's healthy life expectancy, and I think maintaining social interaction and the frequency of going out is also very important. In addition to being comfortable at home, properly ensuring an environment where it is easy to go out is also important for health.

On the other hand, there is a debate about whether people who fall outside the "complete well-being" definition of health are unhealthy. If each person can realize their own abilities and what they want to do within their own physical condition and environment, then even someone with a disability can be considered healthy in a sense.

Therefore, even in a state of aging or disability, it is necessary to maintain a state where that person's abilities can be demonstrated. Thinking that way, if a person continues to live in one house forever, the house also needs to change. Or, depending on the person's situation, moving to a suitable location might be necessary.

Mr. Ito, what are your thoughts? I believe you are already proposing and providing various types of housing while also combining ICT.

I believe that housing is based on "being safe and secure." On the basis of ensuring that the house is a shelter that protects life, it should then be healthy and comfortable.

Ms. Nagata mentioned interaction, and while improving the housing environment, I think it is also important to improve the community and the town where people live. When I was in the Doctoral Programs at Keio in Professor Ikaga's laboratory, we had two of our company's subdivisions surveyed, and we checked the health level of the housing and the town using an evaluation tool called CASBEE.

It is a large subdivision where development began around 1990 and where about 3,000 to 4,000 people live. Because resident activities are active, the neighborhood association is solid, and there is communication and monitoring with neighbors, we were able to receive survey results saying that the "health level of the town is very high." I believe that supporting the formation of town communities is also a role of house makers.

We are also engaged in town planning from the perspective of relocation. At "Egota no Mori" in Nakano, Tokyo, we have built condominiums, rental housing, service-oriented housing for the elderly, and special nursing homes for the elderly within the same development area, creating a system where people can relocate within that town as their life stages change.

I hope to improve the health level of residents by successfully combining housing and the town.

Sekisui House has the image of a provider of high-end detached houses, but recently you have also been doing high-quality low-rise rental housing.

Historically, many rental houses are poor quality, built cheaply to keep rent low and avoid vacancies. If, for example, a young child-rearing generation moves in there, the children also end up getting sick.

There are also situations where elderly people have no choice but to continue living in poor-quality rental housing, and there is talk that "we must do something about rental housing as well."

That's right. Our company also handles rental housing, but some owners do not want to spend much on insulation performance in order to build rental housing cheaply. However, our company proposes rentals that will be chosen for a long time by increasing insulation performance, working on the ZEH I mentioned earlier, and increasing added value. For tenants, there are benefits such as improved health and comfort and suppressed utility costs, and for owners, there are benefits such as being able to maintain high rent levels and stable rental management.

Also, in older houses, apartments are also very cold. I myself have lived in an apartment where my breath turned white when I woke up on a winter morning. We are also making renovation proposals to increase insulation performance for such housing. For older ones, we improve performance. For new construction, we provide those that meet ZEH standards. We are focusing on improving the performance of housing in general, not just detached houses.

Improving the housing environment is extremely important in various aspects. For example, there is the idea that crime can be prevented through environmental improvement. It's called "Crime Prevention Through Environmental Design (CPTED)," but in my lectures, I change the C to an H and teach students the concept of "Health Promotion Through Environmental Design."

In the world of preventive medicine, there are classifications of primary, secondary, and tertiary prevention, but this is the idea of zero-order prevention, which promotes health and prevents disease through environmental improvement in addition to these individual efforts toward health maintenance. I think it is important to organize the surrounding environment in order to maintain individual health.

Earlier, Ms. Nagata spoke about the WHO's physical, mental, and social health. In terms of physical health, first, physical obstacles must be removed to prevent falls and tumbles. Since people whose attention is not very high, such as the elderly and children, are prone to fall injuries first, it is important to create a safe environment for them.

If the air in the room is polluted, it leads to respiratory diseases; if it's hot, it's heatstroke; if it's cold, it's heat shock. I think there are many opportunities to prevent physical dangers.

Mentally, it is said that many people are in a state of depression during the recent COVID-19 pandemic. I think that being inside the house all the time and not getting sunlight, or living a life with day and night reversed, also has an effect.

For example, if the bedroom faces east and the layout allows the morning sun to enter when you wake up, such things might be prevented. If the layout allows for active opening of windows, the air environment can also be corrected. A layout that makes it easy for the family to communicate might also maintain mental health.

In terms of social health, I am currently concerned that the connections between people are gradually weakening. I think environments where people move to the city as single-person households and have no acquaintances around them are also harming social health.

If multiple generations are together, they can talk about various things, and they can monitor children and the elderly. How can we supplement such areas using IoT and the like? We must seek methods that match modern society.

Perhaps the hint lies in old-fashioned house building. For example, if there is an engawa (veranda) space that encourages contact with society, neighbors might stop by for a bit, and from an environmental perspective, it might serve as a buffer space between the cold/hot outside and the house.

Rather than being in a place where the environment is always constant, having a space where you feel a bit of temperature fluctuation might increase our ability to adapt to the thermal environment. I am continuing my research while thinking that I must find more evidence for such things.

In the July issue of the magazine "Public Health," they featured a special titled "I want a healthy home! Easy to live in and extends lifespan." Also, in February of this year, I wrote "Extending Healthy Life Expectancy through Warm Housing" for the Nursing Association's journal "Nursing," and I have started to receive such invitations.

However, on the other hand, some nursing professionals have said they know almost nothing about housing problems within home care. Housing issues might still only be recognized by some people.

For people who are already in a state of needing care, long-term care insurance covers costs for things like installing handrails or eliminating steps. However, when it comes to improving the insulation performance of a house, it costs millions of yen out of pocket, so even if people know it's a problem, they can't even bring it up. I feel that such hurdles still remain.

Unless we send a strong message to healthy people before they reach that state, to prevent it before they need care, they probably won't listen. I feel that such things are the challenges Japan faces.

Next, we will discuss "How to make an even better living environment?", but here I would like to briefly introduce Keio's initiatives. It is a Keio-style co-evolutionary house named "Co-Evo House."

This is located within the Shonan Fujisawa Campus (SFC). In 2014, the Ministry of Economy, Trade and Industry called for applications from various universities for a national project to propose and actually build houses that should be popularized in Japan in the future, and Keio proposed this kind of house. Ms. Nagata, were you aware that such a building exists?

I was aware of it, but unfortunately, I haven't visited yet (laughs).

Professor Yasushi Ikeda from SFC Architecture is a central member of this project, and I from the Faculty of Science and Technology, as well as professors from the Faculty of Nursing and Medical Care, are also involved. Furthermore, Governor Kuroiwa of Kanagawa Prefecture is working on the Mibyou (pre-symptomatic) project as a policy, and this is positioned as one of the sites for its demonstration.

With the goals of maintaining and promoting health and creating a safe regional environment, we built this as a plus-minus-zero house that emits no CO2 from construction to demolition in order to reduce environmental impact. However, this is strictly at the research level.

The challenge is how this can be deployed to actual housing in Japan in the future, but we are proposing it as a "further improved house." The concept of moderate level differences is also included in this design; although it is a single-story house, we have intentionally included distinct steps.

Currently, with the increase in remote work and home learning, we are in an era where everyone is increasingly interested in the performance of their homes. Business managers are also realizing that simply making the office grand is not enough; having employees live in proper housing leads to better health, which improves daytime work efficiency and leads to better business performance. From the perspective of health and productivity management, I think the awareness of managers has changed once again.

We should also consider natural disasters. When heavy rain falls, a power outage occurs, and electricity stops for a while, if a house is safe and has enough power generation capacity to be completely self-sustaining, residents might be able to stay at home.

I believe we must make proposals that include such aspects from now on. What do you think?

Even if we say "for the sake of health," for example, there are not many people who build a house two or three times in their lifetime. I think it remains a once-in-a-lifetime purchase. Consequently, even if they are told their house meets insulation standards from 20 years ago, they cannot easily rebuild it.

Actually, I think the biggest problem might be the significant increase in single-person households. In other words, if you live alone, the idea of rebuilding probably disappears.

Regarding heating and cooling, elderly people in particular tend not to use them when they are alone. Even if their grandchildren or children visit and say, "Turn on the heat/AC properly," they might turn it on while the visitors are there, but once they leave, they say, "It's a waste, and I don't like it."

I believe the fact that there are fewer cohabitants itself is hindering the renewal of housing or the adjustment of the environment with new technologies. Regarding mental health or the issue of houses becoming cluttered with trash, I think the fact that "there is only one person" is also a factor.

I used the word "stress" earlier, but a certain amount of load is necessary for humans. However, unlike when we are young, as physical functions weaken, we must gradually narrow the range of that load. That is why a transformation of housing structure, such as making stairs barrier-free, is required.

At the same time, regarding insulation, for example, it would be good if it could be converted smoothly when one becomes elderly in the future. This would be a proposal like, "If you add one more window pane, the room temperature will improve by this much."

Japan has many disasters, and having four seasons means there are both cold and hot times. I feel it is necessary not just to control everything, but to incorporate parts of it and utilize our ability to adapt to the environment, while providing technical support for the parts we cannot adapt to.

Earlier, Mr. Ikaga pointed out that nursing and medical professionals are indifferent toward housing, which was a bit painful to hear.

It is true that home nursing tends to involve making do within existing housing, and it may not have yet become a culture of actively changing that environment. However, having said that, the fact that housing and lifestyles are at the center of the Community-based Integrated Care System should be common knowledge in nursing by now.

Also, for example, the health strategy of "Health Promotion" proposed by the WHO includes not only individuals making efforts for their health but also improving the overall environment itself. I hope that from now on, it will become an era where it is natural for the nursing side to consider and improve the living environment.

However, even so, I cannot easily recommend to the patients I am involved with that they "should do insulation work immediately." Therefore, I would like to see the development of methodologies that do not incur various costs. Also, I thought it is necessary to change things gradually by promoting WHO standards or insulation standards.

Furthermore, as single-person households increase and the number of household members continues to decrease, I believe "monitoring" will become an important issue. While home nursing also plays a role as a monitor, I think we have no choice but to cover this through multi-layered methods.

I believe there is also urban planning and house building, like an engawa (veranda), that can maintain human connections. I think we can also consider incorporating ICT using the latest technology, monitoring, and sensors to confirm safety, such as detecting falls.

This relates to privacy and has difficult aspects, but I believe systems that sound an alert when there is no movement at all are already being developed.

Since I don't think one method can cover everything, I hope that various methods can cover single elderly households and help reduce instances of lonely deaths even slightly.

Regarding disaster response, from my position, I would definitely like to ask for the construction of disaster-resistant housing. I think disaster prevention can also be a catalyst for strengthening community ties. While neighborhood associations in apartment buildings can be a hassle to gather for, they are quite easy to assemble if the purpose is to prepare for disasters.

While preparing for disasters in terms of hardware is very important, I think software-side preparation is also crucial. How can we cooperate when a disaster occurs? Where are the stockpiled supplies in this area or housing, and where are the people who need help during evacuation? Talking about such things also serves as a catalyst for strengthening the community.

Regarding new housing, various hardware technologies are becoming well-established.

On the other hand, there are many houses that are not like that. For those who feel that performance improvement is necessary but cannot quite take the plunge or do not know what to do, our company now allows people to experience how things actually change at exhibition facilities like experience centers.

When performing renovations, the condition of the house is often only understood after the work begins, but in our case, we manage the information history of the house from the time it was built. This allows us to propose and perform renovations using the optimal methods, which I believe reduces the burden on the customer.

Regarding disasters and environmental changes, our company also provides houses equipped with solar power generation and storage batteries that allow for a normal life for several days even during a power outage. Recently, the need for such housing has been increasing.

Also, regarding methods to prevent heat, one point is how to keep solar heat out of the house. Therefore, in addition to engawa and eaves, creating a garden that provides shade is also important. Our company is promoting the "Five Trees" project as a biodiversity-conscious garden design, with the sentiment of "three trees for the birds, two for the butterflies, using native Japanese species." This creates a rich residential environment where not only shade is provided, but living creatures such as birds and butterflies also visit.

Speaking of monitoring single-person households, we are proceeding with the development of the "Home Early Detection Network (HED-Net)" from the perspective of how to prevent situations where someone suddenly collapses alone at home and no one notices.

Sensors are embedded in the house to obtain vital data such as heart rate and respiration rate of the resident in a non-contact manner. In the unlikely event that something happens, an operator senses that information, performs a safety check, and requests an ambulance if emergency services are needed. It is a system that also remotely locks and unlocks the front door of the house to transport the person to the hospital.

As our country becomes a super-aging society, it is necessary to reduce unfortunate incidents caused by environmental factors in the home, such as heatstroke victims, falls, and accidental drownings. Therefore, I am advocating for "Anti-Aging Housing" and conducting demonstration research toward establishing its philosophy.

We aim to realize housing where both the house itself and the residents living there become "anti-aging." We want the building structure to last long and be resistant to wind and flood damage, and for the equipment to be resistant to deterioration. After all, it is important that the housing, which is the foundation of our lives, lasts a long time. The premise is that people should not have to worry that "in the era of the 100-year life, the house might fall apart in the latter half."

Ideally, because the house lasts long and has good performance, the brain age, vascular age, muscle age, and skin age of the people living inside are maintained youthfully. The ultimate goal is for individuals to achieve a high QOL (Quality of Life) until their final moments and fulfill their well-being (a good state for that person). To put it simply, I believe it is important to create homes where the whole family can live happily.

While maintaining this awareness of the issues, I believe it is my responsibility as a researcher to continue pursuing what the next generation of housing should be.

Technical issues have likely been resolved, and there is no doubt that current technology can sufficiently create housing with no health problems. If so, then how will everyone accept it? Furthermore, how will medical, nursing, and care professionals collaborate with housing providers? I believe there are still major challenges in those areas.

Unless different experts collaborate through multi-disciplinary cooperation, things will not go well in the future. Because of this, demonstration projects for medical-welfare-architecture collaboration are gradually being carried out by the government, with the Ministry of Land, Infrastructure, Transport and Tourism finally being joined by the Health Service Bureau and the Health and Welfare Bureau for the Elderly of the Ministry of Health, Labour and Welfare, as well as the Japan Medical Association, the Nursing Association, and architecture-related organizations.

However, while this project has progressed to the point where doctors challenging home medical care or online medical care can see various vital data, information such as temperature or air pollution is missing.

If a situation is created where doctors and caregivers can check information such as living in a room that reaches 40°C every day in summer along with vital data, I think more collaboration will be possible. I believe the challenges are everyone's awareness and the collaboration among stakeholders.

I suppose the first goal is housing for the elderly, especially those called the vulnerable, but there is one thing I thought could be done immediately.

Caregivers and care managers visit elderly households. For example, during the very harsh seasons of summer and winter, if they say, "I'll just measure the temperature of the living room," and leave a small thermometer there, they can find out what the temperature in that home was for a week. I thought this could be done without much resistance.

I think it would be possible to have caregivers or care managers place thermometers. If we could distribute thermometers that can record how much it cools down at night, I think it would be very effective.

In terms of prevention, that applies to slightly healthier general residents in the community as well, and I think initiatives to pay attention to room temperature can be communicated to people even before they require care.

Hearing the discussion today, I felt that while there are scenes where people may require home care or be transported to the hospital in an emergency, we must proceed while collaborating with medical and care professionals and various partners so that we can propose comfortable and rich housing for them, including new construction, renovation, and relocation.

In what is called the era of the 100-year life, I would like to aim to provide housing where people can live comfortably and happily in the home where they spend much of their long lives.

Today's theme was "Rethinking Japan's Living Environment," but listening to everyone's stories, I felt that I myself must properly rethink today's theme once more. And I thought that the expression "Smart Aging Housing" might be more preferable than "Anti-Aging Housing."

Everyone's body ages over time, but in exchange, life experience increases and one becomes more mature. Similarly, I hope that housing can also undergo smart aging. Current Japanese housing has a high asset value when first built, and the asset value seems to drop continuously from there, but there are parts that become easier to live in as you continue to reside there. If you plant trees, they grow, and the greenery that enters your view becomes richer. There should be places where such added value emerges.

I want to continue making efforts to help people, housing, and society achieve smart aging through research and development.

I hope that various insights will gather and lead to housing that is healthier and safer. Thank you very much for today.