Chronic Illness, Aging Population & Ageism Policy Impacts
Chronic Illness, Aging Population & Ageism Policy Impacts
Armstrong (2014): Chronic Illness Reframed
Armstrong (2014) presents a revisionist account of chronic illness. He challenges the belief that the rise of chronic illness is solely due to acute diseases and an aging population. The construct of chronic illness results from medicine expanding. Natural decline is associated with aging.
CSA Public Policy Centre (2024): Aging Canada 2040
CSA Public Policy Centre (2024) — Aging Canada 2040 — reports that the aging population will reach 22.7 percent by 2040. The dependency ratio increased from 13 to 29 in 2022. Increased life expectancy and declining fertility are straining tax revenues. Healthcare costs represent roughly 45% of provincial/territorial healthcare spending and the system fails to provide more preventative measures to address social determinants of health (income, education, housing, food access). The system operates primarily as sickness treatment rather than prevention.
Key points from CSA Public Policy Centre (2024):
- Requires improvements and transformations in long-term care (LTC).
- Investments in senior support must be balanced against burdens placed on younger generations (increased taxation).
- Prioritize equity, including intergenerational equity.
- Address social isolation, recognized as a global public health concern.
- Chronic noncommunicable diseases (NCDs), e.g., heart disease, cancer, diabetes, are now the greatest cause of lost health and life worldwide.
Dominguez et al. (2024): Dietary Patterns
Dominguez et al. (2024) note that dietary patterns are a modifiable determinant of health.
Martin (2025): Defining Successful Aging
Martin (2025) defines successful aging with criteria including low probability of disease; only 11% of a cohort reached age 85 and were considered successful. Successful aging includes high cognitive and physical functional capacity and active engagement with life.
Martin references Baltes’ Selective Optimization with Compensation (SOC), which views successful aging as a developmental process of adapting to losses by emphasizing components such as selection, optimization, and compensation. A stress-theory based model emphasizes proactive adaptations and corrective adaptations.
Martin notes that definitions of successful aging often lack focus on objective health status alongside subjective well-being, and neglect issues such as successful dying and living with disabilities.
NIA (2017): Why Population Aging Matters
NIA (2017) explains why population aging matters and why we must change our systems to shift burden from future generations. Unsustainability is a consequence of delayed policy action.
Raymond (2013): Participation, Disability, and Exclusion
Raymond (2013) examines participation in policy discourse and documents exclusion of seniors with disabilities. He links participation with usefulness, productivity, and good health, which reinforces polarization between activity and impairment and excludes seniors who do not meet ideal standards for being active and independent.
Raymond emphasizes that ageism has real, measurable effects on health and well-being, causing social exclusion and reduced self-esteem. Older adults may avoid seeking care, underreport symptoms, and accept poor treatment as normal aging. Geriatric care is underfunded.
Sutter (2022): Ageism During COVID-19
Sutter (2022) documents ageism toward older adults during COVID-19, concerning resource use and descriptive stereotypes. Younger adults were significantly more likely to hold ageist consumption stereotypes, reflecting intergenerational conflict, beliefs in group hierarchy, competition, and opposition to social distancing measures.
Syed (2017): Social Isolation in Chinese Communities
Syed (2017) highlights social isolation among Chinese older adults: language barriers, lack of culturally appropriate services, and strained family relationships contribute to isolation. Lack of positive social support is often complicated by intergenerational tensions arising from migration stress, financial dependency on children, and conflicting traditional versus Western values. Women are most at risk of loneliness, influenced by gender roles.
Wang (2019): Older Immigrants’ Access to Primary Health Care
Wang (2019) reports that older immigrants face challenges including health literacy, language, cultural differences, structural inequalities, and poverty. Low-income older immigrants are disadvantaged because the universal system does not cover “medically necessary” services like optometry, dentistry, or extended mental health services, forcing them to pay out-of-pocket or go without care.
Wang (2024): Social Networks, Dementia, and Caregiving
Wang (2024) examines social network types and dementia. Stronger family-dominant networks are associated with lower caregiver burden and greater positive aspects of caregiving. Barriers to seeking support include socio-geographic isolation, reciprocal debt anxiety, and a notable lack of formal support from healthcare providers.
Wang notes gendered caregiving patterns: women are more often caregivers, while men face new social ties after retirement. Limited formal support from healthcare providers tends to focus on medication and diagnosis, leaving unmet needs for respite, training, and psychological support.