World Health Organization
Impact of Ageing on National Policy
UK
In countries worldwide, the percentage of people over 60 is growing more rapidly
than any other age group due to declining fertility rates and longer life expectancy. It is
predicted from 2000 to 2050, the ageing population will triple from 600 million to over 2
billion. The majority of this increase will occur in developing countries - the ageing
population will rise from 400 million in 2000 to 1.7 billion by 2050 (WHO). Globally,
nations are encountering an ageing of their populations with a decrease in the number of
working age people per retiree. A decreased working-age populace will produce less
income for health and pension systems (Facts Behind the Fiction). This overall
demographic transformation has several implications for public health. Good health is vital
for older people to remain autonomous and to participate in family and community vitality.
Life-long health advancement and disease prevention activities can forestall or hinder the
onset of non-communicable and chronic diseases, such as heart disease, stroke and
diabetes (Jeavans). Professor Michael Marmot, a UK specialist in heart disease, warns that a
large increase in coronary heart disease in older people will become present in the next
century if proper care is ignored (Britain’s ageing population). When these afflictions
progress in older people, primary health services must yield attainable, integrated and
consistent care. Older people typically account for about half of the hospital workload; per
capita utilization of health services by seniors is 3-5 times higher than any other
demographic. Chronic diseases necessitate monitoring in order to minimize the
maturation of correlated disabilities and negative effects on the caliber of life. Overall, both
national and international policies must change to adapt to the transforming citizenry,
from inadequate care to proper consideration for the elderly (Rechel). The WHO has allied
with associates and Ministries of Health from both developing and developed countries to
create Primary Health Care Centers (PHC Centers) (General Principles). The ongoing
essence of the care means it is more advantageously provided in community-based
settings, such as PHC Centers. These centers are directed toward assisting the ageing
population to grow and advance in a safe and understandable environment. The New York
Academy of Medicine (NYAM) has developed an initiative that also focuses on active ageing.
Comparatively, the research and initiative of NYAM matches up comprehensively with the
general principles of the UN PHC Center initiative. NYAM is working with WHO in its Global
Age-Friendly Cities project, which will allow economic determinants, health and social
services, behavioral determinants, personal determinants, physical environment, and social
determinants to become prominent in the PHC Center Initiative (Finkelstein). Appropriate
care and consideration for the elderly population will allow for older people to continue
maintaining a critical role in society through volunteering, transmitting experience and
knowledge, helping their families with caring responsibilities and increasing their
participation in the paid labour force (WHO).
The ageing population in the United Kingdom is rapidly increasing and altering the
demographic of the nation. By 2040, the number of people over 64 in Britain is expected to
grow from 9.5 million to 15 million, and the amount of children under 18 is expected to
decrease from 11.2 million to 8.2 million. For the first time in UK history, the aggregate of
adults over 60 outnumber children under 16. This decrease in those coming of age implies
a shortfall of over 2 million workers (Welcome to the Ageing Future). In 1999 the working
population amounted to 47.8% of the total UK population, and by 2030 it will have reduced
44.5%. The 17 million UK baby boomers, born between 1946-64, are now reaching
retirement age, affecting the people, society, and economy of Britain (Britain’s ageing
population). Furthermore, over 50% of all health care spending in the UK is for those aged
over 65 (Facts behind the Fiction). Age related public spending affiliated with pensions,
health and services for the elderly is estimated to rise 3-4 GDP points between 2004 and
2050 (Rechel).
The United Kingdom has taken many steps to reduce the affect of its ageing
population on the National Health System and national policies. In a health care reform
speech (January 2008), Prime Minister Gordon Brown introduced potential new policies on
retirement and pension ages. The UK government is set to introduce these policies
between 2010 and 2020. The state pension age for women would rise from 60 to 65, and
from 65 to 68 between 2024 and 2046. The retirement age would rise to 68 (Britain’s
ageing population). Professor Martin McKee of the European Centre on Health of Societies
in Transition stated that the raising of the retirement age must be accompanied by
measures to support healthy ageing that enable people to stay in work and be productive
for longer. Also, forcing people to save a portion of their income has been considered as a
potential solution. Many lawmakers seem to favour this solution, provided that employers
would contribute. Furthermore, at the Second World Assembly on Ageing in April 2007, the
UK adopted the Madrid International Plan of Action on Ageing and the Political Declaration
(Executive Summary). The Plan focuses on three major areas: elderly people and
development, advancing health and well being into old age, and ensuring supportive
environments. The introduction of the Plan represents the first time governments have
assumed a comprehensive advancement in linking ageing to other frameworks for social
and economic development (Mainstreaming Ageing into National Policy Frameworks). On
13 July 2009, the UK created Building a Society for All Ages. This programme focuses on
the government’s vision for “a society for all ages, where people are no longer defined by
age and everyone is able to play a full part. This will require major cultural change.” The
government approved The Health and Social Care Act on 21 July 2008. It plans to “enhance
the safety and quality of care and improve public health”. Specific procedures include
initiating the Care Quality Commission, a new health and adult social care regulator with
powers to inspect, investigate and intervene where care providers are failing to meet safety
and quality requirements; reforming professional regulation; improving existing public
health protection legislation; and reinforcing the preservation of vulnerable people using
residential care by ensuring that any independent sector care home providing care on
behalf of a local authority is subject to the Human Rights Act (CPA). Additionally, the UK
supports the International Federation on Ageing (IFA) through the Age Concern England
group. Age Concern England, the main contributor to the IFA, is a UK sponsored program
to improve the life of the ageing population. Age Concern England is centered on four
themes that permeate the IFA; they focus on creating an age friendly society, preparing for
later life, living well in later life, and stronger support and protection in later life (The
Ageing Strategy). These policies and actions by the UK government are the stepping-stones
to ensure long, healthy lives for the ageing population elsewhere in the world.
The United Kingdom believes that in order for the older population to be successful
and healthy during their later years, prevention must be the first step taken during early
life. The UK wishes to uphold and maintain the guidelines in Resolution 46/91, United
Nations Principles for Older Persons, adopted by the General Assembly in February 1991.
The focus on care, participation, independence, self-fulfillment, dignity, and principle will
be perpetuated (OHCHR). The UK’s intention is to sustain this principles by integrating
them seamlessly with the WHO’s PHC Center plan. By conserving the principles in United
Nations Principles for Older Persons, the UK desires to procure the continued endorsement
of any General Assembly member involved with this resolution. Currently, the WHO’s PHC
Center plan calls for: providing basic training in age, gender and culturally sensitive
practices addressing knowledge, attitudes and skills for all PHC staff; providing basic
training in core competencies of elder care for all clinical PHC staff Provide age, gender and
culturally appropriate information on health promotion, disease management, and
medications for older persons as well as their informal careers; and reviewing the use of all
medications and other therapies, including traditional medicine and practices (General
Principles Toward Age-Friendly Primary Health Care). The UK aspires to extend these
provisions to include education for the general population worldwide, starting at primary
school age, and promoting the Ageing Strategy virtues of creating an age friendly society,
preparing for later life, living well later in life, and stronger protection and support later in
life. The education aspect will inform people, young and old, of healthy behaviors and the
importance of an active lifestyle. Preparation for later life through education is a vital
requisite for the success of the UK’s plan. These general information classes would be
available through PHC Centers and school-based seminars. They will be free and open to
the public, available for any and all to attend. Each government would be able to run the
program in association with WHO and its own ministry of health. For currently
underdeveloped countries that do not have established public health or schooling systems
will receive additional PHC Centers funded through the World Bank and the UK. The UK
possesses sufficient monetary funds to support the PHC Centers, and is willing to use up to
.5 GDP points ($US) each year to finance the program. This ensures all people will have
equal opportunity to receive long-term life education and health care despite
socioeconomic status.
The UK wishes to encourage other nations to adopt its current policies that are
beneficial economically and socially. The Ageing Populations Economically Plan (APE Plan)
would consist of raising the retirement age to an universally accepted number. Potentially,
this would allow seniors to be active longer and support an active lifestyle. Having an
active lifestyle will prevent a number of debilitating conditions in ageing populations, as
compared to an unhealthy culture. Ageing populations must be strongly encouraged to
remain active and keep at a reasonable weight. The UK plans to do this through the APE
Plan and in conjunction with the PHC Centers. The APE Plan will promote wellbeing,
proper maintenance and checkups, and a stable environment that allows geriatrics to age
gracefully. Additionally, the UK recommends a policy that allows people to choose their
end of life care while they are healthy and able to make supported decisions. Prospectively,
this could help reduce the amount of futile care made for those with no way to
communicate their wishes. The UK hopes that the APE Plan will reduce burdens on the
ageing population and nations worldwide, allowing seniors to fully enjoy their final years of
life.
Works Cited
"Ageing population: Facts behind the fiction." BBC NEWS | News Front Page. BBC, 2 Mar.
2004. Web. 19 Sept. 2009. <http://news.bbc.co.uk/2/hi/programmes/if/3493352.stm>.
The Ageing Strategy. Publication no. 0909. Age Concern UK, Feb. 2009. Web. 8 Oct. 2009.
<http://www.ageconcern.org.uk/AgeConcern/Documents/REf0909submissiontoAgeingSt
rategy.pdf>.
"Britain's ageing population." BBC NEWS | News Front Page. BBC, 15 July 1999. Web. 20 Sept.
2009. <http://news.bbc.co.uk/2/hi/health/395143.stm>.
"Executive Summary." United Nations Department of Economic and Social Affairs, Population
Division. United Nations Security Counsel, 2005. Web. 12 Sept. 2009.
<http://www.un.org/esa/population/publications/WPA2007/ES-English.pdf>.
Finkelstein, Ruth, Ana Garcia, Julie Netherland, and Jessica Walker. Toward an Age-Friendly
New York City. Publication. The New York Academy of Medicine, Fall 2008. Web. 8
Oct. 2009. <http://www.nyam.org/initiatives/docs/AgeFriendly.pdf>.
"General Principles Toward Age-Friendly Primary Health Care." PHC Centers. The United
Nations, Apr. 2002. Web. 12 Sept. 2009.
<http://www.who.int/ageing/projects/age_friendly_standards/en/al_afs_en.pdf>.
Jeavans, Christine. "Welcome to the ageing future." BBC NEWS | News Front Page. BBC, 29
Nov. 2004. Web. 18 Sept. 2009. <http://news.bbc.co.uk/2/hi/uk_news/4012797.stm>.
Mainstreaming Ageing into National Policy Frameworks - An Introduction. Publication. The
United Nations, 2006. Web. 12 Sept. 2009.
<http://www.un.org/esa/socdev/ageing/documents/workshops/Vienna/issues.pdf>.
"Policies on Ageing." Centre for Policy on Ageing. 16 July 2009. Web. 21 Sept. 2009.
<http://www.cpa.org.uk/index.html>.
Rechel, Bernd, Yvonne Doyle, Emily Grundy, and Martin McKee. How can health systems
respond to population ageing? Issue brief no. 10. EU2009.CZ, 2009. Web. 12 Sept.
2009. <http://www.euro.who.int/Document/E92560.pdf>.
United Nations Principles for Older Persons. Publication no. 46/91. OHCHR, Feb. 1991. Web. 8
Oct. 2009. <http://www2.ohchr.org/english/law/pdf/olderpersons.pdf>.
Weaver, Matthew. "Revealed: The Rapidly Ageing Face of Britain." Guardian.co.uk. Guardian
News and Media Limited, 9 Dec. 2008. Web. 12 Sept. 2009.
<http://www.guardian.co.uk/world/2008/dec/09/ageing-britain-population>.
World Health Organization. 2009. Web. 21 Sept. 2009. <http://www.who.int/ageing>.