Health and Mortality among Elderly Populations

Health and Mortality among Elderly Populations

Health and Mortality among Elderly Populations

Health and Mortality among Elderly Populations

Synopsis

In both developed and developing countries, the elderly have enjoyed significant declines in mortality and increased survival. At the same time, these trends have also given rise to many uncertainties and demands on resources which are often not given their due attention. Future mortality declines, particularly among the elderly, are often overshadowed by fears of their increasing share of the total population and the demands that this places on society to resolve the problems stemming from longer survival - problems, for example, which are not just a question of guaranteeing longer life but also of ensuring an acceptable health status. In recent years, there has been a substantial literature on many facets of the daily lives of the elderly. This volume is a further contribution to the literature, pinpointing the most recent trends in the survival of the elderly and in their physical and mental health. It also describes possible scenarios for the early decades of the twenty-first century. To delineate current knowledge with regard to the health and survival of the elderly is a first step towards preparing projections and improving the efficacy of health policies for the elderly. The first section of this volume is dedicated to a discussion about the age at which people become `elderly' and to the application of evolutionary theory to demographic models of human mortality. The second section looks in more detail at different aspects of morbidity and mortality trends and their underlying causes. The third section deals with mortality projections, ranging from the hypotheses to problems of methodology. The fourth section covers social and health strategies to improve the survival and quality of life of the elderly, in view of the fact that more and more people may expect to live longer and longer, and perhaps in increasingly better health.

Excerpt

The promotion of research into leveis, patterns, trends, and causes of mortality has been a primary concern of the International Union for the Scientific Study of Population (IUSSP) since its inception. For several decades, the activities of the IUSSP in relation to mortality studies have emphasized the need to provide reliable, sensitive tools to monitor and assess trends in child survival. This coincided with the focus of the international public health community on the prevention and control of infectious diseases. At the same time, evidence has been accumulating that the survival prospects of infants and children have increased markedly in many parts of the developing world, particularly Latin- America and East Asia, due in large part to the successful and sustained implementation of primary health care strategies. Concomitant with these successes, the chronic diseases have begun to emerge as major public health issues in a number of developing countries. The nature and extent of this epidemiological transition varies between countries, but essentially it is characterized by the progressive replacement of the leading causes of child death (i.e. acute-respiratory infections, diarrhoeal diseases, vaccine-preventable diseases, and malaria) by the major chronic diseases such as cardiovascular diseases and cancer, which are much more common among adults and the elderly.

It was with this realization in mind that the IUSSP Council decided in 1989 to establish a Committee on Adult Mortality, chaired by Alan Lopez of the World Health Organization, to prepare a series of scientific seminars on adult health and survival. The first of these seminars was concerned with causes and prevention of adult mortality in developing countries and was held in Santiago, Chile, in October 1991, being jointly sponsored by CELADE and the Pan American Health Organization. A second seminar on adult mortality in developed countries took place in Taormina, Italy in June 1992, bringing together epidemiologists, demographers, and other social scientists. The third and final seminar convened by the Committee was held in Sendai City, Japan, from 21-5 June 1993, entitled Health and Mortality Trends Among Elderly Populations: Determinants and Implications. This book is based on the thirty- one invited papers presented and discussed at the seminar.

The challenge in developing future public health and social policies for the elderly arises from three major trends in the characteristics of the elderly population. The first of these is the rapid increase in the number of old people, and especially the very old. As the effects of fertility change on age structure . . .

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