Between 2018 and 2020, 742 people in their teens to thirties across Tokyo's 23 wards died alone in their homes. The Tokyo Medical Examiner's Office (TMEO) reported these statistics on July 21. In approximately 40% of these cases, it took more than four days for their bodies to be discovered. The findings highlight that the risk of kodokushi (dying alone) is not limited to elderly people living alone. It is also spreading among younger individuals.
Trigger Warning: This article contains references to suicide.
There is no legal definition of kodokushi, which varies among government agencies and municipalities. However, the TMEO defines it as people living alone who died at home due to unnatural or unexplained causes, such as suicide.
In May 2024, however, the National Police Agency released data for the first time on people living alone who died at home. According to the data, from January to March, police nationwide handled 60,466 bodies. Of these, 21,716 were people living alone who died at home, including those who died by suicide. Elderly individuals aged 65 and older numbered 17,034, representing about 80% of the total. This suggests an estimated annual figure of approximately 68,000 such cases.
Age and Discovery Patterns
Over this three-year period, the TMEO handled 1,145 cases of deaths among young people in their teens to thirties. These individuals died under unnatural circumstances while living alone. Among these, 64.8% (742 people) were kodokushi cases, as defined by the TEMO.
Of the 742 individuals, the largest group was aged 30–39 years, totaling 402 people. This was followed by those aged 20–29 years (325 people) and 15–19 years (15 people). There were no cases for those under 15. Additionally, the data revealed that kodokushi among people in their twenties and thirties has been increasing each year.
Regarding the time from death to discovery, the most common duration was 2–3 days, with 248 cases. In 189 cases, it took 0–1 day. There were 127 cases where discovery took 4–7 days and 114 cases where it took 8–30 days. Additionally, 64 cases were discovered after more than 31 days. Overall, 305 cases, or over 40% of the total, took more than four days before anyone discovered them.
Growing Self-Neglect in Young Adults
Although the TMEO does not track the causes of kodokushi, it believes that many of the 742 cases are likely suicides.
This phenomenon is linked to a growing trend of self-neglect among younger generations, where individuals sever their social connections. They subsequently lose the ability and motivation to care for themselves. Factors contributing to kodokushi include economic hardship and dementia. Yet this self-neglect is also a significant factor. Compounding the issue is the tendency of individuals to sever all external ties, diminishing the visibility of the problem.
Self-neglect includes not only the refusal of necessary medical treatment and care but also failing to maintain personal hygiene. This can lead to rodent or pest infestations and result in the accumulation of garbage or excrement within the home.
A 2011 survey by the NLI Research Institute found that about 80% of the analyzed kodokushi cases were due to self-neglect.
Socio-Economic Effects
Delayed discovery and decomposition of a body often result in cases where the cause of death remains unclear. Moreover, there are socio-economic repercussions, including declines in property value. Local governments also bear increased burdens, such as handling funeral arrangements, particularly when there are no surviving relatives.
The government has taken a broader approach by addressing loneliness and social isolation as societal issues rather than individual concerns. Last year, it convened a working group focused on understanding the realities of kodokushi.
A Concern for All Ages
However, loneliness and social isolation are not confined to the elderly. A government survey of 20,000 people aged 16 and older found that 39.3% reported experiencing feelings of loneliness. The highest incidence was among individuals in their thirties, at 46.1%.
While 45.3% of people in their twenties reported feelings of loneliness, 42.5% of those in their forties experienced similar emotions. In comparison, 36.2% of people in their sixties and 30.5% in their seventies reported loneliness. These statistics suggest that feelings of isolation are particularly acute among the working-age population. It underscores the urgent need for measures to address loneliness and social isolation, including among young people.
'I Musn't Be a Burden'
A 29-year-old former teacher from Fukuoka Prefecture revealed that she fell into self-neglect while living alone a few years ago. "I might have died without my parents even knowing," she reflects.
In 2019, she started her career as a teacher at a special needs school immediately after graduation and underwent initial training. A perfectionist with a strong sense of responsibility, she was determined to adapt to her new environment. She constantly told herself, "I have to give it my all." After a while, she found herself thinking about work, even on her days off.
At work, she maintained a cheerful demeanor but soon felt increasingly overwhelmed, even breaking down in tears during her commute. About two months later, she was diagnosed with adjustment disorder and took medical leave. Although she returned to work a few months later, she had to take another leave the following year. "I mustn't be a burden," she thought, and even limited contact with her parents, isolating herself at home.
Overcoming a Life of Self-Neglect
She spent the entire day feeling lethargic, lying on the bed or floor. Even changing clothes, shopping, or eating proved too much for her. Often, she would go without food for two days at a time. She avoided contact with everyone and threw away the trash only at night. "It was as if I was a zombie," she says.
In fact, she had a history of self-neglect. Bullied in high school, she entered university after repeating a year. At university, she struggled to connect with her peers. She became deeply engrossed in online gaming, spending up to 14 hours a day playing. Besides attending classes to earn credits, she rarely left the house.
There was no one she could casually discuss taking a leave of absence with. Distancing herself from her family, she even considered the possibility of kodokushi. Although she resigned from her teaching job, after starting medication and seeing some improvement in her mental state, she began working part-time. This helped her break free from that lifestyle. "If I had died, I think it would have taken my parents three months to notice," she reflected.
Urgent Need for Research and Support
Self-neglect has traditionally been associated with older adults. However, Toho University Faculty of Nursing Professor Emiko Kishi emphasizes the importance of focusing on younger individuals as well. According to a survey of 5,000 people aged 20 to 74, those in their 20s to 40s are at a notably higher risk for self-neglect compared to individuals over 50. She notes, "Younger individuals are also more likely to report not seeking support from those around them."
Professor Kishi points out that, to the best of her knowledge, there has been little international research on self-neglect among young people. "It is crucial to analyze the risk factors and underlying causes and to explore preventive and responsive measures moving forward," she states. She warns that failing to provide early support to those experiencing social isolation could represent a significant loss for the nation.
SEEKING HELP? If you are in Japan and having trouble with mental health due to workplace harassment, bullying, or for any other reason, someone is ready to help you in English at TELL Japan. Telephone (free dial inside Japan) 0800-300-8355. If you are outside of Japan, please check your national health authorities for guidance in your country.
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Read the articles in Japanese here and here.
Author: Mie Oh
