Population aging presents a continued concern for health care systems placing unsustainable pressure on expenditures in every world region. Undoubtedly, rising health care costs and increased demand for medical services challenge the ability of the system to deliver high-quality care to the growing number of older adults requiring long-term care. Governments and global health organizations are highlighting the need for the effective legislature and social behavioral changes. The purpose of the following paper is to discuss the state of global health of older adults stressing the major challenges associated with this age group.
With the rise of costs and and the decrease in the quality of life in health care facilities, providing adequate patient care to older adults has been a continued concern for governmental agencies worldwide. In 18th century there were no long-term care institutions for older adults where low-income people can safely live the rest of their lives with the assistance of medical professionals. At the beginning of the 20th century the older adults generally died in the place of long-term residence after years of support and supervision of their family members. This tendency has shifted to elderly adults opting for nursing facilities at a certain time in their lifespan. Nowadays, many elderly people state that they do not wish to spend the last years of their lives in assisted living facilities. They are commonly willing to age at home surrounded by their family. Nevertheless, when people are no longer capable of caring for themselves and develop the heavy dependence on others, aging at home, regardless of the associated financial costs, can also severely affect their quality of life. In the modern society, nursing homes have become more prevalent in most countries but still remain hardly accessibly to low-income individuals.
Health Care Disparities and Equalities
Health inequalities are not uncommon in all age groups, including the older population. The recently published research promotes a certain view that considerable health disparities exist among lesbian, gay, and bisexual elderly individuals compared to heterosexual counterparts of the same age. More specifically, the high levels of poor physical and mental health partnered with continued depression contributed to the decrease in life expectancy and high mortality rates among the population. It is worth admitting that LGB males and females are more likely to report discriminative attitudes than heterosexuals. Statistically, they experience unfair treatment at least six times in their lives, which may ultimately increase the risk of developing mental conditions. The lack of financial resources and access to high-quality health care, internalized stigma, and lifelong victimization present the key factors affecting the health outcomes of LGB elderly people, even after they discontinued their sex lives.
Furthermore, disparities in health care by ethnic and racial minority older group have been detected and documented. The recent findings suggest that treatment adequacy of the White population was beyond the level seen among Latino and Black older adults. Elderly Hispanic people have on average more clinical visits and health care expenditures, while Black older adults experience only the increased number of outpatient care visits. Disparities among racial minority and LGB emphasize the challenges of older adult population and promote the new focal point for the inequalities research.
In 1965 the U.S. government implemented the Older American Act (OAA) in an attempt to address the lack of social services for elderly population. Even though nowadays older Americans are offered a variety of different activities, the OAA remains the main vehicle in providing nutrition and social services to this age group. The main purpose of the federal initiative is to ensure adequate financial resources for operation of disease prevention and health promotion programs, elder protection rights programs, community-based services, and caregiver assistance programs. The following regulation aims to provide equal opportunity to sufficient income in retirement, high-quality health care services, regardless of older persons socio-economic status, the improved quality of life, appropriate housing facilities, exercise of independent decision-making, cultural and civic involvement, as well as protection discrimination, abandonment, and exploitation.
Older adult falls are one of the major concerns in the U.S. health care system. Severe physical injuries and brain traumas are only some of the common ramifications of elderly falls, which affect the well-being and increase the risk of premature death. Enacted legislation regarding fall reduction and prevention programs enable older people to implement the corrective measures, thereby decreasing the likelihood of the accidents. Furthermore, the regulations actively promote and establish the requirements for health care professionals to monitor, coordinate, and implement efficient fall reduction strategies and services.
Moral Issues in Global Health Care
In the contemporary society, the process of aging is increasingly associated with costs, losses, and challenges. Moral issues arise when due to these factors people are treated less favorably and are offered fewer opportunities as they age. Many countries in North America and Europe attempt to eliminate such precarious situation by implementing a variety of anti-age discrimination laws, thereby offering protection against abuse and bullying of older people. Importantly, inappropriate treatment and discriminative views about aging have a profound influence on health outcomes of elderly people. Older adults who feel less valued and wanted perceive their social contribution to be less important, increasing the likelihood of isolation and depression.
Several recent studies conclude that elderly individuals who demonstrate negative attitudes towards their aging have fewer chances for rapid recovery from diseases and, statistically, live 7.5 years less than those individuals who have positive views. Ageism can be observed in multiple forms. Specifically, older population can be presented as a burden to the society, discriminatory policies and practices can force employees to retire based on a certain age or provide ration health care on the grounds of age. Age limits enacted by age-discrimination policies do not consider individual differences and abilities, concluding that every elderly individual is the same. This institutionalized discriminative perception can be used to violate the rights of older adults while allocating health benefits and interpreting findings that affect health regulations and policies.
Burden of Chronic Care
The burden of chronic care is largely concentrated in the older population and people living in developing countries. Notably, 23% of the global burden of the disease is associated with conditions in the population aged 60 years and older. The most significant increases in the burden are likely to occur in age-dependent conditions, such as cancer, heart disease, dementia, and stroke. Even though the percentage of the burden attributable to older adults is considerably lower in developing countries, disability-adjusted years are estimated to be 40% lower than in high-income countries. The worldwide epidemic is projected to grow in alignment with the increase in the elderly population and in line with population aging, which is the major booster of the chronic disease. Over the next decade, people in both developed and developing countries will suffer more mortality and disability from non-communicable diseases, including cardiovascular diseases, cancer, chronic respiratory diseases, etc., than from infectious diseases. Nevertheless, the risks of communicable diseases cannot be completely ignored, as long as the elderly population accounts for an increasing proportion of the burden in the developing world regions. Most communicable disease programs often disregard the elderly people and dismiss the impact of population aging. Meanwhile, older adults are particularly vulnerable to the infectious diseases, mainly because of gradual deterioration of immune responses.
Health Care Productivity and Economic Costs
Population aging is expected to alter the patterns of medical expenditures in high-income and low-income countries in the next decades. In highly developed countries, where chronic care facilities and services are accessible and available, the use of health care services increases with age, which contributes to growing long-term care spending among the older age group. A considerable percentage of economic costs attributed to advancing age is commonly spent during the last year of life. There is little published data on health care costs of aging in low-income countries. Initial findings suggest that the rates of age-dependent diseases, such as hypertension, are continually rising among older-adults living in developing regions. In low-income countries poor health care productivity causes people to avoid costly anti-hypertensive therapies, dramatically complicating cardiovascular disease treatment and management. The World Health Organization estimated the potential economic loss for 23 nations to reach $83 billion over the period of 2006-2015. This indicator is likely to increase during the next decades if no preventative measures are implemented.
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All in all, the risk of developing a chronic disease dramatically increases with age. A large percentage of elderly people are either physically or mentally disabled requiring greater amount of health care services than younger population. Age-dependent diseases, such as heart disease, cancer, and dementia, that affect mainly the older-age group impose a significant burden on global health. It is abundantly clear that the rise of chronic diseases partnered with population aging places upward pressure on medical expenditures in developed and developing countries. Therefore, health care inequalities persist even in the modern society, presenting a particular concern for racial and ethnic minority groups and LGB older adults. Ageism, however, may occur in all elderly population groups, regardless of cultural backgrounds and sexual orientation.