Health and Disability

The number of disabled persons is likely to rise rapidly as populations grow older. Emerging morbidity patterns in developing countries may require a reevaluation of health services and service provision.

Given the non-medical factors that can affect health status, the World Health Organization (WHO) takes a very broad view of health, involving the health sector in the larger context of improving the quality of life. This accords with the Organization's definition of health as complete physical, mental and social well-being. In regard to the elderly segment of the population, specific health goals that have been articulated include (a) promotion of maximum independence and productivity and (b) prevention of debilitating conditions in old age through healthier lifestyles, early diagnosis, environmental safety and health education.

As might be anticipated, chronic conditions are more prevalent than acute disorders and infections among the elderly. However, there are substantial short falls in the provision of primary health care services to the aging, and in the provision of health aids, particularly in rural areas. There is high prevalence of physical disability, particularly with regards to sight, hearing, chewing of food and walking. These problems limit the elderly from being active in and to cope with daily living.

Among the elderly, arthritis, high blood pressure, foot problems, heart diseases and stomach ulcers are the five common illnesses. When questioned about morbidity during last twelve months in the SEARO cross-national study, 35.8 per cent of all elderly in Myanmar reported suffering from arthritis, 11.9 per cent in DPR Korea, 49.1 per cent in Indonesia, 31.3 per cent in Sri Lanka and 59.5 per cent in Thailand. Quite substantial proportion of the elderly suffer from hypertension and heart problems, lung diseases and stomach ulcers. These diseases, along with impaired visual and hearing conditions greatly affect their ability to carry out daily activities, self-care functions and employment. Chronic illnesses not only prevent those afflicted from working, but also impose a huge cost on the national health expenditure. For example it has been estimated that caring for patients with Alzheimer's disease in the U.S. in the year 2030 will be $30,000,000,000.

Accessibility and availability of health services are very limited. Of 11 Member States in the SEAR, only 4 countries including DPR Korea, Sri Lanka, India, report that more than 90 per cent of their population have access to a health facility within one hours travel time. The geriatric services, if they exist, are mostly located in urban settings. Although services/programs of non-governmental organizations and charitable agencies are gradually emerging, the number, scale and scope of their activities are far beyond their capability to accommodate the health care needs of the vast number of the elderly population. Increasing technological advances in the field of medicine has created a demand for their utilization. However, their availability comes at a huge cost which many older people are not able to afford. This creates a dilemma between availability and affordability. Compared to a developed country, reported illness among elderly in SEAR countries is much higher whereas utilization of health services is considerably lower. As an illustration, the table shows a comparison of contact with a health professional in Australia and SEAR countries.