SUSTAINABLE AFFORDABLE HEALTHCARE
of their population living in rural areas, the worldwide average being 44 per cent, with some countries
having over 90 per cent. This will impact on the treatment of arthritis, as joint replacement is effectively
inaccessible to rural populations, resulting in increasing numbers with severe deforming arthritis. Asia, where a large percentage of the population lives in rural areas, is a good example. By 2020, over 20 per cent of people over 60 years of age in Asia will have arthritis, with 15 per cent having significant symptoms. One third of these will have debilitating disease, equivalent to over 40 million people. The population is ageing
worldwide. This has been predicted for some time (figures 1 and 2) by the United Nations Department of Economic and Social Affairs. They have produced a world census in 2003, updated in 2007, with ongoing predictions to 2050 which show the gravity of the situation. By 2050, the overall world
population will have increased by 270 per cent since 1950. The number of people under 60 years is predicted to increase by 218 per cent; but
the number of over 60-year-olds is predicted to rise by a staggering 856 per cent. The median age in 1950 was 23.6 years and this is predicted to rise to 36.2 years by 2050. The prevalence of osteoarthritis varies between countries; but, due to its irreversible nature, as the population ages so does the prevalence (figure 3).
The growing burden The rise in worldwide obesity is leading to serious health problems. The obesity rate has more than doubled between 1980 and 2008. In 2008, over one in 10 people were classified as obese worldwide (Obese = Body Mass Index >30, Overweight = BMI >25 but <30, BMI = mass(kg)/height2(m2)) – equivalent to half a billion people. With more than 40 million pre-school children overweight, obesity rates are set to rise further.
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