Global Aging: Impact on Human Resources for Health

1. Global Aging: Impact on Human Resources for Health Barbara J. Hatcher, PhD, MPH, RN Director, Center for Learning & Global Public Health (APHA) Interim Secretary General, World Federation of Public Health Associations (WFPHA)

2. Presentation Overview • Demographic overview & the age wave • World/Region/Country specific demographics • Impact on Human Resources for Health • Future Trends

3. This is the reality in the year 2005 The world stands on the threshold of a demographic revolution called global aging.

4. The whole world is aging—and today’s developed countries are leading the way. Year 2005

5. Fertility in every developed country has fallen beneath the 2.1 “replacement rate.” 2.1

6. Life spans in the developed countries have risen dramatically.

7. Aging Exemplar Source: U.S. Census Bureau

8. Latin America & the Caribbean • Total Population (in millions) - 518.8 • Life expectancy at birth(in years) • Men 67.2 • Women 73.6 • Median Age 24.4 years old • Total Fertility Rate 2.5 children born/woman Sources: CIA World Factbook,(2003); United Nations Population Division, DESA(2003); AARP2005

9. Latin America & the Caribbean • % Population Aged 60+ • Men 7.2 • Women 8.7 • % 60+ Population in Labor Force • Men 47 • Women 12 Sources: CIA World Factbook,(2003); United Nations Population Division, DESA(2003); AARP2005

10. United States • Total Population (in millions) - 293 • Life expectancy at birth(in years) • Men 74.3 • Women 80 • Median Age • Men 34.5 • Women 37.1 • Total Fertility Rate 2.07 children born/woman Sources: CIA World Factbook,(2003); United Nations Population Division, DESA(2003); AARP2005

11. United States • % Population Aged 60+ • Men 15 • Women 18 • % 60+ Population in Labor Force • Men 23 • Women 13 Sources: CIA World Factbook,(2003); United Nations Population Division, DESA(2003); AARP2005

12. Canada • Total Population (in millions) – 32.5 • Life expectancy at birth(in years) • Men 76.4 • Women 83.4 • Median Age • Men 36.9 • Women 38.8 • Total Fertility Rate 1.16 children born/woman Sources: CIA World Factbook,(2003); United Nations Population Division, DESA(2003); AARP2005

13. Canada • % Population Aged 60+ • Men 16 • Women 19 • % 60+ Population in Labor Force • Men 19 • Women 8 Sources: CIA World Factbook,(2003); United Nations Population Division, DESA(2003); AARP2005

14. Mexico • Total Population (in millions) – 106.2 • Life expectancy at birth(in years) • Men 72.4 • Women 78.1 • Median Age • Men 24 • Women 25.8 • Total Fertility Rate 2.45 children born/woman Sources: CIA World Factbook,(2003); United Nations Population Division, DESA(2003); AARP2005

15. Mexico • % Population Aged 60+ • Men 7 • Women 8 • % 60+ Population in Labor Force • Men 65 • Women 15 Sources: CIA World Factbook,(2003); United Nations Population Division, DESA(2003); AARP2005

16. Percentage Population age 60 and over by world region, 2000 & 2050 Source: World Population Prospects, The 1998 Revision, Volume II: Sex and Age. The Population Division, Department of Economic and Social Affairs, United Nations Secretariat

17. Median Age by World Region 1999 & 2050 Source: World Population Prospects, The 1998 Revision, Volume II: Sex and Age. The Population Division, Department of Economic and Social Affairs, United Nations Secretariat

18. The Challenge to Labor • Shrinking Workforces & labor shortages • Aging workers •  Care demands & Needs • Pressure to ↑ immigration • ↑ cross-border outsourcing

19. The Challenge to Labor • Shrinking recruitment pool (in some countries) • mal-distribution: Understaffing in rural areas • Mal-distribution: Understaffing, both areas rural and inner-city • Effective skill mix and utilization

20. Nursing as a Case Study

21. Aging of the Nurse in US • Between 1983 and 1998 the average age of working RNs increased by 4.5 years to 41.9. • Thirty-five percent fewer full-time RNs are observed today when compared to similar age groups of RNs entering the workforce 20 years ago.

22. Aging US Nurse Workforce • Within 10 years, 40 percent of working RNs will be 50 years or older. • As those RNs retire, the supply of working RNs is projected to be 20 percent below requirements by the year 2020.

23. Aging US Nurse Workforce • The Bureau of Labor Statistics reports that jobs for RNs will grow 23 percent by 2008. That's faster than the average for all other occupations. • About half of the RN workforce will reach retirement age in the next 15 years.

24. Aging US Nurse Workforce • The average age of new RN graduates is 31. • They are entering the profession at an older age and will have fewer years to work than nurses traditionally have had. • RN enrollments in schools of nursing are down. • In fall 2000, entry-level BSN enrollment fell by 2.1 percent, dropping for the sixth year in a row, according to the American Association of Colleges of Nursing.

25. Variations in nurse population ratios • The variations can be a hundredfold difference • The average ratio in Europe, the region with the highest ratios, is 10 times that of the lowest regions –Africa and South East Asia.

26. Variations in nurse population ratios • The average ratio in North America is 10 times that in South America. • The average nurse: population ratio in high-income countries is almost eight times greater than in low-income countries.

27. Variations in nurse population ratios • The low availability of nurses in many developing countries is exacerbated by geographical mal-distribution – there are even fewer nurses available in rural and remote areas.

28. Variations in nurse population ratios in the Americas

29. Wisdom At Work • Support and Protect an Older Workforce • Enhance the workforce’s effectiveness through  technology

30. THANK YOU