Japan is enjoying the highest life expectancy in the world with relatively low health care costs (7.9% of its gross national product spent on health care compared with 16% in the United States). Under the universal Long-Term Care Insurance System, people aged 65+ years are entitled to receive long-term care if determined to have care needs. Despite this seemingly rosy picture, Japan faces major challenges stemming from simultaneous population aging and population decline. Japan precedes other countries in experiencing a “super-aging” society not only in rural but also in urban communities.