- Develop an overview of the demography and societal effects of global aging and its relationship to noncommunicable diseases (NCDs)
- Understand the increasing contribution of NCDs to the global burden of disease, especially in less developed countries
- Develop a perspective on the rank order of chronic diseases, risk factors, and causes of death when disability effects are included
- Recognize the increasing contributions of development-related risk factors to the expansion of NCDs
- Become aware of institutional and governmental responses to the challenges of managing increasing numbers of older persons and chronically ill patients
As countries become more developed, changes occur in their populations that alter the types of problems faced by their health care systems and providers. Successful reduction of deaths at younger and adult ages eventually shifts the age distributions so that older persons become an increasingly larger portion of populations. Reductions in deaths related to childbirth, undernutrition, infectious diseases, and injuries allow people to live longer and become more vulnerable to chronic diseases. Although these diseases, as classified in the Global Burden of Disease framework1 may be secondary to group 1 (infectious diseases, perinatal, and nutrition related) conditions or group 3 (injuries), this chapter focuses on the increasingly prevalent group 2 conditions (noncommunicable diseases [NCDs]).
Developing as a nation increases access to the products of global markets. As consumers, people often respond to convenience and marketing influences by changing their lifestyle. Generally, as an economy develops, its citizens utilize less exertion to meet the demands of life, at the same time that they experience increased access to food calories from nontraditional sources. The resulting increase in overweight and obesity with associated comorbidities, combined with the adverse effects of increased tobacco and substance abuse, contribute to increased incidence and the younger onset of many chronic diseases. Although the less developed countries often find it difficult to respond to the double burden of communicable and noncommunicable disease, the more developed countries meet the challenges of chronic NCDs by devoting more resources, including labor. Skilled health care workers are recruited from less developed parts of the world to meet these needs. Initially chronic diseases can be managed medically utilizing these expensive resources, but with time even these resources are unable to prevent functional decline and death.
Chronic diseases have recently become the predominant worldwide causes of death and disability in most countries, and that burden is being carried more and more by the developing areas of the world. Institutions and governments are increasingly focusing on the challenges that this transition in the global burden of disease will present to efforts to improve world health. Age is widely acknowledged to strongly influence the pattern and extent of ill health at both the individual and population level. This makes it important to consider demographic and epidemiologic change in populations, as well as their health systems’ responses to both individual and population aging.
Defining Population Aging