How Grief, Funerals, and Poverty Affect Bereaved Health, Productivity, and Medical Dependence in Japan

Abstract

Grief has been shown to weaken bereaved persons' health, but measurements of their lost time and medical expense remain rare. Funerals traditionally managed and assuaged grief through ritual expression, approval, and social support. Research suggests that satisfying funeral participation reduces grief, while poverty exacerbates it. We hypothesized that: (1) psycho-physical symptoms of grief, (2) abbreviation/dissatisfaction in the funeral, and (3) poverty, correlate with decreased productivity and increased medical and social services use. We collected data from 165 mourning families about their grief, funerals, and subsequent medical conditions. (1) Deeper grief after bereavement in Japan correlated with more physical problems, more down time, and more medical dependency. (2) Low satisfaction with funerals correlated with higher hospital, pharmacy, and counseling costs. (3) Low income families lost more time, while declining incomes showed increased pharmaceutical costs. This suggests that satisfying funerals and income safeguards may reduce costs of low productivity and increased public services dependency.

Utilizing the spirituality of funeral rituals for post-pandemic grief recovery

“…Their preliminary findings were that deeper grief after bereavement correlated with more physical problems and more medical dependency in Japan. High satisfaction with funerals loosely correlated with less expenditure of personal time and money for medical and psychological issues after bereavement, while funeral dis satisfaction correlated more strongly with heightened medical reliance—but they were unable to find statistically significant correlation between specific rituals or funeral practices and specific symptoms of grief (Becker et al, 2021b , 2022 ). In other words, funerals affect the bereaved not only emotionally and spiritually but also psycho-somatically.…”

“…Becker et al ( 2021a , b ) conducted Japan's first major nationwide survey to determine the impact of funeral and memorial practices on psychological grief, physical health, and medical costs. Their preliminary findings were that deeper grief after bereavement correlated with more physical problems and more medical dependency in Japan.…”

“…Traditionally, funerals and rituals addressed and ameliorated some of that grief (see Hoy, 2013 , 2020 ), but pandemic restrictions have hampered funeral gatherings as well. Research suggests that funerals and related rituals contribute substantially to the psycho-spiritual as well as physical health of the recently bereaved (Becker et al, 2021a , b ) yet ironically, the psycho-spiritual value of funerals has not yet been widely studied nor applied to prevent or address psychiatric problems. This essay would propose that funerary rituals support the bereaved by facilitating (1) expression; (2) solace; (3) support; and (4) meaning-making, all central to the spiritual wellbeing of the bereaved.…”

Identifying bereaved grievers with greatest medical or social service needs in Japan

“…Unlike many western nations, Japan’s medical institutions retain no contact with bereaved families, so we sought the co-operation of funeral homes which retain records of bereaved families in the communities they serve. In 2018, our team initiated a pilot survey to determine what questions would most acceptably elicit clear responses from a Japanese bereaved sample 14 15. Based on their feedback, we improved our questionnaire format to include the variables described below.…”

Unexplored Costs of Bereavement Grief in Japan: Patterns of Increased Use of Medical, Pharmaceutical, and Financial Services

“…Given this background-that bereavement grief decreases productivity and increases medical reliance-we crafted a questionnaire for a bereaved Japanese population, to determine what percentage of bereaved Japanese increase their medical and social expenses, and what psycho-social variables affect such increased expenses. Our pilot study was introduced in an earlier issue of OMEGA (Becker et al, 2020); here we introduce the more robust results from our full nationwide survey.…”