Population Aging: Is Latin America Ready?
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Studies from the United States also show that people with higher education tend to live longer. Life expectancy for better-educated people rose by about three years during 1981–2000, compared with half a year for less-educated people (Meara, Richards, and Cutler 2008). The pattern of disease at age 50 for people with less than a high school education is similar to that at age 60 for people with college degrees. Income is also related to health status; low-income people aged 55 to 84 in the United States are more likely than wealthier people to feel limited in basic physical activities, such as climbing stairs and lifting objects. How will health status evolve in developing countries? Medici, in chapter 4, reports on World Health Organization (WHO) projections for trends in the burden of disease by age between 2004 and 2030. The projections assume that burden of disease among infants and youth younger than 15 will continue to decline. Projections are also optimistic for adults, for whom healthier lives are predicted at all ages. Other researchers, however, take the opposite view. Many negative health conditions in adulthood stem from risks established early in life. The birth and development of today’s older cohorts occurred during times characterized by generally poor nutrition and exposure to infectious diseases, such as polio, malaria, and tuberculosis. Early malnutrition in LAC has been found to be correlated with self-reported diabetes (Palloni and others 2006). Looking cross-nationally at data from two surveys of older populations—one in seven urban centers in LAC and one in Puerto Rico—researchers investigated the risk of being disabled according to conditions experienced early in life. In Puerto Rico, the probability of being disabled among people growing up in poor conditions was 60 percent higher than among people with better childhood socioeconomic levels. For the other seven cities, the corresponding figure was 22 percent (Monteverde and others 2007). The number of disabled people in developing countries seems certain to increase. Families in developing countries likely will be challenged to provide the future service and care requirements of older people.
The Impact on the Demand for Health Care Medici, in chapter 4, reviews the evidence concerning service utilization and unit costs by age. Data are surprisingly scarce in this area, given its relevance for the management of health facilities, but the data that exist suggest rising utilization and rising costs with age, leveling out at a certain age. Studies for Brazil find that men’s inpatient rates by age increase rapidly after about age 55. Unit costs for inpatient services also increase