Traditionally, global health efforts have been focused on sharing resources and technologies to improve the quality of health care in developing countries.
Currently, the term “global health” often conjures up images of vaccination campaigns or community health clinics. However, as the global population ages, the global health field must realign its work to address the needs of an evolving demographic.
The global population is rapidly aging. According to the UN, the elderly population, defined as age 65 and up, has very recently exceeded the population of children under age 5.
Going forward, the elderly population is expected to outnumber the population of children under age 10 by 2030, by 1.41 billion versus 1.35 billion. For comparison, in 1980, there were 1.1 billion children under age 10 and 0.4 billion people over age 65.
This changing composition is driven by several factors. Over the past several decades, the global child mortality rate has been steadily declining, and global life expectancy has been increasing.
More and more children have survived into adulthood and eventually grow old. These changes are most prominent in the lower income countries targeted by global health.
A decreasing fertility rate has also contributed to the worldwide trend, although this change is mostly concentrated in developed, wealthier areas.
The elderly population obviously faces different health challenges than their younger counterparts. Children are most affected by infectious diseases, but adults are most affected by cardiovascular diseases and cancer.
In 1980, breast cancer, diabetes, stroke, and other noncommunicable diseases accounted for approximately a quarter of the disease burden in low-income countries; by 2040, this figure is expected to reach as high as 80%.
There has also been an increase in other chronic conditions, such as arthritis, and the elderly population is also more likely to accumulate comorbidities, which can greatly impact disease prognosis and treatments.
Global health efforts must adapt to the increasing incidences of noncommunicable diseases.
Cardiovascular diseases being among the costliest medical conditions— the US loses about $320 billion per year to heart disease and stroke due to healthcare costs and productivity loss, yet only 2% of global health assistance is dedicated to all noncommunicable diseases.
Targeting noncommunicable diseases, especially for an aging population, will not be easy. Conditions like cardiovascular diseases and cancers often require long term and comprehensive treatment.
This is often difficult for the elderly, who may have trouble accessing such care. The World Health Organization proposes developing and strengthening health care systems that can support an aging population’s preferences and needs.
There has also been a push for broader public health policies that can educate populations on risk factors and properly taking of themselves but it's not enough.
As a society, it is a priority to develop a long term plan for the continuum of care for the elderly and their associated medical issues.'
By Nancy Lu