Nursing Outlook
Volume 57, Issue 4 , Page 183, July 2009

Letter to the Editor

  • Zenobia C.Y. Chan, RN, PhD

      Affiliations

    • Assistant Professor, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
    • ,
  • W.F. Lai, BS, is a PhD Candidate

      Affiliations

    • Department of Chemistry, Faculty of Science, University of Hong Kong, Hong Kong, China

Article Outline

 

To the editor:

Nurses should be aware of the economy's impact on older people's health. The financial crisis, which has been simmering for over a year due to extreme over-leveraging and toxic debts in giant investment banks in the US, has been inundating the global economies since September 2008. As far as “vulnerable populations” are concerned, the foremost thing in the public mind is the working and/or investing communities, with little attention paid to the senior population.

Due to the prevalent financial reliance (eg, on pensions or family members) and lack of stable incomes in the senior population, aged people have more difficulty recovering from their financial loss compared to those in the working population. Even if seniors have not been involved in making investments, their financial status may still be compromised by economic hardships experienced by the breadwinners on whom they are relying. As projected by the United Nations' International Labor Organization, 210 million people worldwide may become unemployed by the end of 2009. This change in the social employment pattern not only deteriorates the personal finances of the individuals, but also the elderly members relying on them financially. Furthermore, due to a higher prevalence of chronic disease,1 some elderly people may face the dilemma of reducing medical expenditures or seeking medical treatments. Such possibility was revealed by Yang et al's earlier study2 in which the following data collected during the severe economic recession in Korea in the 1990s was analyzed: (1) urban household income-expenditure survey data, (2) national health insurance claims data, and (3) public health center surveys. Similar situations in healthcare utilization was also observed in Indonesia in 1997–1998 during the East Asian economic crisis.3 In addition to the financial constraints, psychologically some old people may also feel devalued because of financial dependence on others and their perceived powerlessness in confrontation with the ongoing predicament.4

Settling the above hardships in the elderly population is not a light task, and we suggest that adjustments in social security provisions pertaining to the aged should be considered. This may include downward adjustment of social security lines for the elderly and simplification of the application assessment process for social assistance. Such measures may partially alleviate the possible financial constraints of elderly people and reduce the potential poverty-driven reduction of medical expenditures in the senior population. However, governmental support, community development, and public awareness of the negative consequences of the financial crisis are not enough. Nurses should consider the above in the course of caring for and exploring potential resources for our older patients.

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References 

  1. Naughton C, Bennett K, Feely J. Prevalence of chronic disease in the elderly based on a national pharmacy claims database. Age Ageing. 2006;35:633–636
  2. Yang BM, Prescott N, Bae EY. The impact of economic crisis on health-care consumption in Korea. Health Policy Plan. 2001;16:372–385
  3. Waters H, Saadah F, Pradhan M. The impact of the 1997-98 East Asian economic crisis on health and health care in Indonesia. Health Policy Plan. 2003;18:172–181
  4. Fassino S, Leombruni P, Abbate-Daga G, Brustolin A, Rovera GG, Fabris F. Quality of life in dependent older adults living at home. Arch Gerontol Geriatr. 2002;35:9–20

PII: S0029-6554(09)00042-6

doi:10.1016/j.outlook.2009.03.003

Nursing Outlook
Volume 57, Issue 4 , Page 183, July 2009

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