Visit to WHO/EURO from Finland, 8 October 2002

1. Visit to WHO/EURO from Finland, 8 October 2002 • Dr. Rüdiger Krech • Manager, Healthy Ageing • World Health Organization

2. Why is ageing THE key challenge for European societies? • Eighteen out of the 20 countries in the world with the highest percentages of older people live in Europe • Between 13 and 18% of the population are over 65 years old • Within the next 20 years, there will be a highly significant increase in the proportion of people in this age group

3. Why is ageing THE key challenge for European societies? • Fastest growing population segment will be the very old (80+) • In the next 30 years, the proportion of people aged over 80 years (as a share of population 65+) will increase from 22 to over 30%.

4. Why is ageing THE key challenge for European societies? This will have profound effects on the organisation, performance and financing of health and social services as, despite of action towards health promotion, the demand on health and social services will increase.

5. Burden of disease in disability-adjusted life years (DALYs) in Europe, 2000(’000s) Digestive Diseases (7087) Other Noncommunicable Conditions (6336) Respiratory Diseases (6415) Injuries (22707) Cardiovascular Diseases (33381) Respiratory Infections (3891) Tuberculosis (1603) Perinatal conditions (2875) Diarrhoeal diseases (1238) Neuropsychiatric Disorders (31000) HIV/AIDS (764) Nutritional deficiencies (1420) Childhood diseases (432) Maternal Conditions (1562) Other causes (2787) Musculoskeletal Diseases (5305) Sense Organ Diseases (4150) Malignantneoplasms (17643) Diabetes (2516) Source: WHO, World Health Report 2001

6. DALYS, by broad cause group and WHO Region, 1999 DALY = Disability adjusted life-year % 75 Non communicable conditions 50 Injuries Communicable diseases, maternal and perinatal conditions and nutritional deficiencies 25 AFR EMR SEAR WPR AMR EUR

7. F i g . 5 . M a i n c a u s e s o f d e a t h b y a g e i n t h e E u r o p e a n R e g i o n , m i d - 1 9 9 0 s 100 80 60 40 20 0 0–1 1–4 5–14 15–24 25–34 35–44 45–54 55–64 65–74 75–84 85+ A g e g r o u p s ( y e a r s ) Infectious and parasitic diseases Other diseases Cancer External causes Cardiovascular diseases Ill-defined conditions Respiratory diseases E S I U n i t W H O / E U R O S o u r c e : H e a l t h i n E u r o p e 1 9 9 7 . W H O R e g i o n a l O f f i c e f o r E u r o p e , E p i d e m i o l o g y , s t a t i s t i c s a n d h e a l t h i n f o r m a t i o n ( E S I ) u n i t .

8. Concept Active Ageing • Ageing should be put higher on the political agendas • Promote healthy lifestyles • Reduce health risks that would increase dependency • Increase quality of life

9. Gender, Health and Ageing • 657 for every 1000 women in Europe at age 60 and over • Women more often experience violence, and discrimination • Women are more likely to be poor in older age than men • Women are more likely to suffer disability in older age

10. Ethics, health and ageing • Resource allocation • Explicit or implicit rationing of care in older age • Human rights and older people in living facilities

11. Socioeconomic development and ageing • Poor of all ages suffer more disabilities and earlier deaths • Rich – poor gap has been increasing in all parts of the world • Failure to address this has serious consequences for global economy

12. Definition of Active Ageing “Active Ageing is the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age.”

13. Main action areas of WHO • International agreements on health development for older people • Better coordination between health and social services at local level • Which new products are really healthy for older people? • Quality of life indicators • New societal debate on ageing