the greying of the world: ageing matters · 2010-08-02 · measurement and health information the...

Measurement and Health Information

The Greying of the World: Ageing Matters

Commission on Population and Development New York, 10th April 2007

Somnath ChatterjiSomnath ChatterjiMeasurement and Health Information SystemsMeasurement and Health Information Systems

World Health OrganizationWorld Health OrganizationGenevaGeneva


The world stands on the threshold of a demographic revolution called global aging.

Focus on Ageing


Ageing Headlines!• "Life expectancy in most European countries

is increasing now by five hours a day"• "Population ageing will fundamentally change

the lives of Europeans"• "The scale of change will be comparable to or

greater than the effects of climate change or global terrorism"


Ageing concerns• Global leaders see a higher cost for social

services, possible labor shortages, and higher costs for pensions, and health care as probable outcomes from a larger older population (AARP, 2004)


Background

• Changing demography of the ageing population especially in the developing world

• Burden of chronic illness• Issues of compression of morbidity


Trends in Global Ageing

8% 9%10%

12% 13%14%

16%

19%

23%25%

26%

4% 4% 4% 4% 4% 5% 6%8%

10%

13%15%

0%

5%

10%

15%

20%

25%

30%

1950 1970 1990 2010 2030 2050

Developed World Developing World

Percent of PopulationAged 65 & Over: History and UN Projection

Source: UN (2005)


Ageing in the development agenda

“Ageing is a development issue.

Healthy older persons are a resource

for their families, their communities and the economy.”

WHO Brasilia Declaration on Ageing,July, 1996


Feminization of ageing

• NUMBERS• MORBIDITY • POVERTY


Young vs. Old – trends in global ageing

Source: United Nations Department of Economic and Social Affairs, Population Division. World Population Prospects. The 2004 Revision. New York: United Nations, 2005.


Projected Increases in Global Population by Age

Source: United Nations Department of Economic and Social Affairs, Population Division. World Population Prospects. The 2004 Revision. New York: United Nations, 2005.


Increasing Burden of Chronic Non-Communicable Disease


12.416.016.016.416.416.516.716.917.017.117.217.3

17.818.6

19.519.5

United StatesFinland

United KingdomFranceCroatia

LatviaEstonia

SpainPortugalBelgiumBulgariaSwedenGreece

GermanyItaly

Japan

The World’s 15 ‘Oldest’ CountriesPercent Age 65 or Older

•Source: United Nations, World Population Prospects, The 2004 Revision.


Number of Years for Percent of Population Age 65 or Older to Rise from 7% to 14%

* Dates show the span of years when percent of population age 65 or older rose (or is projected to rise) from 7 percent to 14 percent.Source: K. Kinsella and Y.J. Gist, Older Workers, Retirement, and Pensions: A Comparative International Chartbook (1995) and K. Kinsella and D. Phillips, “The Challenge of Global Aging,” Population Bulletin 60, no. 1 (2005).

26

45

45

47

53

65

69

73

85

115

Japan 1970-1996

Spain 1947-1995

United Kingdom 1930-1975

Poland 1966-2013

Hungary 1941-1994

Canada 1944-2009

United States 1944-2013

Australia 1938-2011

Sweden 1890-1975

France 1865-1980

More developed countries Less developed countries

41

27

26

25

24

23

22

21

20

19

Azerbaijan 2000-2041

Chile 1998-2025

China 2000-2026

Jamaica 2008-2033

Tunisia 2008-2032

Sri Lanka 2004-2027

Thailand 2003-2025

Brazil 2011-2032

Colombia 2017-2037

Singapore 2000-2019

Speed of Population Aging in Selected Countries


15 10 5 0 5 10 15

Population Structures by Age and SexMillions

15 10 5 0 5 10 1515 10 5 0 5 10 15

1950 2000

Male Female Male Female

Age

Source: World Population Prospects: The 2004 Revision (2005).

China’s Age Distribution

80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-90-4

Age

2050

Female

80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-90-4

Male


Inequalities – global extremes

Japan Sierra LeoneTotal 81.9 34.0Male 78.4 32.4Female 85.3 35.7

Japan Sierra LeoneTotal 75.0 28.6Male 72.3 27.2Female 77.7 29.9

LEB

HA

LE


456789

10

1982 1989 1994 1996 1999

in M

illio

ns

Projected numbers Actual numbers

456789

10

1982 1989 1994 1996 1999

in M

illio

ns

Projected numbers Actual numbers

Source: US National LTC Survey, May 2001

Chronically disabled Americans 65 years and older

Evidence from the US: disability rates are declining

27 million 33 million 35 million


Population projections: three scenarios

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

2000 2005 2010 2015 2020 2025 2030 2035Year

Popu

latio

n (m

illio

ns)

UN Population Projections(2002 revision)

Baseline scenario

Pessimistic scenario

Optimistic scenario


Broad trends in Mortality for Group II causes

Group II deaths

0

20

40

60

2002 2006 2010 2014 2018 2022 2026 2030

Year

Deat

hs (m

illio

ns)

OtherDigestiveRespiratoryCancerCVD


Global Mortality projections for selected causes

0

2

4

6

8

10

12

2000 2010 2020 2030

Year

Pro

ject

ed g

loba

l dea

ths

(mill

ions

)

Malaria

Cancers

HIV/AIDS

Road traffic accidents

TB

IHD

Stroke

Other infectious


Decomposition of

-10

0

10

20

30

HIV/AIDS Other Group I Group II Group III

Dea

ths

(mill

ions

)Total changePopulation growthPopulation ageingEpidemiological change


Global projected tobacco-attributable deaths

0

1

2

3

4

5

6

7

8

9

10

2000 2005 2010 2015 2020 2025 2030 2035

Year

Toba

cco-

caus

ed d

eath

s (m

illio

ns)

Medium and low income countries

High income countries


WHO Study on Global Ageing and Adult Health SAGE

The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2005. All rights reserved

•Mexico•South Africa•Ghana

•China•India•Russia

•Kenya•Tanzania•Bangladesh

•Viet Nam•Indonesia


SAGE Objectives• To obtain reliable, valid and comparable data on levels

of health on a range of key domains for older adult populations

• To examine patterns and dynamics of age-related changes in health using a longitudinal design

• To supplement and cross-validate self-reported measures of health and the anchoring vignette approach to improving comparability of self-reported measures, through measured performance tests for selected health domains

• To collect data on health examinations and biomarkers to improve reliability of data on morbidity, risk factors and monitor effect of interventions


SAGE Objectives• Follow-up to study intermediate outcomes, monitor trends, examine

transitions and life events, and address relationships between

determinants and health and health-related outcomes;

• To develop a mechanism to link survey data to data from demographic

surveillance sites - INDEPTH

• To build linkages with other national and cross-national ageing studies

– SHARE, ELSA, KLoSA, MHAS, Chile, Argentina

• To provide a public-access information base for an evidence based

policy debate amongst all stakeholders


Living arrangements of the elderly

Percentage of Single member Households of all households with at least one person aged 65 or more by World Bank category

05

1015

202530

3540

4550

GR

CES

PIT

AAU

SG

BRFR

AD

EUN

LDSW

EZA

FM

YS TUR

MU

SM

EX EST

RU

SM

AR LKA

CH

NBR

ABI

HG

EOU

KR IND

PAK

BGD

ETH

GH

AKE

NTC

D

High Upper-Middle Lower-Middle Low

World Bank category

Percent


Health Status by Age

50

60

70

80

90

50

60

70

80

90

18-49 50-59 60-69 70-79 80+ 18-49 50-59 60-69 70-79 80+

High Upper Middle

Lower Middle Low

Female Male

(Hea

lth S

core

)

Age Group

Source: WHS 2002

Health Score by Sex and Agegroup, according to World Bank Categories


Tobacco Use

Tobacco Use by World Bank categories and age groups

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

50-59 60-69 70-79 80+Age groups

Percent

High Upper Middle Lower middle Low


Physical ActivityInsufficient Physical Activity by World Bank categories and age

groups

0.0

10.0

20.0

30.0

40.0

50.0

60.0

50-59 60-69 70-79 80+

Percent

High Upper middle Lower middle Low


Chronic Conditions

Percentage of respondents with one or more chronic condition using standard algorithms by age group and World Bank categories

0

10

20

30

40

50

60

70

50-59 60-69 70-79 80+

Percent

High Upper-middle Lower-middle Low


Stress and Satisfaction


Summary Results• Older populations in worse off health• Low income countries worse than high

income countries• Worse health associated with less

satisfaction, high stress and presence of chronic illness

• Worse health correlated with difficulties with work and household activities


Ageing Matters

• Focus on functioning

• Improve health and well-being

• Decrease disease and death

the greying of the world: ageing matters · 2010-08-02 · measurement and health information the...

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