Question

JAPANESE CASE STUDY #1 This case study is a composite of actual situations. Marianne, who is American, and Ken Shimizu, who is Japanese, have worked in Tokyo for over 30 years as Methodist missionaries. They have annual furloughs and occasional sabbaticals, during which they visit relatives and sponsoring organizations and engage in continuing education in the United States. They met as college students in the United States, and their three grown children have established their own careers in the United States. Ken’s 98-year-old mother resides with Marianne and Ken. She is not Christian but has always been extremely supportive of Ken and Marianne’s work. Ken teaches at a large Christian university, whereas Marianne has served in various church-related positions over the years. As missionaries, they live in subsidized post–World War II housing near Ken’s university. Marianne has been a frugal housewife, preparing local foods in the Japanese style for her family. Ken, who is nearly 60, recently learned that he has glaucoma. By the time it was discovered, he had lost a significant amount of peripheral vision. Although Marianne delivered all three children at a Christian hospital in Tokyo, she gets her annual physical examination when visiting relatives in the United States. She has never believed that the Japanese health system is as proactive as that in the United States. On her most recent visit to the United States, Marianne learned that she has hypertension. Her physician prescribed a medication that is readily available in Japan, but the physician was concerned about the level of stress in Marianne’s life. Mother Shimizu is quite confused and requires considerable care, but it is unthinkable for Ken, the only child, to put his mother in a long-term-care facility. Even if he would, the quality of facilities in Japan leaves much to be desired. Most of the responsibility for Mother Shimizu falls on Marianne, in addition to her work. Marianne’s relatives are urging her to consider placing Mother Shimizu in a church-related life-care community near Marianne’s family in the United States, where Marianne and Ken would like to retire. Marianne’s own parents lived in this facility at the end of their lives. She is considering these issues as she returns to Tokyo.

2. What are the family resources for this international family?

9. Compare and contrast the fertility and mortality rates of Japan and the United States.

Answer 1

2. In this case study family resources that can be used by the Marianne and Ken family to cope with difficult situations are their three grown children who established their own careers in the United States. No information available about Marianne’s family who lives in USA and other relatives.

9. Compare and contrast the fertility and mortality rates of Japan and the United States

	USA	Japan
Population	327,352,000	126,529,100
Surface Area	9,831,510 km2	377,970 km2
Fertility rate	1.8 children born/woman	1.44 children born/woman
Mortality rates	8.685 deaths per 1000 people,	10.427 deaths per 1000 people
Average life expectancy	78.69 years	83.98 years

Fertility rate is more in USA when compared to Japan and mortality rates more in japan when compared to USA. Factors influencing fertility rates are geography, race, education, religion and use of contraceptive etc. In common, fertility rate in developed countries is less in developed countries however, the increased rate in USA due to immigrants from other countries. Though both countries are developed, highly educated and accessible for advance medical facilities, the immigrants from African and Asian countries plays a vital role in fertility and mortality rates. The quality of life style, diet, physical activities and advance healthcare system are other major influencing factors for fertility and mortality rate. The healthy diet in regular intake is better in Japan when compare to USA and it resembles in average life expectancy. Average life expectancy is more in Japan when compared to USA. The poor diet and absence of physical activities in USA life style lead to risk factors such as obesity for life threatening diseases including cardiac disorders and diabetes.