Aging Issues in the United States and Japan (National Bureau of Economic Research Conference Report)

Health Care Issues in the United States and Japan
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These changes included adjusting the height of shelves, adding carpeting, and attaching magnifying lenses to store shelves to help customers read the fine print labels [ 27 ]. Probably no place is this more evident than in brand marketing and packaging. Contrary to popular opinion, technology use is common among the older population, with older adults outpacing younger cohorts when it comes to adopting new technology and online media [ 29 ].

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Product packaging and labeling is another area where the needs of the older consumer may not be very well understood or met. In short, older adults as consumers are often viewed as frail or dependent and thus judged by the faculties and functions they no longer have, instead of by the assets and capabilities they actually possess.

But older adults are much more of an asset than a burden to society [ 31 ]. Some of the innovations to support the development of new approaches in marketing, technology, and packaging that commercial businesses could learn from to help meet the needs of older adults include:. Modern Aging provides a four-month training program to entrepreneurs of all ages and backgrounds who wish to create new businesses to serve the needs of older adults [ 32 ].

The suit could help marketers better understand the needs of older adults. Taking a different approach to beauty. It is predicted that aging Latin Americans will seek more natural and lasting beauty products and services, including exercise, dieting, and spa treatments to reverse or slow the effects of aging [ 35 ].

In Asia, portraying aging in a more positive light has been identified as an important marketing opportunity. One stand-out company who has found success is Shiseido, which has developed beauty products for those over age 50, has included older adults in its advertising, and has packaging with large font-size print [ 36 ].

Not surprisingly, food and nutrition are important areas of focus for older adults. Older adults are more likely to be: 1 health conscious, eat more fruits and vegetables and use nutrition supplements; 2 taste conscious, drawn to strong flavors; 3 package conscious, pay attention to packaging designs and ease of use; 4 value conscious, be concerned about nutritional value more than source of ingredients; and 5 convenience conscious, enjoy prepared foods, and eating out [ 37 ]. A decrease in mental acuity, increase in disability, development and progression of chronic disease and other conditions, problems chewing and swallowing, depression and isolation, decreased appetite, sensory losses including sight, smell, taste, and other factors can all make it more difficult for older adults to shop, prepare, eat, and enjoy food.

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At the same time, nutrient needs are altered with aging, such as decreased energy needs and increased protein needs. Further, in the newest UN Sustainable Development Goals, aging and nutrition are relevant to many of the goals; older adult nutrition is specifically addressed in the target for Goal 2 Target 2. However, to date UN agencies have developed very few--if any—-international nutrition programs specifically targeting older adults and their unique nutritional needs.

Ultimately, changing health and nutrition needs can put many older adults around the globe at risk for malnutrition. Yet, malnutrition is rarely adequately treated in hospitalized older adults [ 42 ]. Malnutrition can lead to increased disability and poor health outcomes. Globally, studies have repeatedly found direct relations between the degree of malnutrition and increased lengths of stay, treatment costs, and hospital re-admission rates [ 44 ].

A study investigating the burden-of-illness of disease-associated malnutrition in 15 diseases in China reported an annual economic burden of U. Several innovative ways nutrition interventions are being tailored to meet the unique nutritional needs of older adults that could be bring opportunities for commercial businesses include:. The research and development of specialized oral nutritional supplements with high levels of protein and specialized functional ingredients which have been shown to help older adults rebuild muscle for strength and energy [ 47 ].

The expansion of meal services, including the regular delivery of ingredients and recipes for in-home preparation or the regular delivery of daily hot meals or frozen meals, including meals tailored to specific medical conditions [ 48 ]. The innovation of 3D printed foods to create smooth and textured foods for older adults with difficulty chewing and swallowing. For example, work by researchers at the Commonwealth Scientific Industrial Research Organization in Brisbane, Australia is focusing on the role of 3D printed foods for dysphagia [ 49 ] and was recently featured at an Asia-Pacific 3D food printing conference in Melbourne, Australia [ 50 ].

The research and development of electric cups and spoons which can create the impression of taste saltiness, sourness, sweetness and boost the flavor of bland foods. For example, engineers at the University of Singapore are developing a device to enhance the flavor of food and restore taste to those who may have lost it because of old age or disease treatment [ 51 ].

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The health diversity seen in older adults is not random. Across APEC countries, the incidence of noncommunicable diseases NCDs including ischaemic heart disease, stroke, cancer, and diabetes has continued to increase as populations age.

NCDs represent a significant economic and social burden; therefore, reducing the disability and complications that result from NCDs is central to helping limit healthcare costs. The UN Agenda for Sustainable Development recognizes NCDs as a major challenge for sustainable development [ 53 ] and WHO has developed a global monitoring framework to enable global tracking of progress in preventing and controlling NCDs and their risk factors [ 54 ]. NCDs are impacted in part by four modifiable risk factors--poor diet, tobacco use, insufficient physical activity, and harmful alcohol use--and thus programs are needed to help target reducing these risk factors.

Dementia is also a growing societal and health burden and the risk for dementia increases with age. In , WHO released a report to help governments, policymakers, and other stakeholders address the impact of dementia as an increasing threat to global health. Healthcare innovations can help improve the sustainability of healthcare provision for older adults. Development of digital healthcare technologies, such as wearable health trackers that can potentially improve patient outcomes through increased treatment adherence and timely access to care.

Application of Uber-style collaborative consumption business models for home nursing and caregiving to help decrease workforce shortages in long-term care. Development of robotic assistance to help improve the mobility of older adults, assist care workers and monitor older adults. Expanding applications and advancement in mobile phone technology, such as augmented reality to help increase engagement in health promotion [ 58 ]. The report defines six main market segments and these may have application for commercial businesses development:.

Health and safety awareness: health vital alerts, diet and nutrition, medication management, personal safety monitoring, telehealth. Care coordination: care planning, care professional engagement, records and benefits management, recovery support. Daily essential activities: meals, home and personal care, home repair, delivery, transportation services. Caregiver quality of life: respite and backup care, social support, health and wellness, financial and job security. Social well-being: digital inclusion, life enrichment and empowerment, community networking, life companions.

Transition support: home retrofit services, long-term care insurance planning and provider referral, legal assistance, hospice and funeral planning [ 20 ]. Globally, life expectancy is increasing by about five hours a day, which translates into three additional months each year [ 59 ]. However, disability-free life expectancy is not increasing any faster than life expectancy, meaning there will continue to be a large and growing number of older adults living with chronic diseases and disabilities. Thus, systemic innovation is needed to mobilize community support, effectively use new technologies, and optimize environments to best support older adults [ 31 ].

Similarly, the APEC Workshop organizers identified that systemic innovation is important as governments build policy frameworks to support commercial business expansion and develop public-private partnerships focused on population aging. Because the effects of aging are particularly significant for healthcare, there continues to be increased interest in sustainable policy reforms in the health and nutrition sectors, which could provide opportunities for commercial business expansion.

One focus area is prevention. For developed economies, strengthen existing policies and public health interventions with the latest evidence to support lifestyle changes and risk factor prevention, improved health outcomes, decreased disease burden. As identified earlier in this paper, NCDs represent a primary area of importance for healthcare, and diet and nutrition are fundamental in the prevention and treatment of NCDs, particularly for older adults.

A number of countries already include nutrition as a part of their aging-related policies. In , HelpAge International commissioned a mapping of policy and legislation on aging and older people in 26 countries across the Asia and Pacific region. They reported that in 10 of 18 countries with national plans on aging, the nutrition needs of older people were included. While nutrition education and information are certainly important, preventing and treating malnutrition among older people requires a multi-sector approach.

Recently, a multi-disciplinary collaboration in the U. The specific Blueprint goals are to:. Advance public health efforts to improve nutrition quality of care for older adults [ 61 ]. The Blueprint can be used as an effective framework on a global scale to set national goals and incentives for addressing quality malnutrition care through developing policies that advance early screening, assessment, diagnosis, and intervention for older adults in hospitals and in the community.

Commercial businesses could then consider for instance, expansion opportunities into home and community-based services by aligning with national goals and incentives to keep older adults healthy and well-nourished. One example is provided below. Tackling complex health problems such as malnutrition involves cross-sector alignment with government, nonprofit and philanthropic organizations, and corporate partners to actively coordinate actions, share lessons learned, and work toward the same goal with the same measures of success.

Abbott is a global healthcare company, dedicated to helping people live their best lives through the power of health. The company has a history of successful partnerships in its core businesses of nutrition, diagnostics, and medical devices and works to help achieve common health goals through innovative solutions. Commercial businesses can be successful in innovating on these opportunities when they better understand the market dynamics and the spectrum of older adults as consumers and view them more as assets rather than as burdens to society.

The opportunities of longer life are impacted by health and a significant part of the diversity in older age is caused by the cumulative impact of health inequities across the life cycle. People are living longer but there is also increasing prevalence of NCDs. Innovations in personalized medicine and older adults taking more active roles in healthcare decisions to live their fullest lives underscore the importance of positive health behaviors like good nutrition and active lifestyles.

Improved nutrition can help preserve cognitive function, delay dependency and frailty, and thus underpin healthy aging. Healthy aging also requires a sustained commitment and action from country leaders to formulate evidence-based polices—like systematic nutrition screening and intervention—and healthcare workforce training and education that can strengthen and support an active aging population. Collective impact will be achieved through the commitment of key stakeholders from different sectors coming together to promote healthy aging. Governments should consider engaging commercial businesses to help set sustainable policies that can advance products for older adults.

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Pavone M. How marketers can get the rich elderly to spend. News Desk. FoodBev Media. Innovation itself is being both outsourced and sent offshore. In , China had fewer than 50 research centers that were managed by multinational corporations; by mid, there were more than The three trends discussed already—the opening of emerging markets, innovation-based development, and the global innovation enterprise—have created a new global labor market, with far-reaching implications. In the last few years, the phenomenon of sending service work overseas has garnered a great deal of attention in developed nations.

The movement of US manufacturing jobs offshore through the s and s had major consequences for domestic employment in those sectors, although many argue that productivity increases were responsible for most of the reported. Council on Competitiveness. Washington, DC: Council on Competitiveness, New York: Farrar, Straus, and Giroux, But new technologies and business processes are opening an increasing number of services to global competition, from technical support to the reading of x-rays to stock research to the preparation of income taxes and even to the ordering of hamburgers at drive-through windows.

There is a US company that uses a receptionist in Pakistan to welcome visitors to its office in Washington via flat-screen television. Forrester Research estimates that 3. Many experts point out that the number of jobs lost to offshoring is small compared with the regular monthly churning of jobs in the US economy.

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Oxford University Press. Correspondence to Mary Beth Arensberg. List of current sovereign monarchs List of current constituent monarchs. Accepts responsibility for the accuracy of the submitted abstract. It is intended to coincide with the Bon Festival vacation time, giving Japanese people an opportunity to appreciate Japan's mountains. Finally, governments should set national and local goals to incentivize commercial business development and investment in public-private partnerships to improve quality of care, promote healthy aging, and impact outcomes for noncommunicable diseases, ultimately benefitting population health for Asia-Pacific Economic Cooperation APEC countries. The duration difference of exercise or sports activities by presence of others among middle-aged adults in Japan.

McKinsey, for example, estimates that about , jobs are likely to be sent overseas each year, a small fraction of the total annual job churn. In , the private sector created more than 30 million jobs and lost about 29 million; the net gain was 1. American Electronics Association. Washington Post , May 10, Forrester Research. Near-Term Growth of Offshoring Accelerating. Bardhan and C. The New Wave of Outsourcing. Fisher Center Research Reports Information Technology Association of America.

US Bureau of Labor Statistics. Once again, this suggests that the US economy will continue to create new jobs at a constant rate, an assumption that in turn depends on our continued development of new technologies and training of workers for the jobs of the 21st century. Economists and others actively debate whether outsourcing or, more generally, free trade with low-wage countries with rapidly improving innovation capacities will help or hurt the US economy in the long term.

The enormous and growing supply of labor in the developing world is but one side of a global demographic transformation. The other side is the aging populations of developed nations. The working-age population is already shrinking in Italy and Japan, and it will begin to decline in the United States, the United Kingdom, and Canada by the s.

As Populations Age, a Chance for Younger Nations

More than 70 million US baby boomers will retire by , but only 40 million new workers will enter the workforce. Population dynamics have major economic implications. Bhagwati, A. Panagariya, and T. Gomory and W. Global Trade and Conflicting National Interests. Thirty-five years from now, the ratio will be 7 to Here in the United States, the ratio of adults aged 60 and over to working-age adults aged is expected to increase from.

Those trends have profound implications for US leadership in science and technology:. The US science and engineering workforce is aging while the supply of new scientists and engineers who are US citizens is decreasing. Immigration will continue to be critical to filling our science and engineering needs. The rapidly increasing costs of caring for the aging population will further strain federal and state budgets and add to the expense columns of industries with large pension and healthcare obligations. Aging populations and rising healthcare costs will drive demand for innovative and cost-effective medical treatments.

Taken together, those trends indicate a significant shift in the global competitive environment. The importance of leadership in science and technology will intensify. As companies come to see innovation as the key to revenue growth and profitability, as nations come to see innovation as the key to economic growth and a rising standard of living, and as the planet faces new challenges that can be solved only through science and technology, the ability to innovate will be perhaps the most important factor in the success or failure of any organization or nation.

Central Intelligence Agency. New York: Columbia University Press. Jackson and N. The Aging Vulnerability Index. Innovate America. What is likely to happen if we do not change our current approach to science and technology? The US lead is so large that it is unlikely that any other nation would broadly overtake us in the next decade or so.

Over the last year or so, a virtual flood of books and articles has appeared expressing concern about the future of US competitiveness. National Intelligence Council. Center for Strategic and International Studies. Some of the most prominent publications include A. Innovation in a Globalized World. Northampton, MA: E. Elgar, ; and R. The US share of world scientific output will continue to decline. The share of US patents granted to US inventors is already declining, although the absolute number of patents to US inventors continues to increase.

The number of scientific papers published by US researchers reached a plateau in If current trends continue, publications from the Asia Pacific region could outstrip those from the United States within the next 6 or 7 years. National Science Board. Table The US share of scientists and engineers will continue to decline. Other nations will have larger numbers of students receiving undergraduate degrees in science and engineering.

In , more than 25 countries had a higher percentage of year-olds with degrees in science and engineering than did the United States. The number of new doctorates in science and engineering peaked in the United States in By , China will produce more science and engineering doctorates than the United States does.

International students and workers will make up an increasing share of those holding US science and engineering degrees and will fill more of our workforce. Our ability to attract the best international researchers will continue to decline. From to , 1, international students enrolled in US science and engineering graduate programs.

In each of the 3 years before that, the number had risen by more than 10, National Science Foundation. Appendix Table Survey of Earned Doctorates, NSF Ratio of PhDs Granted. In the early s, there were more science and engineering students from China, South Korea, and Taiwan studying at US universities than there were graduates in those disciplines at home.

By the mids, the number attending US universities began to decline and the number studying in Asia increased significantly. The United States still leads the world in many areas of science and technology, and it continues to increase spending and output. But our share of world output is declining, largely because other nations are increasing production faster than we are, although they are starting from a much lower base. Moreover, the United States will continue to lead the world in other areas critical to innovation—capital markets, entrepreneurship, and workforce flexibility—although here as well our relative lead will shrink as other nations improve their own systems.

The biggest concern is that our competitive advantage, our success in global markets, our economic growth, and our standard of living all depend on maintaining a leading position in science, technology, and innovation. As that lead shrinks, we risk losing the advantages on which our economy depends. If these trends continue, there are several likely consequences:.

The United States will cease to be the largest market for many high-technology goods, and the US share of high-technology exports will continue to decline. Multinational corporations US-based and foreign will increase their investment and hiring more rapidly overseas than they will here.

The industries and jobs that depend on high-technology exports and foreign investment will suffer. The trade deficit will continue to increase, adding to the possibility of inflation and higher interest rates. Salaries for scientists, engineers, and technical workers will fall because of competition from lower-wage foreign workforces, and broader salary pressures could be exhibited across other occupations. Growth in per capita income will slow despite our relatively high standard of living.

Population Aging and the Generational Economy

Poverty rates and income inequality, already more pronounced here than in other industrialized nations, could increase. The slow erosion of those investments might not have immediate consequences for economic growth and job creation, but the long-term effect is predictable and would be severe.

Once lost, the lead could take years to recover, if indeed it could be recovered. Like a supertanker, the US economy does not turn on a dime, and if it goes off course it could be very difficult to head back in the right direction. Given that they already have a commanding lead in many key sectors, it is likely that US multinational corporations will continue to succeed in the global marketplace.

What it means to be a US company is likely to change as all multinationals continue to globalize their operations and ownership. As China and other developing nations become larger markets for many products and services, and as they maintain their cost advantages, US companies will increasingly invest there, hire there, design there, and produce there. Scenario 1 is the most likely case if current trends in government policies continue both here and in other nations and if corporate strategies remain as they are today.

Two other scenarios represent departures from recent history. As such, they are more speculative and less detailed. In Scenario 1, the United States continues to invest enough to maintain current trends in science and technology education and performance, leading to a slow decline in competitiveness. Scenario 2 considers what might happen if the commitment to science and technology were to lessen. Although that would run counter to our national history, several factors might lead to such an outcome:.

If growth continues. Higher US effective corporate tax rates discourage companies from investing in new facilities and research in the United States. Excessive regulation of research institutions reduces the amount of money available for actual research. Those possibilities would exacerbate and accelerate the trends noted in Scenario The availability of scientists and engineers could drop precipitously if foreign students and workers stop coming in large numbers, either because immigration restrictions make it more difficult or because better opportunities elsewhere reduce the incentives to work in the United States.

US venture capitalists begin to place their funds abroad, searching for higher returns. Short-term cuts in funding for specific fields could lead to a rapid decline in the number of students in those disciplines, which could take decades to reverse. If they were faced with a lack of qualified workers, multinational corporations might accelerate their overseas hiring, building the capabilities of other nations while the US innovation system atrophies. Multinationals from China, India, and other developing nations, building on success in their domestic markets and on supplies of talented, low-cost scientists and engineers, could begin to dominate global markets, while US-based multinationals that still have a large percentage of their employees in the United States begin to fail, affecting jobs and the broader economy.

Many economists argue that such an imbalance is unsustainable in the long term. As innovation and investment move overseas, domestic job creation and wage growth could stall, lowering the overall standard of living in the United States. The rapid pace of technological change and the increasing mobility of capital knowledge and talent mean that our current lead in science and technology could evaporate more quickly than is generally recognized if we fail to support it.

The consequences would be enormous, and once lost, our lead would be difficult to regain. The relative competitive lead enjoyed by the United States will almost certainly shrink as other nations rapidly improve their science and technology capacity. That means greater challenges for the United States, but it also presents an opportunity to raise living standards and improve quality of life around the world and to create a safer world. For that reason, the success of other nations need not imply the failure of the United States.

But it does require that the United States maintain and extend its capacity to generate value as part of a global innovation system. If we increase our commitment to leadership in science and technology, there are several likely results:. Although the US share of total scientific output continues to decline, the United States maintains leadership across key areas. The US education system sets the standard for quality and innovation, giving graduates a competitive edge over the larger number of lower wage scientists and engineers trained in the developing world.

Our universities and national laboratories act as centers for regional innovation, attracting and anchoring investment from around the world.