Key messages

• Per person health expenditures are generally higher among older people than younger people – particularly in developed health systems. As such, policy-makers often assume that population ageing will result in unconstrained growth in health spending.

Key messages-

• Population aging affects a country’s ability to generate revenues for health.

•  We simulate the effects of population ageing on the ability to raise revenues for health from income taxes, goods and services taxes, property taxes, and social contributions. We find that:

日本発のナレッジ・トランスレーションのモデル

ナレッジ・トランスレーション（KT）は、研究から得たエビデンスを解釈して実践へと応用するプロセスです。高齢化に対応する保健システムがエビデンスに基づき適切であることを確実にするためには、KTが不可欠です。健康開発および高齢化のどちらも進んだ段階にある先進国日本において、日本老年学的評価研究（JAGES）はKTのモデルになりえます。JAGESは、地域に暮らす65歳以上の高齢者を対象とした自記式郵送調査による社会疫学的な調査です。1999年以来、3～4年おきに調査が行われています。2016～17年に実施された最近の調査では、全国41市町村に住む約20万人の高齢者から回答を得ています。そのデータに基づく研究からは、ポピュレーションアプローチによって健康の社会的決定要因に取り組むことが高齢者における健康格差の是正や介護予防に効果的であることが分かっています。これらのエビデンスは国の介護政策の改正などに役立てられました。また、研究者グループは、政策や事業の実施に関する実装研究も行い、自治体の行政担当者と協働しながら研究から得られたデータやエビデンスを事業計画における優先順位付けや事業の開発・評価に応用しています。

A model of knowledge translation from Japan

The report of the Second WHO Global Forum on Innovation for Ageing Populations is now available. The World Health Organization Centre for Health Development (WHO Kobe Centre, WKC) convened the Forum to build upon the platform WKC created in 2013 to share information, debate and drive new thinking about the current and emerging health and social challenges surrounding ageing populations and innovations.

The global population, particularly in the Asia Pacific region, is rapidly ageing with implications for swiftly rising health care and social costs, and maximizing the potential of this population’s contributions to society. In the next 20 to 30 years, the greatest growth in ageing populations will be in low and middle income countries. A WHO priority is to enable ageing populations to remain healthy, active and independent for as long as possible.

As society continues to age, considerations for action and policies to cope with the needs and capacities of older people, people with disabilities, and others who need support in a disaster are critical. In the case of the Great Hanshin-Awaji Earthquake (1995), statistics showed that there were 6,433 deaths, 43,792 injured and 510,000 homes damaged. Older people were found to have higher mortality rates: among immediate casualties, 53% in Kobe City and 56.6% in Hyogo Prefecture overall were aged 60 and above. Among later earthquake related deaths: 90% were aged 60 and above.

In 2013, the World Health Organization (WHO) established the Global Forum on Innovation for Ageing Populations as an information exchange platform for diverse stakeholders to address the challenge of meeting the needs of older people in low resource settings with frugal innovations. The Global Forum brought together more than 170 expert participants from 21 countries for 3 days of rich discussion and debate, in order to meet the following objectives:

A publication prepared by the WHO Kobe Centre, “Assistive technologies (AT) for ageing populations in six low-income and middle-income countries: a systematic review”, was published by the British Medical Journal Innovations (BMJ) on 11 September 2015.