Re: Population ageing: the timebomb that isn’t?
Spijker and MacInnes are absolutely right to point out that rising life expectancy makes older people ‘younger’, healthier and fitter, ‘Population ageing: the timebomb that isn’t?’ (BMJ 2013;347:f6598). However, the discussion of the implications for health policy and practice missed the opportunity to discuss how our healthcare system will need to radically rethink how we support people to continue to work.
We already know that the current state retirement age will increase and it is likely that it will continue to be revised upwards. As such, we must increasingly view the working age population as having no upper age limit. We need to gear workplace health and wellbeing initiatives to prepare working people for productive lives well into their seventies. Work is generally good for physical and mental health and well-being – and this applies to the older generation. 1 However, we may need to change working practices and make adjustments to accommodate their needs, secure in the knowledge that unemployment or worklessness has both short-and long-term effects on health.2
The role of occupational health will be crucial here in providing early interventions for those who develop a health condition, using the workplace to promote individual health and wellbeing and creating working environments that enhance the wellbeing and engagement of workers. An older general population means that we cannot afford to delay in taking actions that reduce the incidence of long-term conditions. 15 million people currently have a long-term health condition, many of whom are fit for work. The way these conditions are perceived and managed will become increasingly important factors of employability.
The workplace is a great-untapped resource for addressing these health conditions and enhancing the public’s health. Occupational health professionals have the ability to influence and improve the health of thousands of individuals by changing workplace practices and policies.
The current age profile of occupational health physicians and nurses themselves is aging; over half of occupational health physicians are over 55. Just at the time when occupational health is becoming so important and the evidence of cost effectiveness is compelling, the specialists within the occupational health team are under threat. We need to ensure that there is sustainable funding for trainees and clear pathways for career development. I know from personal experience how fascinating and rewarding this area of medicine is – we also need to raise awareness of this so that occupational medicine is attracting the high caliber talent that it needs.
Occupational health needs to be seen as a mainstream function that is integral to delivering a healthy, productive working population.
1. Waddell G, Burton AK. IS WORK GOOD WELL-BEING? GOOD FOR YOUR HEALTH. TSO. 2006.
2. Marmot FAIR SOCIETY HEALTHY LIVES, THE MARMOT REVIEW - strategic review of health inequalities in england post-2010, mArmot M, 2010 www.ucl.ac.uk/marmotreview, accessed 20.11.13
Competing interests: No competing interests