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The Hill Times (May 28) We live in a rapidly aging society, and with it face big challenges

We live in a rapidly aging society, and with it face big challenges and opportunities

We can make big gains in healthy aging and in the use of technology to improve the lives of older Canadians. But we cannot gloss over the huge challenges in health care, care-giving, housing, and other needs for an aging population.

TORONTO—A recent press release in the name of Families, Children and Social Development Minister Jean-Yves Duclos boasted that “by our actions, the Government of Canada is ensuring that all Canadians have the support they need when they leave work and can live in a safe, secure, and dignified retirement.”

Contrast this sign of complacency with the extensive survey of seniors and seniors’ organizations by the City of Toronto. It found that 18 per cent of seniors had difficulty paying rent, mortgage, a hydro bill, or other housing costs, while 63 per cent listed health care and home-care services as their top concern. The cost and availability of affordable housing is an urgent issue for seniors on fixed and modest incomes as rents soar in Toronto while, as more Canadians pass the age of 80, access to home care services and palliative care also become more urgent. And Toronto is not an isolated case.

Then there is the research of the Canadian Frailty Network (I am a board member), a Network of Centers of Excellence project, which finds that 25 per cent of people over 65, and 50 per cent past 85—about one million Canadians—are medically frail. In 10 years, well over two million may be living with frailty. Frailty is “a state of increased vulnerability” due to reduced physical reserve and a decline in normal bodily functions which makes it much harder to deal with stress, leading to dramatic changes in health. The frail elderly are dependent on caregivers and pose a major challenge to the health-care system which is not currently being met.

The reality is that we live in a rapidly aging society, and with it we face big challenges and opportunities. We can make big gains in healthy aging and in the use of technology to improve the lives of older Canadians. But we cannot gloss over the huge challenges in health care, care-giving, housing, and other needs for an aging population, the costs that will be incurred and changes that may be needed in our health care and other systems.

In 2001, there were, according to Statistics Canada, some 3.9 million Canadians 65 and over. By 2017, this number had skyrocketed to 6.4 million Canadians and is projected to grow to 8.1 million by 2025 and 9.4 million by 2030. It was in 2017 that the number of Canadians 65 and older exceeded the number of young Canadians under the age of 15. But while the number of Canadians 65 and over is projected to continue to soar, the number of Canadians under 15 is almost flat-lined—from 5.9 million in 2001 to 6.1 million in 2017, and projected to grow slightly to 6.7 million in 2025 and 6.8 million in 2030.

The rapid increase in the number of Canadians 65 and over—and the growing number of Canadians 85 and over—will put more pressure on health-care costs. In 2005, according to the Canadian Institute for Health Information, Canadians 65 and over accounted for 44.3 per cent of health-care spending in 2005, rising to 46 per cent in 2015 (when Canadians 65 and older accounted for 15 per cent of Canada’s population). Forecasts suggest that by 2030 there may be just 2.3 workers for every Canadian 65 and over, compared to about four workers today, implying much greater difficulty in financing health care and other aging society costs unless we can successfully raise productivity growth through innovation and increase the proportion of Canadians actively engaged in the workforce.

This implies huge future challenges. Boosting the size of the workforce and hence economic growth and wealth creation to fund health care, by enabling more seniors, women, First Nations, and the disabled to participate in the workforce is one example. Some changes are already occurring: in 2017 some 18.7 per cent of men and 10.4 per cent of women 65 and older were participating in the workforce, compared to 9.5 per cent for men and 3.3 per cent for women in 2000. Some of this increased participation is based on necessity, but it is also because medical science and other factors are enabling healthier aging.

It would be a mistake, though, to see aging as primarily an issue of decline or simply a burden. The big challenge is to promote healthy aging.

The Canadian Longitudinal Study on Aging, which is tracking more than 50,000 Canadians between the ages of 45 and 85 over a 20-year period, aims to develop a much better understanding of the aging process from the life sciences and social sciences and what mix of factors determine why some Canadians are more active and healthier than others. This will help better design policies and interventions to bolster healthy aging. It is a project of the Canadian Institutes for Health Research.

In a report issued this past week, the project provided a wealth of information on data collected from its 51,338 participants over the 2010-15 period, and is well worth reading. This data will form the base for the ongoing tracking of the participants and help us understand, for example, how the aging process and challenges can be quite different for men and women. As the report states, the increase in the size of the population 65 and over is “unprecedented.” Yet it also finds reasons for optimism about the potential for healthy aging based on new thinking.

“If we stop looking at aging only in terms of decline and dependency, we can capitalize on the positive aspects of aging and invest in policies and programs that promote not only living long but also living well,” the report argues. That is an essential part of the framing of the challenges and opportunities of an aging society. Our public discussion, though, is not there yet but given rapid aging in Canada the aging society, in all its dimensions, needs much greater attention.

 

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