MSGID: 1:317/3 6274a4b2   
   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    Asia and Africa have similar aging burden as the West    
    New metric reveals health is more important than age for determining   
   dependency ratios    
      
     Date:   
         May 5, 2022   
     Source:   
         Columbia University's Mailman School of Public Health   
     Summary:   
         Researchers have devised a new metric, the 'Health-Adjusted   
         Dependency Ratio' (HADR) as an alternative to the most commonly used   
         aging metric, the old-age dependency ratio (OADR). The research   
         suggests that age- related health burden is distinct from a ratio   
         based exclusively on age and is the first to incorporate dependency   
         associated with ill-health to generate a new metric that represents   
         a more holistic measure of dependency for 188 countries.   
      
      
      
   FULL STORY   
   ==========================================================================   
   In a study at Columbia University Mailman School of Public Health and   
   the Robert N. Butler Columbia Aging Center researchers have devised a new   
   metric, the "Health-Adjusted Dependency Ratio" (HADR) as an alternative to   
   the most commonly used aging metric, the old-age dependency ratio (OADR).   
      
      
   ==========================================================================   
   The research suggests that age-related health burden is distinct from a   
   ratio based exclusively on age and is the first to incorporate dependency   
   associated with ill-health to generate a new metric that represents a   
   more holistic measure of dependency for 188 countries. The results are   
   published in Lancet Healthy Longevity.   
      
   "Rather than using some arbitrary age limit such as the age of 65, we   
   used absolute health," said principal investigator Vegard Skirbekk , PhD,   
   PhD, professor of population and family health at Columbia University   
   Mailman School of Public Health. "In some countries, a given poor health   
   level occurs in the 40s and in the 70s in others. Thousands of studies   
   have been written using the old age dependency -- but they are likely   
   to be invalid," notes Skirbekk.   
      
   In the current study Skirbekk proposes building a dependency metric   
   using the information from the Global Burden of Disease 2019 Study as   
   an alternative to the OADR. This Health-Adjusted Dependency Ratio was   
   generated for the adult population aged 20+ for each country, where the   
   numerator consists of those in relatively ill-health or the "dependent"   
   population" and the denominator includes those in relatively good health,   
   who potentially could "support" the dependent population. OADR, on the   
   other hand, is more associated with health spending growth.   
      
   The study in Lancet Longevity shows that in African countries, and certain   
   ones in Central Asia, Southern Asia, and Eastern Europe are older than   
   what their demography would suggest. Nations in Oceania, Eastern Asia,   
   Europe, Northern America, Central and South America are younger.   
      
   As examples, Japan had the highest OADR at 0.49 in 2017 followed   
   by countries in Western Europe (with OADR>0.32). The U.S., Canada,   
   Eastern Europe, Uruguay, China, South Korea, and Thailand follow with an   
   OADR>0.24. "This implies that several demographically older populations   
   could have relatively lower HADR burden if health levels are good while   
   demographically younger populations could have a higher HADR if health   
   levels are poor.   
      
   Health-wise, the share of older individuals is about the same for richer   
   and poorer countries. "This is important, as it means the world is   
   similarly old - - or young -- and similar types of health challenges   
   apply. This also means that providing healthcare must be reoriented   
   towards dealing with life-course related diseases, observed Skirbekk. "And   
   finally, being demographically young is no guarantee from being young   
   as a nation; in many cases the opposite is true."  Earlier assessments   
   were composed of measurements that tended to be based on data for only   
   one country -- mainly from European ancestry populations. "In sum,   
   earlier aging measures tend to lack global coverage, global demographic   
   information or global health data," noted Skirbekk, who is also with   
   Columbia Butler Aging Center.   
      
   "In fact, while the old-age dependency ratio or OADR was often used   
   as a proxy for population aging, it did not account for variation in   
   health and may therefore represent an incomplete assessment of aging   
   and aging-related dependency," said Skirbekk. "Traditional indices used   
   on population-level aging variation tended to focus on only demographic   
   indicators. Our method allowed us to generate a new metric for measuring   
   aging, allowing us to assess variation in both demographic aging and   
   age-specific health across countries."  Skirbekk further makes the point   
   that previous research showed that in 2017 the chronological age when   
   this occurs differs by up to thirty years, ranging from 45.6 years of   
   age in Papua New Guinea to 76.1 in Japan.   
      
   "Moving forward, it may be more valuable to more holistically assess   
   dependency and policies associated with age related dependency by using a   
   metric that includes the impacts of ill-health, such as the HADR," said   
   Skirbekk. "The findings of our work have specific policy implications   
   that will help countries to plan, develop, and implement aging policy   
   programs and healthcare reforms in order to address effectively ongoing   
   rapid demographic change."   
      
   ==========================================================================   
   Story Source: Materials provided by   
   Columbia_University's_Mailman_School_of_Public_Health.   
      
   Note: Content may be edited for style and length.   
      
      
   ==========================================================================   
   Journal Reference:   
      1. Vegard Skirbekk, Joseph L Dieleman, Marcin Stonawski, Krystian   
      Fejkiel,   
         Stefanos Tyrovolas, Angela Y Chang. The health-adjusted   
         dependency ratio as a new global measure of the burden of ageing:   
         a population-based study. The Lancet Healthy Longevity, 2022; 3   
         (5): e332 DOI: 10.1016/ S2666-7568(22)00075-7   
   ==========================================================================   
      
   Link to news story:   
   https://www.sciencedaily.com/releases/2022/05/220505085639.htm   
      
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