PS004 - Agequake in Health Systems: Imperatives of an Aging Population

Key Messages:

• Demographic aging will be one of the most dramatic trends of this century. Populations in developed countries are older, but populations in developing countries are aging faster.
• Noncommunicable diseases are now the biggest killers and population aging is one of the underlying socioeconomic, cultural, political and environmental determinants.
• Chronic eye diseases such as Glaucoma, age related macular degeneration, and diabetic retinopathy are the major causes of blindness world wide and their prevalence is increasing due to aging population and life-style changes.

Demographic aging will be one of the most dramatic trends of this century. Ms. Siri Tellier, Director, United Nations Population Fund (UNFPA) noted that aging is the result of two successes of science: prevention of unwanted pregnancy and an end to premature death. However, as populations in developed countries are older, populations in developing countries are aging faster, which poses great challenges for health care systems. One dimension of functional aging is economic, and the concern is usually focused on the proportion of people who are 65 years old and over. Another economic concern deals with financial support in old age, but it does not address the actual situation beyond pay-as-you-go pensions. Aging leads to disability and increased costs, and even though there are some policy initiatives that limit problems of disability, health care systems need restructuring because cost increases are not all age-related.

Mr. Serge Resnikoff, Coordinator, Chronic Disease Prevention and Management, World Health Organization (WHO) also stressed the impact of aging on chronic diseases. Non-communicable diseases (NCD), including cardiovascular disease, cancer, chronic respiratory diseases and diabetes accounted for 60 percent of all deaths worldwide in 2005. In addition, the World Health Organization projects that, over the next 10 years, the largest increase in deaths from NCD will occur in the Sub-Saharan Africa (27 percent). Population aging is one of the main underlying socio-economic, cultural, political and environmental determinants of chronic diseases. Mr. Resnikoff also explained that there are many misunderstandings about chronic diseases. One example includes the misinformation that chronic diseases mainly affect high-income countries, when in fact, 80 percent of chronic disease deaths occur in low- and middle-income countries. In addition, Chronic Disease can be prevented, and the reality is that 80 percent of premature heart disease strokes and type 2 diabetes, and 40 percent of cancer are preventable.

The prevalence of chronic eye diseases is increasing due to aging of populations and currently, there is no public health strategy that exists to address this problem. Dr. Kaweh Mansouri from the Jules Gonin Eye Hospital noted that there are currently 37 million blind people and 124 million with low vision, excluding those with uncorrected refractive errors. The amount of affected people will increase as a result of the effects of population aging, and more needs to be done to address chronic eye diseases leading to blindness. These challenges will be particularly overwhelming in developing countries, with most of them lacking ophthalmic health systems.

In conclusion, as we explore how populations in developed countries are older, populations in developing countries are aging faster, which poses great challenges for social institutions. Negative effects of aging include disability, chronic diseases and increased prevalence of chronic eye disease, leading to increased costs. This poses a challenge in developing countries with most of them lacking the finances and health systems. Older people offer many benefits to the community, such as being able to care for their grandchildren while the parents are working, and having the ability to organize in natural disaster situations. We need to look at aging with a broad perspective, and be aware that the policy responses and their results in different populations should be actively documented and disseminated.