With the rapid rise in life expectancy seen in many societies around the world, the last two decades have seen the emergence of research which focuses on how healthy people are as they reach old age. This edited book is therefore a timely addition to the literature surrounding healthy ageing. The editors have brought together chapters which detail and compare the healthy ageing experience for diverse older adults in three different countries: the United States of America (USA), Sweden and Japan. The aim of the book is to explore the experience of healthy ageing in these countries, to assess this in relation to diversity among older adults within these countries, and to explore healthy ageing and diversity in relation to the implications it may have for policy. Cross-cultural comparisons can be difficult but this book strikes a good balance between discussion of each country and comparison of the commonalities and differences in healthy ageing among diverse older adults in the three countries.
The three chapters covering the USA discuss healthy ageing among older adults in the community context, at the national level and, more specifically, among diverse older adults. The chapters contain many references to relevant studies in the USA, allowing for a clear picture of ageing in the USA to be constructed. In Chapter Two, William A. Satariano gives a brief but engaging appraisal of the current healthy ageing situation in the USA which, given the health inequalities in the country, makes for interesting reading. In Chapter Three, William Tseng argues that it is important to study healthy ageing among diverse older adults in the USA as changing demographics mean that there will be increasing numbers of older adults from different racial groups.
The two chapters which discuss Sweden look firstly at the demographic situation in Sweden in relation to healthy ageing and then healthy ageing specifically among immigrants. Gerdt Sundström and Mats Thorslund discuss the difference in healthy ageing among cohorts, with more recent cohorts having some more chronic conditions by the time they reach old age, with potential implications for health-care policies. In her very interesting chapter, Sandra Torres highlights the lack of studies which have explored the health of older immigrants in Sweden according to a healthy or successful ageing framework. She suggests that studies on health outcomes among this group show that older immigrants in Sweden have relatively poor health compared to non-immigrants yet older immigrants continue to be ‘Othered’ (p. 48) by government policy on health care at older ages.
In the first of the three chapters discussing Japan, Takeshi Nakagawa and Yasuyuki Gondo begin by exploring the development of the policies for older adults resulting in the long-term care system which is in place today. They also look at the differences in health trends for centenarians in Japan and Denmark, and how these relate to the respective health-care systems. Takayuki Sasaki considers the ‘super-aging’ (p. 62) of Japanese society which is happening in the context of a ‘slow-growth economy’ (p. 64). He highlights the combined issues of poverty and inequality as well as the diversifying lifecourse of the population and considers the important role that intergenerational interaction can play in promoting a healthy ageing society. Lastly, Kazumi Hoshino discusses the inflexible attitudes of the Japanese government towards immigrants and advocates for the development of culturally sensitive immigration policies which can increase immigrants' use of health-care insurance as well as reduce service barriers.
The main contribution of the book can be found in the ninth chapter. Kazumi Hoshino interviews eight gerontology expert researchers to ‘clarify commonalities and differences’ (p. 86) among the different sociocultural support models put forward by the researchers for older adults and immigrants in the USA, Sweden and Japan. He presents a useful table (9.1 on pp. 88–9) which summarises his findings from these interviews under four different themes: physical, social, psychological and spiritual. The overall sociocultural support model for healthy ageing is presented in figure 9.1 (p. 94). Importantly, Hoshino recognises that this model is reliant on the discussions with the eight gerontologists and emphasises that the model should be explored with new data from other sources to further validate it. Indeed, it would be interesting to see this model applied to other countries and the extent to which it can be utilised in other sociocultural contexts. The final chapter is a very useful summary of the research discussed and conclusions drawn in the preceding nine chapters, with the editors building a solid argument for how they define healthy ageing, based on this evidence.
Each of the chapters is relatively short which allows the book to be digested in a relatively short space of time. A critique, however, is the lack of explanation of some key concepts and the complex language used for the description of some theories connected to healthy ageing and the sociocultural context, which may make this book a challenging read for those who are unfamiliar with them. As someone who is a relative newcomer to this research area, I found the book interesting and relevant to current debates. It offers some useful insights into the healthy ageing process at the national level and for diverse groups of older adults in these three countries. If an introductory grounding in healthy ageing has already been established, this book offers students, researchers and practitioners a more advanced-level text with a specific focus which allows for a more nuanced understanding of healthy ageing among diverse older adults across different sociocultural contexts.
