Looking back can sometimes
show the way forward. An example is Hong Kong's mortality statistics
for the last 10 years and the implications for health care. The top 10 causes
of death remained the same in 2013 as they were in 2003, except for changes in
the order. But the number of deaths attributed to them rose by 18 per cent,
from 31,101 in 2003 to 36,552 in 2013, compared with a rise of 5 per cent in
the population to 7.25 million. The discrepancy is not explained by more deaths
from other causes. It results from a demographic phenomenon of which economists
and policy advisers have been warning us - ageing of the population.
The percentage increase in deaths
from the top 10 causes was actually in line with an increase in the elderly
population - people over 65 - of 19 per cent from 818,800 to 978,000, as
average life expectancy increased by five years.
Cancer remained the biggest
killer, accounting for 13,538 deaths in 2013, an increase of 2,000-odd over
2003. The figure would have been much higher but for earlier diagnoses and
better and more targeted therapies. But the number that really sticks out is
for dementia - most commonly Alzheimer's disease. As a cause of death it
leapfrogged diabetes mellitus and septicaemia in rising from 10th to eighth, or
nearly fourfold to 1,000 from 256. And that does not include death from
complications. For example, deaths from pneumonia, a common immediate cause of
death among dementia patients, rose by nearly 3,000 over the decade to 6,722,
displacing heart disease as the second highest cause. Dementia-related
conditions have displaced diabetes among the five biggest non-communicable
causes of death in Hong Kong.
Globally the number of dementia
patients is expected to double from 36 million in 2011 to 72 million in the
early 2030s, according to London-based Alzheimer's Disease International. Few
countries have kept up with the demand that places on medical and nursing care.
Hong Kong is no exception. Care of a dementia victim can be financially and
psychologically stressful for families. Experts say the one in 10 people who
will get dementia in their 70s rises to three in 10 in their 80s. As it is now
common for people to live into their 80s, every extended family should expect
to experience dementia. The latest mortality statistics ought to remind the
Hong Kong government of the need for a long-term strategy. Present proposals
for health care reform
do not specifically address policy and financing options.
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