Ⅰ. 서론 1. 연구의 배경 및 목적 ···································································· 3 2. 연구의 범위 및 방법 ···································································· 4 Ⅱ. 대도시 고령사회문제의 개요 1. 고령사회의 세계적 동향 ······························································· 9 2. 고령사회에 대두되는 문제 ························································· 11 3. 고령화가 대도시 지역사회에 미치는 영향 ······························ 11 Ⅲ. 우리나라와 일본의 고령화 현상의 비교 1. 우리나라와 일본의 고령화 추이 ··············································· 17 1) 우리나라와 일본의 기대수명 ··················································· 17 2) 우리나라와 일본의 고령화 추이 ············································· 18 3) 우리나라와 일본의 고령화 차이 ············································· 19 2. 우리나라와 일본의 고령자 의식 및 생활환경 차이 ··············· 21 1) 소득・고용 ················································································· 21 2) 보건・의료・복지 ······································································ 22 3) 학습・사회참여 ·········································································· 24 4) 생활환경 ····················································································· 24 5) 정책의 우선순위 ········································································ 26 Ⅳ. 키타큐슈시 고령사회의 현상과 대응 1. 키타큐슈의 개요 ·········································································· 29 2. 키타큐슈시의 고령사회 현상 ····················································· 31 1) 키타큐슈시의 고령화율 ····························································· 31 2) 키타큐슈시 고령사회의 특징 ··················································· 32 3. 키타큐슈시의 고령사회 대응체제 ············································· 36 1) 키타큐슈시의 고령사회 관련 시책 및 계획 ······················· 36 2) 행정조직의 정비 ········································································ 39 3) 키타큐슈방식에 의한 지역복지 네트워크 구축 ····················· 40 4) 각종 실태조사의 실시 ······························································ 44 5) 키타큐슈시 고령자 관련 계획 수립 시행 ······························ 45 4. 고령사회 대응 주요 계획의 내용 ············································· 47 1) 키타큐슈시 고령화사회대책종합계획 ······································ 47 2) 제4차 키타큐슈시 고령자지원계획 ········································· 57 5. 고령사회 주요 대응시책 ···························································· 69 1) 소득・고용 ················································································· 71 2) 보건・의료・복지 ······································································ 72 3) 학습・사회참여 ·········································································· 77 4) 생활환경 ····················································································· 80 6. 시사점 ··························································································· 82 1) 대응체제 ····················································································· 82 2) 계획의 내용 ··············································································· 83 Ⅴ. 국내외 사례 및 전문가 의견 1. 국내외 사례 ················································································· 89 1) 소득・고용 ················································································· 89 2) 보건・의료・복지 ······································································ 93 3) 학습・사회참여 ········································································ 103 4) 생활환경 ··················································································· 108 2. 전문가 의견조사 결과 ······························································ 111 Ⅵ. 부산시 고령사회의 현상과 대응 1. 부산시 고령사회의 현상 ·························································· 117 1) 부산시 고령화의 전망 ···························································· 117 2) 부산시 고령사회의 특징 ························································· 118 2. 부산시 고령사회 대응시책 ······················································· 121 1) 부산시의 고령자 관련 환경 ··················································· 121 2) 부산시의 행정적 대응조직 ····················································· 125 3) 부산시의 고령사회 대응시책 ················································· 126 3. 부산시 고령사회 대응방안 ······················································· 130 1) 기본방향 ··················································································· 130 2) 대응방안 ··················································································· 131 4. 정책제언 ··············································································· 159 Abstract 164 참고문헌 165 부록 [부록 1] : 우리나라와 일본의 고령자 생활환경 비교 조사 결과 ····· 172 [부록 2] : 키타큐슈시 고령화사회대책종합계획의 시책방향 및 사업··· 184 [부록 3] : 제4차 키타큐슈시 고령자지원계획의 시책방향 및 사업··· 192 [부록 4] : 전문가 조사 결과····························································· 201

<표 Ⅱ-1> 일본과 구미 선진국의 고령화율 추이 ·································· 10 <표 Ⅲ-1> 우리나라와 일본의 기대수명 추이(2000-2040) ·················· 17 <표 Ⅲ-2> 우리나라의 고령화 추이 ························································ 18 <표 Ⅲ-3> 일본의 고령화 추이 ································································ 19 <표 Ⅲ-4> 우리나라와 일본의 고령화율 비교 ······································· 20 <표 Ⅳ-1> 키타큐슈시의 고령화 추이 ···················································· 31 <표 Ⅳ-2> 키타큐슈시의 고령화 전망 ···················································· 32 <표 Ⅳ-3> 일본 정령지정도시의 고령화율(2013. 3) ····························· 33 <표 Ⅳ-4> 키타큐슈시의 구별 연령 3구분 인구(2014.3) ····················· 34 <표 Ⅳ-5> 키타큐슈시의 개호보험 요지원・요개호 인정자 수의 추이 ····· 35 <표 Ⅳ-6> 키타큐슈시의 치매고령자 장래추이 ····································· 36 <표 Ⅳ-7> 키타큐슈시의 고령자 관련 시책 ··········································· 39 <표 Ⅳ-8> 키타큐슈시의 고령자 관련 주요 부서 변화 ························ 40 <표 Ⅳ-9> 키타큐슈시의 고령자 시책 권역 구분 ·································· 41 <표 Ⅳ-10> 키타큐슈시 고령화사회대책종합계획의 심의 경과 ········· 49 <표 Ⅳ-11> 키타큐슈시의 고령사회 대응 주체 간 역할분담 ·············· 50 <표 Ⅳ-12> 키타큐슈시 고령화사회대책종합계획의 기본방향과 목표 ······ 52 <표 Ⅳ-13> 제4차 키타큐슈시 고령자지원계획의 심의 경과 ·············· 60 <표 Ⅳ-14> 지역사회 주체의 역할 ·························································· 61 <표 Ⅳ-15> 키타큐슈시 고령자지원과 돌봄의 질 향상 추진위원회 분과회······ 62 <표 Ⅳ-16> 키타큐슈시 고령자지원계획의 기본방향과 목표 ············· 64 <표 Ⅳ-17> 키타큐슈시의 현행 고령사회 주요 대응시책 ···················· 70 <표 Ⅳ-18> 키타큐슈시의 종합보험복지센터(어시스트 21)의 구성 ··········· 75 <표 Ⅳ-19> 키타큐슈 아노오 돔의 개요 ················································ 78 <표 Ⅴ-1> 지역포괄지원센터의 개요 ······················································ 95 <표 Ⅴ-2> 서울시 어르신돌봄종사자종합지원센터 사업 개요 ··········· 100 <표 Ⅴ-3> 일본 도쿄도 등의 IT를 활용한 고령자 돌봄 사례 ··········· 102 <표 Ⅴ-4> 홋카이도 삿포로시 지역살롱의 예 ····································· 105 <표 Ⅴ-5> 도쿄도 분쿄구의 주거 곤란 고령자 등에 대한 지원사업 ······· 108 <표 Ⅴ-6> 전문가 의견조사 결과 ·························································· 111 <표 Ⅵ-1> 부산시의 연령 3구분 인구 전망 ········································· 117 <표 Ⅵ-2> 부산시와 우리나라의 고령화율 추이 ······························· 118 <표 Ⅵ-3> 부산시의 구별 인구 및 고령화율 (2015. 4) ····················· 119 <표 Ⅵ-4> 부산시와 키타큐슈시의 고령화율 비교 ······························ 120 <표 Ⅵ-5> 부산시 고령자 고용・소득 관련 시책 ······························· 127 <표 Ⅵ-6> 부산시 보건・의료・복지 관련 시책 ································· 128 <표 Ⅵ-7> 부산시 학습・사회참여 관련 시책 ····································· 129 <표 Ⅵ-8> 부산시 생활환경 관련 시책 ················································ 129 <표 Ⅵ-9> 부산시의 고령자 관련 종합 시책 ······································· 130 <표 Ⅵ-10> 부산시의 고령사회 대응방안 ············································ 132 <표 Ⅵ-11> 우리나라와 일본의 남녀별 연령별 노동참가율(2013) ········· 138 <표 Ⅵ-12> 지역포괄지원시스템 구축을 위한 점검 사항 ·················· 142 <표 Ⅵ-13> 제4차 키타큐슈시 고령자지원계획의 치매대책 추진체계와 사업··· 144

<그림 Ⅳ-1> 인구감소와 고령화에 의한 키타큐슈시의 도시활력 저하 ····· 29 <그림 Ⅳ-2> 고령사회대책대강의 체계(1996) ········································ 37 <그림 Ⅳ-3> 키타큐슈방식에 의한 지역복지 네트워크 ························ 42 <그림 Ⅳ-4> 키타큐슈시 고령자 관련 기본계획체계 ···························· 46 <그림 Ⅳ-5> 키타큐슈시 고령화사회대책종합계획 체계 ······················ 53 <그림 Ⅳ-6> 제4차 키타큐슈시 고령자지원계획 체계 ·························· 66 <그림 Ⅳ-7> 키타큐슈 아노오 돔 ···························································· 79 <그림 Ⅴ-1> 후쿠오카현 70세 현역사회만들기 추진체제 ···················· 90 <그림 Ⅴ-2> 카시와시의 ‘삶의 보람 취로’ 운영 프로세스 ·················· 91 <그림 Ⅴ-3> 지역포괄지원센터의 개요 ··················································· 94 <그림 Ⅴ-4> 후쿠오카현 치매의료센터의 연계체계 ······························ 96 <그림 Ⅴ-5> 서울시 마포구의 ‘찾아가는 동주민센터’ 추진 목표와 과제····· 98 <그림 Ⅴ-6> 요코하마 시니어 자원봉사 포인트사업의 흐름도 ········· 107 <그림 Ⅴ-7> 도쿄 분교구의 고령자 등 주거확보 지원사업 모델 ····· 109 <그림 Ⅵ-1> 부산시와 키타큐슈시의 고령화율 차이 ·························· 121 <그림 Ⅵ-2> 치매카페의 역할과 관련기관과의 관계 ·························· 147 <그림 Ⅵ-3> 일본의 고령운전자 표시 ·················································· 157