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Burdens of An Ageing Population


A senior couple walking down an | Source: Unsplash.com


Death is known as the “great equalizer”. It balances out populations in the world and regulates a healthy amount of people to live, play and enjoy the resources in our world. Between the period of life and death, we humans learn about the world, contribute our productivity and eventually retire. The number of people that belong in each of these categories has to remain relatively proportional, but advances in the medical field along with changes in social norms have affected this distribution of population, people are gaining a longer lifespan, expected to work more and on top refuse to retire.


The issue of an ageing population is a serious concern bringing influence and pressure on many societies and their structures. As individual citizens, aka the most important frameworks of the society, there are various indirect impacts of such a phenomenon on us, depending on what society or country we are from, what role we take in the society and in our home, and what responsibilities we carry.


This article will attempt to explain the issue of population ageing and the presence of it in our current world, to spark concerns on how the issue is being addressed, what the different generations are facing, and conclude with a short question of what our future lifestyles might be like under the effects of population ageing.



Causes


The World Health Organization defines the “ageing population” as a "continued decline in fertility rates and increased life expectancy", meaning that the rate of birth is going down while the average death age is going up, causing the average age of the society to increase. While the two main statistical pieces of population-ageing evidence are an increase in life expectancy and a decline in fertility rates, for us to understand more key factors, it is important to find out the root causes of these two phenomenons through an analytical lens.


Our life expectancy is increasing. In the US, a 75-year-old today has the same mortality rate as a 65-year-old in 1952. This means that if a 65 year old in 1952 was as likely to die as a 75 year old today. Similarly, in Japan, 80 is the ‘new 65’. To make a weighted comparison, today’s 75-year-olds are not any older than the 65-year-olds of the 1950s (the World Economic Forum).


Decreased mortality rate causes such a phenomenon. The decrease in mortality rate greatly results from four advancements: better healthcare (essentially better clinical care), disease curing advancements, the spread of knowledge, and health products.


One, better clinical care involves hospitals and the medical and manufacturing industries to design and contribute to efficient medical procedures, accompanied by the growth of hospital numbers in developing countries. Two, disease curing advancements have been prominent on the news for the past decades, especially with pneumonia and influenza being greatly researched and their death rates being greatly minimized by lots of antibiotics and other treatments. Three, Pharmaceutical supplies are pushed by the market competitions, with the best of the best medicines delivered to the general public in an easily accessible fashion under different healthcare policies. Finally, there is no bigger factor to the lower mortality rate than better nutritional and medical knowledge. Greater knowledge around diseases like diabetes and obesity, and awareness towards mental health, compiled into actions by organizations like WHO and FDA have significantly influenced our perspective on senescence and have directly impacted the mortality rate.


However, the cause of the low fertility rate relates less to tech development, but rather the change of social structure and responsibility. Again, take Japan for example. The estimated number of babies born in the country in 2019 fell to 864,000 -- the lowest since records began in 1899 -- according to a report published Tuesday by the Ministry of Health, Labor and Welfare. This could be due to these reasons: One, shrinking and temporary employment resulting in an insecure job market. Two, overworking, which unsurprisingly, has risen to become an even larger issue/phenomenon in recent years.


Because of these developments, in Japan, a name has been popularized for those suffering from overworking. "Karoshi 過労死", which is literally defined as "death from overworking", a sentiment many Japanese works share. A 2016 report examining numerous karoshi cases and their causes of death found that more than 20% of people in a survey of 10,000 Japanese workers said they worked at least 80 hours of overtime a month.


Finally, a comparison between the US and Japan could implicitly demonstrate the influence of World War II as a direct factor of an increase in population. In the US, there have been two main spikes of generational population increase: the first spike being the 1920s economic prosperity, the other spike being the baby boomers from the war. On the contrary, we can see an instance of a steady increase in the population of Japan. As a country that heavily participated in the war and suffered a great economic loss, Japan's population was led to a precipitous decline in its average birth rate, and to a dramatic restructuring of its age distribution.



Impacts


Knowing the main causes of an increase in population ageing, it is worth mentioning the current situation and the extent of the phenomenon. In Japan, the median age has risen from 26 in 1952 to 46 today. In China, it has risen from 24 to 37 over the same period and is expected to reach 48 by 2050. On the surface, different social circumstances resulted in an increase in numbers and proportions of people who are over sixty, but deeper results of societal ageing are also viewed as bad news for the economy because they mean that fewer people work and contribute to economic growth, and more people collect pensions and demand health care. The increase in OADR (old-age dependency ratio) is implying slower economic growth and mounting pressure on public budgets.


The situation is bad news for the elderly population themselves as well. In different countries, the roles of old people include caring for family members and friends or carrying out after-retirement work in organizations and associations. The role of the elderly generation is impacted by different social circumstances, for example in Africa, with an issue being the elderly supporting children because of HIV/AIDS of parents' generation. In this specific case, the number of HIV patients rise due to cultural desire for more children and polygamy with long term relationships, which is an issue that the society is already facing, and when this issue collides with another issue like ageing, they lead to more pressure and workload for the older generation.


The reduction of the labour-producing population could slow down economic growth, but it also brings forth the hope to increase the general productivity of people with technology, to compensate for the potential economic downfall. Conclusively there are two main burdens of an ageing population, one being a possible financial decline and the other being the society’s limited capacity for elderly care. These effects on our future society and the elderly group have to be mitigated.



Actions


To combat the issue, the World Health Organization (WHO) has put in guidelines regarding the healthcare policy sector, to strengthen care for the elderly and provide more benefits. These guidelines include prevention of chronic disease, access to age-friendly primary healthcare, the establishment of age-friendly environments, and policies, and benefits for old workers. WHO also has a study on global ageing and adult health: this longitudinal follow-up of approximately 50 000 older adults is being carried out in China, Ghana, India, Mexico, the Russian Federation, and South Africa.


We will have to look at Japan again since it is one of the most affected countries on the list. Japan has taken action as a country and a market, creating benefits for both the economy and for the elderly age group.


The first group of actions is targeted towards the economy. Japan, along with other countries, are raising the bar of retirements, encouraging more birth and advocating for technical jobs, to reduce the amount of labour needed for the economy.


Japan is raising the bars of retirements, which essentially keeps the older population on their work while the younger population adapts to the proportionally large work they are taking over. Along with other countries, Japan also encourages more births, targeting the low fertility rate issue as previously mentioned. Additionally, Japan advocated for the pursuit of technical jobs, as it reduces the amount of labour needed for the economy, by providing society with more productive workforces.


The second group of actions is targeted towards the elderly population. Policies and services regarding elderly healthcare have a long history in Japan. Although Japan's universal health insurance coverage system has been in place since 1961, its long-term care, including welfare services, was separated from the medical care insurance scheme in 2000 when Japan already recognized as an ageing society, due to the financial burdens to the health sector. After which was a long period of particular focus on pharmaceuticals, achieving a degree of success in reducing their costs. Then, "The Community-based Integrated Care System" was introduced, with the aim of building comprehensive up-to-the-end-of-life support services in each community. The system has four proposed elements: self-help (Ji-jo), mutual aid (Go-jo), social solidarity care (Kyo-jo), and government care (Ko-jo). From the financial perspective, as the government struggles against the financial burdens of an ageing population, they are considering self-help and mutual aid. Based on Japan's present situation, both these elements could lead to positive results.


Companies in the technological market took action, carrying out research on products helping the elderly population. There is the advancement of digital healthcare, AI, data science, healthcare technologies to make better environments, new medical detection products, and efficient healthcare communication. An example of this is "YaDoc" launched by a Japanese doctor Dr. Shinsuke Muto. YaDoc is an online medical consultation system that targets senior citizens, the system/platform has plenty of data & medical knowledge regarding the common health issues elderly people face. There are also more establishments of senior homes, which became some sort of a popular choice, pushed by Prime Minister Shinzo Abe's plan to increase the number of nursing homes.



Future?


Actions from the government and the market are gradually reducing the impacts of population ageing, but as we have witnessed, the situation is very unstable. The implications of this problem are truly evident when something like a virus strikes, as the most dangerous group exposed to one will likely be the elderly. For COVID-19, eighty percent of the deaths reported in the US are adults 65 years or older.


Not only is COVID-19 a big hit to the economy, it is also a big hit to the healthcare sector of the countries facing old-age problems. Such a disease occupies a big space from the healthcare system, which causes severe pressure for hospitals that already deal with an overflow of patients with other medical issues. Economic doomsayers have long warned that the ageing populations of industrial and post-industrial countries represent a “demographic time bomb.” However, through this virus, we are continuously learning that the "time bomb" doesn't go off from the direct impacts of ageing, but from the unpredictable factors waiting to ignite a multitude of drastic problems. As it keeps ticking, we risk destabilizing our very healthcare systems and economies, creating further problems for the vulnerable population.


The United Nations estimates that between now and 2050, the share of the population aged sixty-five and older will increase in every country, expecting a one-sixth ratio by 2050. In a world with this kind of rapid growth, what kind of future is waiting for us? What will be there for the individual? Perhaps, better healthcare and technology, or perhaps, something unpredictable? We don’t know, and don’t have the luxury to wait.


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