When will countries wake up to ageing issues? More thoughts on social determinants of health and ageing
Having had time to reflect since my previous blog, I wanted to share some more of experiences from the WHO World Conference on Social Determinants of Health in Rio de Janeiro in October.
One is an anedote about a comment I made in one of the sessions, regarding my surprise that the ageing of the world's population was not being taken into account in the conference - given that it is the issue that will affect all countries in the world this century the most and therefore all the health systems.
A minister of health mockingly retorted: "Let's take things in context and not generalise. I wish I had that problem in my country. Life expectancy is 58 - I wish I had a problem of ageing to deal with".
Unfortunately, I did not get a chance to clarify to him that the Life Expectancy at Birth indicator is a reflection of the continued high mortality rates due to infant deaths and HIV/AIDS, rather than a reflection of how older people can live in his country.
Debunking the myths on ageing
What can we do to debunk the myths and misunderstandings around ageing? This is an especially pertinent question in developing countries, where the burden of infectious diseases continues to be high and stops many people from reaching a ripe old age.
However, with HIV rates in any given country at a maximum of 20% (???) in extreme cases that still leaves 80% of the population to potentially grow old. Given the fact that the HIV and AIDS pandemic is wiping out a huge chunk of the middle generation, it in fact causes premature ageing.
This means that in these societies, the percentage of people over 60 in this and the next generation will actually be prematurely high and create an accelerated demographic transition....
No mention of preparing health systems for ageing populations
The final declaration of the conference sadly made no specific mention of the need to prepare health systems to deal with their ageing populations or look at the social determinants of healthy ageing.
However, it did make specific reference to gender, disability and indigenous health aspects. It is recognised that social determinants of health are those "health inequities that arise from the societal conditions in which people are born, grow, live, work and AGE", but the conference did not go any further in making countries wake up to the fact that one of the biggest challenges they will face in the next 50 years or less is the ageing of their populations and accompanying health challenges.
We must use the review process of the Madrid International Plan of Action on Ageing (MIPAA) to get more traction on this issue and bring it to the world's attention.
See the impact of HIV and AIDS on populations