Ageing, Health and Equity—Broad Perspectives Are Needed to Understand and Tackle Health Challenges of Ageing Societies

Zeeb, Hajo; Rothgang, Heinz; Darmann-Finck, Ingrid

doi:10.3390/ijerph15030457

Cited by 10 publications

(6 citation statements)

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“…The pursuit of health equity in ageing societies raises several concerns – on the one hand there is persisting health inequity among social groups and on the other hand, distribution of scarce public healthcare resources always raises a question on distributive justice. Fair and effective functioning of the public health system is more important and relevant to elderly people as they carry higher burden of diseases, specifically noncommunicable diseases [7]. To achieve Universal Health Coverage (UHC), the World Health Organization (WHO) [8] has identified three aspects of healthcare systems – ensuring that all people receives the needed quality healthcare services, everyone should be protected from health threats and financial hardship due to treatment should be avoided.…”

Section: Introductionmentioning

confidence: 99%

Equity in distribution of public subsidy for noncommunicable diseases among the elderly in India: an application of benefit incidence analysis

Bose

Banerjee

2019

BMC Public Health

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BackgroundRapid ageing of the population and increasing non-communicable diseases (NCDs) among the elderly is one of the major public health challenges in India. To achieve the Universal Health Coverage, ever-growing elderly population should have access to needed healthcare, and they should not face any affordability related challenge. As most of the elderly suffers from NCDs and achieving health-equity is a priority, this paper aims to - study the utilization pattern of healthcare services for treatment of NCDs among the elderly; estimate the burden of out-of-pocket expenditure for the treatment of NCDs among the elderly and analyze the extent of equity in distribution of public subsidy for the NCDs among the elderly.MethodsNational Sample Survey data (71st round) has been used for the study. Exploratory data analysis and benefit incidence analysis have been applied to estimate the utilization, out-of-pocket expenditure and distribution of public subsidy among economic classes. Concentration curves and indices are also estimated.ResultsResults show that public-sector hospitalization for NCDs among the elderly has a pro-rich trend in rural India. However, in urban sector, for both inpatient and outpatient care the poorest class has substantial share in utilization of public facilities. Same result is also observed for rural outpatient care. Analysis shows that out-of-pocket expenditure is very high for both medicine and medical care even in public facilities for all economic groups. It is also observed that medicine has the highest share in total medical expenses during treatment of NCDs among the elderly in both the region. Benefit incidence analysis shows that the public subsidy has a pro-rich distribution for inpatient care treatment in both the sectors. In case of outpatient care, subsidy share is the maximum among the richest in the urban sector and in the rural region the poorest class gets the maximum subsidy benefit.ConclusionsIt is evident that a substantial share of the public subsidies is still going to the richer sections for the treatment of NCDs among the elderly. Evidences also suggest that procuring medicines and targeted policies for the elderly are needed to improve utilization and equity in the public healthcare system.

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Section: Introductionmentioning

confidence: 99%

Equity in distribution of public subsidy for noncommunicable diseases among the elderly in India: an application of benefit incidence analysis

Bose

Banerjee

2019

BMC Public Health

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“…What's more, we are facing a really big challenge of inequalities for non-communicative diseases service in LMICs. Many studies also show that most of the health problems of older age are related to chronic diseases, and this underlines the role of prevention and health promotion throughout the life course to help reduce this burden due to non-communicable diseases (Zeeb et al, 2018).…”

Section: Conclusion and Discussionmentioning

confidence: 99%

“…Demographic change and the evolving demands on healthcare systems, especially in the provision of healthcare and long-term care for a growing number of older people, are among the greatest social challenges of the next decades (Zeeb, Rothgang, & Darmann-Finck, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, as resources are scarce, social challenges to healthcare and the healthcare system will always entail questions of distributive justice. This is even more important as the fair and effective functioning of health care and social systems is of particular relevance to older people, who carry a much higher overall burden of disability than, for example, middle-aged population groups (Zeeb et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Income-related inequalities in health care utilization among old adults in six LMICs: China, Ghana, India, Mexico, Russian and South Africa

Ruan¹

2021

Preprint

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Common and long-running concern across the world relates to the impact of increasing population aging on health care utilization and more evidence about the inequality in health care utilization by older adults in low- and middle-income countries (LMICs) is necessary for assessing the capacity of health care systems in LMICs to align with the universal health coverage agenda. In this paper, using data from WHO Study on Global Ageing and adult health (SAGE) in China, Ghana, India, Mexico, Russian Federation and South Africa, the multi-national magnitude in inequality of health care use is measured by concentration index in each country. The results show that a pro-rich inequality in health care utilization existed: China Mexico and Ghana show up with a high degree of inequality in outpatient service utilization; most of the countries show up with a low level of inequality for inpatient service (except China). Then especially India, but also Ghana, South Africa, and China, show up with a high degree of inequality and inequity in chronic diseases service utilization. However, there doesn’t appear to be one system characteristic of inequality in health care utilization since these six countries all have very diverse characteristics with different stages of the demographic and epidemiological transitions. The decomposition shows that income itself is the most important but not the only driving factor. And the distribution of education, health insurance, and urban/rural residents are the prime other contributors to health inequality. Also, this paper shows that inequalities for non-communicative diseases service utilization in LMICs produce big challenges, which underlines the role of prevention and health promotion throughout the life course to help reduce the burden due to non-communicable diseases. This paper provides a number of new insights on population aging’s impact on health care utilization in low- and middle-income countries.

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“…The social network covers socio-emotional needs (such as attachment and relationships with peers), and instrumental support in daily tasks [4]. The productive activities carried out by retired people are not evaluated in economic terms, but are looked at in terms of how these types of activities contribute to the maintenance of a healthy society and older people’s personal development [5,6]. On the other hand, a large group of researchers agree on the importance of including subjective parameters among the indicators of successful aging [7].…”

Section: Introductionmentioning

confidence: 99%

Evaluating Successful Aging in Older People Who Participated in Computerized or Paper-and-Pencil Memory Training: The Memoria Mejor Program

Requena

Rebok

2019

IJERPH

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Background. The evaluation of successful aging includes objective criteria to measure cognitive function and psychological well-being and levels of functional capacity needed to perform daily activities related to the preservation of autonomy. In addition, the emergence of computerized cognitive training programs has allowed us to use a new class of tools to verify the theoretical postulates of neural plasticity in aging. Objective. The present study investigates subjective and objective criteria of successful aging in healthy older adults participating in a memory training program offered as two versions: computer and paper-and-pencil. Method. Fifty-four healthy older adult participants recruited for the study were organized into two training groups. Group 1 (G1) used the computer program and Group 2 (G2) used the paper-and-pencil program. Results. The analysis revealed no significant differences in psychological well-being between the two training groups. However, the groups did differ significantly in objective evaluations of successful aging, as measured by attention and everyday memory, and brain activity as measured by sLORETA, with G1 outperforming G2 on both measures. Conclusion. Computerized memory training programs show promise for restoring cognitive and cerebral functioning in older adults, and consequently, may be better suited to achieving the objective criteria of successful aging than paper-and-pencil memory training programs. However, this conclusion should be taken with caution since differences in age and educational level may have influenced the results.

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Ageing, Health and Equity—Broad Perspectives Are Needed to Understand and Tackle Health Challenges of Ageing Societies

Abstract: Demographic change and the evolving demands on healthcare systems, especially in the provision of healthcare and long-term care for a growing number of older people, are among the greatest social challenges of the next decades.[...]

Cited by 10 publications

References 11 publications

Equity in distribution of public subsidy for noncommunicable diseases among the elderly in India: an application of benefit incidence analysis

Equity in distribution of public subsidy for noncommunicable diseases among the elderly in India: an application of benefit incidence analysis

Income-related inequalities in health care utilization among old adults in six LMICs: China, Ghana, India, Mexico, Russian and South Africa

Evaluating Successful Aging in Older People Who Participated in Computerized or Paper-and-Pencil Memory Training: The Memoria Mejor Program

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