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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