We all heard that “demography is destiny”. But how many of us truly believe it? If demography was destiny, the world would look very different today. The two demographic giants China and India would be uncontested economic and military powers. The United States would be a regional power struggling to keep up. Larger European nations such as Britain, France and Germany would barely register on the economic map, while smaller ones such as Switzerland and Finland would be invisible. Nigeria and DR Congo would be African powerhouses. Brazil, Indonesia and the Philippines would be the shining stars of their continents. Read more
22 April 2015
Cardiologist Michel Accad advocates early testing for detection of heart disease.
“We do have very robust technology, non-invasive technology that is simple to use and reliable and that has been established for a long time, to try to detect heart disease before it actually causes any problems. Most of the time when heart disease becomes manifest with symptoms or sudden cardiac arrest or a heart attack, it has been present for many many years before that time. So there is an opportunity to make a diagnosis that is very specific.” Dr. Michel Accad, Athletic Heart of San Francisco.
Demography is one of the recurrent themes at populyst. In America Heading towards Zero Population Growth, I wrote that the population of the United States is growing at a slowing rate and that, except for immigration, it will not grow at all in the 2030s and 2040s. This prediction may however come into question if US life expectancy increases significantly in the next 20 years.
For this and other reasons, it is useful to periodically examine the progress being made in health and medical practice.
Heart disease remains the number one killer in the United States, accounting for 611,000 of the 2.6 million deaths in 2013. Strokes were responsible for an additional 129,000 fatalities, which means that cardio-vascular ailments led to 29% of all US deaths. By way of comparison, cancer in its various forms accounted for 23% of US deaths.
Death by heart attack is largely an older person phenomenon. According to the Center for Disease Control (CDC), as many as 40% of fatal heart attacks strike people aged over 85 and only 8% strike people aged under 55. This means that a hypothetical increase in US life expectancy, which currently stands at 79 years of age, must probably be accompanied by a measurable reduction in heart disease.
The table, compiled from CDC data, shows the percentage of heart disease and cancer fatalities per age group.
Detection and prevention are seen as essential ways to fight back against cancer. It has become widely accepted that after a certain age, people should undergo routine testing for detection of some cancers even if they appear on the surface to be completely asymptomatic. Some such tests are mammograms and colonoscopies. It is important to note that these tests are most often covered by insurance, a factor which certainly raised their adoption among patients and their doctors.
By contrast, historically, the approach to detection of heart disease has relied primarily on a nebulous review of the usual risk factors, mainly diabetes, blood pressure, cholesterol, smoking, and their frequently attendant obesity. More recently however, a growing number of cardiologists have started advocating proactive testing via CT Scans (aka CAT Scans) of all people over 45 or 50.
One of the most vocal among this group is San Francisco-based Dr. Michel Accad, a practicing cardiologist who is also the founder and medical director of Athletic Heart of San Francisco.
In addition to early detection of coronary heart disease and other heart ailments, Dr. Accad also champions a more proactive approach to early detection of any risk of sudden cardiac arrest. Although relatively rare compared to coronary heart disease, sudden cardiac arrest can strike any person of any age during strenuous physical activity.
Dr. Accad’s years of experience coincided with rapid advances in technology and the two have converged today into the following messages:
1- It is a good idea for any person over the age of 45 to get a CT Scan. Because the first manifestation of heart disease can be catastrophic (one third of all heart attacks are fatal), it makes sense to try to detect the presence of any plaque in the arteries.
2- It is a good idea for any person of any age who is active in high-intensity physical activity to undergo tests designed to detect early any risk of sudden cardiac arrest.
As noted above, insurance typically covers cancer tests such as mammograms and colonoscopies. But CT scans designed to detect plaque in the arteries are not generally covered. Perhaps this is due to the fact that treatment of cancer can be far more expensive than treatment of heart disease, at least in its milder form. Dr. Accad notes nonetheless that the cost of CT scans is not prohibitive for a vast majority of patients.
I discussed all of these issues and questions of life expectancy with Dr. Accad in a podcast which you can hear through this link or by clicking the timeline below.
TO HEAR THE PODCAST, CLICK HERE OR ON THE TIMELINE BELOW:
Disclosure: Sami Karam and populyst have no business dealings with, and receive no compensation from, Dr. Michel Accad, Athletic Heart of San Francisco or any other parties named in the podcast.
The government has plans to reduce the total fertility rate from 4.6 to 2.6 children per woman.
Ann Wafula, 30, patiently waits to see the gynaecologist at Gilead Medical Centre, situated in the upmarket Upper Hill area of Nairobi.
The mother of a three-month-old baby boy, who is also her first born, is here to consult with the doctor on what contraceptives she should use, based on a hormonal test carried at the hospital.
In Hagadera, three hundred kilometres away to the east of Nairobi, 21-year-old Asha Abdalla is a proud mother of twin girls, delivered just a few days ago at a local dispensary. The twins are her second and third born, while her first born is aged barely two years. “I conceived when he was just nine months,” she explains. READ MORE.
As a large number of India’s population moves towards the 50 plus bracket, The Economist Intelligence Unit (EIU) Report 2012 shows that in the absence of proper healthcare infrastructure and adult vaccination programmes, the elderly population in the country are highly vulnerable to infectious diseases.
India’s population is undergoing a dramatic transition, the report says adding that the proportion of older people is expected to rise three- to four-fold in the next 40 years. India’s population of people aged 65 and over will be second only to China’s. Even conservative estimates predict that the number of people aged 60 and over will reach 323 million by 2050. By then, people in their fifties are expected to account for 30% of the population, while those in their sixties will make up 20%. READ MORE.
BUNMI MAKINWA, Director of the United Nations Population Fund – Africa, argues that “we need to recognise that the demographic dividend is no guarantee, and neither will it occur by itself. This is an opportunity that must be harnessed now for great gains in the future.”
From ALLAFRICA.COM: http://allafrica.com/stories/201210020326.html
The African Union’s ministers in charge of youth have underscored the need to harness the potential of the youthful population on the continent for its transformation. At the end of their two-day Conference in Addis Abba (12-14 Sept 2012), they tasked the AU Commission and the Economic Commission for Africa to identify policy recommendations for African governments in order to adequately address the challenges of young people.
This is a welcome development, and it’s heart-warming news.
Africa’s youth bulge
The notion of a demographic transition resulting in a youth bulge in Africa has been evident in the last 10 years. But it is gratifying that this is beginning to receive some attention among various policy makers on the continent. Ultimately, it should be the central focus of development strategy at the regional and national levels.
Currently, Africa is the most youthful continent in the world. At least 35 per cent of its more than one billion population is between the ages of 15 and 35. Experts estimate this could double by 2045.
In 2010 young people aged 15-24 years accounted for slightly more than 20 per cent of the total African population. In East and Southern Africa specifically, those aged between 10 and 24 years make up 32 per cent of the population of 125 million.
A new report from the UN Population Fund and advocacy group HelpAge International, Ageing in the 21st Century: a Celebration and a Challenge, deems that:
Population ageing is one of the most significant trends of the 21st century.
It has important and far-reaching implications for all aspects of society. Around the world, two persons celebrate their sixtieth birthday every second – an annual total of almost 58 million sixtieth birthdays. With one in nine persons in the world aged 60 years or over, projected to increase to one in five by 2050, population ageing is a phenomenon that can no longer be ignored.
Ageing in the Twenty-First Century: A Celebration and A Challenge analyses the current situation of older persons and reviews progress in policies and actions taken by governments and other stakeholders since the Second World Assembly on Ageing in implementing the Madrid International Plan of Action on Ageing to respond to the opportunities and challenges of an ageing world. It provides many inspiring examples of innovative programmes that successfully address ageing issues and the concerns of older persons.
The report identifies gaps and provides recommendations for the way forward to ensure a society for all ages in which both young and old are given the opportunity to contribute to development and share in its benefits. A unique feature of the report is a focus on the voices of older persons themselves, captured through consultations with older men and women around the world.
The report, which is the product of a collaboration of over twenty United Nations entities and major international organizations working in the area of population ageing, shows that important progress has been made by many countries in adopting new policies, strategies, plans and laws on ageing, but that much more needs to be done to fully implement the Madrid Plan and fulfil the potential of our ageing world.
The NATIONAL RESEARCH COUNCIL released a new report Aging and the Macroeconomy: Long-term Implications of an Older Population. Excerpts of the press release:
Population Aging Will Have Long-Term Implications for Economy; Major Policy Changes Needed
WASHINGTON — The aging of the U.S. population will have broad economic consequences for the country, particularly for federal programs that support the elderly, and its long-term effects on all generations will be mediated by how — and how quickly — the nation responds, says a new congressionally mandated report from the National Research Council. The unprecedented demographic shift in which people over age 65 make up an increasingly large percentage of the population is not a temporary phenomenon associated with the aging of the baby boom generation, but a pervasive trend that is here to stay.
“The bottom line is that the nation has many good options for responding to population aging,” said Roger Ferguson, CEO of TIAA-CREF and co-chair of the committee that wrote the report. “Nonetheless, there is little doubt that there will need to be major changes in the structure of federal programs, particularly those for health. The transition to sustainable policies will be smoother and less costly if steps are taken sooner rather than later.”
Social Security, Medicare, and Medicaid are on unsustainable paths, and the failure to remedy the situation raises a number of economic risks, the report says. Together, the cost of the three programs currently amounts to roughly 40 percent of all federal spending and 10 percent of the nation’s gross domestic product. Because of overall longer life expectancy and lower birth rates, these programs will have more beneficiaries with relatively fewer workers contributing to support them in the coming decades. Combined with soaring health care costs, population aging will drive up public health care expenditures and demand an ever-larger fraction of national resources. READ MORE.
The number of seniors living in a collective dwelling such as a nursing home has increased from 285,370 in 2001 to 393,150 in 2011.
Canada’s rapidly aging population has prompted a 38 per cent increase of the number of seniors living in nursing homes or other collective dwellings over the last decade, according to census figures released Wednesday by Statistics Canada.
The numbers suggested that many trends were steady since 2001, with nearly four out of five seniors still living alone or with their partners, and the rest living either in a collective, with relatives or non-relatives.
But the growth in the total amount of Canadians aged 65 and over, from about 3.9 million in 2001 to about 4.9 million in 2011, is causing significant growth in every category, including retirement and nursing homes or hospitals.
“You hear the story that everybody is living longer, healthier lives, and that’s still true,” said Susan Eng, a vice president for CARP, an advocacy group for Canadian seniors, said in an interview. READ MORE.
Britain faces a growing crisis in its ability to care for people dying of cancer, dementia and other long-term diseases, doctors are warning.
More hospices, care homes and other end-of-life facilities are needed to help cope with increasing numbers dying ‘gradual’ deaths, say specialists worried that supply is not keeping pace with demand.
Better health care, and to some extent a fitter older population, means less are experiencing ‘sudden’ deaths, for example from heart attacks.
But while increased longevity is to be welcomed, doctors say not enough resources are being devoted to making the last days of the elderly as comfortable as possible.
Writing in the publication, British Medical Journal Supportive and Palliative Care, doctors warn that gradual deaths from cancer and other chronic disease are already “a considerable burden” for European countries, including Britain. READ MORE.
There has been much speculation that single-family housing prices could take a hit as increasing numbers of baby boomers downsize and leave larger homes behind as they move into retirement age. That assumption is too general to be entirely accurate, according a pair of major economic papers on the topic of aging and property prices.
What is clear is that this ongoing population shift holds important ramifications for the multifamily property sector, including senior and assisted living facilities. And it is also becoming an issue of increasing importance for commercial real estate investment researchers.
“As Baby Boomers enter retirement age, many ’empty nesters’ may downsize, leaving their current homes in favor of smaller condos or age-restricted communities. Therefore, prices for large single-family homes located in high property tax areas could be under pressure over the next decade,” Tim Wang, senior vice president and head of investment research for Clarion Partners in New York, told CoStar News. “However, seniors today are often healthier and live longer; because of this we believe it is still premature to invest in assisted living or nursing homes.” READ MORE.