People are living longer across the OECD, but many spend a significant portion of their lives beyond age 60 in poor health, with chronic conditions, functional limitations, and complex care needs. This burdens older adults and their families, as well as healthcare and long-term care systems, which are expected to grow as populations continue to age.
Healthy Ageing
Although people are living longer, they are not always in good health. As populations in OECD countries are ageing rapidly, the impact and cost of long-term care will grow sharply, with more years of life being spent in poor health. Increasing healthy life years is feasible and has significant benefits for older people, their caregivers and health systems, but it requires targeted preventive action and health systems that are better adapted to the needs of ageing populations.
Key links
Key messages
Engaging in physical activity, maintaining a balanced diet, and having regular vaccinations and medical check-ups early on in life enables people to live longer and healthier lives. Despite significant financial and health benefits, prevention currently accounts for only a small share of the health spending of OECD countries, leaving large untapped potential.
Services like adult day care, community and advanced practice nurses, or innovative living arrangements can be cost-effective ways to allow people to stay home for longer, even with severe care needs. However, health systems in many countries are designed around institutional care, making alternatives hard to access or requiring large out-of-pocket payments.
Context
Slowdown in health improvement
While life expectancy at age 60 has increased by several years since 2000 in most OECD countries, healthy life expectancy has often not kept pace, leading to a growing number of years spent in poor health. This is especially driven by inequalities: On average, women live 5.1 years longer than men across the OECD, but they also spend more years in ill health and experience worse health outcomes. Socioeconomically disadvantaged people have both shorter overall and healthy life expectancies than their better-off counterparts, and the gaps are widening. Shrinking the gaps between total and healthy life expectancy and those between different population groups is key to sustainably managing ageing populations.
Proven benefits of prevention spending
Prevention currently makes up less than 5% of total health spending across the OECD. However, even modest increases in prevention budgets can lead to measurable health improvements. For example, increasing prevention spending by 10% is associated with a 0.9% decrease in the share of people with chronic conditions after five years. Preventive measures like health literacy campaigns, incentives for healthier lifestyles and free and easily accessible vaccinations and check-ups can therefore be highly cost-effective. Additionally, while an early start is desirable, maintaining healthy behaviours in later life still offers significant benefits.
Enhancing health through day care
Day care is an alternative approach to long-term care with proven significant benefits, but it currently accounts for a small share of long-term care in the OECD. Barriers include insufficient supply, complex eligibility requirements, lack of awareness, and high costs for recipients. However, many countries are working to expand day care and other innovative solutions which support ageing in place, improve quality of life and health outcomes and offer respite to informal caregivers. Projections suggest that a 1% increase in spending on home and community-based long-term care could result in a 0.5% reduction in overall long-term care expenditures, as these approaches can prevent and delay hospital and nursing home admissions.
