Epidemiologic data for demographic and policy transitions
Paul Kowal and Julie E. Byles
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.
This article discusses the contribution of research evidence to shifting the focus of international policy planning on ageing from predominantly humanitarian aspects to predominantly developmental aspects. Opposing views on the implications of population change for societal development are delineated. Particular attention is paid to efforts aimed at linking research and policy processes in the area of population ageing. The role of international cooperation in developing/strengthening national capacity for evidence informed policy on ageing is reviewed.
This paper sets out a number of issues related to the translation of research into evidence and policy for long-term care (LTC) in low and middle income countries (LMICs). First, it assesses the role research can play in problem definition, including establishing the scale of long-term care demand in LMICs and identifying potential negative consequences of policy inaction. Second, it assesses the role that research can play in identifying and evaluating solutions to the problem, in the form of suitable policies and interventions. Lastly, it assesses mutual accessibility between researchers and policy-makers, paying particular attention to institutional and organisational structures. Applying this framework, the paper demonstrates that the capacity for research to influence long-term care policy is very limited. The paper calls for the establishment of an adequately resourced global institutional hub to support research in this area and to promote knowledge-sharing between academics and policy-makers.
Despite having the second largest population of people over age 60, India has yet to generate an effective national framework for confronting the exigencies of later life, especially those that are derived from a lifetime of poverty. This article demonstrates that this lack of interest in 'past' generations is driven by the unfortunate coincidence of externally endorsed concerns and concepts, and internal politics. Foundational assumptions on the economy and development and on old-age capacities and inter-generational relations, push for evidence collation which disincentivises more empirically relevant analyses, creating the fiction of dependency ratios and inhibiting the generation of evidence-based knowledge on later life. The consequence is that India prioitises current and future generations over ‘past’ generations. Policies on older people, who are treated as 'other' at international and national levels, are tied to competition for votes at national and state elections. Currently, policy is not designed around the concept of older people’s rights, nor of meeting need. The first outcome of external and internal drivers is that national and state governments are not interested in, nor know, how many older people qualify for a pension; instead they fix budget ceilings and, at a local level, allocate and manage pensions in a random fashion. The second outcome is that pension values are allowed to wither on the vine, waiting on the political context in which one or more parties places a pension uplift at the centre of their manifesto.
This paper considers the question, what can governments in sub-Saharan Africa do to accelerate the decline of fertility in the region? It begins with a review and discussion of United Nations projections of fertility for sub-Saharan Africa, and suggests that in light of the stalling of fertility decline that has been observed in some countries of the region, those projections may be optimistic regarding the pace of fertility decline. An overview of the policy environment emphasizes several aspects of government views and policies on fertility and population growth and how they have changed over time, and some differences among sub-regions are noted. The Easterlin framework for fertility analysis serves as the theoretical framework for examination of how existing policies function to influence fertility. The paper concludes by discussing what governments can do to accelerate the decline of fertility.