Magazine article Americas Quarterly

Will Old Age & Bad Health Bankrupt the Americas?

Magazine article Americas Quarterly

Will Old Age & Bad Health Bankrupt the Americas?

Article excerpt

The rise of noncommunicable diseases is taking a toll on productivity and straining public budgets across the Americas.

The long history of effective public health and development efforts in the Americas has produced tremendous health gains. Life expectancy has increased from an average of 59 years in 1950 to 75 years today, and the incidence of communicable diseases has dramatically declined.

But with people living longer and healthier lives, the region has joined the global trend of an aging population. Between now and 2050, seniors (those 60 and older) will make up a larger share of the population. Brazil and Costa Rica will experience the largest increases in the 60-plus age group. And Mexico is already among the top three in the 60-to- 79-year-old bracket. [see figure 1]

While the aging population of the Americas is a welcome testament to victories over communicable diseases like cholera, malaria, severe diarrhea, and tuberculosis, new health challenges could undermine the hard-won progress.

Noncommunicable diseases (NCDs)-the four leading ones being cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes-are now the world's biggest killers and the causes of disability among people of all ages, including in the Americas. Their rising prevalence threatens not only the health of the Americas but also its future economic competitiveness. They drive poverty by forcing individuals to drop out of the workforce and by increasing the financial burden on families who must spend down their savings to pay for treatment and care. And while all countries face projected increases in NCDs, some are confronting a dual burden of noncommunicable and still-prevalent communicable diseases, which exacerbates health disparities.

This year, about 75 percent of those who die in the Americas will die of an NCD.1 Over 33 percent of these NCD deaths will occur in people under age 70 and thus are considered premature. Some 25 percent of all NCD deaths will occur among working-age people.2

Although the four main NCDs pose the greatest health burden, other NCDs-ranging from neuropsychiatric conditions (e.g., schizophrenia, depression, Alzheimer's disease) to musculoskeletal conditions (e.g., rheumatoid arthritis) and sense organ disorders (e.g., cataracts, hearing loss)-are responsible for a large proportion of ill health, disability and human suffering. To complicate matters, many people with an NCD have more than one coexisting condition, greatly increasing both suffering and costs.3

Absent a timely and vigorous policy response, universal trends such as rapid unplanned urbanization, the aging of the population and the spread of unhealthy lifestyles will likely increase the burdens NCDs impose on bodies and budgets in the Americas.

Fortunately, however, the global community's search for options to prevent and control NCDs has already delivered some positive results.

Demystifying NCDs

NCDs tend to develop over time, are long-lasting and reflect the cumulative influence of factors such as behavior, environment, genetics, and how those genetics are expressed as people age. The growing prevalence of NCDs is further aggravated by urban environments that inhibit physical activity, gender inequalities that restrict access to adequate health care for women, school policies that allow unhealthy food to be served, and trade and agriculture policies that favor the availability of unhealthy foods.

Within this context, there are four modifiable behavioral NCD risk factors- all characteristics that societies or individuals can change to improve health outcomes.

1Tobacco use. "A cigarette is the only consumer product which when used as directed kills its consumer." This line from former World Health Organization (WHO) Director- General Dr. Gro Harlem Brundtland encapsulates the tremendous risk that tobacco use poses to health. The Americas are home to 145 million adult smokers,4 with 1 million tobacco-related deaths each year. …

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