Health System and Aging Society

According to the published statistics of WHO in 2012, elderly people are the fastest growing age group in the world. By 2050, there will be over two billion people or nearly one out of every four people whose age is over 60 years old (WHO, 2012b,c). Figure 4.1 shows the trend of population aged 60 years or over by development region from projected population during 1950-2050 (United Nations, 2013).This aging population occurs highest in less developed countries, which consequently have less ability and knowledge comparing with the elderly in developed countries.

This data send a sign that countries need to be ready and prepare for a social transition towards an effective healthcare system.

In 2050, most of elderly people will be living in developing countries that will have difficulties in facing these challenges. Therefore, WHO aims at increasing access of mobile medical devices and assistive devices for elderly people in low to middle income countries. The organization aims to find out what are the feasible technologies for these countries to implement in order to overcome the lack of resource problems, and also identify solutions to enhance the healthcare system. For this reason, WHO scheme focuses on research and development of appropriate devices designed for aging populations who live in rural areas or poor villages in low to middle income countries.

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Figure 4.1Population aged 60 years or over by development region, 1950-2050 (United Nations, 2013)

The Asian health system is a factor in sustaining the well-being of elderly people through physical and mental healthcare. The health system from WHO perspective focuses on the health workforce, infrastructure, and technology. It represents the ability and workload ratio with the number of resources and the population in each country. WHO health statistics reports in 2013 shows that the health systems of Asia have a lack of healthcare resource problem; especially for low to medium income countries, which account for 90% of Asia populations (WHO, 2013).

These low to middle income groups include countries from Eastern Asia, South Asia, and Southeast Asia. Most of them are developing countries that have tried to improve service quality in healthcare services for their people.

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Notes: All data are based on the United Nations medium fertility variant. The analysis also includes Taiwan.

Figure 4.2 Expected trends of population aging in the major regions of Asia, Europe, and North America in 2000–2050 United Nations (2001).

Today, population aging is much more advanced in Japan than in the other countries in Asia. The temptation might be to dismiss aging as an issue that needs not be considered until some point in the future. Figure 4.2 shows the projected trend that Asian countries have just begun experience population aging. However, in the case of Asia, the process is occurring much more rapidly than it was in Europe or North America(United Nations, 2001).These changes occurred over 50 years in the West are being compressed into 20 to 30 years in Asia. Moreover, Asian countries will have less time and resources to prepare for aging, but most countries will have to meet the challenges of aging at much lower levels of development than in Japan or the West. Anyway, the developing countries require to public systems prepared to deal with population aging which is occurring more rapidly than economic growth.

0 5 10 15 20 25 30

2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050

Percentage of population age 65 and above

Year East Asia

South Asia Southeast Asia Europe N.America

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The workforce ratio by persons per population of 10,000 during 2005 – 2012 for physicians, nurses, and pharmacists are 5.5, 9.9, and 4.2 respectively, for developing countries; and 21.4, 41.4, and 21.5 for developed countries. These ratios affect the workload of the health workforce and service quality of healthcare systems. Therefore, Asian countries should prepare their healthcare systems to face with healthcare service demand from the aging population growth.

Statistics on healthcare expenditure of WHO is also a factor that relates to quality of life of people. WHO collects and measures these statistics on the basis of gross domestic product (GDP) of each country. They measure the statistics from 194 member states to find the status and policy of countries that provide budgets to sustain the healthcare system. Healthcare expenditure from their report focuses on the ratio of investment from government and private sectors, which in Asia has an average healthcare expenditure as percentage of GDP in 2010 at 3.6% for developing countries and 12.4% for developed countries. Healthcare expenditure ratios from governments in Asia are 34.7% and 55.5% for developing countries and developed countries, respectively. Both healthcare expenditure statistics implies the ineffective and poor ability of the developing countries compared with those of developed countries. Thus, developing countries need to find appropriate technologies to increase the quality of their healthcare service systems on the basis of the limit of capital expense, infrastructure, and workforce.

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Figure 4.3 Population pyramid of countries in Asia (WHO, 2013)

In Asian countries, the public sector provides low support to the elderly who need to assist themselves and supports from family. Although the elderly pay tax and supports in public utilities, what they receive back from the public, such as social welfare, is much less (Mason &

Lee, 2011). Figure 4.3 shows population pyramid of developing and developed countries in Asia that are expected to be in aging population societies (WHO, 2013).The governments and people are necessary to prepare and accumulate their resources to get ready for the yet to be aging societies. In general, there is a wide range of assets which public-sector and community can support the elderly. To ensure that the elderly get suitable healthcare supports, good pension and healthcare systems are essential to be included in principle of public policy and social capital.

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