Population ageing in developed and developing regions: implications for health policy
Section snippets
Definitions, meanings and trends
There is general dissatisfaction with defining old age in purely chronological terms, but there would appear to be no universally appropriate alternatives to this approach. Old age is perceived and understood in a multitude of different ways, often with important cultural variations. These may refer to physical appearance, key life events (for example retirement or some other form of disengagement), or social roles (grandparenthood, or ceremonial duties) (Midwinter, 1991). Since old age can
Health needs of older people
There is still debate about whether increased longevity means an extension of healthy active lives or an extension of morbidity. Studies from the UK and USA suggest the former is occurring (Fries, 1980, Manton et al., 1997). However, this finding is not universal (Sidell, 1995), and data for developing countries are particularly inconclusive. A survey in Mexico reported that ageing was associated with extended periods of morbidity, and that diagnoses were being made earlier, which further
Financing and organising health services
In every country, levels of health spending are considerably higher for the aged than for younger age groups (OECD, 1996). As such, it might be expected that population ageing will inevitably lead to increased expenditure on health services. Nevertheless, it is dangerous to draw too close a relationship between the two. For example, a study from the US, where the total spend grew by about 8 times between 1940 and 1990, calculated age differentials in spending rates and found that demographic
New policy frameworks
In order to optimise the impact of social policies, it is essential to take a holistic and inter-sectoral approach to the welfare of the aged. Health policies should not be considered in isolation, but within a broader quality of life framework, which also includes older peoples’ economic and social well-being. At the same time, policy must recognise that they often make substantial contributions to their own welfare and to that of other people. As part of an objective to promote active,
Old age in a changing world
Tremendous advances in technology and the development of health services mean that the great majority of older people enjoy a far better health status and a longer life expectancy than at any time in the past. However, these undeniable benefits must be placed in the context of other impacts which multiple processes of change and modernisation may be having on quality of life of the aged. Historical research has largely scotched the myth of a “golden age”, when older people were the objects of
Key challenges for the future
This paper has attempted to cover a large number of often quite complex, inter-connected issues relating to health policies for older people. As such, it may be useful to identify a number of key themes and lessons which emerge from this compressed review. To begin with, it is essential that the aged are not considered as a homogeneous group, and that the variety of experiences, needs and capabilities of different older people is recognised in health policy. In a similar vein, health care must
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