4 ways to improve the lives of older people

Population ageing and the resulting demographic transition around the world present complex challenges. It is estimated that the global population of older persons will rise by 56% between 2015 and 2030, from 956 million to 1.4 billion, and hit the 2.1 billion mark by 2050. Between 2015 and 2050, the proportion of the 60+ age group globally is expected to rise from 12% to a staggering 22%. People over 60 will outnumber those below the age of 15 for the first time in history.

The transition is rapid and dramatic, and uneven in different parts of the world. While it took France about 150 years to rise from 10% to 20% of the population being older than 60, a similar transition will occur India, China and Brazil in about 20 years. In high-income countries, the proportions of older people have been rising gradually, with over 28% of Japan’s population already being over 65 years of age.

Large numbers of older people, particularly in lower- and middle-income countries, live in severe poverty and in poor health, with no or limited access to basic health services and social protection benefits. There are gender disparities too, with older women experiencing greater deprivation. Research suggests that in sub-Saharan Africa households headed by older women live in greater poverty compared to households headed by men of equivalent age. Furthermore, the correlation between ageing and disability is clear, with over 46% of older people worldwide living with some form of disability. Over 250 million older people have moderate to severe disabilities. These numbers are likely to rise further, causing more hardship.

This significant demographic transition means there is unprecedented need for age-friendly and responsive healthcare systems and a range of coordinated services to address the complex needs of this ageing global population.

The proposal of observing a Decade of Healthy Ageing from 2021 to 2030 was adopted by the UN General Assembly last December. This global collaboration is led by the World Health Organization (WHO) and will bring together governments, civil society, international agencies, professionals, academia, the media, and the private sector, in alignment with the Sustainable Development Goals (SDGs).

To foster healthy ageing and to improve the lives of older people, the Decade of Healthy Ageing will focus on four action areas. The first is to create and strengthen age-friendly environments by removing physical and social barriers and by converting them into better places to live and to age. The second is to combat ageism: Older people, despite their significant contributions to society, are often overlooked and subject to prejudice. Such stereotyping and discrimination must be addressed.

The third is to provide integrated care. All older people should have non-discriminatory access to integrated care, which should include but is not limited to: prevention, promotive, curative, rehabilitative, and palliative and “end of life” care – which must be safe, affordable and of good quality. The fourth is to support long-term care (LTC). With significant decline in their mental and physical capacities, many older people are unable to live an independent life or to actively participate in society. Hence, access to good LTC services is essential to maintain their functional ability, to ensure that they enjoy basic human rights and that they live a life with dignity.

Four further enablers will be critical to the Decade of Healthy Ageing: engaging directly with the voices of older people; leadership development and capacity-building at all levels; connecting all stakeholders; and strengthening research, data and innovation.

The decade, its action areas and enablers lay out a solid framework to foster healthy ageing around the world. However, stronger efforts will have to be made into converting a theoretical framework into practical and measurable actions. To date, progress has been limited and further delayed by priorities imposed by the pandemic. On 1 October, International Day of the Older Persons (IDOP), which this year has a theme of Digital Equity for All Ages, is an important opportunity to take stock of what has been achieved.

Looking ahead, it may be worthwhile to categorize basic needs into groups. The first is to design a comprehensive communication mechanism and to deliver the decade of healthy ageing messages to all stakeholders, most importantly to older people themselves. The sooner the information disseminates and is well understood, the more active the stakeholder participation should be.

A second key group of needs is to develop a strategy for partnerships that are going to be crucial in engagement of key groups, delivery of services and for research and advocacy. Civil society, government agencies and the private sector are three important constituents of the partnerships spectrum, and a clear plan for involving them must be developed at both macro and micro levels.

A third is to create guiding groups at national level (and at provincial or sub-national levels too in the case of larger countries) comprising representatives from different sectors who can ensure dynamic planning, implementation and monitoring of actions.

Fourthly, the decade also provides an important opportunity to strengthen LTC services and improve integrated care – fundamentally important blocks of healthy ageing that require greater attention. Community-based LTC will have to be reinforced by promoting self-care and by training and capacity-building of formal and informal caregivers. Primary care needs must be addressed in remote and rural settings, assuring integrated care for older people. Existing models and past experiences from Help Age Global network and from organizations like GRAVIS in India may provide replicable insights. The knowledge accumulated by senior-age people’s organizations, especially how to strengthen intergenerational exchanges to ensure lifelong application of healthy ageing principles, is a valuable resource worth utilizing.

COVID-19-related challenges are already a hindrance and will likely continue to hamper progress on healthy ageing for many years. Mitigation strategies will have to be worked out in advance in the context of community education and delivery of care services using digital education, telemedicine and within COVID guidelines, keeping the local context and situation in view. Existing healthcare infrastructure overburdened by the pandemic will have to be used judiciously.

Urgent action will help progress on meeting the complex needs of healthy ageing and ensure an alignment with the 2030 agenda’s overall vision. Let this IDOP be an important reminder of the priorities and to pick up the pace of the action.