Following the May presidential election, however, the new Socialist government announced a series of measures allowing workers who began their career before age 20 and had contributed to the program for at least In contrast with the United States, France does not have a public insurance program specifically targeting older people, such as Medicare.
Instead, France has a fragmented health insurance system that became fully universal only in January , with the implementation of the Universal Health Coverage Act. Although this health care system performs well, on average, France is not as successful as other countries in controlling costs. In , the country spent the equivalent of In France as elsewhere, population aging creates new challenges for the health care system, for both controlling costs and meeting new societal demands.
Although it goes well beyond traditional health care reform, in France long-term care has emerged as one of the most crucial social policy issues. In , the heat wave created a major political shockwave in France, as it resulted in the death of 15, older persons.
Limited access to air conditioning, as well as urban pollution, social isolation, and a lack of experience in handling such heat waves, led to dehydration and excessive sun exposure, which largely accounted for the high number of casualties. In the aftermath of the heat wave, efforts were made to deal with some of these problems and find ways to avoid future heat-related catastrophes. Moreover, at a broader level, this traumatic episode helped push aging onto the policy agenda. Partly as a result, the French government launched an ambitious Aging and Solidarity Plan — , granting massive investments for the construction or renovation of nursing homes as well as the development of new long-term care services.
Additionally, another initiative launched in allocated more than 9 billion euros to the improvement of health care and home care for older people. Many other initiatives in public health policy have also been launched in France to improve the well-being of the older population and addressing major aging-related issues. A 5-year Alzheimer Plan — was launched to support research, improve care, and both inform and mobilize citizens regarding this issue. Additionally, the French state has launched other public health initiatives that can directly affect older people, although without necessarily targeting them directly.
These initiatives include a plan against pain Plan Douleur, — , a plan for palliative care — and a plan for suicide prevention — Overall, the state is extremely active in demographic, economic, and social research, which explains why state actors play such a central role in French gerontological research. Another specific aspect of French gerontological research is the direct and extensive research involvement of autonomous social insurance agencies.
Universities are also meant to be key institutions around which research is organized. Another major research player in France that is involved in some academic research dealing with aging is the state-funded National Center for Scientific Research Centre National de la Recherche Scientifique , whose goal is to foster research excellence in France. These remarks cannot hide the scattered and underdeveloped nature of French academic research on aging, a problem that recently reforms in French universities and research failed to address. After an attempt to better organize research at the beginning of the s, France proved unsuccessful in creating a truly integrated institutional setting to organize a comprehensive, mid- and long-term national research agenda on aging.
No equivalent to the National Institute on Aging was allocated sufficient resources to implement an integrated policy agenda similar to the one associated with this American institution.
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Instead, the research priorities for the next decade only took place at the European level, in the context of the Futurage Program discussed subsequently. From this perspective, an opportunity was missed during the Sarkozy years — to improve university-based aging research in France, which remains scattered and poorly integrated, at least from a country-level perspective.
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Learned societies also play a direct role in the development of French expertise on aging. SFGG is a major pool of expertise available to the French government, as top-ranking members are close to policy makers and are typically consulted as part of the aging policy formulation process. In contrast to the GSA, however, the SFGG long focused primarily on medical and biological issues and has struggled over the years to include social sciences research as part of its primary research foci.
In parallel, the French Sociological Association created a sociology of aging network in to promote research in social gerontology. Nevertheless, these initiatives still leave social gerontology research underdeveloped institutionally and highly fragmented. Nongovernmental foundations are another type of institutional actor in French aging-related research. Over the last decade, private companies such as the insurance company AXA or the HSBC bank, which have a stake in increasing knowledge about aging, have also sponsored aging-related research.
In the last two decades, the EU has affected aging-related research in France. For example, French research organizations such as the INED have been involved in EU-wide research projects such as the Future Elderly Living Conditions in Europe, which has assessed the situation and social needs of older people in 10 EU countries from and Yet, this Europeanization cannot hide or reduce the sheer institutional fragmentation of social gerontological research in France and in Europe.
This is especially obvious within the French academic system, where isolated initiatives do not compensate for the lack of a national and integrated research strategy. Due to limited space, out of the many emerging aging-related issues facing France, we will address only several of them.
Aging and society
First, the issue of active and healthy aging is relevant at both the French and the European levels. The Pilot European Innovation Partnership on Active and Healthy Aging promotes healthy, active, and independent aging to improve the sustainability and efficiency of the social and health care systems. It also supports the emerging markets related to aging. The ambition of this European partnership is to increase the average healthy life span by 2 years by The evaluation of public policy programs designed to reach this ambitious goal should soon become a key research topic, in France and elsewhere in Europe.
These changes have occurred rapidly, requiring a quick and appropriate response that cannot take place without the intervention of the State through the establishment and implementation of fundamental public policies. Projections indicate that by "the Brazilian population will be million, the fifth largest population in the world, smaller only than India, China, USA and Indonesia". This will be only 40 years after , when the country's total fertility rate reached 2. Population aging increases health problems which in turn put pressure on healthcare and social security systems.
Getting older does not necessarily mean becoming sick. Unless there are associated illnesses, aging is associated with a good level of health. Moreover, advances in the fields of health and technology allow people with access to adequate public or private services to have a better quality of life at this stage of life. In addition, it is essential to invest in preventive actions throughout the course of life due to their potential to "solve the challenges of today and, increasingly, those of tomorrow".
Aging and society - Wikipedia
It is for this reason that countries are increasingly seeking to understand the process of population aging and searching for alternatives to "keep their elderly citizens socially and economically integrated and independent". The proposal of the present study was to analyze the current and future challenges related to the planning of public policies and population aging, in a context of demographic transition and transformation of the demographic profile in the decades to come.
A case study on population aging and its relation with the planning and formulation of public policies was carried out. To characterize the scenario, secondary data from the main information systems in Brazil was utilized. To analyze the planning of public policies in the context of these transformations, eight people occupying relevant positions in social politics, health management and the legislative authorities were interviewed a former national Health Minister, former secretaries of the Ministry of Health, and former state and municipal secretaries of health in addition to intellectuals and planners from the area of health.
This study is an excerpt from a doctoral thesis on Public Health, which, as selection criteria to select participants, chose participants who had built their reputations in defense of the right to health, and who had been included in the political context and the organization of the country's health system since its inception. In addition to the population data, three demographic indicators relating to the period were analyzed.
According to the Interagency Network, 8 it is common for the calculation of these indexes to consider elderly people as those aged 65 and over and the potentially productive to be between 15 and 64 years of age. However, to maintain consistency with the other indicators and to comply with the National Policy for the Elderly Law no.
Active benefits were analyzed, meaning those considered by the MPS to actually generate monthly payments to the beneficiary. For the analysis of morbidity and mortality, standardized rates were calculated per , elderly people in each year studied. The technique of direct standardization by age was applied 60 to 69, 70 to 79 and 80 years and over , considering the resident population in the country in as standard.
The information is only related to hospitalizations in the SUS network and therefore, does not include hospitalizations that occurred in the supplementary system. Average values were calculated by means of the ratio between the amount paid by AIH and the number of hospitalizations, and were updated according to the IPCA National Index of Consumer Prices of the year, The number of hospital beds available through the SUS National Health System only was obtained from the monthly records of the Ministry of Health, and an annual average was calculated from this data.
To verify the seasonal tendency of the variables, linear trend analysis was used. The coefficient of determination R2 indicated the explanation capacity of the model. All decisions were made considering a statistical significance level of 5. To conduct, carry out and analyze the interviews that took place between June and July of , the seven stages of research proposed by Kvale were applied.
The analysis of each question in the interviews was carried out using the meaning condensation technique, where formulations were constructed based on the responses of each of the respondents, the units of natural meanings are determined based on the content expressed by each subject, the core issues are determined in relation to the natural units and an essential description of the themes identified in the interview is performed, as defined by Kvale.
The research complied with ethical standards and the databases are public domain, requiring publication of the source of data. The elderly population is rising dramatically in Brazil, based on the concept of the World Health Organization which considers a person to be elderly at 60 years of age or older if residing in a developing country. In , life expectancy was only With this profile, for every children 0 to 14 years of age , Brazil had approximately 11 elderly people table 1.
Recife-PE, In table 1 , with the doubling of life expectancy almost 74 years of age , Associated with this, there is an increase in the aging index and a reduction in the dependency ratio. Population estimates by the IBGE Brazilian Institute of Geography and Statistics indicate that the participation of elderly people will reach approximately With the number of elderly people increasing in relation to the young, it is estimated that there will be an inversion of the relation between young and old, with elderly people for every people under 15 years of age table 1.
The transition in birth and mortality rates, from high to low, made major changes in population structure part of the demographic transition debate. The country is aging at an alarming pace. Changes in population structure are clear and irreversible. Since the s, the highest rates of population growth have been observed among the elderly. Contrary to what has occurred in many developed countries, in Brazil, as seen in this text, the aging process has been extremely rapid.
In the interviews carried out, it was affirmed that the country is not prepared to meet the needs generated by this aging of the population. According to one of the interviewees, only in recent years has the country directed its efforts to long-term policies, while being faced with emergency demands at the same time. Interviewee 7. According to the World Health Organization, 13 the aging of the population is one of the greatest triumphs of humanity and yet also one of the major challenges to be faced by society. In the 21 st century, aging will increase social and economic demands across the world.
However, despite being greatly ignored, the elderly should be considered essential to the structure of societies.
Table of contents
In its report on aging in the 21st century, the United Nations Population Fund 14 stressed that although many countries have made substantial progress in adapting their policies and laws, it is necessary to direct more efforts to ensure that older people can reach their potential. There was consensus among the interviewees that an aging population requires the urgent introduction of policies appropriate to their needs. The growth of the elderly population and increased life expectancy at birth, already discussed, represent major challenges for the country.
Some interviewees pointed out, for example, the challenge to be faced by the social security system to adapt to the new demographic reality of Brazil. For the system to better adapt to the process of aging of the population". Brazil has already implemented some changes and these are objects of great political debates, but surely, you can't maintain the same social security system created for a society in which life expectancy was 55 years, for a society with a life expectancy of 75 years of age [ Interviewee 2.
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THE CHALLENGES OF AGING SOCIETY
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