900 million and counting

Epidemiologic data for demographic and policy transitions

Open access


This paper will highlight current evidence about health and well-being that could encourage investment in health for older populations. The paper uses the example of hypertension throughout to illustrate how data collection efforts are translating research to policy. Hypertension, is a global scourge for poor and wealthy, younger and older adults, increasing the risk of stroke and cardiovascular disease. Although it is easily diagnosed and can be effectively treated the burden of hypertension continues to grow as awareness, prevention and treatment lags, particularly for the poor and old. The focus is brought back to how current research can inform policy for ageing populations in the final section, using Ireland’s experience to demonstrate how to legislate the good life for older adults.

Addo, J., Smeeth, L., Leon, D.A. (2007) ‘Hypertension in sub-Saharan Africa - A systematic review’, Hypertension, vol. 50, December, no. 6, pp. 1012-1018.

African Union. (2013). Status report on hypertension in Africa. Retrieved from


Beard, J., Officer, A., Cassels, A., editors. (2015) World Report on Ageing and Health. Geneva: World Health Organization.

Bloom, D.E. (2011) ‘7 Billion and Counting’, Science, vol. 333, 29 July, 562-569.

Borgman, C.L. (2015) Big Data, Little Data, No Data. Scholarship in the Networked World. Cambridge: MIT Press. https://mitpress.mit.edu/big-data

Bosu, W.K. (2010) ‘Epidemic of hypertension in Ghana: a systematic review’, BMC Public Health, vol. 10, p. 418.

Bromfield, S. & Muntner, P. (2014). ‘High blood pressure: The leading Global Burden of Disease risk factor and the need for worldwide prevention programs’, Current Hypertension Report, vol. 15, Jun, no. 3, pp. 134-136.

Brown, W. J., Hockey, R. & Dobson, A. (2007). ‘Rose revisited: A “middle road” prevention strategy to reduce noncommunicable chronic disease risk’. Bulletin of the World Health Organization, vol. 85, pp. 886-887.

Business Day, (2014) “High blood pressure ‘runs rampant in SA’”, 14 Feb 2014. www.bdlive.co.za/life/health/2014/02/04/high-blood-pressure-runs-rampant-in-sa

Byles, J., Hockey, R., McLaughlin, D., Dobson, A., Brown, W., Loxton, D., Mishra, G. (2015) Chronic conditions, physical function and health care use: Findings from the Australian Longitudinal Study on Women’s Health. Report prepared for the Australian Government Department of Health. Canberra: Department of Health. www.alswh.org.au/images/content/pdf/major_reports/2015%20ALSWH%20MRJ%20Final.pdf (last accessed 03 December 2015)

Charlton, K.E., Webster, J., Kowal, P. (2014) ‘To legislate or not to legislate? A comparison of the UK and South African approaches to the development and implementation of salt reduction programs’, Nutrients, vol. 6, no. 9, pp. 3672-3695.

Christiani, Y., Byles, J.E., Tavener, M., Dugdale, P. (2015) ‘Assessing socioeconomic inequalities of hypertension among women in Indonesia’s major cities’, Journal of Human Hypertension, 5 February. doi:10.1038/jhh.2015.

Christiani, Y., Tavener, M., Byles, J.E., Dugdale, P. (2016) ‘Inadequate collaboration: A challenge to reaching global targets for non-communicable disease control and prevention. Journal of Public Health Policy, vol. 37, no. 1, pp. 114-117. ’

de Carvalho, I.A., Byles, J., Aquah, C., Amofah, G., Biritwum, R.B., Panisset, U., et al. (2015) ‘Informing evidence-based policies for ageing and health in Ghana’, Bulletin of the World Health Organization, vol. 93, no. 1, pp. 47-51.

Department of Health, Republic of Ireland. (2013) Healthy Ireland - A Framework for Improved Health and Wellbeing 2013-2025. Dublin: Department of Health.

Department of Health, Republic of Ireland. (2014) Positive ageing - starts now! The National Positive Ageing Strategy. Dublin: Department of Health.

health.gov.ie/wp-content/uploads/2014/03/National_Positive_ Ageing_Strategy_English.pdf

Eksteen, G., & Mungal-Singh, V. (2015) ‘Salt intake in South Africa: a current perspective’, Journal of Endocrinology, Metabolism and Diabetes of South Africa, vol. 20, no. 1, pp. 9-13.

Fan, W., Guo, Y., Chatterji, S., Zheng, Y., Naidoo, N., Jiang, Y., et al. (2015) ‘Common risk factors for chronic non-communicable diseases among older adults in China, Ghana, Mexico, India, Russia and South Africa: the Study on global AGEing and adult health (SAGE) wave 1’, BMC Public Health, vol. 15, February, p. 88.

Feng, X.L., Pang, M., & Beard, J. (2014) ‘Health system strengthening and hypertension awareness, treatment and control: data from the China Health and Retirement Longitudinal Study’, Bulletin of the World Health Organization, vol. 92, no. 1, pp. 29-41.

Ferreira, M. (2005) ‘Research on ageing in Africa: What do we have, not have and should we have?’, British Society of Gerontology, vol. 15, no. 2, pp. 32-35.

Forouzanfar, M.H, Alexander, L., Anderson, H.R., Bachman, V.F., Biryukov, S., Brauer, M., et al. (2015) ‘Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013’, Lancet, September, http://dx.doi.org/10.1016/S0140-6736(15)00128-2

Fried, L.P. & Paccaud, F. (2010) ‘Editorial: The public health needs for an ageing society’, Public Health Review, vol. 32, December, no. 2, pp. 351-355.

Friedrichs, M.J. (2014) ‘High hypertension rates in low- and middle-income countries’, JAMA, vol. 311, no. 11, p. 1101.

Garrison, S.R., Kolber, M,R,, Korownyk, C.S., McCracken, R.K., Allan, G.M. (2015) Blood pressure targets for hypertension in older adults (protocol). The Cochrane Collaboration: Wiley, issue 3, March. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011575/epdf

Hotez, P.J., & Peiperl, L. (2015) ‘Noncommunicable diseases: A globalization of disparity?’, PLoS Medicine, vol. 12, no. 7, pp. e1001859.

Jackson, C., Herber-Gast, G. C. & Brown, W. (2014) ‘Joint effects of physical activity and BMI on risk of hypertension in women: a longitudinal study’, Journal of Obesity, 2014, 271532.

James, P.A., Oparil, S., Carter, B.L., Cushman, W.C., Dennison- Himmelfarb, C., Handler, J., et al. (2014) ‘Evidence-based guideline for the management of high blood pressure in adults.

Report from the panel members appointed to the Eighth Joint National Committee (JNC 8)’, JAMA, vol. 311, no. 5, pp. 507-22.

Jiang, B., Liu, H. Ru, X., Zhang, H., Wu, S., & Wang, W. (2014) ‘Hypertension detection, management, control and associated factors among residents accessing community health services in Beijing’, Scientific Reports, vol. 4, May, pp. 4845.

Kowal, P., Chatterji, S., Naidoo, N., Biritwum, R., Wu, F., et al. (2012) ‘Data Resource Profile: The World Health Organization Study on global AGEing and adult health (SAGE)’, International Journal of Epidemiology, vol. 41, pp. 1639-1649.

Lancet, The. (2014) ‘Hypertension: an urgent need for global control and prevention’, Lancet, vol. 383, no. 9932, p. 1861.

Lawes, C.M., Van der Hoon, S., Rodgers, A. (2008) ‘Global-burden of blood pressure related disease’, Lancet, vol. 371, pp. 1513-1518.

Lee, R. (2011) ‘The outlook for population growth’, Science, vol. 333, no. 6042, pp. 569-573.

Leng, B., Jin, Y., Li, G., Chen, L., Jin, N. (2015) ‘Socioeconomic status and hypertension: a meta-analysis’, Journal of Hypertension, vol. 33, no. 2, February, pp. 221-229.

Lim, J., Chan, M.M.H., Alsagoff, F.Z., & Ha, D. (2014) ‘Innovations in non-communicable diseases management in ASEAN: a case series’, Global Health Action, vol. 7, pp. 25110.

Lozano, R., Naghavi, M., Foreman, K.T., et al. (2012) ‘Global and regional mortality

from 235 causes of death for 20 age groups in 1990 and 2010: a systematic

analysis for the Global Burden of Disease Study 2010’, Lancet, vol. 380, pp. 2095-2128.

Lloyd-Sherlock, P., Beard, J., Minicuci, N., Ebrahim, S., & Chatterji, S. (2014) ‘Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control’, International Journal of Epidemiology, vol. 43, no. 1, pp. 116-128.

Lu, Z., Cao, S., Chai, Y., Liang, Y., Bachmann, M., Suhrcke, M., & Song, F. (2012) ‘Effectiveness of interventions for hypertension care in the community - a meta-analysis of controlled studies in China’, BMC Health Services Research, vol. 12, July, pp. 216.

Ministry of Health, Republic of Ghana. (2012) Strategy for the management, prevention and control of chronic non-communicable diseases in Ghana, 2012-2016. August.


Ministry of Health, Indonesia. National Institute of Health and Research Development. (2008) Basic Health Research: National Report. Jakarta, Ministry of Health Indonesia.

Murphy, C., Kearney, P., Shelley, E., Fahey, T., Dooley, C., Kenny, R.A. (2015) ‘Hypertension prevalence, awareness and control in the over 50s in Ireland: evidence from The Irish Longitudinal Study on Ageing (TILDA)’, Journal of Public Health, vol. 37, April, no. 1: fdv057.

National Department of Health, South Africa. (2013) Strategic plan for the prevention and control of non-communicable diseases 2013-2017, Pretoria: Department of Health.

National Development Planning Commission, Republic of Ghana. (2010) Ghana Shared Growth and Development Agenda (GSGDA), 2010-2013. Accra; NDPC.

new economics foundation. (2015) People, planet, power: towards a new social settlement. London: nef.

Nolan, A., O’Regan, C., Dooley, C., Wallace, D., Hever, A., Cronin, H., Hudson, E., Kenny, R.A. (2014) The Over 50s in a Changing Ireland Economic Circumstances, Health and Well-Being. Dublin: TILDA.


Nolte, E. and Pitchforth, E. (2014). What is the evidence on the economic impacts of integrated care?, WHO Regional Office for Europe and European Observatory on Health Systems and Policies.

Oeppen, J, Vaupel JW. (2002) ‘Broken limits to life expectancy’, Science, vol. 296, no. 5570, pp. 1029-1031.

Olsen, M.H., & Spencer, S. (2015) ‘A global perspective on hypertension: a Lancet Commission’, Lancet, vol. 386, issue 9994, August, pp. 637-638.

Olshansky, S.J., Perry, D., Miller, R.A., & Butler, R.N. (2007) ’Pursuing the longevity dividend, scientific goals for an ageing world’, Annals of New York Academy of Science, vol. 1114, pp. 11-13.

Patel, V., & Chatterji, S. (2015) ‘Integrating mental health in care for noncommunicable diseases: An imperative for personcentered care’, Health Affairs, vol. 34, no. 9, pp. 1498-1505.

Peoples Republic of China Ministry of Health and World Health Organization Western Pacific Region. (2013) China-WHO Country Cooperation Strategy 2013-2015: Bridging the past, towards a new era of collaboration, Geneva: WHO. www.wpro.who.int/china/en_chinaccs13.pdf

Pertiwi, H.W. (2013) ‘Faktor-faktor yang berhubungan dengan frekuensi kehadiran lanjut usia di Posyandu Lansia (Factors associated with the frequency of older people’s attendance in Posyandu Lansia)’, Bidan Prada: Jurnal Ilmiah Kebidanan, vol. 4, no. 1, pp. 1-15.

Republic of Ghana Ministry of Health. (2012) Strategy for the Management, Prevention and Control of Chronic Non- Communicable Diseases in Ghana 2012-2016. August. www.nationalplanningcycles.org/sites/default/files/country_docs/Ghana/ghana.pdf

Republic of Ghana Ministry of Health . (2014) Health sector medium-term development plan (2014-2017). Accra, Ghana Health Service, 01 October. www.nationalplanningcycles.org/sites/default/files/planning_cycle_repository/ghana/hsmtdp_2014-2017_final_draft_9_oct.pdf

Sanderson, W. C., & Scherbov S. (2010) ’Remeasuring aging’, Science, vol. 329 no. 5997, pp. 1287-1288.

Sachs, J. (2015) The age of sustainable development. New York: Columbia University Press.

Schumacher, E.F. (1973) Small is Beautiful: A Study of Economics as if People Mattered. Blond and Briggs.

Seaford, C. (2011) ‘Policy: time to legislate for the good life,’ Nature, vol. 477, pp. 532-3.

Seychell, M. (2015) Introductory speech, Innovative financing. Opportunities for active & healthy ageing. European Commission, Brussels, (June). http://ec.europa.eu/health/ageing/docs/ev_20150603_co01_01_en.pdf

Sparrow, R., Suryahadi, A., & Widyanti, W. (2013). Social health insurance for the poor: targeting and impact of Indonesia’s Askeskin programme. Social Science & Medicine, vol. 96, pp. 264-271.

Stiglitz, J., Sen, A., Fitoussi, J-P. (2010) Report by the Commission on the Measurement of Economic Performance and Social Progress. www.stiglitz-sen-fitoussi.fr/documents/rapport_anglais.pdf (accessed 16 Sep 2015).

Suhrcke, M., McKee, M., Stuckler, D., Arce, R.S., Tsolova, S., & Mortensen, J. (2006) ‘The contribution of health to the economy in the European Union’, Public Health, vol. 120, October, pp. 994-1001.

United Nations Population Division. (2015) World population prospects: The 2015 revision. New York: United Nations.

Vos, T., Barber, R.M., Bell, B., Bertozzi-Villa, A., et al. (2015) ‘Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013’, Lancet, vol. 386, 22 Aug, no. 9995, pp. 743-800.

World Health Organization (2007). Prevention of cardiovascular disease: Guidelines for assessment and management of cardiovascular risk. Geneva (Switzerland), WHO.

World Health Organization. (2010) Global status report on noncommunicable diseases 2010. Geneva: WHO.

World Health Organization (2012). Prevention and control of noncommunicable diseases: guidelines for primary health care in low resource settings. Geneva (Switzerland), WHO.

World Health Organization. (2013) A global brief on hypertension. Silent killer, global public health crisis. Geneva: WHO, (April).

World Health Organization. (2014a) Ghana country assessment report on ageing and health. Geneva: WHO. http://www.who.int/ageing/publications/ghana/en/

World Health Organization. (2014b) WHO Regional Framework for action on ageing and health in the Western Pacific (2014-2019). Geneva: WHO.

World Health Organization and International Society of Hypertension Writing Group. (2003) ‘2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension’ Journal of Hypertension vol. 21, no. 11, pp. 1983-92.

Population Horizons

Analysis and debate on policy questions raised by population change

Journal Information

Cited By


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 227 223 27
PDF Downloads 94 94 18