Where do the Elderly Go? ―Migration of the Elderly in the Tokyo Metropolitan Area

My fields of research are local finance and social security policy. I employ empirical methods to consider the decision-making of local governments and residents, as well as the impact of those decisions. My selection of research fields seems to have been strongly influenced by my career and living environment. I was attracted to local public finance as a research field because I came from a rural area where the decline and aging of the population is progressing rapidly. I also focus on long-term care policy, especially within social security policy. I believe my interest in this field was spurred by a question that occupies my mind--what should I do if my parents (who continue to reside in my rural hometown) require long-term care in the future? Furthermore, because of my own experience of moving from a rural area to Tokyo, I also have a strong interest in the movement of people (inter-regional migration).

Based on this awareness of these issues, I have been conducting research to understand the inter-regional migration of the elderly and related primary factors. As the Japanese population ages, the birthrate declines, and family differentiation progresses, long-term care resources become limited. In response to these trends, I am examining the questions that from whom and where the elderly will receive long-term care, and where the elderly will go. This article introduces part of that research. Specifically, I assess the trends in inter-regional migration of the elderly based on the 2020 census in Tokyo, the Tokyo metropolitan area, and other regions.^[1]

According to the Preliminary Report on Vital Statistics released on February 27, 2025, the number of births in Japan in 2024 dropped to a new low of approximately 720,000. The number of deaths in the same year was approximately 1.62 million, a natural decrease of approximately 900,000. Japan has been in a state of continuous population decline since 2008, and it is estimated that the population will decrease by approximately 40 million by 2060. This figure is roughly equal to the total population of five prefectures--Ibaraki, Saitama, Chiba, Tokyo, and Kanagawa.

This declining birthrate will cause major changes in the nature of families. The number of households in Japan has continued to increase even after the country entered an era of declining population. Meanwhile, the average number of people per household has continued to decline from five in 1953 to 2.23 in 2023.^[2] We can expect an increase in households such as those without children and those where people live apart from their parents like me. In 1986, the most common type of household for elderly people aged 65 or older was "living together with a child, his/her spouse, and their child(ren)." This household type accounted for 46.7% of all households with elderly members. However, by 2023, the proportion of this household type dropped to just 7.5%. In contrast, in 2023, single-person households accounted for 21.7% and couple-only households for 40.7%, reaching 62.4% of households in total. In the past, it was common for the elderly to live with their children. However, with the declining birthrate and the differentiation of families, it is now common for elderly people to live alone.

So, when an elderly person requires long-term care, where and from whom will they receive it? In the past, it was common for the elderly to receive long-term care from family members (children) living together. However, as already mentioned, elderly people living with their children are now in the minority. Although a public long-term care insurance system was introduced in 2000, this system alone is not enough to cover all long-term care. I started this research because I wanted to examine whether elderly people who require long-term care are moving; specifically, whether children are calling their elderly parents to live together or whether the elderly are moving to long-term care facilities.

The national census in Japan is a source of data that captures the migration of the elderly. The census conducts a survey of population migration every 10 years. Specifically, by asking about the place of residence five years ago and the place of residence at the time of the survey, it is possible to grasp migration by age group at the municipal level. Here, I will use the 2020 survey to examine the migration between the Tokyo metropolitan area and other regions, as well as the migration within the Tokyo metropolitan area.^[3]

Table 1　Migration of the elderly in each region and the Tokyo metropolitan area (people) 

	Early-stage elderly (65 to 74 years old)			Late-stage elderly (75 years old and older)
	From Tokyo metropolitan area	To Tokyo metropolitan area	Total	From Tokyo metropolitan area	To Tokyo metropolitan area	Total
Hokkaido	3,381	1,857	1,524	1,425	2,341	-916
Tohoku	7,213	3,734	3,479	3,340	4,555	-1,215
Northern Kanto	8,297	3,840	4,457	9,134	4,956	4,178
Chubu	12,233	6,454	5,779	8,128	8,713	-585
Kinki	5,444	4,479	965	2,928	5,644	-2,716
Chugoku	2,580	1,438	1,142	1,176	2,002	-826
Shikoku	1,460	644	816	552	859	-307
Kyushu	8,243	3,288	4,955	3,285	4,103	-818
Total	48,851	25,734	23,117	29,968	33,173	-3,205

Table 1 shows the migration of the elderly between the Tokyo metropolitan area and each region. The "Total" column shows the outflow from the Tokyo metropolitan area minus the inflow to the Tokyo metropolitan area. If the total value is positive, it means there is an excess of outflow from the Tokyo metropolitan area, and if it is negative, it means there is an excess of inflow to the Tokyo metropolitan area.

Migration patterns are clearly different between the early-stage elderly and the late-stage elderly. For the early-stage elderly aged between 65 and 74, there is an excess of outflow from the Tokyo metropolitan area to other regions. There is a large excess of outflow to regions close in distance, also the Kyushu region experiencing a large excess of outflow. On the other hand, for the late-stage elderly aged 75 and older, there is an excess of inflow from other regions, with the exception of northern Kanto. Possible movement patterns for the early-stage elderly include those who choose to live in rural areas after retirement, and those moving back to their hometowns. On the other hand, it can be observed that the late-stage elderly, who are at high risk of requiring long-term care, are moving from rural areas to large cities.

When examining trends in the Tokyo metropolitan area (Tokyo and three adjacent prefectures), Tokyo is experiencing an outflow of both early-stage and late-stage elderly people, while Saitama Prefecture, Chiba Prefecture, and Kanagawa Prefecture are experiencing an outflow of early-stage elderly people to other regions, and an inflow of late-stage elderly people from other regions. Looking more closely, there is an outflow of late-stage elderly people from Tokyo's 23 cities (formerly, 23 wards). The destination of these people tends to be the Tama region, the three adjacent prefectures, and the northern Kanto region. It turns out that the three prefectures adjacent to Tokyo are destinations for late-stage elderly people from other regions except Tokyo and northern Kanto.

There are many hypotheses as to why the late-stage elderly are moving out of Tokyo's 23 cities and circulating in surrounding cities, however, research is still ongoing. There are fewer studies on the migration of the elderly in Japan compared to other age groups, and there is very little data that can tell us where the elderly moved from, where they moved to, and why they moved. Among them, Nakazawa (2017) has approached the causes of migration by examining movement by municipality and age group, showing the relationship with the quantitative availability of long-term care facilities for the elderly.^[4] Furthermore, Sumita, Nakazawa, and Kawase (2021) used individual data to show that relocation of the elderly was affected by the housing ownership status of the elderly and the location of long-term care facilities.^[5]

Considering the declining birthrate and aging population, changes in family structures, and issues with funding for medical care and long-term care, we may see a greater migration of the elderly in Japanese society. In fact, when looking at census data, it is apparent that the migration of the elderly has been increasing since 1990. Meanwhile, while local government officials are very concerned about the aging of people who currently live in their respective areas, they do not seem to pay much attention to migration itself. Once, during an interview with a local government official, I presented data showing that a large number of late-stage elderly people move their residence, the person in charge was very surprised.

If we consider elderly people to be mobile, their movements will have a major impact on local government finances and welfare policies. It could also lead to regional competition, such as child-raising support policies, or it could cause opposite competition. I believe these issues need to be considered, including the future of local communities and local government administration and finance.

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[1] Tokyo metropolitan area refers to Saitama Prefecture, Chiba Prefecture, Tokyo, and Kanagawa Prefecture.
[2] Ministry of Internal Affairs and Communications: Comprehensive Survey of Living Conditions.
[3] The prefectures composing each region are as follows.
Tohoku: Aomori Prefecture, Iwate Prefecture, Miyagi Prefecture, Akita Prefecture, Yamagata Prefecture, and Fukushima Prefecture
Northern Kanto: Ibaraki Prefecture, Tochigi Prefecture, and Gunma Prefecture
Chubu: Niigata Prefecture, Toyama Prefecture, Ishikawa Prefecture, Fukui Prefecture, Yamanashi Prefecture, Nagano Prefecture, Gifu Prefecture, Shizuoka Prefecture, and Aichi Prefecture
Kinki: Mie Prefecture, Shiga Prefecture, Kyoto Prefecture, Osaka Prefecture, Hyogo Prefecture, Nara Prefecture, and Wakayama Prefecture
Chugoku: Shimane Prefecture, Tottori Prefecture, Okayama Prefecture, Hiroshima Prefecture, and Yamaguchi Prefecture
Shikoku: Tokushima Prefecture, Kagawa Prefecture, Ehime Prefecture, and Kochi Prefecture
Kyushu: Fukuoka Prefecture, Saga Prefecture, Nagasaki Prefecture, Kumamoto Prefecture, Oita Prefecture, Miyazaki Prefecture, Kagoshima Prefecture, and Okinawa Prefecture
[4] Nakazawa, K., Social Trends of the Elderly and the Long-Term Care Insurance System, Journal of Social Security Research, Vol. 2, No. 2-3, 2017.
[5] Sumita, K., Nakazawa, K., and Kawase, A., Long-term care facilities and migration of elderly households in an aged society: Empirical analysis based on micro data, Journal of Housing Economics, 53, 2021.