We’re living longer – but how can we ensure we stay healthy, too? | #elderly | #seniors | #execrise
- Our populations are growing older, but we still have work to do to ensure we stay healthier for longer, too.
- The key is to promote collaboration between different sectors.
- This will generate new possibilities and innovations.
Over the past century, great efforts have been made to improve human longevity. Public health policy and strong healthcare systems have been the most important areas of focus in pursuing this aim, with medical experts together with public authorities and non-profit organizations leading the way.
These great initiatives did improve average life expectancy, first in advanced economies and then in emerging economies. Almost all the world’s countries will experience a super-aged or ultra-super-aged society within the 21st century – and this is a great achievement.
However, once a higher average age was achieved, we found another purpose of longevity; that is, a healthy life expectancy. We can still observe a 10-year gap between life expectancy and healthy life expectancy even in advanced economies (see figure below. Healthy means not only an objective physical condition, but also a subjective level of satisfaction, or happiness. Here, one should pursue a more comprehensive, human-centric approach to realizing a better quality of life – including, of course, medical, social and financial aspects. We must revisit all issues related to human life and find new focus and actions.
As the goal of longevity has evolved from a longer life expectancy to a healthy life expectancy, it now demands comprehensive analysis and a wide range of actions by various stakeholders. No single profession, academia, business or government sector alone can find an effective solution. Rather, new collaboration among different sectors is the key to finding better solutions for individuals and society. We can easily understand this fact through considering our response to COVID-19.
Smarter healthcare with a reduced social burden
Healthcare experts and ordinary people tend to have a positive view of longevity, welcoming improvement to people’s quality of life. On the other hand, economists and businesses may have pessimistic views about the same issue, being wary of less economic power and more social expenditure. However, we can and should find concrete actions to improve both one’s quality of life and economic activities. For example, older people, regardless of age and health status, can continue to work, produce, consume and contribute to society when a flexible and inclusive environment is provided. Active social participation of the elderly will improve their health as well as national or local economic power and social stability.
While taking actions to prevent illness and providing day-to-day support are necessary to improve one’s quality of life and happiness, ordinary consumption in daily life, rather than subsidized public services, may provide some of them in an effective and efficient way. We should be mindful of this approach when we consider our response to COVID-19, where too much social separation of people may lead to disastrous economic and social situations as well as poor quality of life for older people due to a lack of social participation. Collaboration between healthcare experts and economists may uncover smarter healthcare policies with less social burdens.
Towards P4 medicine
P4 medicine (predictive, preventive, personalized and participatory medicine) becomes more important in an ageing society. It requires continuous monitoring, intervention and data analysis throughout people’s lives in communities, schools, workplaces, hospitals, elderly care homes and elsewhere. Here, smart digital solutions such as sensors, wearables and smartphones play a bigger role rather than fixed medical equipment inside hospitals. Business-to-consumer businesses such as retail, transportation and entertainment will join up with healthcare firms, following traditional pharmaceutical and medical equipment companies. Of course, new entrants to this sector will have to learn basic norms, ethics and rules regarding the healthcare business. We can observe lots of remote, non-contact and non-face-to-face healthcare solutions with digital applications – as well as uptake by the business-to-consumer sector – during the COVID-19 crisis, and these may eventually become reliable tools in the move towards P4 medicine.
Resilient healthcare supply chains and logistics
We need resilient supply chains and logistics for medical goods in order to prepare for healthy longevity. However, COVID-19 has revealed that our systems are vulnerable. We experienced and are experiencing shortages of masks, gloves, ventilators, test-kits and various medical goods in many countries. Pharmaceutical and medical equipment companies alone cannot respond to the huge demand for medical goods and manage urgent global procurement. We observed lots of non-medical businesses such as those in the automotive and electronics industries help emergent supply increases, by providing clean rooms, engineers and local and global business networks. We need more collaboration among medical-related and non-related industries to help build more resilient supply chains and logistics. Interestingly, the trend of capital markets towards stakeholder capitalism, environmental, social and governance (ESG) concerns and the Sustainable Development Goals are helping to drive such collaboration.
A multi-stakeholder approach
A multi-stakeholder approach, in which experts with different background come together to pursue the same goal, can generate ideas and opportunities for all. It can work well in finding directions and solutions in healthy longevity, as we observed at the first-ever global Silver Economy Forum, which was held in Helsinki last year. Traditional business and medical networks in each country have different norms, incentives and opportunities to collaborate, which tends to frustrate cooperation. Social security systems and pharmaceutical regulations do not allow agile development in general. In short, medical doctors feel comfortable with medical representatives from large firms, but tend not to trust young digital start-ups. Elderly caregivers trust local volunteers but have less opportunities to share issues with foreign companies. A multi-stakeholder approach is necessary to rethink these traditional networks and find new opportunities for collaboration.
While it is obvious that the World Economic Forum’s Global Future Councils has a multi-stakeholder approach, we can also see this in various other multi-stakeholder approaches towards healthy longevity. Economic ministries in Japan, Finland, Singapore, the Netherlands and China are engaging with longevity issues, together with health ministries and traditional social welfare communities. I had chances to observe start-up pitches and cross-sectoral innovation initiatives for healthcare in London, Singapore, Tokyo, Israel, Helsinki, Bangalore, Tsingtao, California and Boston, among other places. Concrete global initiatives for dementia, fragility fractures, work-style reforms and financial longevity have advanced. The Global Coalition on Ageing (GCOA) is an example of working across sectors, disciplines and generations for healthier longevity. The Davos Alzheimer’s Collaborative (DAC) is an example of innovative platform focusing on specific but impactful issues such as dementia. Healthcare Innovation Hub (InnoHub) is an example of open platform to facilitate new collaboration beyond sectors and boundaries. COVID-19 accelerates the necessity of smarter healthcare solutions, including digital healthcare applications and innovative solutions to new challenges. In this regard, we should encourage more multi-stakeholder approaches towards a healthily ageing society.
The application of “precision medicine” to save and improve lives relies on good-quality, easily-accessible data on everything from our DNA to lifestyle and environmental factors. The opposite to a one-size-fits-all healthcare system, it has vast, untapped potential to transform the treatment and prediction of rare diseases—and disease in general.
But there is no global governance framework for such data and no common data portal. This is a problem that contributes to the premature deaths of hundreds of millions of rare-disease patients worldwide.
The World Economic Forum’s Breaking Barriers to Health Data Governance initiative is focused on creating, testing and growing a framework to support effective and responsible access – across borders – to sensitive health data for the treatment and diagnosis of rare diseases.
The data will be shared via a “federated data system”: a decentralized approach that allows different institutions to access each other’s data without that data ever leaving the organization it originated from. This is done via an application programming interface and strikes a balance between simply pooling data (posing security concerns) and limiting access completely.
The project is a collaboration between entities in the UK (Genomics England), Australia (Australian Genomics Health Alliance), Canada (Genomics4RD), and the US (Intermountain Healthcare).