Date: 12 December 2024
In the her latest blog to mark UHC Day, ILC’s Research and Policy Officer, Anna Van Renen, challenges common myths about ageing and highlights the benefits of investing in longevity for all economies, health systems and all members of society.
On 12 December 2012, the United Nations adopted a resolution that urged every country to prioritise universal health coverage (UHC) for all – that is, for all people to have access to the full range of quality health services they need, when and where they need them, without financial hardship. This includes everything from essential health services to health promotion to prevention, treatment, rehabilitation and palliative care.
UHC is a core part of the Sustainable Development Goals. But despite global commitments, the world is far from on-track to achieve UHC by 2030. Exponential improvement has been made over the last twenty years, particularly in low- and middle-income countries (LMICs), but recently, progress has flattened. One of the reasons is that policymakers are not thinking of long lives and the impact of demographic change when it comes to UHC. And indeed, older groups are often excluded from these policy discussions. Without the voices of people of all ages, we will not achieve UHC for all.
Myths and misconceptions about ageing perpetuate barriers to inclusive healthcare. As we celebrate UHC Day, it’s time to challenge some of the persistent myths that hinder progress toward inclusive health systems. Here are some misconceptions about ageing and UHC, and the truths that debunk them.
Myth: Older adults are a burden on health systems
The reality: Older adults are contributors, not burdens – and UHC systems must recognise their value.
There is a false notion that older adults consume more healthcare resources than they contribute. Previous research at the ILC has shown that increasing preventative health spend by just 0.1 percentage points can unlock a 9% increase in annual spending by people aged 60+, and an additional 10 hours of volunteering. Older adults also play vital roles in caregiving, particularly grandparental care in LMICs. Investing in age-inclusive health systems under UHC benefits not just older adults but entire communities and can ensure future healthier older populations.
Investing in preparing for ageing populations means people will remain active and engaged members of society for longer, resulting in better health outcomes and improved economic growth. Older adults’ societal and economic contributions are significant, and UHC systems that include longevity will support older adults to continue contributing for longer.
Myth: Ageing populations take resources away from younger generations
The reality: If UHC adequately considers and includes people of ages, such as age-inclusive health services and support systems, everyone will benefit, and intergenerational support will strengthen.
There is no zero-sum game between older and younger generations. Investing in UHC that considers longevity and age-related diseases means every person can stay healthy and independent for longer. Older adults can continue contributing to society and economies, and dependency on younger family members for care is reduced. When health systems focus on prevention, particularly the prevention of age-related diseases, this benefits everyone: it helps older people today and will support future generations who may face these age-related challenges.
UHC also offers financial protection, ensuring access to affordable medications, and supporting community-based care for ageing populations. For instance, in many LMICs, older adults often lack pensions or social security safety nets, making out-of-pocket healthcare costs catastrophic for households. Subsidised health services for older adults not only protect them but also free up family resources that might otherwise be spent on healthcare. This enables younger friends or family members, who might otherwise be caring for older adults, to pursue work opportunities or invest in education, entrepreneurship, or housing.
Myth: Population ageing is only a problem in high-income countries
The reality: Population ageing is a global phenomenon, and every country must adapt to meet the challenge.
By 2050, there will be 2.1 billion people aged over 60 worldwide, and 80% will reside in LMICs. These countries face unique challenges in providing UHC, including limited infrastructure and financial resources. But longevity isn’t a problem, it’s an opportunity. Community-based health programmes often found in African countries have improved healthcare outcomes by providing easily accessible care. Similarly, Thailand’s Village Health Volunteer programme empowers local health workers to provide preventive and palliative care for older adults.
Scaling these models to help achieve UHC can deliver sustainable, accessible care, particularly for age-related diseases. Ignoring longevity within UHC planning could leave millions of people without essential health services resulting in significant health and economic costs.
Myth: Longevity is too expensive for LMICs to address
The reality: Addressing the universal health needs of the whole population is an investment, not a cost.
Failing to address and prepare for longevity would be far more expensive in the long term than investing in it now. For instance, immunisation, screening programmes, and health checks are known to be both cost-effective and cost-saving and investing just $1 in adult immunisations generates $19 in economic returns. Yet LMICs often face challenges related to under-resourced health infrastructure and limited hospital capacity. Integrating ageing into UHC means that complications from preventable diseases can be avoided, improving overall population health and reducing strain on health systems.
Adapting healthcare systems to better support ageing populations does require upfront investment, which can be particularly challenging for LMICs with lower financial capacity and competing priorities. Here, donor funding and international aid can play a critical role in supporting LMICs. By earmarking funding specifically for initiatives that integrate longevity into UHC, such as preventive care, age-inclusive health services, and workforce training, LMICs can begin to address the unique health needs of ageing populations while building sustainable health systems.
Far from being a financial burden, longevity represents an opportunity for LMICs to build resilient health systems that serve everyone. UHC provides the framework for achieving this by ensuring health services are affordable, accessible, and effective for everyone, including older adults.
What happens next?
This UHC Day, we are calling for longevity to be viewed as an opportunity that must be included in UHC agendas. We will be launching our new report – Universal Health Coverage in Low- and Middle-Income Countries – on Tuesday 18 February 2025 at a webinar featuring a presentation of our research and insights from expert speakers. Register here to attend.
This blog and wider project programme are kindly supported by Amgen.
Anna Van Renen
Anna Van Renen
Research and Policy Officer