Changing priorities: looking after aging dependent populations

The numbers of people needing daily care in developing countries will increase by as much as five or six times over the next 50 years.  As countries grow richer, so the health needs of their populations change.  Fewer children and mothers die in childbirth, people live longer and, as a result, develop more long-term illnesses.

Priorities for health andsocial care are changing in both developed and developing countries. In wealthycountries, low birth rates and long life expectancy mean there are fewer peopleto care for an increasingly elderly and disabled population.  By the middle of the 21st century will we stillbe able to look after the needs of the growing numbers of elderly people whoare no longer able to take care of themselves?

Research from the Queen’sMedical Centre, Nottingham, UK and the University of Southampton, UK, analysedthe World Health Organisation's 'Global Burden of Disease' study to identifyhow many people at present are so severely disabled that they need dailycare.  The researchers also sought topredict the number of people who would suffer from long-term or chronic diseaseover the next 50 years.

Chronic disease can oftenlead to disability and may mean that a sick person becomes dependent on anotherperson for meeting some of their basic needs, such as moving about, eating orwashing.  Most of these people are caredfor by family members and the constant burden of care can affect both themental and physical health of the carer. 

The study predicted that overthe next 50 years:

• there will be 30 percent more dependent people inthe developed world than at present
• the number of people dependent upon daily care insub-Saharan Africa, the Middle East, Asia and Latin America may increaseby as much as five or six times
• the ratio of dependent people to people ofworking age (the dependency ratio) will increase due to populationincreases by 7 percent to 10 percent
• the same ratio will increase most in India (12 percent)and China (14 percent)
• in eastern Europe, where populations are expectedto fall due to low birth rates, there will be fewer people of working ageand the dependency ratio will rise from 8 percent to over 12 percent.

The dramatic increase in thenumbers of elderly and disabled people in developing countries over the next 50years will put a huge burden on governments’ resources.  In the developed world, due to decliningfertility and an aging population there will be fewer people of working age togenerate wealth or to take on the professional or caring roles required by thedisabled.  The predicted changes arelarge and will put major pressure on health care services and other supportnetworks.  The report recommends that:

• governments must give greater priority in theirhealth budgets to measures to prevent disability
• the infrastructure for the health and social careof the severely disabled must be expanded
• caregivers receive the support they need, as many peoplewho look after the disabled struggle alone without any outside help or anytime for themselves.

Almost every country in theworld will be greatly affected by the demographic changes expected in the next50 years and they will need to find the finances and train the staff to look afterthe ever-growing numbers of dependent people.