An Old Seoul: Connecting the Elderly in a Lonely South Korea

A N O L D S E O U L Connecting the elderly in a lonely South Korea

CONTENTS Summary

2

1. Introduction

3

• 1.1 Context • 1.2 Drivers • 1.3 Framework

4 5 6

2. Current scenario

7

• 2.1 • 2.2 • 2.3 • 2.4

Socio-economic Socio-cultural Cultural-economic Trajectory

8 9 10 11

3. Future scenario

12

• 3.1 • 3.2 • 3.3 • 3.4 • 3.5 • 3.6

13 14 15 16 17 18

Theory and concepts Precedents Policy and objectives Communication and engagement Tools for implementation Adaptation and implications

4. Reflection

19

Bibliography

20

Economic Socio-economic Barriers

Cultural-economic Barriers

Loneliness

Social

Cultural

Socio-cultural Barriers

SUMMARY By 2050 South Korea will be considered one of worlds the first “super-aged� societies, with an elderly community (65+) exceeding 25% of the total population (Lowe-Lee, 2009). To accompany this South Korea is home to the highest rates of elderly poverty amongst OECD nations, equating to 45% (OECD, 2016) of over 65s living in relative poverty (less than half the median household disposable income). Poverty and the cultural stigma surrounding (Jo & Walker, 2014) it puts up socio-economic barriers around poor elderly communities segregating them from necessary services and amenities, such as, health care and quality public space (Kim & Shin, 2012). This segregation limits opportunities to create social connections and increases the likelihood of loneliness, which can be linked to physical and mental health problems (Kim & Shin, 2012).

This report identifies 3 key barriers that isolate elderly communities in the capital of Seoul, exploring how elderly loneliness in South Korea has been perpetuated by systems that segregate communities and isolate individuals. Through employing data and frameworks put forward by NGOs such as the WHO and UN, as well as the South Korean government, this report will aim to propose informed educated suggestions to changing current policy.

INTRODUCTION

(OECD, 2016) With a major shift in demographic, has come a change in the traditional family hierarchy. With children becoming more career focused in a competitive Korean work culture, a neglect for traditional caretaking duties has left elderly citizens both socially and financially stranded (Kim & Lee, 2017).

14.2%

Widespread cultural stigmas surrounding poverty perpetuates this sense of isolation, with elderly citizens forced to reside in poorly serviced, underfunded districts. The lack of public infrastructure in these districts reflects the disparity of government funding, reducing accessibility to health services and quality public space for the elderly (Kim & Shin, 2012).

of Koreas elderly population lives in poverty (OECD, 2016)

of Koreas population are 65+ years old (Statistics Korea, 2016)

45%

(OECD, 2016) The loneliness amongst the Seoul’s elderly is a multifaceted issue driven by economic, cultural, and social barriers. These barriers manifest themselves through socio-economic and socio-cultural systems, such as the poverty stigma, which limits accessibility to services and amenities (Jo & Walker).

As result of loneliness many elderly Koreans experience mental health problems and when equipped with this poor access to health services and lack of social stimulation, it can result in cases of depression and suicide, particularly for those with existing health conditions (Stravynski & Boyer, 2001).

40 suicides

/100,000 deaths in males over 75 (WHO, 2013)

26%

increased risk of dimentia associated with loneliness (McKeehan, 2019)

FRAMEWORK The framework for this report seeks to identify the intersections between economic, social, and cultural drivers that are perpetuating loneliness amongst Seoul’s elderly community.

Distinguishing where these drivers overlap means for a holistic analysis of the contributors to loneliness. Analysing socio-economic, socio-cultural, and cultural-economic barriers, highlights grey areas in existing policy’s and societal norms. The more tangible manifestations of these barriers can then be isolated and examined.

Economic Socio-economic Barriers

Cultural-economic Barriers

Loneliness

Social

Cultural

Socio-cultural Barriers

Government Allocation of Services

The Sampo Generation

The Poverty Stigma

CURRENT SCENARIO

SOCIO-ECONOMIC BARRIERS: Government Allocation of Services

Economic Socio-economic Barriers

Cultural-economic Barriers

Loneliness

Affluent socio-economic bubbles, specifically the southern district of Gangnam (Jo & Walker, 2014), can be seen to host a majority of Seoul’s health services (red, pink and yellow).

This is disproportionate to location of age centres and elderly facilities most notably in the aging communities of Guro-gu and Chang-dong (50Plus, 2018).

Identified by the 50Plus foundation (2018), these districts lack the infrastructure to support their aging communities. Interventions by the foundation have resulted in two elderly learning centres (green) for adults aged over 50 and have been well implemented in engaging the community. This opens the door to other programs that could exist in these settings.

CULTURAL-ECONOMIC BARRIERS: The Poverty Stigma

Social

Cultural

Socio-cultural Barriers

4/8

Hospitals in the Gangnam district

Economic Socio-economic Barriers

Cultural-economic Barriers

Loneliness

In a modern, career driven Korea, poverty is often frowned upon and shamed as a sign of “poor work ethic” (Jo & Walker, 2014). This is problematic for Seoul’s elderly communities, leaving the already financially isolated population even more alone.

The cultural nature of the poverty stigma has allowed it to infiltrate government and societal systems, leading to the neglect of less affluent districts in the allocation of services and amenities (Kim & Shin, 2017). This creates “pensioner’s ghettos” (Smith, 2018) out of elderly communities, hosting cramped high density living and low-quality public spaces.

Social

Cultural

Socio-cultural Barriers

14.8%

of Koreans live in relative poverty (Statistics Korea, 2018)

50Plus Foundation

Mental Health

Hospitals

Other

SOCIO-CULTURAL BARRIERS: The Sampo Generation

Economic Socio-economic Barriers

Cultural-economic Barriers

Loneliness

The competitive work culture in South Korea, responsible for the poverty stigma, has birthed a generation of Koreans, of young men and women who have little time or interest in partaking in family life (Kim, 1999).

Particularly with many career driven women rejecting traditional family values and gender roles, Korea has become home to the lowest fertility rates in the world (OECD, 2016), perpetuating its aging population.

This rejection of traditional family hierarchy has also resulted in the extinction of the conventional caretaking role that was once expected of young Korean adults (Kim, 1999). In a system where the elderly are expected to receive financial support later in life, low pensions and an underfunded of welfare systems do very little to aid the aging poor (Kim & Shin, 2017).

Social

Cultural

Socio-cultural Barriers

60yo

Average age of retirement

1.1children

born per woman is the average national rate

Inclusive Growth in Seoul, South Korea An OECD framework for age inclusive growth Seoul (OECD, 2018)

TRAJECTORY Initiated in 2011, the Seoul 2020 Master Plan for the Aged Society was the first Seoul Metropolitan Government (SMG) report addressing the concept of an age-friendly city (AFS, 2016). Upon joining the WHO Global Network for Age-friendly Cities and Communities (GNFCC) in 2013, the report adheres heavily to the WHO guide and address 6 main areas and 35 tasks, via two 3-year action plans. These areas include “customized jobs, healthy old age, comfortable living environment, vibrant recreational culture, respect, and intergenerational integration.” (WHO, 2016)

“Seoul, a city whose citizens enjoy healthy and active lives of up to 100 years” Vision of the Seoul 2020 Master Plan for the Ages Society

The report provides insight to issues of elderly poverty and the generational divide, through elderly welfare centres and generational workshops (AFS, 2016), however, it is problematic in its inability to address the issue of loneliness and its detachment from the poverty situation.

Asides from the report, a Senior Policy Monitoring Group (AFS, 2016) composed of 50 people over 65, are selected by the SMG, allowing senior citizens to have direct involvement with policy decisions and policy making. However, the board responsible for the Senior Policy Monitoring Group is not representative of the elderly poor, again displaying this detachment from

Global Age Friendly Cities: A Guide The WHO framework for the age friendly city

(AFS, 2016).

FUTURE SCENARIO

PRECEDENTS Community Aging in PlaceAdvancing Better Living for Elders, is a program run the John Hopkins University which practices accessible and affordable ageing in place.

It has worked well amongst elderly minority groups in the redlined suburbs of Baltimore, which Seoul elderly programs could learn from.

(Szanton & Leff, 2016).

Yakult is a very popular product amongst the elderly in South Korea for its probiotic benefits. In collaboration with local governments in South Korea, Yakult has started a new program in which not only yoghurt is delivered to lonely citizens but a person to talk to and confide in. (Lee, 2019)

The New Hyundai Colatec once an unused youth hall, has been repurposed into an over 65s disco on Monday afternoons. This is an example of how unused spaces within Seoul’s districts can be utilised. Encouraging social interactions and getting lonely elderly citizens out of their homes.

(Kim 2018)

AGEING IN PLACE Ageing in place is a practice often regarded as the antithesis to aged care homes, allowing the elderly to grow old in the comfort of their own homes, however, many do not have the luxury of choice when the cost of staying in a home is out of budget. (Szanton & Leff, 2016) Associated with elderly autonomy and independence, ageing in place is often criticised for its ability to foster loneliness and isolate the elderly.

If refocussed towards the needs of poverty-stricken communities, it has the potential to incite social interactions through medical staff or caretakers, in a scenario where people would be getting none at all.

The United Nations Sustainable Development Goals include the goal of creating age friendly cities and communities.

ELDERLY ENGAGEMENT Barriers such as mobility, fatigue and mental health all play big roles in the engagement of elderly citizens, making it difficult to motivate these communities in the face of change. In their 2015 study, Goll and Charlesworth found identity and connection to place increases participation in social interaction and acts to improve rates of loneliness.

The 50Plus Foundation (2018) runs elderly learning facilities in Seoul and has been commended on its ability to engage stakeholders in both the community and local governments. Through rigorous workshopping and relinquishing self-empowerment to the stakeholder, participants come to their own unique solutions, giving sense of accomplishment and satisfaction.

Seoul 50Plus Foundation uses the philosophy of self-empowerment to engage elderly stakeholders.

AGEING IN SPACE Redefining the practice of aging in place and borrowing self-empowering practices from elderly engagement techniques, Aging in Space aims to engage elderly communities through the introduction of programs and services in underutilized, local, public spaces.

This could be facilitated via exercise and events, or health check-ups and information sessions, that would occupy accessible spaces within the community while encouraging social connectedness between citizens.

AGEING IN SPACE: OBJECTIVES

1. Reduced rates of loneliness 2. Increased access to services and amenities 3. Creation of local community connections

4. Greater generational connectedness

AGEING IN SPACE: POLICIES 1. Increasing opportunities for social connections - Marketing and invitations to new events and services - Actively seeking engagement from citizens - Group education on mental health and isolation

2. Services and amenities brought into communities - Aging in Space programs in new public space - Aging in place programs by appointment - Additional medical infrastructure and services

3.Activation of public spaces: - Refurbishment and construction of interactive spaces - Empower the elderly through event and program planning - Age friendly infrastructure and wayfinding around public space

4. Gradual changes to cultural attitudes - Cohabitate senior facilaties with youth amenities - Financial incentives for families living together - Elderly role models in early learning

COMMUNICATION AND ENGAGEMENT With such polarised stakeholders, represented in the young and old, there are cultural attitudes and indifferences that must be addressed before the two can be engaged. Collaborative stakeholder engagement programs will be held families of lower socio-economic backgrounds; this may not amend attitudes short term but will highlight tensions that exist to be addressed in the long term (50Plus, 2018).

In making use of the aforementioned Senior Policy Monitoring Group (AFS, 2016), an effective mediator between government and citizen decisions arises. To be more representative of the wider elderly community, community leaders from around Seoul could be nominated for board positions apposed to a volunteer system. This would give voice to a wider demo-

Healthcare systems may experience a strain but with appropriate funding the new policies in place will create new jobs, new clients and hopefully fulfilling rewarding work. New policies will also introduce renovations to some existing infrastructure as well as the construction of new hospitals and amenities for struggling communities.

TOOLS FOR IMPLEMENTATION The Aging in Space concept will be facilitated via public services and amenities in order to connect the lonely elderly back into Seoul’s society. These amenities will take the form of public spaces such as squares, plazas and parks, to increase social connectedness within communities while also running medical clinics and information sessions.

The universal healthcare system in South Korea simplifies this process through its ability to bring the same service across the city of Seoul, this allows for consistent information over a variety of communities.

However, for each unique community, local councils and community leaders can programme these spaces to conduct events that reflect the communities wants and needs.

ADAPTATION AND IMPLICATIONS Opportunities - A more connected community - Future proofing for following generations - End the cycle of elderly poverty stigma - Eliminate the “pensioner ghetto�

Threats - Inability to engage the next generation of Koreans - Cultural stigmas are too deeply ingrained - Elderly gentrification of renovated districts - A greater disparity to those on the brink of poverty

REFLECTION Throughout the semester engaging with coursework has been difficult as a result of the disruption caused by the pandemic, however it has also provided a fresh perspective into the workings of scenario planning. With the world changing so rapidly, a sense uncertainty was always in the back of my mind when considering policy and changes.

Workshops and lectures helped highlight this uncertainty via discussion of the ever-present threats in climate change and poverty as well as other global trends. My major take-away from the lecture content however were the broader planning strategies and techniques that underpinned my final report.

Workshop discussion and group work in zoom helped to broaden my perspective within my chosen field, while also teaching me a lot about a multitude of global issues I would never have spent time researching. With the help of feedback from my tutor and peers this semester has still remained highly engaging and has left me excited to get back to University next semester.

BIBLIOGRAPHY (references) • ARUP. (2019). Cities Alive: Designing for Ageing Communities. Retrieved from https://www. arup.com/perspectives/publications/research/section/cities-alive-designing-for-ageing-communities •

Age friendly Seoul. (n.d.). https://afc.welfare.seoul.kr/afc/eng/suggest/monitoring.action

• Jo, Y., & Walker, R. (2014). Social Isolation and Poverty in South Korea. Poverty And Shame, 175-187. doi: 10.1093/acprof:oso/9780199686728.003.0014 • Kim, I. (1999). Population Aging in Korea: Social Problems and Solutions. The Journal of Sociology & Social Welfare, 26(1), 107-122. Retrieved from¬ https://scholarworks.wmich.edu/jssw/vol26/ iss1/8 • Kim, G. H., Lee, H. A., Park, H., Lee, D. Y., Jo, I., Choi, S. H., … Jeong, J. H. (2017). Effect of Individual and District-level Socioeconomic Disparities on Cognitive Decline in Community-dwelling Elderly in Seoul. Journal of Korean Medical Science, 32(9), 1508. doi: 10.3346/jkms.2017.32.9.1508 • Kim, D., Shin, H., & Kim, C.-Y. (2011). Equitable Access to Health Care for the Elderly in South Korea. Research on Aging, 34(4), 475–496. doi: 10.1177/0164027511423538 • Lowe-Lee, F. (2009). Is Korea ready for the demographic revolution? : The world’s most rapidly aging society with the most rapidly declining fertility rate. Retrieved from http://keia.org/publication/ korea-ready-demographic-revolution-worlds-most-rapidly-aging-society-most-rapidly-declin • OECD. (2016). Economic Surveys: Korea. Retrieved from http://www.oecd.org/economy/surveys/Korea-2016-OECD-economic-survey-overview.pdf • Smith, N. (2018). Old people struggle to survive as South Korea becomes ‘aged society’. Retrieved from https://www.telegraph.co.uk/news/2018/10/07/old-people-struggle-survive-south-korea-becomes-aged-society/ • Statistics Korea. (2018). 2018 Population and Housing Census. Retrieved from http:// kostat.go.kr/portal/eng/pressReleases/8/7/index.board?bmode=list&bSeq=&aSeq=&pageNo=1&rowNum=10&navCount=10&currPg=&searchInfo=&sTarget=title&sTxt= • Stravynski, A, Boyer, R. (2001). Loneliness in Relation to Suicide Ideation and Parasuicide: A Population-Wide Study. Suicide and Life-Threatening Behaviour31(1),32-40. doi:10.1521/ suli.31.1.32.21312 • WHO. (2013). Country profiles: suicide data reported by Member States. Retrieved from https://www.who.int/mental_health/suicide-prevention/country-profiles/KOR.pdf •

WHO (2015). Age-Friendly World: Seoul. Retrieved from. https://extranet.who.int/agefriend-

BIBLIOGRAPHY (images) Images 1,3,5 were from ARUP,s Cities Alive Report (2019) The rest were taken by myself in Korea (July, 2019)