Aging and demographic changes in Americas (long-term care) - PAHO/OPS

Submitted by rruggia on Wed, 05/01/2019 - 10:36
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Between 2000 and 2050, the proportion of the world’s population aged 60 years and older will double, from about 11% to 22%. The absolute number of people 60 years and older is projected to increase from 900 million in 2015 to 1.4 billion by 2030, to 2.1 billion by 2050, and to 3.2 billion in 2100 (1). Between 2025 and 2030, life expectancy in Latin America and the Caribbean (LAC) will increase to a projected 80.7 years for women and 74.9 years for men; in Canada and the United States of America, those numbers are projected to be even higher: 83.3 years for women and 79.3 years for men (2). The increase in life expectancy is due to several factors, including a decline in fertility rates and success in reducing fatal childhood diseases, maternal mortality, and mortality in older ages (1, 3). However, longer life expectancy is also a source of concern for policymakers; income growth may become harder to realize in countries with large populations of older people, and meeting the needs of a large elderly population will be especially difficult in low- and middle-income countries. It will be necessary to create economic and social institutions that provide income security, adequate health care, and other needs for the aging population (4). An additional issue that policymakers are facing today is how to best define an older person. Terms used to define an older people include “the aged,” “the elderly,” “the third age,” and, in some cultures, “the fourth age” (5). However, being “old” comes at different times to different people (6). How to define older persons will remain a challenge because “the elderly, despite being a class, consist of individuals with unique life experiences, goals, and needs,” and because becoming older involves a change in capacity, social involvement, and physical and mental health (7). In response to these demographic transitions and concerns, the the Pan American Health Organization (PAHO) and the World Health Organization (WHO) have approved strategies and guidelines related to aging and health. In 2002, for the first time, PAHO Member States approved a resolution on health and aging (CSP26.R20). The Region of the Americas was the first WHO region to approve a strategy and plan of action on aging and health, in 2009(8). In June 2016, the Organization of American States, with the technical support of PAHO and the Economic Commission for Latin America and the Caribbean (ECLAC), approved the Inter-American Convention on Protecting the Human Rights of Older People (9). These instruments, which have been developed in the international context of health and aging, highlight the need for an innovative approach in the care of older persons. However, most of the countries in the Region still lack a holistic view of the demographic transition and do not provide an integrated approach to the care of older persons. The challenge posed by this change is viewed in a fragmented way, addressing the increased prevalence of chronic diseases, disability, and care dependency, or the consequent impact of these problems on health services, medication use, and long-term care. Therefore, it will be necessary to continue developing an integrated approach and working on comprehensive public health actions “to ensure healthy lives and promote well-being for all ages through universal health coverage including financial risk protection” (1).

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