Federal Institute for Population Research

Chapters in Edited BooksAging and Global Health Section, Principles, and Drivers of Global Health

Jakovljevic, Mihajlo; Westerman, Ronny; Sharma, Tarang; Lamnisos, Demetris (2020)

Haring, Robin; Kickbusch, Ilona; Ganten, Detlev; Moeti, Matshidiso (Eds.) Handbook of Global Health. Cham: Springer: 1–30

DOI: 10.1007/978-3-030-05325-3_4-1

Population aging became a globally widespread phenomenon during the last decades. Its core underlying causes are extended life expectancy at birth, improved early childhood survival, education, absorption of women into the labor markets, and consequences of sexual revolution leading to decreased female fertility. The scale of this demographic transition is unique in the entire history of mankind including a profound societal change that is now taking its toll on most countries, rich and poor alike. Shrinking of capable labor force coinciding with the expanding share of elderly and retired citizens continues to happen as a longterm trend. Thus, long-term financial sustainability of public social and health insurance funds becomes more and more questionable. Health expenditure growth continues to accelerate worldwide, with increases mostly on demand side. To a large extent, it is attributable to the needs of elderly citizens for home-based medical care. Last year of life phenomenon confirmed that almost entire life span medical consumption of an individual citizen is equal to the last 12 months of costs of treatment of expensive autoimmune, malignant, or vascular diseases. Most national and transnational authorities seem to be forced to consider reform of the current healthcare financing pattern inherited from the demographic growth era. Such exit strategy is necessary to make the financial burden of population aging bearable for modern-day universal health coverage and retirement policies. Ultimately, without bottom-up rethinking of universal health coverage and social support legacies, burden of global population aging might remain virtually unbearable for the most of modern societies.

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