Georgsson, M. (November, 2018). An Aging Population, Larger Chronic Disease Burden, and Reliance on Digital Self-Management Tools Require Contributions from Nurse Informaticians. Online Journal of Nursing Informatics (OJNI), 22(3). Available at http://www.himss.org/ojni
Many nations are facing challenges today due to the ongoing and increasing demographic shift in age among their populations. The United Nations reported that the world’s population of elderly who are 60 years old will double and those who are 80 years old will triple during the next 30 years at the same time as other age groups will decrease in number (Department of Economic and Social Affairs Population Division, 2017). In the United States, the U.S. Census Bureau’s national population projection reports that older adults currently make up about 15% of the population, and by the year 2060 is estimated to amount to 23.5% (U.S. Census Bureau,2017). There are similar numbers reported for Europe, where the group of 65-year old or older make up 19% of the population and is predicted to amount to 29% of the total population by the year 2080 (European Commission, 2017). For Sweden, my country of origin, the figures for those 65 years old or older amount to 19% of the population and is expected to increase to 25% by the year 2070 (World Health Organization, n. d.).
The demographic shift is not only a challenge in itself, but also because the development of chronic disease is often associated with and more common among older age groups. These groups will need considerable support from society in the future due to that they have to live with and manage chronic conditions over the long term, often for the rest of their lives (World Health Organization, n. d.). The most common of the chronic diseases are cardiovascular disease, diabetes, cancer and chronic respiratory disease, Together, they account for 41 million deaths in the world every year, and this number is increasing (World Health Organization, n. d.). The Centers for Disease Control and Prevention (CDC) estimated that about 50% of all adults in the US have one or two chronic diseases and that 25% have two or more (Centers for Disease Control and Prevention, 2017). In Europe, about 50 million adults have multiple chronic diseases (Rijken et al., 2013), In Sweden, 44% of the population have one chronic disease and 25% two or more (The Swedish Agency for Health and Care Services Analysis, 2014).
What these amounts to is a tremendous challenge for national and international health care systems. Apart from the societal challenge with the rising number of elderly, and an increased number having chronic disease, there are also challenges related to the projected shortage of health care professionals. The WHO estimates that the global shortage of health care professionals will amount to 12.9 million by the year 2035 due to an aging workforce and retirement at the same time without enough new young health professionals to replace them (World Health Organization, 2013). In the U.S., the number of physicians and nurses are expected to amount to a shortage of 624 000 persons by the year 2025 (CSC.com, 2013), and in Sweden the corresponding shortage in health care professionals with a university degree are expected to be 150,000 by the year 2030 (Statistiska centralbyrån, 2012; Statistics Sweden, 2017). This will occur at the same time that the need for hospital beds is expected to increase (Sveriges kommuner och landsting and Socialstyrelsen, 2007).
One way to meet these challenges is to make use of new information and communication technologies and to offer easily accessible digital health solutions for older adults with chronic disease as a support in their self-care. Mobile health solutions are one such example. Through these solutions, the demand for regular health and primary care can be relieved and mobile health solutions can assist in supporting the patients between care visits. The possibilities and availability of these mobile solutions for elderly who suffer from chronic disease have never been greater. Today 40% of the older population in the U.S. own a smartphone – double the amount compared to the year 2013 (Pew Research Center, 2018). Similar numbers are present in Sweden where 52% of the elderly population own a smartphone (The Internet Foundation in Sweden, 2018). It is clear that the technology is there and ready, and a large number of elderly people have it readily available to them. Nurses and nurse informaticians therefore can contribute in many important ways to the design, development and implementation of these solutions. By making use of the important skills of nurse informaticians within these areas, there are increased possibilities that these digital health solutions can be implemented to achieve the favorable outcomes needed for both care providers and care receivers to combat the abovementioned future societal challenges.
Mattias Georgsson, PhD, MSc, RN, has a Master of science degree in nursing and master degrees in health informatics and interaction design. He completed his Ph.D. in applied health technology in the spring of 2018. His research interests involve eHealth and mHealth solutions to support chronically ill patients with a special focus on usability.
CSC.com (2013). U.S. health care workforce shortages: Caregivers. Retrieved from http://www.csc.com/health_services/insights/48705-u_s_healthcare_workforce_shortages_caregivers
Department of Economic and Social Affairs Population Division. United Nations. (2017). World Population Ageing 2017. New York, NY: United Nations.
European Commission. (2017). Eurostat regional yearbook 2017. Luxembourg: Publications Office of the European Union.
Centers for Disease Control and Prevention. (2017). Chronic diseases: The leading causes of death and disability in the United States. Retreived from https://www.cdc.gov/chronicdisease/overview/index.htm.
Pew Research Center. (2018). Tech adoption climbs among older adults. Pew Research Center.
Rijken, M. et al. (2013). ICARE4EU: Improving care for people with multiple chronic conditions in Europe. Retrieved from http://www.icare4eu.org/pdf/icare4eu-improving.pdf
Statistiska centralbyrån (SCB). (2012). Trends and forecasts 2012 - population, education and labour market in Sweden. Retrieved from http://www.scb.se/UF0515
Statistics Sweden. (2017). Trends and forecasts 2017 - population, education and labour market in Sweden. Stockholm: Statistics Sweden, Forecast Institute.
Statistics Sweden. (2018). The future population of Sweden 2018–2070. Stockholm: Statistics Sweden.
Sveriges kommuner och landsting and Socialstyrelsen. (2007). Patienter i sluten vård 2006. Stockholm: Sveriges kommuner och landsting i samarbete med Socialstyrelsen.,116(9). s.
The Internet Foundation in Sweden (IIS). (2018). Swedes and the internet 2017. Stockholm: The Internet Foundation in Sweden (IIS).
The Swedish Agency for Health and Care Services Analysis. (2014). VIPs in health care?: About challenges in health care for persons with chronic illness. Stockholm: The Swedish Agency for Health and Care Services Analysis.
The U.S. Census Bureau.(2017) National Population Projections. Retrieved from https://www.census.gov/programs-surveys/popproj.html.
World Health Organization (WHO). (n. d.). Noncommunicable diseases fact sheet. Retrieved from http://www.who.int/en/news-room/fact-sheets/detail/noncommunicable-diseases/
World Health Organization (WHO). (2013). A universal truth: No health without a workforce. Third Global Forum on Human Resources for Health Report. Geneva: World Health Organization (WHO).