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Objectives: Our objective was to assess morbidity trends in Europe and to classify European countries based on population ageing theories: the compression, expansion and dynamic equilibrium of morbidity. Methods: The proportions of healthy life years were calculated for 31 European countries for the period 2005--2019 based on life expectancy values and healthy life years at age 65 years adopted from the Eurostat database. European countries were classified according to morbidity patterns applying the standard deviation distance from the average of relative change method between the selected years. Results: A large degree of variation in terms of life expectancy and healthy life years at age 65 years was determined between 2005 and 2019. While the life expectancy differences between men and women were consistent across all the European countries, the gender gap concerning healthy life years was more diverse. Approximately one-third of the countries fell into the expansion, compression and dynamic equilibrium categories, respectively. Conclusion: Significant variations were identified in healthy life year trends across European countries, which underscores the need for preventive strategies. [ABSTRACT FROM AUTHOR]

The rising healthcare costs due to population aging present a complex issue, with debate centering on whether these costs are driven by aging or end-of-life care. This study examines healthcare expenditures in Chinese households using data from the 2005 and 2018 Chinese Longitudinal Healthy Longevity Survey. By applying the Heckman select model and a two-part model, the research innovatively includes time to death, income, social security and health level in the benchmark regression in order to validate the recent some new Red Herring hypothesis. The findings show that time to death is the primary determinant of healthcare expenditures, while the effect of aging is minimal. Income, social security, and health status also significantly influence health expenditure, but they do not function as Red Herring variables. [ABSTRACT FROM AUTHOR]

The role of care planning in addressing eldercare challenges has received increasing attention. However, the influence of the uncertainty triggered by the coronavirus disease 2019 (COVID-19) pandemic, in conjuction with significant social unrest, on family eldercare planning remains unclear. This study examines eldercare planning experiences of families in Hong Kong, focusing on the evolving changes and adaptations faced by both local residents and mainland Chinese immigrants during the COVID-19 pandemic and the 2019–2020 social unrest. Through purposive sampling, we conducted semi-structured interviews with 93 local residents and 66 migrants from 2020 to 2021. Five main themes emerged: (1) increased awareness of healthcare preparation and planning during the COVID-19 pandemic, (2) residential care homes as a suboptimal choice after the COVID-19 pandemic, (3) influence of the COVID-19 pandemic on financial planning for eldercare, (4) distant family care after the social unrest, and (5) the need to improve remote care under border restrictions. This study contributes to the literature by examining the intersection of crisis events and eldercare planning, viewing the family as a planning unit. It also deepens the understanding of caregiving within the context of health and social crises, providing valuable insights for the development of future support systems for older adults and their caregivers in similar circumstances. [ABSTRACT FROM AUTHOR]

Walking benefits older pedestrians but exposes them to traffic crashes. With an aging population, designing age-friendly cities is crucial, yet research on older pedestrian safety at a micro-level is limited. This study aims to reduce older pedestrian–vehicle collisions and create more livable environments through infrastructure policies derived from statistical data analysis. Special attention is focused on collecting a holistic set of infrastructure variables to reflect most of the street built environment elements, which helps policymakers implement short-term safety measures. Using Bayesian Poisson regression, this study analyzes factors contributing to the occurrence of crashes involving older and non-older pedestrians on road segments in Madrid, Spain. The results indicate that different factors affect the occurrence of crashes for all pedestrians versus older pedestrians specifically. Traffic crashes involving all pedestrians are affected by leisure points of interest, bus stops, and crosswalk density. Older pedestrian traffic crashes are influenced by population density, the presence of trees and trash containers, and contour complexity. Proposed measures include relocating trees and trash containers, modifying bus stops, and adding crosswalks and traffic lights. This paper also shows that these countermeasures, aimed at creating age-friendly streets for older pedestrians, are not expected to worsen the road safety of other pedestrians. [ABSTRACT FROM AUTHOR]

Objectives Considering the rapid growth of the aged population and given that older people are the main consumers of health services, it is important to address the effects of population ageing on the health system function. Therefore, this study aims to review the evidence related to the impacts of population ageing on various functions of the health system, including stewardship, financing, resource development, and service provision. Methods & Materials This is a systematic review study. The data were collected through searching in PubMed, Web of Science, ProQuest and Google Scholar for articles published from 2000 to 2022, using the related keywords. Quality assessment of selected articles was done using the STROBE checklist. To analyze the extracted data, the World Health Organization's health system performance assessment framework was used. Results Of 1954 identified articles, 23 were finally selected based on inclusion and exclusion criteria. In the function of stewardship, the impacts were related to the managerial and policy aspects and the increased need to respond to the growing health needs of the elderly. In the function of financing, the impacts included the increase of financial burden on the health system and the need to provide financial resources. In the resource generation function, the impacts were categorized into human, information and physical resources. In the function of service provision, the impacts were on the demand for services, the complexity of service provision, and the method of service provision to elderly. Conclusion The impacts of population ageing on the functions of the health system, especially the financing function, are inevitable. The increase in the aged population is associated with the increase in health costs. Policy makers and managers of the health system should use practical strategies to strengthen the health system against the effects of population ageing. [ABSTRACT FROM AUTHOR]

Abstract The rising healthcare costs due to population aging present a complex issue, with debate centering on whether these costs are driven by aging or end-of-life care. This study examines healthcare expenditures in Chinese households using data from the 2005 and 2018 Chinese Longitudinal Healthy Longevity Survey. By applying the Heckman select model and a two-part model, the research innovatively includes time to death, income, social security and health level in the benchmark regression in order to validate the recent some new Red Herring hypothesis. The findings show that time to death is the primary determinant of healthcare expenditures, while the effect of aging is minimal. Income, social security, and health status also significantly influence health expenditure, but they do not function as Red Herring variables.

Objectives Considering the rapid growth of the aged population and given that older people are the main consumers of health services, it is important to address the effects of population ageing on the health system function. Therefore, this study aims to review the evidence related to the impacts of population ageing on various functions of the health system, including stewardship, financing, resource development, and service provision. Methods & Materials This is a systematic review study. The data were collected through searching in PubMed, Web of Science, ProQuest and Google Scholar for articles published from 2000 to 2022, using the related keywords. Quality assessment of selected articles was done using the STROBE checklist. To analyze the extracted data, the World Health Organization’s health system performance assessment framework was used. Results Of 1954 identified articles, 23 were finally selected based on inclusion and exclusion criteria. In the function of stewardship, the impacts were related to the managerial and policy aspects and the increased need to respond to the growing health needs of the elderly. In the function of financing, the impacts included the increase of financial burden on the health system and the need to provide financial resources. In the resource generation function, the impacts were categorized into human, information and physical resources. In the function of service provision, the impacts were on the demand for services, the complexity of service provision, and the method of service provision to elderly. Conclusion The impacts of population ageing on the functions of the health system, especially the financing function, are inevitable. The increase in the aged population is associated with the increase in health costs. Policy makers and managers of the health system should use practical strategies to strengthen the health system against the effects of population ageing.

The COVID-19 epidemic caused an increase in excess deaths worldwide, most of which were in the elderly. This study aims to identify the impact of the COVID-19 epidemic on reducing the intensity of change in population aging between 2020 and 2022 in selected European countries. Time-series analysis methods with trend and seasonality are used to estimate excess deaths. The study found that of the nearly 1.5 million excess deaths observed between 2020 and 2022 in the 28 European countries analyzed, almost 93% of these were in people aged 60 years and older. The results of the study indicate that in some countries (mainly central and eastern Europe), the scale of deaths due to the COVID-19 epidemic was large enough to clearly inhibit the aging dynamics of their populations.

Much contemporary economic policy analysis deploys demographic projections. To explore their macroeconomic significance, this article draws on documentary evidence from two case studies: (1) the World Bank's Human Capital Index and (2) European Union models of population ageing within debt sustainability analysis. Combining constructivist and Foucauldian insights, we develop a threefold argument about the constitutive effects of quantified demographic futures on macroeconomic policy analysis. First, the World Bank's and the European Union's respective demographic futures mobilise urgency for contingent policy choices with reference to expected future 'gaps'. Second, they build credibility for contested bodies of expertise on the basis of long-term population forecasts. Third, they delineate agency such that the effects of structural inter-dependencies between economies are rendered as national-level policy risks. These findings demonstrate how quantified demographic futures circumscribe national policy space, mediate the politics of macroeconomic ideas and contribute to the depoliticisation of economic policymaking. [ABSTRACT FROM AUTHOR]

This study examines the impact of the growing elderly population and single-person households on residential electricity demand in China. Using a dynamic panel model, this study investigates a balanced panel dataset encompassing 30 provinces in China from 2006 to 2016. The results indicate that households in China show limited responsiveness to changes in electricity prices and household income in the short and long run. Regarding demographic transitions, the results reveal that the presence of working-age individuals, elderly individuals, and single-person households contributes to an increase in electricity demand. Furthermore, the results highlight the significance of higher education in reducing electricity demand, suggesting the need for educational programmes that promote energy-saving behaviour and environment-friendly attitudes. These findings offer valuable insights for policy makers and stakeholders aiming to develop effective strategies for managing residential electricity demand in light of changing demographics. [ABSTRACT FROM AUTHOR]

This study seeks to characterise the effects of migration on the population development of Hong Kong where there has been rapid population transition due to extremely low fertility and uncertainties in migration flows. We explore actual historical trends during the period 2011–2021, and how these trends could shape the future demographic distribution if they persist. Using population census data, we estimate the net migration numbers in Hong Kong during the period 2011–2021, and develop population projections from 2026 to 2056 based on three alternative migration scenarios: (1) no net migration, (2) constant at the 2016–2021 level (negative growth), and (3) constant at the 2011–2016 level (positive growth but stable). Projected overall dependency ratios are also estimated under the three migration scenarios, as well as two retirement age scenarios: retiring at 65 years and 70 years. Our findings demonstrate that immigration would become an important and positive factor to slow down the process of population ageing to achieve a more sustainable development. The extension of the retirement age from 65 years to 70 years will certainly help to mitigate the ageing pressure in Hong Kong. We also provide implications of these projections for other Asian societies in similar situations. [ABSTRACT FROM AUTHOR]

The COVID-19 epidemic caused an increase in excess deaths worldwide, most of which were in the elderly. This study aims to identify the impact of the COVID-19 epidemic on reducing the intensity of change in population aging between 2020 and 2022 in selected European countries. Time-series analysis methods with trend and seasonality are used to estimate excess deaths. The study found that of the nearly 1.5 million excess deaths observed between 2020 and 2022 in the 28 European countries analyzed, almost 93% of these were in people aged 60 years and older. The results of the study indicate that in some countries (mainly central and eastern Europe), the scale of deaths due to the COVID-19 epidemic was large enough to clearly inhibit the aging dynamics of their populations. [ABSTRACT FROM AUTHOR]

Purpose: Population ageing is a demographic transition and burdens every country's health sector. A lack of social security combined with low government health-sector spending has made health-care utilisation difficult among elderly in many developing countries like India. This makes population ageing a global phenomenon for policymakers, researchers and stakeholders to discuss and debate in 21st century. The purpose of this paper is to examine the behavioural determinants of health-care utilisation among elderly population in Punjab. Design/methodology/approach: This study examines health-care utilisation among the elderly population in Punjab. A structured questionnaire was used to collect the data in the state of Punjab, with a multi-stage stratified random sample of 385 respondents. Logit regression was used to analyse the association between several behavioural factors like age, gender, place of residence, source of livelihood, education and frequency of visits with health-care utilisation among elderly aged 60 and above. Findings: This study revealed that gender, age, place of residence, source of livelihood, education and frequency of visits were significant determinants of health-care utilisation among elderly population. Originality/value: This study directs the need to improve health-care utilisation in a country, reducing inequalities that exist among the elderly population with respect to socio-economic and demographic differences. [ABSTRACT FROM AUTHOR]

The study compares the conditions created by ageing processes. It recognises differences in the situation of people aged 65 and older from a macrolevel perspective in 34 OECD countries in 2020, that is, the first year of the Covid‐19 pandemic. The paper analyses the (dis)similarities of OECD economies with regard to a set of selected variables that represent different macrolevel dimensions. Cluster analysis and linear ordering were applied, which made it possible to group the countries into separate clusters. The most obvious difference was found for the cluster consisting of Luxembourg, Belgium, France, and Spain, relative to the group that includes Mexico and Türkiye and the cluster that comprises Korea, Latvia, Japan, and Lithuania. Influential variables for grouping countries were old‐age income poverty, public transfers in the form of pensions, effective labour market exit age, and differences between expected years in retirement for women and men. The cluster analysis for 2020 also revealed the general difference between European countries and the rest of the OECD economies, as well as the importance of regional differences. The results also indicate that the clusters partially correspond to the differentiation of OECD countries based on the typology of the pension regimes, as outlined in the literature. Finally, comparing the 2020 clusters with the pre‐Covid‐19 pandemic results (2018) indicates that countries in the top and bottom‐ranked groups were resistant to the pandemic shock. [ABSTRACT FROM AUTHOR]

Ensuring equitable access to healthcare is important for universal health coverage (UHC). Using the enhanced two-step floating catchment area (E2SFCA) method, we found disparities in the spatial accessibility of outpatient and inpatient healthcare facilities in the Philippines, particularly in the central and southern regions of the country. Municipalities with a higher proportion of older people had better spatial accessibility to outpatient care, while municipalities with a higher density of older people had better accessibility to inpatient care. Municipalities with high poverty rates had better accessibility to outpatient care but poorer accessibility to inpatient care. Addressing these disparities is essential for achieving UHC in the Philippines. [ABSTRACT FROM AUTHOR]

ObjectivesOur objective was to assess morbidity trends in Europe and to classify European countries based on population ageing theories: the compression, expansion and dynamic equilibrium of morbidity.MethodsThe proportions of healthy life years were calculated for 31 European countries for the period 2005–2019 based on life expectancy values and healthy life years at age 65 years adopted from the Eurostat database. European countries were classified according to morbidity patterns applying the standard deviation distance from the average of relative change method between the selected years.ResultsA large degree of variation in terms of life expectancy and healthy life years at age 65 years was determined between 2005 and 2019. While the life expectancy differences between men and women were consistent across all the European countries, the gender gap concerning healthy life years was more diverse. Approximately one-third of the countries fell into the expansion, compression and dynamic equilibrium categories, respectively.ConclusionSignificant variations were identified in healthy life year trends across European countries, which underscores the need for preventive strategies.

The article discusses the Madrid International Plan of Action on Ageing and its connection to the 2030 Agenda for Sustainable Development. It highlights the importance of addressing population ageing for development, emphasizing the need for practical strategies to support older individuals. The text also underscores the disparities in implementing the Plan, particularly in Africa, and the necessity for collaboration among governments, civil society, and academia to address the challenges of population ageing while leveraging the opportunities it presents. [Extracted from the article]

Abstract Background The study explored the levels and associated factors of undiagnosed depression among community-dwelling older Indian adults. It also identified the socio-demographic predictors of undiagnosed depression among the study population at national and state levels. Methods The study employed data from the Longitudinal Ageing Study in India wave-I, 2017-18. Based on the data on depression from interviewee’s self-reporting and measurement on Composite International Diagnostic Interview– Short Form (CIDI-SF) and Centre for Epidemiological Studies- Depression scale (CES-D) scales, we estimated undiagnosed depression among older adults (age 60+). We estimated multivariable binary logistic regressions to examine the socio-demographic and health-related predictors of undiagnosed depression among older adults. Findings 8% (95% CI: 7.8–8.4) of the total older adults had undiagnosed depression on CIDI-SF scale and 5% (95% CI: 4.8–5.3) on the combined CIDI-SF and CES-D. Undiagnosed depression was higher among those who were widowed, worked in the past and currently not working, scheduled castes, higher educated and the richest. Lack of health insurance coverage, presence of any other physical or mental impairment, family history of Alzheimer’s/Parkinson’s disease/ psychotic disorder, lower self-rated health and poor life satisfaction were significant predictors of undiagnosed depression on both CIDI-SF and combined scales. Conclusion To improve the health of older adults in India, targeted policy efforts integrating mental health screening, awareness campaigns and decentralization of mental healthcare to primary level is needed. Further research could explore the causal factors behind different levels of undiagnosed depression.

Background: The study explored the levels and associated factors of undiagnosed depression among community-dwelling older Indian adults. It also identified the socio-demographic predictors of undiagnosed depression among the study population at national and state levels. Methods: The study employed data from the Longitudinal Ageing Study in India wave-I, 2017-18. Based on the data on depression from interviewee's self-reporting and measurement on Composite International Diagnostic Interview– Short Form (CIDI-SF) and Centre for Epidemiological Studies- Depression scale (CES-D) scales, we estimated undiagnosed depression among older adults (age 60+). We estimated multivariable binary logistic regressions to examine the socio-demographic and health-related predictors of undiagnosed depression among older adults. Findings: 8% (95% CI: 7.8–8.4) of the total older adults had undiagnosed depression on CIDI-SF scale and 5% (95% CI: 4.8–5.3) on the combined CIDI-SF and CES-D. Undiagnosed depression was higher among those who were widowed, worked in the past and currently not working, scheduled castes, higher educated and the richest. Lack of health insurance coverage, presence of any other physical or mental impairment, family history of Alzheimer's/Parkinson's disease/ psychotic disorder, lower self-rated health and poor life satisfaction were significant predictors of undiagnosed depression on both CIDI-SF and combined scales. Conclusion: To improve the health of older adults in India, targeted policy efforts integrating mental health screening, awareness campaigns and decentralization of mental healthcare to primary level is needed. Further research could explore the causal factors behind different levels of undiagnosed depression. [ABSTRACT FROM AUTHOR]

Several factors contribute to the lack of long-term care (LTC) insurance in Taiwan, insufficient data and an absence of unified definitions of LTC are two of them. In this study, we use LTC-related catastrophic illness (CI) as the assessment criteria to investigate the demand for LTC insurance. We selected 13 categories of CI and explored the spatial–temporal properties of LTC incidence rates and mortality rates from the National Health Insurance Research Database. The study shows that the incidence rates did not change much, while mortality rates decreased significantly. Taiwan's LTC population, which was 0.29 million in 2013, is accordingly expected to triple before 2040 based on the proposed cohort change ratio approach. Currently, Taiwan's government has planned to fund LTC insurance via a pay-as-you-go system. Furthermore, the increasing LTC population indicates that commercial insurance can play a vital role as a supplement to social LTC insurance. [ABSTRACT FROM AUTHOR]

Just six decades ago, the world was experiencing remarkably high population growth rates, which led to the coining of the term 'demographic bomb' to describe concerns associated with population size. At the time, the global population was three billion. Since then, an extra billion people have been added every 12 years. However, the pre-eminent demographic challenge of the twenty-first century is population ageing, a global, irreversible and unprecedented trend. The number of people aged 65 and over has almost doubled since the turn of the century and currently accounts for 10% of the global population. An extra billion people are expected to age into the older category within the next 35 years. In Europe, half of the population is above 45 years of age, and the number of those above 65 years old is greater than the number of children under 15. Commonly referred to as the 'silver tsunami', it is feared that the increasing number of older people will have a destructive impact on economies and social systems. Never before have our lives been longer, our families smaller and our societies more multigenerational. The new reality of longevity requires a shift in how we approach ageing. This article explores ways to cope with the challenges of the silver era we are heading towards. [ABSTRACT FROM AUTHOR]

Demographic issues are becoming key to the debate on the future of Europe, and of Italy in particular, which has the lowest birth rate in Europe but is among the top-ranked countries for demographic ageing. The general improvement of living conditions and the ageing of large cohorts cannot be supported by the economic activity of the younger generations, which calls into question the security of certain aspects of the social pact, such as the provision of pensions and health care. While encouraging an awareness among Italians of the trends and problems they will have to deal with, all national actors must cooperate to ensure the recovery of the birth rate, and to harness the economic benefits of incoming migrants and the experiences of older people. It is equally necessary to meet the needs of young people and enhance their social role. Only through such cooperation will it be possible to create a favourable climate for actions that will allow us to control and direct these demographic phenomena and not to suffer from them. [ABSTRACT FROM AUTHOR]

The demographic transition poses a significant challenge for health systems, especially in Central and Eastern European (CEE) countries, where the healthcare needs of aging populations are on the rise. This study aimed to describe and compare the health status and utilization of health services among the elderly residing in urban and rural areas of the most deprived region in Hungary. A comprehensive health survey was conducted in 2022, involving a randomly selected sample of 443 older adults (≥ 65 years) in Northeast Hungary. Multivariable logistic regression models adjusting for age, sex, education, financial status, chronic diseases, and activity limitations were used to investigate the association between type of residence and health service use. Among the study participants, 62.3% were female, 38.3% attained primary education, 12.5% reported a bad or very bad financial situation and 52.6% lived in urban areas. Overall, 24% of the elderly rated their health as very good or good (27.8% in urban and 19.7% in rural areas), while 57.8% (52.6% and 63.5% in urban and rural areas) reported limitations in daily activities. Compared to urban residents, rural residents reported lower rates of dentist visits (p = 0.006), specialist visits (p = 0.028), faecal occult blood testing (p < 0.001), colorectal cancer screening with colonoscopy (p = 0.014), and breast cancer screening (p = 0.035), and a higher rate of blood pressure measurement (p = 0.042). Multivariable models indicated that urban residence was positively associated with faecal occult blood testing (OR = 2.32, p = 0.014), but negatively associated with blood pressure (OR = 0.42, p = 0.017) and blood glucose measurements (OR = 0.48, p = 0.009). These findings highlight the influence of residence on health service utilization among older adults in Hungary. Further comprehensive studies are needed to better understand the health needs of the elderly population and to develop policies aimed at promoting healthy aging in CEE countries. [ABSTRACT FROM AUTHOR]

Gavin Jones’ professional career, from the 1960s to the 2020s, coincided with one of the most important periods of demographic change—the Asian fertility revolution. This article examines how his prolific research offers a unique window into understanding the fertility changes in Asia during the late-twentieth and early-twenty-first century. Across his vast scholarship, Jones documented the fertility change in real time while they were underway, through careful measurement and insightful interpretations of their causes and consequences. As the spread and pace of fertility transitions varied across countries, ethnic communities, geographical regions, and educational groups, he assembled data to measure and analyse patterns and trends. He drew upon multiple theories to explain unexpected patterns. Finally, he documented the emergence of Asia’s ultralow fertility in recent decades. Jones’ mastery of statistical demography combined with his intimate connection with datasets and vast knowledge about the region, produced a truly comprehensive scholarship on Asia’s fertility transitions. [ABSTRACT FROM AUTHOR]

This article highlights the lessons learned from a study of the 2021 Intergenerational Report hosted by the Academy of the Social Sciences in Australia. That study, published in a book, More than Fiscal, (Podger et al., 2023, More than Fiscal, ANU Press), also advises how to improve future IGRs. The article includes a brief assessment of the extent to which the recently published 2023 IGR takes up the improvements suggested. [ABSTRACT FROM AUTHOR]

Neighbourhood plays an increasingly prominent role in the provision of elder care in light of population ageing. Many governments worldwide have committed to improving neighbourhoods to promote ageing in place. This article investigates the association between neighbourhood social conditions and depression among the elderly Hong Kong population ages 60 and older with a focus on neighbourhood elderly services, a modifiable factor with policy implications. Using two waves of data from the Hong Kong Panel Study of Social Dynamics (HKPSSD), the ordinary least squares (OLS) regression estimation reveals that neighbourhood centres aiming to encourage social interaction among the elderly are significantly related to reduced symptoms of depression. The beneficial effects of such facilities are greater among older individuals living in low socioeconomic (SES) neighbourhoods. These results suggest that neighbourhood-based services are effective in enhancing healthy ageing in an ultra-dense Chinese metropolis, and policies should put priority to address social service and facility issues in disadvantaged neighbourhoods. [ABSTRACT FROM AUTHOR]

Population ageing is a global phenomenon, affecting most European countries, including Romania. This is due among other things to high migration, rising life expectancy and a steadily declining birth rate. The consequences of this demographic phenomenon are particularly important because the social and economic effects are long-term. Some of the research in this area has focused on studying the population aged 65 to 74 (young seniors) who may represent a labour resource at a time when many countries are facing an acute shortage of human resources. This study aims to analyse the demographic situation in the EU and Romania through a comparative analysis of the number of seniors in both EU countries and Romania. In more developed countries such as Italy, France, Germany and Finland, the elderly population exceeds 20% of the total population, confirming concerns about demographic ageing. By residence environment, in Romania we have identified a quite obvious delimitation by fields of activity. While in rural areas, agriculture is the predominant activity, the urban population often opts for fields requiring higher education such as education and health. As a result, although challenging, the inclusion of older people in the labour market can reduce labour shortages, increase contributions to the state budget and at the same time contribute to greater social cohesion. [ABSTRACT FROM AUTHOR]

Familial composition has always occupied the center stage in sociological research and is linked with different socio-economic and demographic transitions. This study examines the change in the pattern of one-person (OP) and one-couple-only (OC) households in India for the period 1993–2050. Household-level data was obtained from three rounds of the National Family Health Survey and closely matched with the estimates of the Census. We adopted the spline method for age smoothing, the ordinary least squares regression method for examining the factors affecting OP and OC households, and the logistic curve for making projections. The findings show that during 2015–16, 4% of the households in India were OP households, which figure is expected to become 5.5% (4.9%-5.6%) by 2030 and 6.7% (5%-7%) by 2050. The percentage of OC households was 8% in 2015–16, which will increase to 10.4% (9.2%-10.8%) by 2030 and 12.6% (9.8%-14.2%) by 2050. In 2015–16, the proportion of OP households ranged between 1.54 in Jammu & Kashmir and 8% in Arunachal Pradesh. while that of OC households ranged from 3.3% in Meghalaya to 14.4% in Andhra Pradesh. The demographically advanced state of Kerala is projected to have the highest proportion of OC households in the coming years. One-man households were concentrated in the younger ages, while one-woman households dominated in the older ages. The share of OP households was higher among older persons from rural areas than those from urban areas. The increasing share of OP and OC households among the elderly may accelerate the already-underway processes of feminisation and ruralisation of ageing. The ongoing increase in urbanisation and decline in the Total Fertility Rate (TFR) would lead to an increase in the share of both OP and OC households in India in the future. [ABSTRACT FROM AUTHOR]

The article introduces the tentative concept of deep aging – a label used for a situation when the overall ageing effects of the second demographic transition, due to fertility below replacement level, are topped by the excessive emigration of the fertile contingent (additional loss of active population). Deep ageing thus accelerates population decline. But the loss of fertile contingent may affect the total fertility rates and its apparent rise (TFR). Here, the tempo effect of fertility plays the decisive role. The article first assesses the demographic change in the European macroregions in the period after the fall of the Iron Curtain (1990–2020). It then analyses the changes in the area of former Yugoslavia to assess the extent of population change in the last intercensal period, 2011–2022. Building on the previous research of population loss and migration flows after the break-up of Yugoslavia, the overall population change in the region is being assessed. It is also shown that tempo distortion of fertility rates considerably affects the realistic level of fertility and that approximate completed fertility rates fell less dramatically. Since the migration data are less reliable, the analysis of intercensal change was applied to assess the migration losses across the ex-Yugoslav space. To assess the extent of deep ageing, the intercensal projection of fertile contingent was introduced. The stage of deep ageing is the most pronounced in Croatia and Serbia, especially at the younger fertile group, while the overall loss of fertile population is profound and will certainly affect the further future decrease in population. Similarly difficult demographic situation is in other post-Yugoslav countries, where only Slovenia has not yet slid into the stage of deep ageing.

The growing number of hip replacements associated with an ageing population requires more accurate and efficient methods of planning operations to ensure the success of interventions and minimise the risk of complications. The study aimed to demonstrate how changes in the pelvic angle affect the accurate determination of the centre of rotation of the hip joint. The study used dry pelvic and femoral bones with a 4 mm diameter implanted steel ball in the femoral head for modelling. X-rays were taken using a PLX 140 X-ray machine to record the displacement of the centre of rotation. The study confirmed the hypothesis that a change in the pelvic angle leads to a shift in the centre of rotation of the hip joint. This displacement requires attention during preoperative planning, as it can affect the choice and placement of the endoprosthesis. The study found that a high pelvic angle makes it difficult to fit a hip prosthesis, increasing the risk of prosthesis wear and dislocation. This requires an individualised approach to each patient, the use of special implants and postoperative monitoring. It is necessary to assess the anteversion and inclusion of the prosthesis, adjust the implantation depth and select the appropriate types of prosthesis based on the patient’s anatomy. The use of 3D modelling helps to optimise the placement of the prosthesis. Addressing anatomical features is key to reducing the risk of complications and improving the long-term results of arthroplasty

Abstract Background Universal health coverage means that all people can access essential health services without incurring financial hardship. Even in countries with good service coverage and financial protection, the progress towards universal health coverage may decelerate or be limited with respect to the growing older population. This study investigates the incidence/prevalence, determinants, and consequences of catastrophic health expenditure (CHE) and unmet need for healthcare and assesses the potential heterogeneity between younger (≤ 64 years) and older people (65 years≤). Methods Utilising an annual nationally representative survey of Japanese aged 20 years and over, we estimated the incidence of CHE and unmet need for healthcare using disaggregated estimates by household members’ age (i.e. ≤64 years vs. 65 years≤) between 2004 and 2020. Using a fixed-effects model, we assessed the determinants of CHE and unmet need along with the consequences of CHE. We also assessed the heterogeneity by age. Results Households with older members were more likely to have their healthcare needs met but experienced CHE more so than households without older members. The financial consequences of CHE were heterogeneous by age, suggesting that households with older members responded to CHE by reducing food and social expenditures more so than households without older members reducing expenditure on education. Households without older members experienced an income decline in the year following the occurrence of CHE, while this was not found among households with older members. A U-shaped relationship was observed between age and the probability of experiencing unmet healthcare need. Conclusions Households with older members are more likely to experience CHE with different financial consequences compared to those with younger members. Unmet need for healthcare is more common among younger and older members than among their middle-aged counterparts. Different types and levels of health and financial support need to be incorporated into national health systems and social protection policies to meet the unique needs of individuals and households.

Abstract Background In China, the healthcare financing structure involves multiple parties, including the government, society and individuals. Medicare Fund is an important way for the Government and society to reduce the burden of individual medical costs. However, with the aging of the population, the demand of Medicare Fund is increasing. Therefore, it is necessary to explore the sustainability of the healthcare financing structure in the context of population ageing. Objective The purpose of this paper is to organize the characteristics of population ageing as well as healthcare financing in China. On this basis, it analyzes the impact mechanism of population ageing on healthcare financing and the sustainability of existing healthcare financing. Methods This paper mainly adopts the method of literature research and inductive summarization. Extracting data from Health Statistics Yearbook of China and Labor and Social Security Statistics Yearbook of China. Collected about 60 pieces of relevant literature at home and abroad. Results China has already entered a deeply ageing society. Unlike developed countries in the world, China's population ageing has distinctive feature of ageing before being rich. A healthcare financing scheme established by China, composing of the government, society, and individuals, is reasonable. However, under the pressure of population ageing, China's current healthcare financing scheme will face enormous challenges. Scholars are generally pessimistic about the sustainability of China's healthcare financing scheme. Conclusions Population ageing will increase the expenditure and reduce the income of the Medicare Fund. This will further affect the sustainability of the healthcare financing structure. As a consequence, the state should pay particular attention to this issue and take action to ensure that the Fund continues to operate steadily.

Demography is one of the factors determining and influencing the geopolitical balance of power in international relations. Politicians are the main actors in international relations, but powerful human dynamics are at work behind them. The study of geopolitics describes these dynamics, linked to human and physical geography. In the evolution of great power competition, economic, military and technological factors are taken into account, but the importance of demographic trends, which will play a key role in the struggle for world power, is often underestimated as a political and geopolitical factor. Demography works over long periods of time, i.e., over generations. The aim of this paper is to illustrate the importance of the above theory by looking at the demographic shock that France experienced in the 19th century and the geopolitical resulting consequences. As a result of this demographic shock, France lost its supremacy as the most populous country in Europe and was definitively overtaken by Germany. It is a scenario that can be useful for understanding the evolution of demographic competition in the 21st century, such as that of China versus India. In 2023, China will lose its supremacy as the world's most populous country to India. This will be the first time that China has lost its primacy since the United Nations began tracking global demographic trends in 1950. China, like France in the past, is in danger of never catching up with its demographic disadvantage. History suggests that once a country crosses the threshold of negative population growth, regardless of the differences in national experiences, there is little that its government can do to reverse it.

This paper provides a first assessment of the fiscal and distributional consequences of the ongoing structural changes in the labour markets of EU member states, mostly driven by technological progress and ageing. The Cedefop 2020 Skills forecast (including the effects of COVID-19), population projections and the forecast on pension expenditures depict a scenario of an ageing population, an inverted U-shaped unemployment trend and potentially polarising labour markets in the EU till 2030, the latter mostly driven by a surge in high-skill occupations. We make use of the microsimulation model EUROMOD and reweighting techniques to analyse the fiscal and distributional impacts of these trends under a no-policy-change assumption. The results suggest that the macro trends will increase pressure on government budgets, however, we also show that the current tax-benefit systems have the capacity to counterbalance the increases in income inequality and poverty risks triggered by the expected future labour markets developments.

Abstract Background While informal caregiving is crucial for improving and maintaining health of the elderly, there is limited evidence of its potential effect on caregivers’ wellbeing. Understanding this effect is important for policy makers to design effective long-term care policies. This longitudinal study aims to investigate the impact of informal caregiving on caregivers’ subjective wellbeing in China. Methods Three waves (2016, 2018, 2020) of data from the China Family Panel Studies (CFPS) are constructed for empirical analysis. Ordered logit model is first used to estimate the effect. Fixed effects ordered logit model and mixed effects ordered logit model are further employed to control for the possible bias from unobserved individual heterogeneity. Results Informal caregiving significantly reduces caregivers’ subjective wellbeing and the negative effect is stronger for high-frequency caregivers. Subgroup analysis reveals that informal caregiving imposed greater negative impacts on women, those living in rural areas, being married, working, and living separately from parents. Further analysis of mechanism indicates that decrease in wage income, leisure and sleep time were channels through which informal caregiving affects caregivers’ well-being. Conclusion When policy makers formulate sustainable long-term care policies and home support services, interventions to improve caregivers’ stress-coping skills and ensure their engagement in leisure and social activities could be adopted to mitigate the negative effects on caregivers’ subjective well-being.

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