China’s population is aging faster than that of any other country, partly due to major healthcare improvements, while longevity in Hong Kong is now the highest in the world. Similarly, old-age dependency ratios are increasing across Europe. Norman Yao and Somesh Chandra, AXA specialists in Hong Kong and European markets respectively, describe the evolution in elderly care in these regions.

This article was first published in the AXA Research Fund report Silver Age: Ageing Better.

You are both working in very different geographical areas. What are the main changes in societal aging?

Somesh Chandra, Chief Health Officer European Markets, AXA: Life expectancy is increasing throughout Europe, which isn’t front-page news. However, the retirement age remains around 60, while birth rates are declining. And because the greatest healthcare costs occur in our later years this means the financial burden on the state and individuals is increasing.

Norman Yao, Chief Risk Officer and Fraud Control, AXA China Region: Life expectancy in Hong Kong has definitely changed over the years. Particularly for women who are now at the top of global longevity rankings. In mainland China, health conditions continue to improve as the country undergoes rapid economic growth, accompanied by increasing health awareness, food quality, medical care, etc.

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How is the rising number of elderly people impacting social structures and healthcare systems?

NY: The traditional family concept is still very much maintained in modern Chinese society. It continues the custom of families supporting their elderly relatives. Families may provide this care themselves, or by paying for care workers or home care services. In Hong Kong, the need for healthcare and elderly home care services is changing, along with the need for longer term financially sustainable solutions to provide the necessary funding. The Hong Kong government is unlikely to take on a much larger burden in terms of retirement and healthcare provision, so the private sector will play a more critical role. Demand for Long-Term Care insurance is expected to increase in the future to support the growing nonagenarian population.

SC: In Europe, the need for healthcare is growing. First, new innovations are increasing the quality of health outcomes, thus driving further investment; second, awareness on health is increasing in today’s digital world, driving higher consumption; we also observe a shift from public to private care. In the meantime, the number of very elderly hospitalized patients is growing rapidly. Most of these hospitalizations relate to acute infectious diseases and heart-related conditions. This is putting a lot of pressure on public healthcare and on insurance premiums as healthcare becomes more expensive and more people need treatment or care.

The concept of successful aging means living longer, but also being in good health and remaining independent. What steps would you say are necessary to achieve it?

NY: Health awareness is a decisive factor in successful aging. Today’s young people are much more health-aware than previous generations; for example, many use devices to track exercise and well-being. Insurers are even starting to offer discounts on insurance premiums to people who lead healthier lifestyles.

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SC: Successful aging requires the right care at the right time and at the right place. To achieve this, a focus must be placed on preventive care, which includes taking the relevant vaccinations at the right time and undergoing regular health check-ups.

What is the role of insurance?

NY: Due to the increasing strain on public hospitals, most of Hong Kong’s working population have their own medical insurance or group coverage from their employers. In Mainland China some insurers are branching out of their core business areas by operating elderly care homes or day care facilities. Entire retirement towns have been built to provide accommodation as well as medical treatment facilities.

SC: At AXA we are helping to address the issue by increasing awareness and helping people keep fit through well-managed lifestyles with insurance products that integrate data collected from connected devices. This can reduce non-communicable diseases, which account for 80% of healthcare costs. We are also creating savings-led products to help customers save in their younger years, giving them access to quality healthcare when they are older. Research in this field is vital for spreading awareness and identifying cost-effective and efficient care solutions.

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