New age thinking

Paola Testori Coggi, Director-General of DG Sanco, considers how Europe can adapt to care for its ageing population...

We are all aware of the challenges posed by the ageing of the European population. Advancements in health policy, increased wealth, improved wellbeing and general living standards and better nutrition have all contributed to higher life expectancy. This is certainly a great achievement. However, as a result of both increased longevity and reduced fertility rates, Europe will have a much greater share of older people in the future, compared to today. In fact, 50 years from now, a quarter of the EU population will be aged 65 or over.¹

At the same time, illnesses often associated with ageing are expected to rise. For example, age is one of the most powerful risk factors for chronic diseases. People aged over 65 are more likely to have a chronic condition, and a high proportion have two or more. Chronic diseases are currently responsible for over four million deaths in the EU every year, representing over 86 per cent of all deaths, and 75 per cent of this group comprises people over the age of 60. It is predicted that the ageing of the EU population will result in an increase of up to 40 per cent in the prevalence of chronic diseases over the next 20 years.² Against this backdrop, we estimate a shortfall in the care workforce and increased demand for health services and long-term care.

This relentless demographic transition simply cannot be ignored. If we do not tackle this phenomenon head-on, health systems, the economy and society as a whole will creak under the weight of additional pressure.

By 2060, age related public spending is expected to rise to 4.75 per cent of GDP in the EU. Today, for every retired person there are four people of working age; by 2060, there will only be two.

Ageing should be viewed as an opportunity and not as an inconvenient truth. We therefore need to modify our mindset to value older people and their assets and capabilities, to see them as informed and empowered consumers who make a valuable contribution to society and the wider economy.

Of course, this will not happen with each government, company and organisation working in isolation.

For this reason, we launched the European Partnership on Active and Healthy Ageing almost one year ago. This partnership is a core component of the EU's Europe 2020 Strategy – a blueprint to come out of the current financial turmoil stronger. It brings together the widest possible range of stakeholders – carers, care providers, insurers, governments, industry and many others – to help translate innovative ideas and technologies into concrete applications, specifically designed to help older people lead more active and independent lives. Older people themselves are, of course, at the core of this process. As the partnership is developed for older people, it also has to be developed with older people.

A healthy population has a positive impact on economic growth and competitiveness. With this in mind, and faced with formidable demographic and considerable budgetary pressure, there is an urgent need to put people's health and wellness at the core of EU policies, mirroring action taken at national level.

For this reason, it was decided to make Healthy Life Years (HLYs) a headline indicator of the partnership. Setting a clear and firm health target has become imperative, and the core objective of the European Innovation Partnership on Active and Healthy Ageing is to increase people's healthy lifespan by two years by the end of this decade.³

This is ambitious, but not insurmountable. Healthy and active ageing can help ease the burden on care structures. More HLYs mean a healthier workforce, and fewer cases of retirement on the grounds of ill health; HLYs also lead to less strain on public finances and contribute to the longer-term sustainability of our health and social systems as the population ages. Decreased prevalence of chronic diseases, frailty and disability translates into gains in HLYs.

It is important to invest in both health and health systems but, given financial constraints and demographics, we need to act in a way that brings tangible benefits faster despite fewer resources being available. One approach to smart investment involves placing greater focus on responsible innovation in all its forms – spanning technology, process, organisation and the social dimension.

Innovative solutions such as initial risk screening or patient-centred diagnostic tools, for example, offer huge potential in reducing the risk of falls, or preventing a chronic disease from developing. Assistive technology can help loosen the grip of functional limitation in older people's independence. It is a proven fact that integrated chronic conditions models can help multi-morbid patients to better manage their own health.

e-Health is another example of how innovative thinking can help deliver better and safer healthcare, and bridge the distance between patients and their carers. In the same vein, smartly-designed cities with age-friendly environments afford older people the opportunity to be more active and independent, and to play a full part in society.

To ensure efficiency gains and long-term outcomes, the partnership is focusing on evidence-based, effective and cost-efficient innovations. Only with efficient healthcare spending can we guarantee continuity of care and sound management of chronic diseases for older patients, and provide integrated services to patients in hospital, at home and in the community.

However, innovation does not happen courtesy of a 'Eureka' moment, when an idea appears from nowhere. Rather, its success depends on how it is put to use. Even today, innovation in health and ageing faces numerous obstacles, including: a lack of interaction between the supply and demand sides; limited care systems collaboration and their inflexibility in adopting innovations; lack of involvement of end-users; and discrepancies and fragmentation within regulatory schemes. Such issues often delay the full deployment of innovations, holding them back from the market. The concerted efforts of all actors across the entire innovation value chain are critical if we are to break down these barriers.

I look forward to the next phase of the partnership, where concrete actions for implementation will be announced early next year. This will provide the basis for meeting the partnership's triple targets of an additional two healthy and quality of life years, more sustainable care systems, and productivity and competitiveness gains for Europe's businesses.

We aim to contribute to building a solid future in which people can enjoy active and healthy lives for longer. The vision of the partnership can be best summed up with the words of the Nobel Prize laureate Rita Montalcini: "Live not to add a day to your life, but live to add life to your day." At the age of 102, Rita still enjoys a healthy, active and independent life.

¹Eurostat figures: http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/Population_structure_and_ageing
²Eurostat. OECD
³http://ec.europa.eu/health/ageing/innovation/index_en.htm


This article originally appeared on publicservice.co.uk: New age thinking