Demographic and social factors

Abstract

The increase in the proportion of people aged over 65 years in the community is not only a phenomenon of Western society but is to be found in Eastern countries as well. What is, perhaps, more significant from the point of view of health care, is that the number of people of over 75 years is rising even more greatly in proportion to the total population. The reasons for these facts in civilized societies are not difficult to understand. In the last 70 years there has been a reduction in the death rates in all age groups under 65 years, most marked in the first year of life. For example, in Great Britain at the time of the 1851 census the death rate in children aged 0–1 year was 153 per thousand live births. The impact of public health measures, such as the Sewage and Sanitation Act and the Smallpox Vaccination Act, at the end of the last century started to reduce the childhood mortality and by 1941 there had been a reduction in the death rate of children 0–1 years to 58 per thousand live births. The current death rate for the same age group is now below 18 per thousand live births. This has meant that a male infant born now is expected to live to the age of 68.8 years and a female to 74.8 years.