A LIFECOURSE APPROACH TO AGEING Paul Ong

November 11, 2013

Zurich

Health…

• …in an older population is a unique construct

• Why?

• 100% of older people will eventually die

• We all have to die of “something”

The Individual Causes…

• …of Mortality are preventable, but, Death is not

Income and Life Expectancy

UK USA

Philippines/Egypt

Ghana/Cambodia

Mozambique/ Sierra Leone

Mexico

Economic Development…

• …only goes so far towards improving health, and especially quality of life

A Quote

• You can live to be a hundred if you give up all the things that make you want to love to be a hundred

• Woody Allen

Physical health declines with age globally (data by country groups)

Quality of life can be maintained

“Happiness” can be maintained

Four Health Outcomes (1)

• …distinguishes health for ageing populations from other agendas

• HUMAN and economic Development that has worked well will enable:

• ONE: A good QUANTITY of life with attendant good QUALITY of life

For example

• Japan:

Life expectancy from birth :83

Healthy life expectancy :75

• Sweden

Life expectancy from birth :82

Healthy life expectancy :73

Four Health Outcomes (2)

• ONE:A good QUANTITY of life with attendant good QUALITY of life

• TWO: A good QUALITY of life when abundant quantity is no longer possible

• Do older people get tired of life?

• What does dying well mean?

Bishkek – Older People (Kyrgyzstan)

Outcomes 2

• Mental health and quality of life are connected:

Welfare safety nets enhance well-being and coping strategies Physical decrepitude is not a death sentence

Four Health Outcomes (3) • ONE:A good QUANTITY of life with attendant good QUALITY of life

• TWO: A good QUALITY of life when abundant quantity is no longer possible

• --- Critical need for developmental intervention ---

• THREE: Where there is reasonable quantity but little quality of life

• FOUR: Where there is neither quality nor quantity of life

Outcome 3…

• …is where substantial amount of our programming is focussed

• It is where development is still needed, e.g.,

• Bangladesh

Life expectancy from birth :70

Healthy life expectancy :54

Outcome 4 • Do we have a role in promoting longevity, to advocate for closing gaps in longevity? Is there such a thing as life and healthy life equity?

• Tanzania:

Life expectancy from birth :59

Healthy life expectancy :40

• Mozambique

Life expectancy from birth :53

Healthy life expectancy :37

Outcome 4

• There are older people in Tanzania of course!

• 2% of the population

• But fewer people make it to 60

• Is it right that an average Swiss only has a 2% chance of dying between the ages of 55-59

• But in Tanzania and Mozambique, the risks are four times greater (8%)?

• WHO recommends that older age be defined from 50 or 55 in Africa

• Are the causes of premature ageing our business?

Mozambique

Peru

Healthy Ageing: What is it?

Healthy Ageing: What is it?

Ageing…

• …is more much much more than just the risk of dying

• The costs to society will be about maintaining quality and dignity

• It is about the world we want when we are old

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