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Some Important Facts About Ageing and Health in Pakistan
During the last 60 years, there has been 23.4 % increase in the average duration of life in the country. 2.07 % of the world’s senior citizens live in Pakistan.
6.4 % of Pakistan’s population is 60 years old and above. Senior citizens will make up 15.8 % of the country’s population by the year 2050.
The population of old people in the country will increase more than two times in the coming 50 years. Pakistan stands at #143 in the global ranking of life expectancy at birth. Pakistan stands at #126 in the global ranking of old people.
Everyone wishes to remain healthy in every period of his life. Healthy life style and access to improved medical facilities are the primary motives of healthy life. On account of these basic factors, the crude death rate in the world was reduced by 123 % from 1950 to 2010. Life expectancy at birth increased by 43 % and fertility rate of children per woman decreased by 100 %. Such factors are responsible for increase in the ratio of old people in the world’s population. The theme for this year’s World Health Day is ‘Ageing and health, good health adds years to life.’
Statistics reveal the fact that the spectacular progress in the field of medicine during the twentieth century caused a sharp reduction in the death rate. The crude death rate in the world which was 18.7 per thousand in 1950-55, was reduced to 8.4 per thousand by the year 2005-10. In other words, there was 10.3 per thousand decrease in death rate during 60 years. Life expectancy at birth in the world which was 48 years in 1950-55, increased to 68 years by the year 2005-10. Thus, life expectancy in the world increased by 20 years during the last half century. Besides this, fertility rate of children per woman was reduced from 5 % to 2.5 % from 1950 to 2010. These factors are responsible for increase in the ratio of old people in the world’s population. According to a UN report called the World Population Prospects, the 2010 Revision, from the year 2011 to 2050, the number of people at the age of 60 or above is likely to increase by 2.44 % annually and the number of people at the age of 80 or above is likely to increase by 3.5 % annually. On the contrary, the growth rate of population during this period will be 0.74 % annually. According to the United Nations’ Population Division, the number of people at the age of 60 and above was 784 million in the world. In other words, 11 % of the world’s population consisted of senior citizens. At the same time, the number of people at the age of 80 and above was 109 million. Thus, they made up 2 % of the world’s population. By the year 2050, this figure will rise to 4 %, while elderly people at the age of 60 and above will make up 22 % of the world’s population at that time. At this time, one out of every nine persons living in the world is a senior citizen, while according to the UN Population Division, by the year 2050, one out of every five persons in the world will be at the age of 60 or above. In 2011, 2.07 % of the world’s senior citizens were living in Pakistan. According to the US Census Bureau, International Database, by the middle of the year 2011, their total number was 16.27 million. 47.72 % of them consisted of old men and 52.27 % of them consisted of old women. According to the UN Population Division, between 1950 and 2005, there was a steady increase in the number of people all over the world, who were likely to reach the age of 60 and above. As compared to the past, those who reach the age of 60, have far more chances of living an even longer life. Less than half of the people who were born till the middle of the twentieth century were likely to reach the age of 60. Keeping in view the crude death rate in 1950-55, 46 % of the people living in the world were likely to reach the age of 60. However, in the light of the death rate in the year 2005-10, it has been estimated that now, 73 % of the people living in the world will reach the age of 60 or above. 73 % of men and 79 % of women will reach the age of 60. Keeping in view the death rate in 2005-10, it is said that the women who reach the age of 60, live for another 21 years, while men remain alive for another 18 years. In Pakistan, this duration is the same between men and women. Men and women, who reach the age of 60 in Pakistan, remain alive for another 18 years.
The increasing number of old people in the world points to the availability of better medical facilities, but at the same time, it is also a prelude to the growing pressure on these medical facilities. The reason is that during old age, with the weakening of the immune system, the body finds it difficult to fight against diseases. Consequently, as long as they live, elderly people are always vulnerable to various diseases and thus require more medical care. Medical experts are of the view that the moderate and severe impairment faced by the people having the age of 60 and above, is three times more than that of the people between the age of 15 and 59 years. Besides experiencing hearing and visual impairment, they also have to face various mental and psychological problems. According to the World Health Organization, 27 % men and 24 % women in the people having the age of 45 and above, face some sort of hearing impairment. Hearing impairment is the main disease faced by the old people living all over the world. In addition to this, they also face depression, loneliness and anxiety. All such problems are the outcome of certain changes in life, such as death of the life partner or sudden break down of health. Depression is often accompanied by heart diseases, diabetes, paralysis and cancer, etc. which seriously affect the life of old people. In these circumstances, life becomes all the more difficult, if proper medical facilities are not available or if old patients have no easy access to medical facilities. On account of the ever increasing cost of medical facilities, they are going beyond the reach of the old people belonging to poor and middle classes. Global economic recession, inflation, poverty and unemployment are some of the problems which are seriously affecting the availability of adequate medical facilities. The tsunami of growing population is putting an extra burden
on these facilities. World Health Organization has stated that 57 countries of the world, most of which are situated in Africa and Asia, are facing acute shortage of health workers, as a result of which, these countries are unable to provide basic health facilities to their people.
The condition of medical facilities in Pakistan can be judged from the Economic Survey of Pakistan 2010-11, according to which there is one doctor for 1222 persons, one dentist for 16854 persons and one bed for 1701 patients. If we analyze the medical facilities for the people reaching the age of 60 and above, we will find that there is one doctor for 81 old people, one dentist for 1107 and one bed for 112 such persons. Only one nurse is available for 159 old people. There is an urgent need for increasing medical facilities in the country and for achieving this goal; the amount of money being spent on health sector should also be increased. But according to the Economic Survey of Pakistan, in 2000-01, the money spent on health was only 0.72 % of our total GDP. It was reduced to 0-51 % in 2005-06. This amount was further reduced to 0.23 % in 2010-11.
In this situation, providing effective medical facilities to everyone is a major challenge. The situation is being further aggravated by new medical problems and diseases. One such example is the outbreak of dengue fiver in Punjab, which is putting an additional burden on the already meager health expenditures in the country. If an elderly person becomes a victim of dengue fever, on account of his weak immune system, the pace of his recovery is much slower than that of youngsters and thus, he requires more medical care and attention. United Nations has rightly pointed out that as a person becomes older, his health expenditures also increase. They are particularly high in the final few years of life. Due to certain reasons, for most of the old people, it is difficult to bear these heavy expenditures. United Nations have predicted that by the year 2050, people at the age of 60 or above, will make up 15.8 % of Pakistan’s population. Moreover 1.7 % of the country’s population will consist of people having the age of 80 and above. It means that the population of senior citizens in the country will increase by more than two times in the coming fifty years.
population. Japan has the highest number of senior citizens in the world. In 2011, 31.1 % of its people were at the age of 60 and above. With 26.8 % senior citizens in its population, Italy ranks second in this list while Germany ranks third where senior citizens make up 26.3 % of the country’s population. In this global ranking of 196 countries, Pakistan stands at #126, with 6.4 % senior citizens in its population. With reference to the number of people who are 80 years or above, Pakistan stands at #132 in the list of 196countries of the world. Japan’s population consists of 6.6 % people who are eighty years old or above and are classified as the oldest old. With 6 % of such people in its population, Italy ranks second in this list, while France ranks third having 5.5 % of such people in its population. But experts have predicted that in future, the pace of increase in the number of senior citizens will be faster in the developing countries than the developed countries.
According to the United Nations, in the developed countries in the coming forty years, there will be 1.08 % annual increase in the number of people sixty years old and above. At the same time, 2.07 % annual increase is expected in the number of people eighty years old and above. During this period, population in the developed countries will increase at the rate of 0.14 % annually. In contrast, by the year 2050, population in the developing countries will increase at the rate of 0.85 % annually. The number of people at the age of sixty and above in the developing countries will increase at the annual rate of 2.95 %, while an annual increase of 4.30 % is expected in the number of people at the age of eighty and above.
Another interesting fact is that women live longer than men. Thus, in 1950-55, there was a difference of two years between the life expectancy of men and women. In other words, the average life of women was two years more than that of men. But by the year 2005-10, the difference increased to 5.6 years. In 1950-55, female life expectancy at birth was 48.7 years, while male life expectancy at birth was 46.7 years. In 20005-10, it rose to 70.1 and 65.7 years respectively. In Pakistan between 1950 and 2010, female life expectancy at birth increased from 41.5 years to 65.4 years. On the other hand, male life expectancy at birth rose from 41 years to 63.8 years during the same period. Thus, during 60 years, female life expectancy in Pakistan increased by 24.1 years, while male life expectancy increased by 22.8 years. In 2005-10, the average age of women in the developed countries was 80.4 years. However, the average age of women in the developing countries was 67.8 years. It means that the average age of women in the developed countries was 13.4 years more than that of the developing countries.
According to a UN Wall Chart named Population Ageing and Development 2009, by the year 2009, there were 74 men as compared to 100 women at the age of 60 and above. The situation is different in Pakistan, where there were 105 old men as compared to 100 old women.
According to the World Health Organization, 84 % deaths among the people at the age of 60 and above were caused by non-communicable diseases. 10 % deaths resulted from communicable diseases and nutritional conditions, while 4 % deaths occurred due to injuries.
Advancing health and well-being into old age is among the priority directions of the Madrid International Plan of Action on ageing. Achieving high health status is both a central aim of development and a key promoter of economic growth and social progress. Older individuals in good health enjoy a greater sense of personal well-being and can participate more actively in the economic, social, cultural and political life of society.
