Aging populations strain resources for health care in Colombia

The proportion of the world’s population over 60 years of age is expected to nearly double between 2015 and 2050. (Credit: Steve Slater/Flickr)

Populations are aging – that is to say, there’s a growing proportion of older adults compared to the rest of society – across the Americas. While not a concern in itself, aging populations are a concern for mental health care in countries such as Colombia, where 41 percent of older adults have symptoms of depression, according to a new report.

Findings from the country’s first National Poll of Health, Well-being and Aging were presented by the Colombian Ministry of Health, and showed that 84 percent of older Colombians (in this survey, those over 60) have at least one chronic health condition. The most common of these is hypertension, affecting around 68 percent of older Colombian women and 55 percent of men.

The survey offered a host of potential explanations for the high rate of depression and other health concerns; Eight out of ten older adults live in urban areas of Colombia, and they are largely uneducated, with the average cumulative education of just 5.5 years.

It also is little help that few seem to have a pension: In rural areas, only 12 percent of older adults have this benefit, compared to 34 percent in urban areas. Twenty-one percent have no home of their own, and although more than half use mass transit, 71 percent do not have places to sit at bus stops. And because chronic conditions such as heart disease, cancer and diabetes are more frequent in older adults, their prevalence may increase, and the health system will have to come up with the resources to accommodate them.

To put Colombia’s situation in perspective, depression affects 11.2 percent of Chilean adults older than 65, between 15 percent and 30 percent of older Brazilians (depending on where and how it is measured), and between 21.7 percent, and 25.3 percent of Mexican adults 80 or over.

In the U.S., 5.4 percent of older adults have symptoms of depression, according to data from the Centers of Disease Control and Prevention.

In general, older people actually have fewer diagnosable psychiatric disorders, said Norman Abeles, professor of psychology at Michigan State University who specializes in mental health and aging. The exception, Abeles said in an interview with Humanosphere, are cognitive impairments such as memory, attention and concentration.

But treating depression in older populations still has its barriers, one of them being the stigma against mental health treatment. Most older adults grew up in a society where seeing a shrink for therapy was not well thought of, Abeles explained, so when looking to treat depression-specific problems – irregular sleeping habits, loss of appetite, fatigue – they may be more inclined to pay a visit to their family physician instead.

In the words of Colombia’s Vice Minister Fernando Ruiz there’s a need for policies to improve care for older adults, and Colombia needs to prepare for the challenges posed by this growing population.

“While in 1951, for every 100 people under 15 there were 12 seniors, by 2020 we expect that figure to be 50,” said Ruiz in an interview with Colombian newspaper El Espectador.

“So,” he added “over the next three years we must have a model that reverses the way we respond to health problems: We need to emphasize primary care and with more continuity because it is so fragmented today.”

According to World Bank statistics, most countries in the Americas are aging (albeit at varying rates); and globally, the World Health Organization predicts, the proportion of the world’s population over 60 years of age will nearly double between 2015 and 2050.

With people living longer in countries around the world, especially developing nations, health-care resources are often strained, but diseases like chronic depression – which can lead to a host of other complications, including nearly doubling the risk of stroke – remain critical to treat.

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Lisa Nikolau

Lisa Nikolau is a Madrid-based reporter for Humanosphere, covering gender equality, indigenous rights and poverty in Latin America and worldwide. Find her on Twitter at @lisanikolau, email lisa.nikolau@humanosphere.org or see her latest work at www.lisanikolau.com