Handling Human Longevity in a Developing Society

Over the last few decades, the life expectancy of humans has rapidly increased in most developed countries. It has been posited that babies born in the early 2000s in countries such as France, Italy, the UK, Canada, or Japan, will most likely live past 100 years old. There is a pattern of trends in all these countries that are playing an important role in the aging of the population, such as better healthcare leading to a longer life, low immigration, and low fertility rate (Christensen et al.

, 2010, 1196). Moreover, “the United Nations estimates that 15% of the world’s population will be over the age of 60 years old by 2025” (Doherty et al., 2018).

With this taken into account, the main question tackled in this paper is whether this rise in life expectancy will cause many challenges for our society and how it will affect its future development of it. This, however, is a very complex question and may be seen as a wicked problem, as many factors need to be considered, for example: whether our society can handle taking care of an aging society, whether countries can afford to dedicate more resources to the elderly, or if the elderly have access to the same health-care services in all countries.

Therefore, this research paper aims to synthesize the causes and effects of the upsurge in human longevity, and in light of these, it will show how healthcare has improved to support this change, and equally, it will explore potential innovations which could support healthcare systems to adapt to the challenge of aging populations in the future.

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Firstly, in terms of the causes of longer life expectancy, there has been a tremendous amount of improvement in the medical field. For example, the development of antibiotics has helped humans fight many different infectious diseases and have played a big role in extending the lifespan of humans. Besides medicines, new medical technologies such as radiation therapy, heart surgery, and organ transplants gave years of life to many patients (Laxminarayan et al., 2013). The development of radiation therapy in combination with other methods such as chemotherapy is used to target and destroy cancer cells, helping cancer patients live longer (Weatherall et al., 2006.).

Heart surgery and many advancements like stents and pacemakers have also helped people for whom medication was not enough to cure or improve their heart condition. Finally, people who would have died due to failure of their heart, lungs, liver, or kidneys, now have a chance to live a long life due to the advances in organ transplantation. Furthermore, there have been multiple studies debating whether aging and human longevity can be determined by either our genes or our lifestyle. One particular study carried out by Passarino and others (2016) demonstrates that “about 25 % of the variation in human longevity is due to genetic factors.” It has been found that certain genes, such as those involved in cardiovascular homeostasis, immunity, metabolism, and inflammation appear to have significant roles in aging, age-related disorders, and organism longevity. In parallel to this, data shows that our lifestyle also has a strong impact on the human lifespan— this includes environmental factors, diet, etc. To emphasize the importance of diet, another paper (Rizza et al., 2014) demonstrates that long-term calorie restriction with “high-quality food and adequate nutrients intake” appears to reduce the risk of cardiovascular disease, diabetes, and some types of cancer. Their study found that diets such as the Mediterranean diet or a low-fat vegetarian diet lessened the risks of cardiovascular disease, stroke, and coronary atherosclerosis. Moreover, in high-income, developed countries, older age mortality has decreased due to other lifestyle changes such as decreasing tobacco use (primarily for men) as well as due to lower alcohol consumption (Mathers et al., 2015). It is important to note that the analysis of factors influencing life expectancy presented here is largely limited to high-income countries. Interestingly, in middle-income countries such as multiple Eastern European countries, older age mortality has remained static or even increased. This could primarily be because these countries don’t have effective health care coverage yet, and citizens are still highly exposed to risk factors, as many Eastern European governments haven’t initiated any new health policies. However, the work of Mathers and others (2015) supports the view that considerable increases in life expectancy at an older age could be achieved in countries at all income levels in the next decade, mainly through improvements in the control of non-communicable diseases, their established risk factors and through more effective lifestyle changes. Even though a longer lifespan seems to be an advantage for future generations, it could come at the cost of greater challenges and issues that need to be considered—most importantly, whether our society handles to take care of an aging society, and if so, whether there will be a gap between higher-income and lower-income countries.

Will the elderly have access to the same healthcare services in all countries, and would smart homes for elderly healthcare be a solution for decreasing long-term care costs, or should we dedicate more resources to promote healthy aging? Population aging and growth in the number of very elderly persons, in particular, puts pressure on health systems, increasing the demand for appropriate care, services, and technologies to prevent and treat chronic conditions associated with old age, and to allow the elderly to be active and independent for as long as possible (Christensen et al., 2009, Arai et al., 2012, Bloom et al., 2015). So, what are the possible strategies to cope with the effects of a longer life expectancy and an aging population? A reasonable strategy to cope with the economic implications of population aging is to raise the typical age of retirement, and most governments are moving in this direction (Christensen et al., 2009, Bloom et al., 2015). This is necessary, as a declining working-age population would generate less income for health and pension systems. And while expenditure on long-term care is certain to increase with the aging of the population, the effects on health care expenditure are difficult to quantify (Bernd et al. 2009). It is clear that if appropriate and timely measures are progressively implemented, population aging may not inevitably lead to significantly higher health care expenditure. With this said, appropriate health policy decisions are needed to ensure that tomorrow’s elderly people will enjoy a better health status, have less need for health and long-term care services, and be supported by a balanced and integrated provision of care. Technology is a major factor contributing to the improvement of health care and an abundant amount of research has been carried out, with possible solutions to many issues in the medical field right now. While these many solutions seem to be proposed, several challenges need to be overcome for their implementation (e.g. high costs, lack of regulatory standards).

Countries with advanced healthcare systems and significant resources allocated to healthcare services are expected to be the first to implement such solutions. For instance, the Committee for Establishing a Scientific Community for Sustainable Aged Society” of the Science Council of Japan prepared a proposal for a better-aged society already in 2011 (Arai et al, 2012), recognizing the need for a multidisciplinary approach and promotion of gerontology, of building new geriatric medical centers and promoting home‐based care. In the past decade, there has been enough technological progress allowing for long-term care (LTC) to provide a promising solution. Researchers have already identified potential research areas for improving the quality of life of LTC residents, also tackling the barriers to the implementation of LTC technology (which include awareness, access, and adoption of these technologies, and the lack of regulatory standards, reimbursement, and evaluation processes) and the potential need for transformation of current care practices. In their paper, Tak and others (2010) present a vision of future technology use that could transform current care practices in nursing homes. The authors suggest that future nursing homes for the elderly will have to integrate multiple technologies incorporated into new buildings (e.g. devices that can detect falls, can generate alerts and reminders, aid with the location of lost objects, dispense medications, and emergency response systems). Furthermore, due to the decrease of technologies’ prices over time, they will become affordable, thereby increasing access. They also consider that introduction of new technologies will stimulate nursing staff to specialize in overseeing and ensuring the residents’ quality of care, instead of simply charting and administering medication. In conclusion, if designed and implemented appropriately, technology potentially can be an important instrument to critically improve the quality of care for this population. In another recent study on ICT-supported services in a single hospital or rehabilitation setting for the management of older patients with chronic diseases, Vollenbroek-Hutten et al (2017) report that such services are scarcely implemented in everyday care. They emphasize that while patient satisfaction with such services was moderate/good, the actual use among the professionals was low. One explanation suggested by the authors was the professionals’ feeling that introducing these services was something on top of their daily work. This observation suggests that for the large-scale implementation of new ICT-supported for the elderly, education and involvement of professionals could be essential for their adherence to this new healthcare environment. Alternatives to LTC have been also proposed, such as smart homes for the elderly (Majumder et al., 2017).

Smart homes refer to elderly individual homes which incorporate environmental and wearable medical sensors, actuators, and modern communication and information technologies, all of which can enable continuous and remote monitoring of elderly health and well-being at a low cost. They may allow the elderly to remain in their comfortable home instead of expensive and limited healthcare facilities. Healthcare personnel would also keep track of the overall health condition of the elderly in real-time and provide feedback and support from distant facilities. Furthermore, smart homes would also require the implementation of remote health monitoring, E-health (e.g. electronic health records, and electronic prescriptions for patients, which are essential for a future fully functional E-health system), and M-health, which is based on modern mobile communication technologies such as Enhanced Data GSM Environment (EDGE), 3G, High-Speed Packet Access (HSPA), and Long-Term Evolution (LTE), which offer high-speed and seamless data transfer from anywhere, at any time, thus allowing people to remain connected with the central M-health system. To develop a complete infrastructure of an E-health or M-health system, there are still certain key challenges such as ensuring seamless connectivity, secured transmission channels, and data storage that will need to be surpassed. Therefore, these are highly-advanced technological features that have yet to be perfected. Thus, smart houses would be extremely powerful, however, before they can be implemented, further research and development are still required in this sector to develop a fully-functional smart home that ensures system reliability, privacy and data security, seamless connectivity with minimal transmission delay, energy-efficiency and low setup and maintenance cost (Majumder et al., 2017).

To conclude, life expectancy has increased over the past decades and will continue to increase within the next years as well, due to medical improvements and better lifestyles. In some high-income countries, policies have been put in place to ensure that future generations will benefit from improved healthcare, and innovations in health care have been initiated, although most are still not advanced enough to be implemented as of now. However, high-income countries seem to be in the position to be able to apply new technologies for LTC shortly. Nevertheless, more research is needed to evaluate how to enable the use of technologies for LTC of the elderly in an efficient, economical, and systematic way and also to explore the possibility to integrate them into the overall health care system and even into the “Internet of things.” Another matter for future research would be how health care could be improved in lower or middle-income countries so that society as a whole will be prepared to face the challenges of an aging population.