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

Today, I would like to discuss with everyone the idea of re-evaluating Japan's residential 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 Care through Re-evaluating Housing and Lifestyles." However, at present, evidence-based data is scarce in Japan.

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

Particularly now, there is an effort to support the elderly through community-based integrated care. The "flowerpot" that serves as the foundation for this is "housing and lifestyles," but I feel the current situation in Japan is that this important flowerpot has "cracks" in it.

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 was written in the Kamakura period, suggesting that one can manage even if it is cold in winter. Even today, architects and housing providers use these words as a golden rule, citing them as a basis for claiming 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 considering Tohoku or Hokkaido. The problem is that this idea is widely circulated.

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

They have even set temperature standards, informing citizens 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 residential environment in their health policies. 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 residential environment is recognized as a health issue, but it remains uncertain whether this will ultimately be reflected in the final policy.

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 something of a "final destination." It's not about going to a nearby hospital because you feel a little unwell; it's the image of a condition becoming severe and requiring urgent attention.

Where are such people transported from? Of course, they come from places they've visited or their workplaces, but many are also transported from their homes. Recently in Japan, the role of emergency services as a so-called safety net has become very heavy. What I mean 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 residential environments of these people have become quite dire. Many have almost no interest in health and are living neglected lives. It is extremely important to consider the environment of the residences where we spend so much of our lives.

There is hypertension, cardio-vascular disease, and in emergency medicine, we also see deaths while bathing. Furthermore, injuries from falling inside the house are increasing. 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, as COVID-19 continues to cycle through outbreaks and subsidences, I actually suspect that waves occur when the environment necessitates the use of heating or air conditioning.

For example, at the beginning of the first wave, there were many infected people in Hokkaido. Since Hokkaido is a cold region, people seal their rooms to heat them. I think there is a high possibility of infection if people do not ventilate while 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 role is to provide support so that patients—for example, those who have returned from the emergency room or are at risk of needing emergency care—can continue living in their own homes for as long as possible.

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 building without an elevator.

Also, as mentioned, there are homes that are very cluttered—or to use a media term, what are called "hoarder houses." Even in such a state, some people say they prefer that environment. To the individual, it is never trash; it is all their precious memories and treasures.

We must provide daily nursing care to ensure these people maintain their health and that their conditions do not worsen, while fulfilling their wishes as much as possible in their various environments. It is easy to tidy up to prevent falls, but the items in the house are their property. If we take it upon ourselves to clear things away because they are "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 the environment, gaining their consent by saying things like, "If we clear this area a bit, it will be harder to trip 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 about on the ground is air conditioning in the summer.

The idea of "making the summer the primary concern" is also still not fully realized. Even as it becomes increasingly hot and humid, and despite living in sealed apartment complexes or densely packed housing that differs 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 conditioning even a little, building trust while attempting to make the room temperature even slightly more comfortable.

Also, it might be slightly different from a housing problem, 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.

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 our 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, as expected, 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, leaving a household of only an elderly couple. Therefore, rather than renovating the entire two-story house, we recommend starting with the areas 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 stabilize the temperature in the living areas. 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.

Additionally, for new constructions, 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 keeping installation costs down. 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 feeling 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 builds 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 phase and checking the state of the indoor air.

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

Buildings are an important foundation for life 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 for nurturing 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 desperate 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 until around 2000, the direction was to gradually improve quality. Along the way, sick building 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.

Compared to the dire state of housing shortages, it is gratifying that housing is now generally available, but a frequently cited problem is the short lifespan of houses. Compared to other countries, the period of scrap-and-build is frequent.

The Long-Life Quality Housing certification system has been proposed as a countermeasure, 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 examine what to do with housing as a social asset, and we must also improve environmental performance. However, since housing is a social asset but also the private property of individuals, we cannot forcibly modify it, so how do we improve the quality of the housing stock in the market as a whole? This is a very difficult area.

SDGs appear everywhere lately, 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 disposal" is also important. In other words, after use is finished, 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, there has been a call for strengthening safe and secure home building.

In 1961, the WHO released "Four conditions for satisfying basic human life needs regarding the residential 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-evaluate 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 around 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 these environmental disorders, and heatstroke and sunstroke in summer, as well as hypothermia in winter, occur very frequently among the elderly, and they are often living in such environments.

Regarding the bath, 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, to prevent it, one must reduce the amount of heat received from the water around the body.

In short, this means lowering the water temperature or shortening the time spent in the bath. 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 housing that is not heavily influenced 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 room for variation.

The word "health" in the phrase "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 mentioned, 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 these 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 form of stress is actually better.

Going up and down stairs ensures daily exercise, and while small steps can easily lead to falls, a raised entryway (agari-kamachi) with a step requires lifting the feet properly, and 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 motor skills.

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, ensuring an environment where it is easy to go outside 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, in a sense, be considered healthy.

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 about it that way, if a person is to continue living 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.

What about you, Mr. Ito? I believe you are already proposing and providing various types of housing while also incorporating ICT.

I believe that housing is fundamentally based on "safety and security." Once it is ensured that the house is a shelter that protects life, then it is about being healthy and comfortable.

Ms. Nagata mentioned interaction, and along with preparing the housing environment, I think it is also important to prepare the community and the town where people live. When I was in Professor Ikaga's lab for my Doctoral Programs at Keio, 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 among neighbors, we received survey results showing that the "health level of the town is very high." I believe 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 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, haven't you?

Historically, many rental houses have been poor quality, built cheaply to keep rent low and avoid vacancies. If, for example, a young family of the child-rearing generation moves in, the children might get sick.

There are also situations where elderly people are forced 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, at our company, we propose 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 reduced utility costs, and for owners, there are benefits such as being able to maintain high rent levels and stable rental management.

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

Preparing the housing environment is extremely important in various aspects. For example, there is the idea that crime can be prevented through environmental design. 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 concept of zero-order prevention, which promotes health and prevents disease through environmental preparation in addition to these individual efforts toward health maintenance. I think it is important to prepare the surrounding environment to maintain individual health.

Ms. Nagata spoke about the WHO's physical, mental, and social health earlier. In terms of physical health, first, physical obstacles must be removed to prevent falls and tumbles. Since elderly people and children, whose attention levels are not very high, are the most likely to suffer from falls, it is important to create a safe environment for them.

If the air inside a 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 have become depressed during the recent COVID-19 pandemic. I think this is also influenced by staying indoors all the time without sunlight or living a life where day and night are reversed.

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 family communication to occur 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 have various conversations and monitor children and the elderly. We must explore methods that match modern society, using things like IoT to complement those areas.

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 drop by, and from an environmental perspective, it might serve as a buffer space between the cold/hot outside and the house.

Having a space where you feel a bit of temperature fluctuation rather than being in a constant environment all the time might also increase our ability to adapt to the thermal environment. I am continuing my research while thinking that I need to 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 was able to write "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 a few 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 convey a strong message to healthy people before they reach that state and prevent it before they need care, they probably won't listen. I think such things are the challenges Japan faces.

Next, we will discuss "How to create an even better residential 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 on the Shonan Fujisawa Campus (SFC). In 2014, the Ministry of Economy, Trade and Industry called for proposals from various universities for houses that should be popularized in Japan in the future and to actually build them as a national project. 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 the SFC architecture department 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 'Me-Byo' (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 local 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 to deploy this into actual Japanese housing in the future, but we are proposing it as a 'further improved home.' The concept of 'appropriate elevation changes' 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 owners 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 believe the awareness of executives has changed once again.

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

I believe we must include such things in our proposals from now on. What do you think?

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

Actually, I think the biggest problem is 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 living alone often do not use them. Even if their grandchildren or children visit and tell them to 'turn on the heat or the AC,' 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 hinders the renewal of housing or the adjustment of the environment with new technologies. Regarding mental health or the issue of 'hoarder houses,' I think the fact that 'there is only one person' is a factor.

I used the word 'stress' earlier, and 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 smoothly converted 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 some elements 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 often involves making do within existing housing, and it may not have yet become a culture of actively changing that environment. That said, 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 individual efforts for health but also the improvement of the overall environment itself. I hope we are entering an era where it becomes natural for the nursing field to consider and improve the living environment.

However, even so, I cannot easily recommend to the patients I am involved with that they 'should undergo insulation work immediately.' Therefore, I would like to see the development of methodologies that do not incur various costs. Additionally, I thought it 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 plays a role in monitoring, I think we have no choice but to cover it through multi-layered methods.

I believe there is a way to build towns and houses with features like 'engawa' (verandas) that help maintain human connections. We could also consider incorporating ICT using the latest technology, such as monitoring and sensors, to ensure safety against falls and other accidents.

This involves 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 one method cannot cover everything, I hope we can cover single elderly households through various methods to reduce instances of lonely deaths as much as possible.

Regarding disaster response, from my position, I would definitely like to ask for the construction of disaster-resistant housing. I believe disaster prevention can also be a catalyst for strengthening community ties. While apartment residents' associations can be a hassle to gather for, they tend to gather more easily 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 complex, and where are the people who need help during an evacuation? Talking about these 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 the need for performance improvement but cannot take the plunge or do not know what to do, our company now provides exhibition facilities like 'experience centers' where they can actually experience how things change.

When performing renovations, the condition of the house is often only understood after the work begins. 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 can also reduce the burden.

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 key point is how to keep solar heat out of the house. Therefore, in addition to verandas and eaves, creating gardens that provide shade is also important. Our company is promoting the 'Five Trees' project for biodiversity-conscious gardening, with the idea of planting 'three trees for birds and two for butterflies, using native Japanese species.' This creates a rich residential environment where living creatures like birds and butterflies visit, in addition to providing shade.

Speaking of monitoring single-person households, we are developing the 'Home Early Detection Network (HED-Net)' from the perspective of how to prevent someone from collapsing suddenly at home alone without anyone noticing.

Sensors are embedded in the house to obtain vital data such as heart rate and respiration rate of the residents in a non-contact manner. In the unlikely event that something happens, an operator detects that information, performs a safety check, and requests an ambulance if dispatch is necessary. 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 the unfortunate incidents caused by environmental factors in the home, such as heatstroke victims, falls, and drowning. 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 'anti-age.' We want the structure to last long, be resistant to wind and flood damage, and be resistant to the deterioration of equipment. First and foremost, 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.'

The ideal is a house that lasts a long time and has such good performance that 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 create housing that is sufficiently problem-free in terms of health. Then, the question is how everyone will accept it. Furthermore, how will medical, long-term care, and nursing 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, finally, demonstration projects for medical-welfare-architecture collaboration are gradually being carried out by the government, involving the Ministry of Land, Infrastructure, Transport and Tourism, the Health Service Bureau and Health and Welfare Bureau for the Elderly of the Ministry of Health, Labour and Welfare, the Japan Medical Association, the Nursing Association, and architectural 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 and 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—alongside vital data, I think better collaboration will become 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.

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

In terms of prevention, that applies to slightly healthier general residents in the community as well, and I think the initiative to be careful about room temperature can be communicated to people before they reach the stage of needing care.

Hearing the discussion today, I felt that we must proceed while collaborating with medical and care professionals, as well as various partners, so that we can propose comfortable and rich homes—including new construction, renovation, and relocation—for people who may find themselves receiving home care or being transported to the hospital in an emergency.

In what is called the era of the 100-year life, I want 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 after listening to everyone, I felt that I myself must properly rethink today's theme once more. And I thought that the expression 'Smart-Aging Housing' might be preferable to '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 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 stay. 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 will continue to strive to help people, housing, and society undergo smart aging through research and development.

I hope that various insights will come together to create housing that is healthier and safer. Thank you very much for today.