SPECIAL REPORT: How and why Japanese forced to embrace ‘Lonely Deaths’

Nearly 40,000 people in Japan died alone at home in 2024, many of them going unnoticed for months, according to a report in The Lancet. The issue of “lonely deaths” (kodokushi) has raised widespread concern and prompted new policies to address the growing problem.

In August, the discovery of an older woman’s skeleton in Kyoto made national headlines. The woman’s remains were found by a specialist cleaning team hired to clear her cluttered apartment, which was reportedly filled with garbage. Initially mistaken for a model skeleton, the body was identified as the apartment’s occupant, who had been missing for a decade. This tragic case highlights the increasing number of lonely deaths in Japan, with tens of thousands more occurring every year.

The Lancet report reveals that nearly 40,000 people died alone in the first half of 2024, with many of the deaths going unnoticed for extended periods. Of the 37,227 people found dead at home between January and June, 40% were discovered within 24 hours, but nearly 4,000 were not found until a month after their death, and 130 people were only discovered after a year. This data, provided by the National Police Agency, is considered the first national analysis of the phenomenon.

The report has reignited concerns about the causes of these deaths, which experts attribute to a combination of demographic, cultural, and economic factors. “Lonely deaths have haunted Japan for two decades,” says Jieun Kim, Associate Professor of East Asian Studies at the University of Leeds. The term “lonely death” gained prominence after the 1995 Great Hanshin Earthquake, which displaced many elderly people and forced them into temporary shelters, where they struggled to care for themselves.

A report from 2020 found that 4,207 people aged 65 and older died alone in Tokyo, a 35% increase from 2015. However, inconsistent data collection in Japan has made it difficult to fully understand the scale of the problem. There is no nationwide coroner system, and deaths are often recorded by local police, which may lack forensic expertise. As a result, the exact figures remain uncertain, but experts agree that the phenomenon is significant.

Factors contributing to lonely deaths include Japan’s high proportion of single-person households. By 2024, nearly 38% of Japanese households consist of one person, and this number is expected to rise to 44.3% by 2050. This shift is driven by declining marriage rates, rising divorce rates, and lower fertility. “The number of single-person households is steadily increasing,” explains Yumi Shimabukuro, Director of the Urban & Social Policy Program at Columbia University. However, the most pressing issue is Japan’s aging population. By 2050, 10.8 million older people are expected to live alone, accounting for 20.6% of all households. Of the 37,227 people who died alone in the first half of 2024, 76.3% were aged 65 or older.

As Japan’s older population becomes more isolated from their extended families, particularly in rural areas, the burden of elderly care has shifted to public policy. However, the country is facing a severe shortage of caregivers, exacerbated by an aging workforce. A report from the Ministry of Welfare forecasts a shortage of 570,000 caregivers by 2040, and the healthcare system is already stretched thin. “The Japanese medical system relies on the saintly self-sacrifice of healthcare workers,” says Kazuo Komamura, a Japanese clinician. “This shortage is expected to worsen as overtime limits are enforced in 2024.”

Social pressures also play a role. Many elderly people avoid seeking public welfare because they don’t want to burden already-struggling family members. The concept of “responsible aging,” in which individuals are encouraged to manage their own health and end-of-life plans, adds additional pressure on the elderly.

In response, the Japanese government has implemented various measures to combat lonely deaths. Since 2007, the Ministry of Health, Labour, and Welfare has promoted initiatives to prevent isolated deaths, including local monitoring systems and wellness checks. Many municipalities have developed volunteer networks to visit elderly people living alone and offer support. However, these efforts address only the immediate aftermath of a lonely death and do little to reduce the isolation that leads to these tragedies.

A recent survey revealed that 40% of Japanese people experience loneliness at least occasionally, with over a million reporting depression. Mental health awareness and treatment, however, remain insufficient, and Japan has one of the highest suicide rates among OECD countries, with approximately 20,000 suicides each year. Loneliness and isolation are major contributors to this loss of life, and experts warn that the situation will worsen unless more is done to address the underlying issues.

In April 2024, Japan passed the Act on Promotion of Policy for Loneliness and Isolation, which makes isolation a societal issue and requires local governments to establish support groups for those facing loneliness. The policy includes training for workers to help combat isolation, as well as a national database to track the effectiveness of these measures.

This new legislation is seen as a step in the right direction by experts like Naoki Kondo, a professor at Kyoto University, who points to a growing recognition of the need for more social participation opportunities for older adults. Local initiatives such as community salons, which encourage socializing to prevent isolation, are already being expanded. The government has allocated US$30 billion in incentives to promote these programs.

Despite these efforts, the problem of lonely deaths remains a pressing issue in Japan. “In a collective society like Japan, a solitary death is considered one of the worst ways to die,” says Chikako Ozawa-de Silva, Associate Professor of Anthropology at Emory University. “The fear surrounding kodokushi is palpable, and as marriage and birth rates continue to decline, this phenomenon is only set to increase.”