The demographics of the US are shifting. Columbia University’s Health and Aging Policy Fellows state: “In many ways, gerontology represents the future of healthcare . . . By 2030, 71 million Americans will be 65 and older. These individuals are at high risk for complex health problems, chronic illness, and disability, and they are, and will continue to be, the heaviest users of healthcare. Although estimates vary, today, older adults account for a substantial proportion of hospital days, ambulatory adult primary care visits, home care visits, and nursing home residents. Over the next 30 years, as the number of older Americans doubles, almost every medical specialty will have an increasingly older patient base. As a result, society is facing critical challenges regarding health and social services.” Aging populations raise specific concerns about the prevalence of disability, quality of life, public policy, and impact on healthcare.
Morbidity
The National Institute on Aging Global Health & Aging Report indicates that, “Some researchers think there will be a decrease in the prevalence of disability as life expectancy increases, termed a “compression of morbidity.” Others see an “expansion of morbidity”—an increase in the prevalence of disability as life expectancy increases. Yet others argue that, as advances in medicine slow the progression from chronic disease to disability, severe disability will lessen, but milder chronic diseases will increase. In the United States, between 1982 and 2001 severe disability fell about 25 percent among those aged 65 or older even as life expectancy increased.” The compression or expansion of morbidity has implications for the quality of life.
Quality of Life
A new study led by Eileen Crimmins, USC University Professor and AARP Professor of Gerontology at the USC Davis School of Gerontology, sheds light on quality of life issues for older populations. Emily Gersema and Beth Newcomb, of USC News, wrote that a, “USC-led report examined life expectancy trends and disability rates over a 40-year span from 1970 to 2010. The analysis of U.S. vital statistics found that the average total life span increased for men and women in those 40 years, but so did the proportion of time spent living with a disability. The study found increased longevity is not necessarily indicative of good health. Most age groups live longer with a disability or other health problem.”
“We could be increasing the length of poor-quality life more than good-quality life. There are a number of indications that the baby boomer generation that is now reaching old age is not seeing improvements in health similar to the older groups that went before them,” Eileen Crimmins.
These research findings have implications for policymaking.
Public Policy
There are multiple policy areas addressing the needs of older populations such as transportation, housing, and urban design that impact health and healthcare services. Policies and programs that are feasible and effective are needed.
Relationship of Public-Sector Programs & Policies to Health Services for Older Persons
Adapted from the National Research Council (US) Panel on a Research Agenda and New Data for an Aging World.
Healthcare Challenges
In Preparing for an Aging World: The Case for Cross-National Research, researchers explicit that healthcare services for aging populations presents unique challenges. “Healthcare for older persons is thus different from that provided to other age groups in several respects: greater resource demands; the intertwining of professional health services with social services; the frequent occurrence of important ethical conundrums; a higher prevalence of physical and mental disabilities; and, perhaps not as obvious in policy formulation, less scientific evidence for use in determining effective preventive and medical interventions.”
The complexities of the healthcare challenges facing an aging population abound. The various public policy areas that represent the intersection of older populations and pubic health issues are ripe for intervention strategies. While quality of life makes the shifting demographics of the US a top priority for healthcare providers. Healthcare leaders need to take a big picture view that incorporates healthcare challenges, policy interventions, and delivery strategies.
