Population ageing is commonly cited as one of the main drivers of increasing pressures on health care systems, as more people with chronic morbidities live to older ages. This chapter digs deeper into this presumed relationship by estimating the successive health impacts of: total population change, population ageing, changing ethnic mix of the population and trends in the age-specific incidence of disease. The decomposition of a set of health projections is developed using a micro-simulation model. These projections are based on the population of England aged 50 and over, classified by local authority of residence. The model projects forward, for the 20 years beyond 2011, the prevalence of cardiovascular disease, diabetes and respiratory illness. For diabetes the finding is that population increase alone contributes to a 24 % increase in prevalence by 2031, while the changes in gender, ethnicity and age composition together contribute another 24 %. Taking account of all potential contributions, the overall diabetes prevalence count increases by 57 %. For cardio-vascular disease (CVD), population increase contributes a 23 % increase; demographic composition processes a further 30 %; while decreases in CVD prevalence rates reduce prevalence by 60 %, resulting in an overall decrease of 35 % in those with CVD by 2031. For respiratory illness, population increase contributes 23 %; demographic composition changes 13 %; while a decrease in prevalence rates of 29 % means that the burden of the disease reduces by a modest 1 %. These results underline the potential for successful health intervention (as in CVD), the urgent need for prevention (as in diabetes) and the incentive to continue to care about health to very old ages (as in respiratory illness). These headline results refer to England as a whole but we also show how they vary across local authorities by area type, pointing to models of good practice in morbidity control.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)