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The world is getting older. What now?

Older women and men wait in front of a bank on the outskirts of Dhaka for their monthly old age allowance of US$4.25 from the Bangladesh government. Nearly 1.7 million people over 65 receive this payment. Photo: Contributor/IRIN.Life expectancy in 135 countries studied by the UN Development Programme is now 70 (see related story). However, global life expectancy could be five years higher if five risk factors are addressed:

  • underweight childhood
  • unsafe sex
  • alcohol use
  • lack of safe water
  • sanitation and hygiene and
  • high blood pressure

These are responsible for one quarter of the 60 million deaths that occur annually and are the leading risks for the global burden of disease, according to a WHO report on Global Health Risks (p. v).

However, the leading global causes of death are

  • high blood pressure (responsible for 13% of deaths globally),
  • tobacco use (9%),
  • high blood glu­cose (6%),
  • physical inactivity (6%), and
  • being overweight or obese (5%).

In low-income countries, the leading cause of death is pneumonia, followed by heart disease, diarrhoea, HIV/AIDS and stroke (pp. v, 8). In sub-Saharan Africa, the number of cases of diabetes is projected to double, reaching 24 million by 2030

Depression is the leading global cause of years lost due to disability (p. 8). More than 500 million people in the world are disabled as a consequence of mental, physical or sensory impairment, according to the UN.

Health workers and governments in low-income countries are being forced to confront new risks and rethink old ones. The WHO report stated that, as life expectancy increases, "many low- and middle-income countries now face a growing burden from the modern risks to health, while still fighting an unfinished battle with the traditional risks to health" (p. 3).

That growing burden, combined with the challenges of disability and old age in lower-income countries, not received proportionate media coverage. The story is fundamentally one of equality. As an African, Asian or Latin American Shylock might ask, are they not "subject to the same diseases, healed by the same means?"

Investments made and policies pursued in the coming decades will determine the global toll both "modern" and traditional health risks exact.

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