How the elderly will be healthier in the future

We are living longer. The population aged 60 and over is steadily increasing. The proportion of very old people, those over 90, is increasing the most. This is, of course, good news, but an increasing proportion of the population needing care in the same way as today poses real challenges for healthcare. 

Broadening concepts and working preventively 

One of the solutions, which is already in place in many places around the world, is to allocate more resources to preventive care. 

“Sweden is already a high-tax country, but healthcare costs will continue to increase,” says Sarah Thunberg, Head of the Health and Life Science business and innovation area at RISE. “In addition, there will be a shortage of labour in the health sector throughout the Western world in the coming years. If we are to cope with a future where an increasing part of the population is old, we must find ways to keep a larger proportion out of the traditional healthcare system.” 

For obvious reasons, it is difficult for municipalities and regions to work long-term and preventively, while at the same time having to contend with immediate challenges.  

“But really, it’s a no brainer – a lot of research shows the great benefit of preventive work,” says Aslak Felin, Senior Project Manager in Preventive Health at RISE. 

Behaviours a big part of health 

Felin provides some basic figures: Of Sweden’s total public health budget, 27% is invested in clinical care and only 1% in lifestyles. But when we look at health outcomes, i.e. the effect of our combined efforts, healthcare makes up only 8% while health behaviours constitute a third. 

So how do we bring about a system change with a focus on preventive solutions and behaviours instead of just reacting when people get sick? 

“For the regions, this approach poses challenges,” says Thunberg. “For example, procuring normal healthcare is obvious, but how can a buyer in a region buy ‘20 fewer broken hip joints in the future?’”  

Technology will be an important part of the solution. Digitalisation, automation, and AI. As well as working methodology and streamlining.  

But: 

“Basically, we need to find ways to take better care of ourselves,” asserts Felin. “We need to see people holistically and identify them before there is a decline in their various health indicators and eating habits, and they find it more difficult to change their lifestyle.”  

Preventive models being tested 

Projects are being run in several areas to test different preventive models. To return to the example of procurement, different models are being tested where the operator receives outcome-based compensation at a later date. Another example is the provision of public health advisors, who seek out individuals and constructively discuss health issues. 

“There is good evidence for what affects individuals: the social environment, the individual’s own perception of whether they are healthy, and lastly, the perception of self-determination,” says Felin. “Someone else nagging you doesn’t work; you have to feel it is your choice, and that you make certain choices because you want to.” 

Marie-Louise Möllerberg, researcher at RISE, has been involved in the Preventive Child Health project: 

“We work with method development and measure experiences and self-assessments to assure the quality of various initiatives. To put it bluntly, prevention must begin before you are born. We saw that you need to start with the mother’s diet and well-being, because it affects the baby’s ability to avoid bad lifestyle choices. School can do some things, such as serving fruit or a healthy breakfast, but this is extremely complex and requires the involvement of many different actors.” 

Secure coordination of data 

Technology will be part of the solution. 

“Sweden embraced digitalisation early, after which we have developed and evolved the systems,” says Möllerberg. “Any initiative to securely coordinate data would help, such as when several regions merge into the same system. There is also all the private health data you submit via smartwatches and other devices. Together, this can provide an overview of you as an individual and help healthcare to think holistically, assess risks, and anticipate problems that may arise.” 

She adds: 

“We support startups and regions in various projects, and we participate in discussions at national level with the Swedish Association of Local Authorities and Regions, the Public Health Agency of Sweden, and the Swedish National Board of Health and Welfare to make major changes so that we ultimately know what we are deciding on.”