Changing US and World Demographics: Consequences for the Practice of Medicine

Demographics is a field of study in which statistical characteristics of a population are followed over a period of time. Commonly, demographic data are used in analyses involving fields such as sociology, public policy, and marketing. Characteristics that are followed often include gender, age, survival, a variety of disabilities, urbanization, socioeconomic factors, educational level, and many other variables. Demographic changes in a population can have major consequences for healthcare delivery and planning. For example, if the population in a specific country demonstrates a demographic trend for increasing numbers of geriatric individuals, this will have a major impact on the demand for inpatient hospital and rehabilitation services because this age group has a high rate of use for such services.

Recently, 2 major US periodicals have given extensive coverage to demographic changes in our country and throughout the world.(1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12) Written primarily by professional journalists, these reports are both easily understood and comprehensive. Similar trends are described in both magazines: Technologically advanced countries will continue to see dramatic increases in the percentage of their population aged 65 years or more, combined with marked decreases in per capita birth rates, so-called fertility rates. For example, Brazil, a country rapidly advancing into the category of technologically advanced, has seen a marked decrease in fertility rates, which has been ascribed to female access to education and employment combined with ease of access to contraception. In addition, female media role models are commonly portrayed as actively involved in their careers with minimal numbers of children under their care.

Many technically advanced countries are expected to experience declines in population over the coming decades because of decreasing fertility rates. Declining population growth and reduced numbers of residents are expected to be particularly challenging in countries with low immigration rates, such as Japan, where elderly individuals represent an ever-increasing segment of the population. In the United States, fertility rates are expected to remain relatively constant because of higher birth rates among new immigrant families. In most countries experiencing decreasing fertility rates, the death toll also is decreasing, with these 2 factors leading to an increased percentage of the population aged more than 65 years. Clearly, this demographic trend has major implications for healthcare distribution and financing.

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— Joseph S. Alpert, MD (Editor-in-Chief, The American Journal of Medicine)

This article originally appeared in May 2012 issue of The American Journal of Medicine.