The increasing population of older people has drawn attention to the need to revise humanitarian policies to adequately serve this group’s basic living and health requirements. In 1999, the UNHCR announced the International Year of Older Persons with the observation that “older refugees have been invisible for too long”. In a multi-country study of older people in emergencies,2 HelpAge International concluded that “if invisibility, exclusion
and powerlessness are common themes emerging from the experience of older people, then consultation, inclusion and empowerment through partnership have emerged as the primary indicators for best practice.”

From a health perspective, it is important to recognize the needs of older persons and to develop appropriate policies to promote emergency health care. Yet it is equally critical to assess and prepare for demographic and health trends that determine the shape of future emergencies. By 2050, the prevalence of disability in some developing countries is projected to rise by 400% as the population ages. An epidemiological transition also is shifting the burden of disease from communicable to noncommunicable diseases. In 1996, deaths in developing countries attributable to communicable and noncommunicable diseases were 41.5% and 49.8%, respectively; yet this is expected to shift to 11.7% and 76.8% by 2020. Health planners must make allowances for the years of disability that accompany many noncommunicable diseases (e.g. loss of mobility after a stroke). In developing countries, the old-age dependency ratio in 2020 is expected to reach 11 (ratio of persons 65 and over to persons aged 15–64), up from 7.6 in 1998.

Emergency health policy and programming will also need to take into account probable shifts in health care strategies. Modernization and urbanization, as well as shifting values regarding family care for older people, has contributed to a marked breakdown of community and intergenerational support mechanisms (14). As increasing numbers of frail older people become both dependent and isolated, there is mounting pressure in some countries towards their institutionalization. Emerging care and support models may take various forms, including community-based care and health maintenance approaches, but all will require strategies to protect older people during emergencies.

Read the full WHO report here.