Reasons for Our Overburdened Healthcare Systems: Aging
3 minute read
Part One: An Aging Population
The median aging of the population is a trend that began in first-world countries, but has now spread globally. Around the world, we are collectively aging due to a combination of declining average fertility and an increasing life expectancy.
The number of people over 60 years old has more than quadrupled since 1950, and the senior and geriatric population is expected to exceed 2 billion people by 2050 (UN DESA 2019; UN 2007). For the first time in history, in 2019 the number of Dutch people over 50 years outnumbered those under 50 (CBS 2014).
Effects of Population Aging
This is a significant change. As the World Health Organization points out (2010), an aging population has a sweeping effect on all aspects of our social and economic systems. Some of the largest changes affected by an aging population are:
- Older people tend to spend less on consumer goods than young people. In addition, people planning ahead for more years in retirement tend to save and invest more, instead of purchasing consumer goods.
- Governments everywhere need to adjust their national pension systems, as more people are using these pensions for more years, and fewer working young people are contributing. Many government and private pension systems have built-in incentives that encourage early retirement, which increases the dependency burden. If governments and private systems increase the retirement age, it may penalize those in manual labor, who cannot physically sustain such work into old age.
- Finally, an aging population tends to lead to decreased inflation and lower interest rates, which effects the economy as a whole.
- On the other hand, an aging population reduces the need for government expenditures in education and job creation. In Japan, an aging population is instrumental in shifting their economic development to automation and technological solutions without causing job loss.
- Governments are attempting to provide social and wellbeing services to an older population by promoting urbanization and mixed-use communities. The World Health Organization has emphasized the need to create age-friendly environments, with easy access to transportation, social activities, and healthcare infrastructure. Older adults living below poverty levels tend to be the poorest population overall, with the greatest need for social services.
- Purposefully providing for an overall better quality of life is an important aspect of care as populations grow older. Studies conducted by the Rutgers School of Public Health show that social services for the elderly that promote wellness, physical activity, and ease loneliness and depression, have a positive effect on physical health and reduce the need for hospital care (Rutgers 2018).
- In many countries, healthcare is now the largest area of government expenditure, and this trend is likely to increase. Older people require more medical care and more prescription drugs, and, as life expectancy increases, these expenses go on for longer. Again, The WHO calls for even more access to preventive care for the elderly, and renewed efforts to prevent chronic diseases that require decades of management.
To support and care for an aging population and manage healthcare costs, we need to gain a better understanding of the relationship between age and health. As pointed out in the European Journal of Ageing back in 2013 (de Meijer et al.), poor health is not a necessary consequence of aging, yet poor health (rather than simply aging) is the primary driver of healthcare expenditure. According to this research, aging alone contributes 1% of the annual increase in healthcare costs, while health and disability contribute 3%. While 1% a year is not trivial, a shift in perspective toward health at any age will help to control some of the costs and consequences of an aging population.
United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Prospects 2019, Online Edition. Rev. 1.
United Nations. World Population Prospects, The 2006 Revision Vol. I: Comprehensive Tables. New York, NY, USA: Population Division, Department of Economic and Social Affairs; 2007.
Central Bureau of Statistics. (2014, September 16). Half of Dutch adults will be over 50 in 2019. https://www.cbs.nl/en-gb/news/2014/38/half-of-dutch-adults-will-be-over-50-in-2019
World Health Organization. (2010, October 2). Ageing: Global Population. https://www.who.int/news-room/q-a-detail/population-ageing
Rutgers University. (2018, October 11). Elderly housing with supportive social services can reduce hospital use, study finds. EurekAlert! https://www.eurekalert.org/pub_releases/2018-10/ru-ehw101118.php
de Meijer, C. et al. (2013, December 10). The effect of population aging on health expenditure growth: a critical review. European Journal of Ageing. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549212/