PAHO/WHO – With advances in medicine helping more people to live longer lives, the number of people over the age of 60 is expected to double by 2050 and will require radical societal change, according to a new report released by the World Health Organization (WHO) for the International Day of Older Persons (1 October).
“Today, most people, even in the poorest countries, are living longer lives” said Dr. Margaret Chan, director-general of WHO. “But this is not enough. We need to ensure these extra years are healthy, meaningful and dignified. Achieving this will not just be good for older people, it will be good for society as a whole.”
“These are advances that we should be proud of,” said Dr. Carissa F Etienne, director of the Pan American Health Organization (PAHO), WHO’s Regional Office for the Americas, where the WHO report was launched today. “It’s important to note, however, that we need to be ready to respond to the challenges that this demographic shift will inevitably bring to our societies, social protection systems, and especially to our health systems.”
Longer lives not necessarily healthier lives
Contrary to widespread assumptions, the report finds that there is very little evidence that the added years of life are being experienced in better health than was the case for previous generations at the same age. “Unfortunately 70 does not yet appear to be the new 60,” said Dr. John Beard, director of WHO’s Department of Ageing and Life Course. “But it could be. And it should be”.
While some older people may indeed be experiencing both longer and healthier lives, these people are likely to have come from more advantaged segments of society. “People from disadvantaged backgrounds, those in poorer countries, those with the fewest opportunities and the fewest resources to call on in older age are also likely to have the poorest health and the greatest need,” said Beard.
The report stresses that governments must ensure policies that enable older people to continue participating in society and that avoid reinforcing the inequities that often underpin poor health in older age.
Aging in the Americas
The population of the Americas is among the world’s oldest. In 2006, there were 50 million older adults in the region, and that number is expected to double by 2025, and again by 2050, when 1 in 4 people in the Americas will be over 60 (globally, the proportion will be 1 in 5).
People in the region are now living longer. Today a 60-year-old can expect to live until age 81, that is, 21 more years. In the last five decades, regional life expectancy has increased an average of 20 years.
More than 80% of people born in the Americas today will live to age 60, and 42% of them will live past 80. In 2025, there will be an estimated 15 million octogenarians in the region.
“Every country in the region is aging, and they are aging at a speed that has never before been seen in history,” said Etienne. “But we still have time to respond to this demographic change.”
Currently, the country with the oldest population in the region is Canada. However, projects based on data from the U.N. Population Division indicate that in less than a decade, the older population in countries such as Barbados, Cuba, and Martinique will surpass Canada’s.
“This report makes clear that aging in and of itself is not the problem,” said Etienne, “nor are older persons the problem. Rather, it is the loss of 10 years of healthy living that is the problem, as our health and social systems are not ready to provide independent living and long-term care for those who need it. The report also makes clear that for achieving and maintaining a fully functioning life, older adults need to not merely fight against disease, but to live out their full potential in conducive environments.”
Etienne said the report is a valuable tool to identify new ways of adapting health systems to the needs of older adults and to ensure that those needs are considered within the context of universal access to health and universal health coverage.
Aging, a missed opportunity for society
The new report rejects the stereotype of older people as frail and dependent and says the many contributions that older people make are often overlooked, while the demands that population aging will place on society are frequently overemphasised or exaggerated.
The report emphasises that while some older people will require care and support, older populations in general are very diverse and make multiple contributions to families, communities and society more broadly.
It cites research that suggests these contributions far outweigh any investments that might be needed to provide the health services, long-term care and social security that older populations require.
And it says policy needs to shift from an emphasis on controlling costs to a greater focus on enabling older people to do the things that matter to them.
This will be particularly important for women, who comprise the majority of older people and who provide much of the family care for those who can no longer care for themselves. “As we look to the future, we need to appreciate the importance of aging in the lives of women, particularly in poorer countries,” said Dr. Flavia Bustreo, WHO assistant director-general for family, women’s and children’s health. “And we need to think much more about how we can ensure the health of women right across the life course.”
The report highlights three key areas for action that will require a fundamental shift in the way society thinks about aging and older people. These actions can give older people the ability to invent new ways of living, both today and in the future.
The first is to make the places we live in much friendlier to older people. Good examples can be found in WHO’s Global Network of Age-friendly Cities and Communities, which currently comprises over 280 members in 33 countries. These range from a project improving the security of older people in the slums of New Delhi to “Men’s Sheds” in Australia and Ireland that tackle social isolation and loneliness.
Realigning health systems to the needs of older people will also be crucial. This will require a shift from systems designed around curing acute disease, to systems that can provide ongoing care for the chronic conditions that are more prevalent in old age.
Initiatives that have already proved successful can be expanded and introduced in other countries. Examples include the establishment of teams composed of different specialists such as physiotherapists, psychologists, nutritionists, occupational therapists, doctors and nurses in Brazil, and the sharing of computerized clinical charts among care institutions in Canada.
Governments also need to develop long-term care systems that can reduce inappropriate use of acute health services and ensure people live their last years with dignity. Families will need support to provide care, freeing up women—who are often the main caregivers for older family members—to play broader roles in society.
Even simple strategies like internet-based support for family caregivers in the Netherlands or support to older peoples’ associations that provide peer support in Viet Nam hold great promise.
PAHO, founded in 1902, is the oldest international public health organization in the world. It works with its member countries to improve the health and the quality of life of the people of the Americas.
It also serves as the Regional Office for the Americas of WHO.