A risky heating up

S
outh and Southeast Asia have just finished suffering through yet another sweltering summer, but other parts of the world are only beginning to brace themselves for higher temperatures – and their dire consequences. In Japan, fears of multiple heatstroke cases, especially among the elderly, have already become reality right at the start of its summer season, with some resulting in deaths. 

In Tokyo in mid-June, temperatures have already soared to as high as 36°C. On June 19 alone, at least 100 people in the capital were rushed to the hospital for suspected heatstroke, according to the Japanese broadcaster NHK. Data from the Fire and Disaster Management Agency also show that between June 2 and 8, some 1,200 people had been taken by ambulance to health facilities because of heatstroke.

At least two deaths suspected to have been due to complications of heatstroke have already been recorded this June in the capital; both fatalities were later reported to be elderly women who had not used their home air conditioners. Four deaths in other parts of Japan during the third week of June, all of them involving individuals above the age of 65, are also believed to have been related to the sweltering heat. 

Last year, there were 2,000 deaths from heatstroke from June to September, according to the Ministry of Health and Welfare. Official data also revealed that 80 of the victims were elderly and belonged to low-income households. A recent Agence France Presse report said that senior citizens “made up more than 80 percent of heat-related deaths in the past five years.”

Climate change and health expert Kazuhiko Ota told Asia Democracy Chronicles (ADC) that his research has identified summers as particularly dangerous to seniors who are struggling financially. “What is particularly distressing,” he said, “is the key contribution to heatstroke (is) the fact that they are not using air conditioning to save costs.” 

Japan’s summer season is usually from June to August. In the last few years, however, Japan’s summer has at times begun as early as May and lasted even well beyond September. The Ministry of the Environment itself has pointed to climate change as the primary reason for these shifts in the duration of seasons, as well as for the intensifying heat. But as Japan – the world’s fifth largest carbon emitter – processes new pledges to reduce carbon emissions to meet targets for 2030 and beyond, there have been increasing calls for policies addressing climate change to include those covering its socio-economic impact, particularly on the elderly.

Japan has long been known to have a rapidly aging population. Today nearly 30 percent of its 123 million people (or about 37 million) are 65 years old and above. Less well known is the fact that a significant number of Japan’s senior citizens are living in poverty; according to the Organization for Economic Cooperation and Development (OECD), 20 percent of Japanese who are 65 years old and over are financially challenged, compared with the OECD average of 14.2 percent for the same age group.  

Poverty is a hidden issue in Japan, commented Naoyuki Imaoka, spokesperson for the Japanese non-profit labor organization Posse, whose work also helps senior citizens who live alone. Primary care doctor and Green Practice Japan head Takashi Sasaki told ADC: “The climate crisis disproportionately affects the poorer sections of society, and there is an urgent need to address health inequalities that is linked to global warming.” 

Policy gaps 

According to environmental economist Moegi Igawa of Doshisha University in Kyoto, government climate-change reduction policies suffer from economic gaps. These, she said, include the 2016 renewable-energy surcharge tax, which Igawa said has raised the financial burden on Japan`s growing number of low-income households. 

“Japan is the fourth richest nation in the world,” she said. “Yet as the number of people living on public welfare is growing, my studies stress the rights of this sector to have access to an adequate level of energy services.”

Such access is most crucial to impoverished seniors, especially in times of extreme temperatures. In summertime, the medications they take as well as chronic health problems make older adults suffer more from heat intolerance, noted a 2021 article in Harvard Medicine, the magazine of the Harvard Medical School. The report also said that “it can be hard for even healthy older adults to tell when it’s too hot or if they’re dehydrated.”

“Cognitive decline exacerbates these problems,” it continued. “Older bodies also hold more heat than younger ones when the temperature climbs. Glands don’t release as much sweat. The heart doesn’t circulate blood as well, so less heat is released from vessels in the skin. Systems from the cardiovascular to the immune struggle to compensate.” 

One sector dominated by the elderly in Japan is agriculture, where work requires exposure to the sun for much of the day. Of Japan’s 1.4 million farmers, 70 percent are aged 60 years and over. Complicating the situation is the increasing number of impoverished Japanese elderly who live by themselves. According to an April 2025 report by the daily Mainichi newspaper, more than half of households currently receiving public assistance are of seniors living alone. 

Based on a three-level hierarchical model that investigates socioeconomic factors, Igawa’s research identifies low-income households saving on their utility bills as a critical source of survival. This category is dependent on public pensions at around JPY 160,000 (about $1,100) or lower monthly. 

Igawa said that when people cut down on energy use, the situation affects not only their quality of life but also their health and safety. Yet high temperatures can be so unbearable that “some are cutting their food intake to be able to pay for electricity during the summer,” she said. For older adults, especially, lesser nutrition can only worsen existing health problems. 

Band-aid solutions?

With increasing data highlighting the risk facing the poor in Japan, the Tokyo metropolitan government announced recently that more than eight million households or almost half of the population living in the sprawling metropolis will not have to pay the basic water rate for four months starting this June. This is aimed at easing the increasing financial burden on households caused by a soaring cost of living, said the Tokyo local government.

Across the country a special heatstroke alert system to detect dangerous heat levels is also being launched this June by the national government. With the special alert in effect, municipalities will make air-conditioned facilities designated as cooling shelters open to the public. Organizers of school events will be requested to reconsider outdoor events. 

In 2024, an alert for high temperatures was issued almost 1,800 times, a record number. Other changes recently initiated by the government include instructing businesses, such as construction sites, to take measures to prevent severe heatstroke among employees or face criminal punishment. 

An unimpressed Igawa, however, remarked that such measures are temporary and do not address energy poverty. She added, “There are more meaningful activities conducted at the private level conducted by individuals and grassroots organizations.”

Tokyo-based Posse, for instance, has had volunteers accompanying elderly people living on welfare to public airconditioned places to protect them from heatstroke. 

Posse spokesperson Imaoka said that the move was initiated last year after the group’s Saitama branch received more than a hundred calls from people seeking advice on how to avoid heatstroke without threatening their budgets. At a 2024 press conference, Posse volunteers said that some of the individuals they helped were in homes that had temperatures reaching 37°C. 

“There were some people who also complained about official emergency alerts that include air conditioning as a mitigation measure,” Imaoka said. “They pointed out that they could not afford high electricity bills as they are on welfare allowances.”  

Encouraging lifestyle changes

For its part, Green Practice Japan, composed of 73 doctors committed to linking health to the environment, has been conducting workshops and events that teach patients the importance of sustainable lifestyles such as reducing energy.

“Global warming poses health risks and extreme stress in people,” said the organization’s Sasaki. “We need to combat this danger by educating people about the threats posed by climate change.”

In 2023, Sasaki also led an online campaign that called on the Japanese government to protect lives from heatstroke, torrential rain disasters, and other impacts caused by the climate crisis. Addressed to the Ministry of Health and Welfare, the campaign called for the establishment of a climate-resilient healthcare system based on a commitment to achieving net-zero greenhouse gas emissions in the healthcare, medical, and nursing care sectors by 2050. The organization collected almost 700 signatures that were presented to the government. 

Climate-change expert Ota, who works at the National Institute for Environmental Studies, a think tank that advises the government’s climate-change policy, said that his research is focusing on adaptation to build resilience.

 “A major adaptation strategy is educating the public about behavior change, such as not going out during the most hot days and drinking water,” he said. Fostering community collaboration can help as well in combating heat-related health risks, Ota added. 

Government officials say that Japan has been trying to do its part to address climate change. This February, the Japanese government approved a new plan to bolster renewable energy to help the country’s greenhouse-gas emissions by more than 70 percent from 2013 levels. A target has been set to reduce carbon emissions by 60 percent by 2035. 

But climate-change experts say that Japan is still struggling to reduce its fossil-fuel reliance. They assert that the country is in fact six points short of the reduction needed to limit the temperature increase to 1.5° C above pre-industrial levels, as stipulated by the Paris Agreement. ◉

Suvendrini Kakuchi is a Sri Lankan journalist based in Japan, with a career that spans three decades. She focuses on development issues and Japan-Asia relations.