Original from Chelsea98.com Hui Zhou Million Dragon Great Health
According to the traditional United Nations standard: When an area over 60 years old reaches 10% of the total population, (new standard) 65-year olds account for 7% of the total population, that is, the area is regarded as entering an aging society. From 2015 to 2050, the proportion of the global population over the age of 60 will nearly double, from 900 million people to 2 billion in 2050, when the 80% elderly will live in low- and middle-income countries.
Population aging has become one of the most important social trends in the 21st century, affecting almost all social fields including labor and financial markets, demand for goods and services such as housing, transportation, and social security, family structure, and intergenerational relationships. This article briefly analyzes and contrasts the current situation of the elderly in China, Europe, America and Canada.
1. China's pension status
In China, there have always been sayings such as "supporting the elderly" and "respecting one's parents". These are the traditional virtues of the Chinese nation and have been propagated for thousands of years. But with the progress of modernization, aging and chronic diseases have begun to threaten the Chinese nation, which has a population of 1.4 billion.
A communiqu issued by the National Bureau of Statistics in 2017 showed that in 2016, there were 230 million people over 60 years old in China, accounting for 16.7% of the total population. The characteristics of China's aging society have been very significant. According to a report by the China Foundation for the Development of Aging, by 2020, the elderly population will reach 248 million, and the aging level will reach 17.17%. It is estimated that by 2050, the proportion of people over 60 years old will reach 31%.
The annual cost of a middle-level pension is about RMB 55,000.
1, China Pension Service
Judging from the current situation of China's elderly care institutions, public elderly care institutions set up by the government are responsible for some elderly people who have no support for the elderly, and such nursing homes also undertake paid elderly care services for some elderly people who do not meet the conditions for free elderly care. The nursing homes funded and managed by the government basically meet the needs of the “three nos” elderly in urban areas and the “five guarantee households” in rural areas.
With the increase in the number of elderly people in China, the market demand for elderly care institutions has become stronger. Some elderly people who do not meet the conditions provided by the government for the elderly, in order to better spend their old age, choose commercially operated elderly care institutions at their own expense, and some elderly people ask a nanny to take care of them at home. However, due to the lack of a complete legal system and regulatory agencies to regulate the elderly care institutions and the elderly care intermediary service market, incidents of infringements on the rights and interests of the elderly have occurred frequently, and the serious ones have been suspected of criminal offenses.
2, China's pension system
China's current social endowment insurance system can be divided into three parts: urban enterprise employee endowment insurance, government and public institutions endowment insurance, and rural endowment insurance according to population types. The original social pension insurance system in China was the urban pension insurance system. The old-age insurance system for the personnel of state agencies and institutions was separated from the old-age insurance system for urban employees. After that, it went through a process of merger and separation in the process of system reform.
On July 13, 2018, the International Symposium on China's Pension System was held in Beijing. It is reported that the size of China's pension empty accounts is approximately 1.3 trillion. In 2004, the figure was 740 billion. Compared with Latin American countries, China's system is still relatively imperfect. The reform of the Latin American pension insurance system has solved the cost problem of the transformation of the pension insurance system by means of subscription coupons, but China has not been able to solve this problem. At present, urban employees in China pay pensions based on 8% of their wages and establish individual accumulation accounts. Employers pay pensions based on total employee wages of 20%, and the government establishes a basic pension pooling account.
China's pension insurance system mainly consists of social pension insurance, enterprise annuities and personal commercial pension insurance. The basic old-age insurance consists of three components: old-age pension for employees of enterprises and public institutions (the so-called "social insurance"), new-type rural old-age pension and urban residents' old-age pension. It is the core part of the national pension security system. As far as the current state of pensions in China is concerned, the coverage and scope of social security are relatively narrow, while the level of coverage of urban residents' pension insurance is relatively low and has not yet been fully popularized. It needs the active and effective supplement of commercial pension insurance. However, the types of commercial pension insurance are very single and the design structure is not reasonable enough to meet the needs of consumers of different levels, especially low-income consumers.
3, Problems in China’s pension system:
(1) The government-led elderly care services are inadequate, and the development of civilian nutrition institutions is insufficient. At present, government-led elderly care services generally can only provide basic elderly care security. However, due to the high requirements of infrastructure construction in the elderly care service industry, the initial investment required is huge, the responsibility is high, the risk is high, and the profit rate is relatively low. As a result, the development of civilian nutrition and elderly institutions is insufficient, and private capital has a wait-and-see and hesitant attitude towards the elderly care industry, which causes the supply of elderly care services to be unable to meet the huge market demand.
(2) The problem of difficult pensions in rural areas is outstanding. For a long time, the pension for Chinese residents has been divided into urban employee pension and rural pension. Among them, the old-age care of urban employees mainly depends on pension insurance funds, while the elderly in rural areas mainly depend on their children. In addition to the government-led "five guarantee households", most of the rural elderly depend on their children for support. Since the reform and opening up, rural labor has shifted to cities. Whether it is migrant workers or settled in cities, the proportion of bringing their parents to live in cities is relatively low. The rural left-behind elderly and empty-nest families account for a large proportion, making the rural elderly care problem more prominent. In recent years, with the rapid progress of my country's economic development, we are exploring the establishment of a universal pension system covering the elderly in urban and rural areas. The new universal old-age insurance system has incorporated the rural elderly into the old-age system, but it will take time for the rural old-age service system to have insufficient resources and uneven distribution. Solving the problem of elderly care services in rural areas is one of the key links in responding to the aging of the population and accelerating the construction of the elderly care service system in the new era. The problem of rural elderly care is also a bottleneck restricting the rapid and efficient development of my country's elderly care service industry.
(3) There is a lack of senior care workers and professional skills are not up to standard. Judging from the current status of employment, there is a considerable gap in pension practitioners, and the loss of existing pension practitioners is quite serious. Among them, the problem of disabled and semi-disabled elderly pension practitioners is even more serious. According to surveys, among all domestic service items, elderly care, especially for disabled elderly care, is often resisted by domestic workers due to factors such as job responsibilities and risks. The shortage of elderly care professionals and the overall low quality of nursing skills have become one of the bottlenecks restricting the healthy development of China's elderly care industry.
Second, the current situation of elderly care in Europe and America
The increase in the proportion of the elderly population calls for more general social welfare. The booming economic situation provides the impetus for this, plus the long-existing legal basis-starting from the enactment of the German Pension Insurance Act in 1911, to 1958, almost all Western European countries have completed the legislative work of the endowment insurance system, and European and American countries have been at the forefront of the world in terms of endowment insurance. The U.S. pension insurance system began with the Social Security Act of 1935. Since 1940, the U.S. federal government began to pay pensions, spending 35 million U.S. dollars in that year; in 1950, this expenditure increased to 961 million U.S. dollars; in 1960, Soared to 11.2 billion US dollars. In 20 years, this expenditure has increased by more than 300 times! Therefore, European and American countries have always been regarded as welfare states, which is also an important reason for many Chinese emigrating overseas.
For middle-level European and American pensions, the monthly cost is about $1500 – $6000 US dollars, depending on the type of service and time required, or $38/hour.
2, Look at the status quo
The 2020 new crown epidemic is a major test for the pension systems in Europe and the United States. On August 13, 2020, the latest statistics released by the World Health Organization showed that the number of confirmed cases of new crowns worldwide exceeded 20.2 million (on September 8, it exceeded 27.5 million). This huge number reflects the severity of the epidemic and the difficulty of fighting the epidemic.
In European and American countries, nursing homes where the elderly gather have become "severe disaster areas."
According to the Associated Press, on May 1, local time, a nursing home in New York City reported that 98 people had died from the new crown virus. However, as of that day, the United States officially counted only 13 deaths in the nursing home. The New York House of Representatives asked for an investigation. In fact, only about one-third of the 15,000 nursing homes in the United States can be tested for the virus at any time. Within two months, the cumulative number of deaths due to the new coronavirus infection has exceeded 11,000!
Public data shows that there have been 2,000 nursing homes in the UK with the new crown epidemic. This figure is relatively conservative. BBC statistics show that among the 210 nursing home care management agencies surveyed, 159 still have not yet received the virus test.
According to the “Guardian” report on April 13, a report published by the London School of Economics and Political Science in the United Kingdom showed that according to statistics from European countries, nearly half of the deaths from new coronary pneumonia in Europe came from nursing homes, accounting for 42% to 57% of the total deaths. According to a report by Deutsche Welle, as the new coronavirus spreads within nursing homes, the government predicts that the country’s mortality rate will continue to rise. As of April 7, a total of 1,607 elderly patients in Germany had died of new coronary pneumonia, with an average age of 80 years.
According to CNN, in a nursing home in Milan, more than one-third of the elderly died of the new coronavirus within one month. Experts say that Italy's high urbanization population density and large elderly population may be responsible for the country's higher mortality rate. Old people who were supposed to enjoy a peaceful old age are facing the dual threat of death and loneliness.
On the one hand, the pension institutions dominated by capital are independent of each other and lack unified management. During the epidemic, they are independent, with lagging statistics and lack of control. On the other hand, the already insufficient manpower and equipment are overwhelmed by the epidemic. The market has abandoned nursing homes, and European and American governments have also forgotten or even abandoned them. The original order has been disrupted and the drawbacks brought about by marketization have detonated a "time bomb". In the face of the chaos, since mid-April, European and American countries have successively introduced remedial measures to strengthen the prevention and control of the epidemic in nursing homes. In nursing homes in Europe and the United States, including Japan, the problem of elder abuse in nursing facilities is generally very serious.
Why does a large-scale epidemic break out in nursing homes?
According to the US "Atlantic Monthly" report, first of all, the elderly are more susceptible to virus infection no matter where they are. Robyn Gershon, clinical professor of epidemiology at New York University’s School of Global Public Health, said, “As people grow older, people’s immune systems are no longer what they did when they were young. Older people are more likely to develop chronic diseases such as diabetes, heart disease or lungs. This also makes them more susceptible to infection during the outbreak.”
Secondly, when the elderly live together, they can easily spread diseases. Skin diseases and influenza occur frequently in nursing homes. Apart from the new crown pneumonia epidemic, approximately 380,000 people living in nursing homes in the United States die from staphylococcal infections and diarrhoeal diseases each year.
In addition, the staff of nursing homes are also the “source of infection” of the virus. These caregivers need to maintain close contact with the elderly and help them dress, bathe and eat. However, under normal circumstances, caregivers do not have a certain degree of protection. They are not only at risk of contracting the new crown virus, but also at the risk of spreading the virus to the elderly. If a worker is infected with the new coronavirus, they may continue to work because the symptoms are mild, but if the virus is transmitted to the elderly, it may cause their death.
3, Pension systems in major European and American countries
(1) American pension system ((The current status of elderly care in Canada is specifically introduced below)
American scholars often refer to the American pension system as the "three legged stool" (three legged stool). The so-called "three legs", among which, "social pension insurance" is the first leg (first pillar), which is led by the government and enforced by the social security benefit system (Social Security Benefit), which is the "spirit of American pensions." "Pillar" or "Last Line of Defense"; "Enterprise Annuity" is the second leg (second pillar), which is a supplementary pension insurance system for enterprises led by enterprises and jointly funded by employers and employees, namely the enterprise annuity plan (401K plan). The "material basis" or "loading subject" for Americans to provide for the elderly; the traditional "individual retirement savings and insurance investment" with the family as the main body of responsibility is the third leg (the third pillar). The personal pension plan (IRA plan) of the savings endowment insurance system is an indispensable "important supplement" for the American pension.
On April 22, 2019, the U.S. Department of the Treasury released the "2019 Social Security and Medicare Trustee Report" that the consolidated trust fund in the social security plan will be exhausted in 2035, and the social security plan will not be able to pay all benefits on schedule. . In addition to the emergency of basic social security funds, the personal pension savings situation in the United States is not optimistic. In this context, the "SECURE Act" ("Setting Every Community Up for Retirement Enhancement Act of 2019") was passed with an overwhelming advantage. The official website of the U.S. Congress shows that the bill has been transferred to the Senate, and there are still two steps before it becomes a law, passed by the Senate and signed by the President. In view of the fact that the Senate had proposed a similar plan earlier but has not yet voted, some American analysts believe that the Senate will pass the "SECURE Act" after adjusting and unifying the two major plans. Some American media reported that the new retirement bill is expected to land around 2020.
(2) European countries
In fact, from the perspective of the development of the global pension system, almost all mainstream countries have experienced a journey from a single public pension model to the shared responsibility of governments, enterprises and individuals. Among them, western countries started the exploration and reform of establishing a multi-level, market-oriented pension mechanism earlier. Take the United Kingdom as an example. In 1980, it established and perfected the third-pillar personal pension system with a wide range of plans and flexible tax incentives. In recent years, it has shown a trend of merging with the second-pillar; the Australian Parliament passed relevant legislation in 1993 It has established its third-pillar super annuity regulatory system.
The Reserve Bank of France Global Asset Management Group released the "2017 Global Elderly Index Report" and pointed out that the countries with the best retirement environment are still mainly located in Europe. Among the top ten countries in the index, the top three are Norway, Switzerland and Iceland. The others are Sweden, New Zealand, Australia, Germany, Denmark, Netherlands and Luxembourg. The report started in 2012 and took 43 countries around the world as the research object. The calculation of the index is based on four major criteria, namely health services, material welfare, pension finance and quality of life. Based on these four standards, each country gets a comprehensive ratio index between 1% and 100%, which represents the living standards of the country’s retired elderly.
The best elderly care environment in Nordic countries: Norway continued to top the list last year, with the highest composite index of 86%. In the specific ranking of the four major indicators, Norway ranks first in material welfare, third in health services and quality of life, and ninth in pension finance. This is mainly due to the impact of higher tax rates and inflation. In the 2016 pension index report, Switzerland also ranked second overall. In terms of specific material benefits, Switzerland ranked third, pension finance ranked fourth, and health services ranked eighth. Compared with 2016, Iceland's status has improved significantly, mainly reflected in the improvement of material welfare, ranking second in the world and seventh in quality of life.
Third, the current situation of elderly care in Canada
1, Canada's pension institution
Canada has a large area and a small population. The pension policy and insurance system are becoming more and more perfect, the resource allocation is relatively reasonable, and the pension model is also diversified. The general can be divided into three categories: long-term nursing homes, private nursing homes and home care.
Due to lower labor costs, Canada’s pension costs are lower than those in Europe and America, and the types of services are similar.
Stay in a long-term care home(Long-term care homes) are basically those who have completely lost their ability to take care of themselves. Operating a long-term care home in Canada requires a license issued by the provincial government. The Ministry of Health of the Government will allocate funds based on the number of license beds obtained by each nursing home and the difficulty of nursing care for the elderly. The government allocates funds to cover all nursing expenses, food, entertainment, part or all of accommodation and other miscellaneous expenses. Housing is generally divided into standard rooms (2-4 people/room), double rooms and single rooms. Doctors, nurses, nurses and other professionals provide 24-hour service. The provincial government has set up a special health assessment agency called Community Care Access Centre (CCAC). This institution conducts a health care assessment of each applicant based on the elderly’s application and doctor’s recommendation. Only the elderly who meet the requirements can be admitted to this long-term care home.
Private nursing home(Retirement Homes) is mainly suitable for the elderly with a higher degree of self-care. Except for part of the medical care expenses borne by the government, other expenses shall be borne by themselves. According to the different nursing services provided and the needs of the elderly, private nursing homes are divided into several forms: Seniors Apartment, Independent Living, Assisted Living, and Memory Care. Some nursing homes only provide one form of service, and some nursing homes integrate different care methods, but they are scattered on different floors.
Generally, private nursing homes provide 24-hour nurse services and doctors' outpatient treatment services. Each room has its own bathroom with shower and is equipped with an emergency call system (nursing call bell system). Private nursing homes are equipped with gymnasiums, playrooms, small libraries, private meeting rooms and private restaurants for family reunion and dining. Some high-end nursing homes also have swimming pools. The structure is roughly divided into nursing department, entertainment program department, catering department, environmental management department, marketing department, dean and office.
Home care(Home care) is the old-age care method chosen by most elderly people in Canada. Services include: nursing (bath, dressing, blood pressure measurement, blood glucose monitoring...), companionship, cooking, cleaning, shopping assistance, etc. The service staff and nurses who come to the door are professionally trained. Home care is also within the scope of CCAC's assessment, and the government that meets the assessment provides service fee subsidies, which are calculated by time.
In Canada, whether long-term care homes, private nursing homes or home care, practitioners must be professionally trained and hold a practising certificate. For example, nurses must graduate from college and hold a registered nurse certificate and a registered practice nurse certificate. Have a PSW certificate, a chef must have a chef certification, a dietitian must have a dietitian certification, and a physiotherapist must have a professional physiotherapist qualification certificate. All practitioners, whether they are managers or front-line service personnel, must pass a non-criminal record review.
The laws and regulations related to the elderly care industry in Canada are very sound. Each province and region has promulgated bills for nursing homes and their services, covering various aspects such as nursing home qualification requirements, planning and construction standards, medical care standards, nursing staff training, elderly rights, nutrition matching, nursing home supervision and violation punishment regulations Manage pension institutions. The government will also hire inspectors to conduct random inspections from time to time, and those who fail to pass will be ordered to change or close business.
2, The disadvantages of Canadian pension
The Ontario Ministry of Long-Term Care website states that every nursing home is subject to an annual inspection, which includes interviews by inspectors with residents, family members and staff of the elderly’s home, as well as nursing care services for the elderly. Direct observation. In April 2020, the Canadian Broadcasting Corporation CBC reported that Ontario has substantially reduced annual detailed inspections of residential and care institutions for the elderly since 2018. In 2019, of the 626 elderly care institutions in the province, the provincial government only inspected 9 of them. A quality check was carried out.
CBC has investigated the data of Ontario elderly homes for the past 6 years, including reports of abuse incidents in each nursing home, and compared the incidents with the beds in the nursing homes, and calculated the abuse rate. The data is simply shocking: 2011 to 2016 During the year, the abuse rate in Mississauga-Halton and Toronto Central increased by nearly 801 TP1T. At the same time, the rate of abuse among elderly people living in nursing homes has also increased by 51%, and the rate in Central Toronto has increased by 129%.
In the 2020 COVID-19 pandemic, the disaster in Canada’s nursing homes was too serious and has reached the point where ordinary nursing staff could not handle it. Therefore, the Canadian military finally played the role of the People’s Army to protect the people. At the request of local governments, they were assigned by the federal government to send military personnel to various nursing homes and long-term care centers to take care of the elderly instead of nursing workers. As a result, after taking over long-term care centers and nursing homes for a period of time, the Canadian military issued a rare statement stating that after the military entered, the status quo in the institutions being taken over was frightening.
According to two documents sent by the military to the provincial governments of Ontario and Quebec this week, soldiers were sent to elderly care institutions with a high rate of COVID-19 infection, and found that the current situation in the institutions was horrible (this is the original term used by people). Although there is no physical abuse of the elderly, from the ignorance of the elderly to the absenteeism of employees, to the theft of personal protective equipment and drugs, the chaos is astounding. The most serious situation occurred in Ontario, where more than 300 Canadian armed forces personnel were sent to five elderly care institutions that were hit hard by the epidemic. The report from the military to the Ontario government clearly stated that there were cockroaches everywhere in the house, the living environment was messy, the leftover food was not cleaned up, the food was allowed to grow and mold, and the old people’s diapers were not dirty. Replace it in time, the air is full of odor.
A poll conducted by the well-known Angus Reed Institute in Canada of 1,777 adults in the country found that Canadians with 66% believe that long-term care should be carried out in accordance with the Canadian Health Act. Elderly care institutions have become the hardest hit by the epidemic, of course, because of the fragility of the elderly. But more important is the problems of the elderly care institutions themselves, including the lack of staff training, many of them are underpaid and move back and forth between different institutions; many elderly living quarters are blocked, and the chronic shortage of nursing and medical tools.
3, Canada’s pension benefits
Canada’s old-age security system is relatively sound. Although there are many types of services in the old-age system, the levels are very clear and can be roughly divided into the following four pillars:
The zero pillar is the Old Age Income Security Scheme (OAS), the first pillar is the Canadian Pension Plan (CPP/QPP), the second pillar is registered pension plans (RPPs), the third pillar is registered retirement savings plans (RRSPs).
Zero pillar: Old-age Income Security Plan. The plan is a social safety net aimed at realizing social redistribution and preventing poverty in the elderly. The source of the planned funds is included in the federal government budget, and the national finance department is responsible for the government tax contributions, and individuals do not need to pay. Therefore, the plan is only distributed to specific elderly groups. Strictly speaking, the system should not belong to the pension system, but more of a social security function. From the perspective of fund operation and management, this type of plan has neither independent fund collection nor additional fund surplus. The plan type is a pure DB plan, without market management. The current plan types include old age security (OAS), guaranteed income allowance (GIS) and spouse allowance (SPA) (including widowed spouse allowance (WSPA)).
First pillar: Canada Pension Plan. The plan is a mandatory, income-related, income-determined (DB) pension insurance contribution plan for all residents. Its main purpose is to maintain the basic living standards of the participants after retirement/old age. Currently, it includes the Canadian Pension Plan (CPP, excluding Quebec) and the Quebec Pension Plan (QPP). The plan was to change from the initial pay-as-you-go system to the current fund accumulation system in 1998, and the payment is borne by the employer and the employee jointly or by the self-employed person independently. The plan pension payment includes two parts: basic pension (retirement pension) and supplementary pension (including death, disability, inability to live, orphans, and raising children, etc.).
Second pillar: Registered pension plan. This plan is the most important form of Canadian employer-sponsored pension plan. Refers to pension plans initiated and established by employers voluntarily, employers and employees pay their own fees, are registered and approved by tax authorities, and enjoy deferred tax benefits. The plan can be divided into two categories, DB and DC, and the main purpose is to maintain the normal living standards of participants after retirement. The planned pension cannot be received until the retirement age. Early receipt will reduce the pension level, and delayed receipt will moderately increase the pension level. At present, RPP has become an important part of Canada's pension plan, especially for higher-income groups, and it has become one of the important methods for improving pension benefits.
Third pillar: Registered retirement savings plan. The plan refers to a personal retirement savings pension plan that is established by individuals voluntarily, pays their own fees, is registered and approved by the tax agency, and enjoys deferred tax benefits. The Canadian government launched the RRSPs plan in 1957. The purpose is to encourage middle- and high-income groups to plan individual retirement accounts early and accumulate enough balances to improve their living standards after retirement. At present, the plan is completely DC-type, and the operation and management of the RRSPs plan is very mature in Canada and has become an important part of the retail pension market. Individuals can open RRSPs accounts in banks, insurance companies, trust companies, mutual fund companies, or other licensed financial institutions. Different institutions adopt trust-style or contract-style management operations, and investment returns will vary.
It can be seen from the above that the framework of the Canadian pension system is roughly as follows: the first two layers (OAS and CPP) belong to the public pension plan, which are compulsorily established by the government. They are the basic level of the Canadian pension system, mainly to prevent poverty and satisfy The basic living expenses of the elderly are needed. The sum of the replacement rates of the two plans can roughly reach the average income level of nearly 60%. The second level is employer (enterprise) pension plans, and the third level is personal savings pension plans, both of which are needed to improve the living standards of the elderly after retirement. Among them, the second tier is mainly to make up for the insufficient pension replacement rate of the first two tiers to meet the needs of maintaining normal living expenses for the elderly; the third tier is to improve the level of pension benefits for the elderly and maintain a higher standard of living for the elderly. .
to sum up
The 2020 new crown epidemic has made people more aware of the importance of pension issues.
WHO is working on three areas that are directly related to aging: prevention of chronic diseases, access to primary health care that benefits the elderly, and creation of an environment that benefits the elderly. The WHO has developed guidelines to help countries understand the types of programs that can be established to improve the health care environment and urban conditions to better meet the needs of older people. WHO supports the establishment of networks where countries can share technical information and discuss strategies and policies that have proven effective in their countries to improve the lives of older people.
In order to improve our understanding of the impact of aging on health, especially for less developed countries, WHO is conducting a "Global Research on Aging and Adult Health." The study will follow approximately 50,000 elderly people longitudinally and is currently being carried out in China, Ghana, India, Mexico, Russia and South Africa. The study is linked to a related international health and population monitoring network (demographic evaluation of populations and their health, INDEPTH). Comparing with similar studies done in high-income countries will give people an opportunity to understand the similarities and differences in the health and well-being of older people around the world.
Physical health is the key to the elderly to maintain the ability to live independently and play an important role in family and community life. Promoting health and longevity and disease prevention activities can prevent or delay the onset of non-communicable diseases and chronic diseases, such as heart disease, stroke, and cancer. However, these diseases also need to be detected and treated early to minimize the consequences. Those patients with advanced disease need appropriate long-term care and support. These services can be best provided through comprehensive primary care. Public health actions can also use the capabilities of older people. For example, an increasing number of elderly people around the world play a very important role through voluntary services, imparting experience and knowledge, helping to care for their families, and participating more in paid labor. Old age does not necessarily mean poor health. Many health problems faced by the elderly are related to chronic diseases, especially non-communicable diseases. Most of these diseases can be prevented or delayed by adopting healthy behaviors. Other health problems can also be effectively controlled, especially if they are detected as early as possible.
The elderly are increasingly seen as contributors to development, and their ability to take action to improve the conditions of themselves and their communities should be incorporated into policies and programs at all levels. In the coming decades, many countries will face financial and political pressures related to public health care systems, pensions, and social security in order to adapt to the growing elderly population. China's population aging process is significantly faster than other low- and middle-income countries. Therefore, it is urgent to carry out timely and reasonable policy interventions based on the principle of fair access to and utilization of care services to meet the care needs of the elderly in China and improve the quality of life of caregivers and care recipients. Canada is one of the countries with good old-age welfare in the world, but there are also some problems. It requires the joint efforts of Canadian health and medical institutions and professionals to make various explorations and solutions for themselves, for their families, and for the elderly care of the next generation. reform!
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