Study sees global challenge on health care.

Health Philadelphia:
by James A. Duffy, Inquirer Washington Bureau
INQUIRER WASHINGTON BUREAU WASHINGTON

Major increases in life expectancy are setting the stage for health-care challenges in the 21st century in the United States and other nations, a Census Bureau study to be released today shows.

"While the pace of aging varies, all nations are, or soon will be, facing important issues regarding health care for their expanding older populations," said Kevin Kinsella, who wrote the report with Yvonne J. Gist.

"Most issues will affect elderly women, who greatly outnumber elderly men in most nations." While boys outnumber girls in every country, differences in mortality rates between the sexes eventually throw the balance sharply the other way.

By age 35, women outnumber men, and their proportion continues to rise as people get older, according to the study.

A core question, in the United States and elsewhere, is how a smaller working-age population can find the resources needed to support these older women and a smaller number of older men in retirement and provide the health-care services they need. With life expectancy growing significantly, these costs are expected to mushroom around the world.

"A silent and unprecedented revolution in longevity has occurred in the 20th century," said Dr. Robert N. Butler, president and chief executive officer of the International Longevity Center and a professor of geriatrics and adult development at the Mount Sinai School of Medicine.

"The industrialized world has gained over 25 years of life, and this achievement is nearly equal to the life expectancy attained during the preceding 5,000 years of human history," he said at a recent hearing by the Special Senate Committee on Aging.

China, the world's most populous nation, has doubled its life expectancy since the 1950s with improved health care, according to the World Health Organization. Almost every other nation has continued to improve in life expectancy, with the exception of some countries in Africa where mortality remains high because of the spread of AIDS, the census study said.

Worldwide, deaths under age 50 are expected to be reduced 50 percent by 2025, thanks to major steps taken to improve health care, the World Health Organization said.

About 10 percent of the world population is 60 or older. By 2050, the figure will rise to 20 percent, and by 2150 it will soar to 33 percent. Also by 2050, the share of people 80 or older will grow from the current 11 percent to 27 percent.

As birthrates continue to decline in most areas of the world, that good news means a heavy economic burden for the seniors' children and grandchildren.

Over the next dozen or so years in the United States, for example, roughly 77 million members of the baby-boom generation will begin to retire. With that, America should experience strains as the government tries to pay the mounting costs of Medicare.

"Since these baby boomers will hopefully be Medicare beneficiaries, this means that millions more Medicare recipients will depend on long-term care than today," Sen. John B. Breaux (D., La.) said at a recent Capitol Hill hearing.

In fact, an American Association of Retired Persons report this year found that out-of-pocket costs of health care in the United States already are too much for many Medicare beneficiaries 65 and older.

Butler, the expert on aging, suggested that the mounting numbers of older people should prompt the world to take advantage of an elderly person's potential to be productive.

"The sheer numbers of older persons in society today serve to contradict stereotypes and undermine conventional wisdom," he said. "Society must find new ways to utilize the skills of older persons."

The growing expenses of all these seniors may be moderated somewhat by the fact that older women tend to live more disability-free years than their male counterparts, according to various studies.

The census study said cardiovascular disease was the primary cause of death at older ages in developed countries and more recently had become the number-one killer in developing countries. Deaths from the ailment are expected to remain at least constant, if not rise, the study found.

Nearly 60 percent of deaths among women 60 and older were caused by heart disease, a 1996 analysis showed. It killed 50 percent of men in that age group.