Currently, there is a trend around the world for a steady increase in life expectancy, as well as an aging population. These factors are especially relevant for developed industrial and post-industrial countries, including the United States and Russia. In these countries, an increase in life expectancy has been observed for several decades. However, in comparison with the United States, Russia has a significantly higher rate of increase in life expectancy, which outstrips global indicators. Despite this, both countries observe differences in these indicators depending on regions and characteristics of population groups. It is also important that both in the United States and in Russia, ageism and age discrimination are currently developed as social phenomena. Against the background of this problem, a transformation of society is needed, also expressed in improving the access and quality of medical care for the older population. Nevertheless, both countries face challenges in developing a relevant healthcare infrastructure to adapt to changing demographic conditions.
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Currently, many industrial and post-industrial countries are faced with population aging. The United States, as one of the most developed countries in the world, is experiencing demographic changes, as the population over 65 years from 2005 to 2015 “increased by over 12 million people. from 35 million to 47 million” (Chiu & Pinto, 2018, p. 697). Gietel-Basten et al. (2019) report that Russia is also facing the issue of aging of the population, which is evidenced by the dynamic changes in life expectancy over the past few decades. In general, this factor is a global trend, within which the average life expectancy has increased from 62 years in the 1980s to more than 70 at present (Chiu & Pinto, 2018, p. 697). The drivers of these changes are primarily improved healthcare, in particular for older people. In general, there is a growing trend in life expectancy in the world, but for different countries, this growth rate differs. Moreover, within the same country, different population groups experience different rates of growth in life expectancy depending on various characteristics.
At the same time, the demographic characteristics of different countries in terms of life expectancy are not uniform. In the United States, the growth rate of life expectancy is lower than the world average (Chiu & Pinto, 2018). Harper et al. (2017) report that in 2015, the United States experienced a slight decrease in life expectancy from 78.2 to 78.1 (p. 54). The reasons for this situation are varied and consist of an increase in the number of deaths from diseases, accidents, and homicides (Harper et al., 2017). It is noteworthy that the reasons differ for age and racial groups, including White, Black, and Hispanic populations, which identifies social and health disparities (Harper et al., 2017). Additionally, there are differences in life expectancy and mortality rates for immigrants of various origins (Markides & Rote, 2019). This factor may also be related to higher taxes on health insurance for immigrants compared to US-born citizens (Markides & Rote, 2019; Zallman et al., 2019). This aspect identifies that despite the steady increase in life expectancy in the United States, this figure is not the same for different racial and ethnic groups. This aspect can identify differences in healthcare accessibility for different social and ethnic groups.
Russia has also seen a steady increase in life expectancy. However, in comparison with the United States, these indicators in the country exceed global trends (Pomazkin, 2019). Pomazkin (2019) reports that the average life expectancy rate for the US and Europe “is about 1 year of age within 5 calendar years” (p. 22). In Russia, since 2006, the growth rate of life expectancy among men began to reach 1 year of age within 1 calendar year (Pomazkin, 2019, p. 23). Thus, in 2017, the average life expectancy for men was over 67 years, while for women over 77 years (Pomazkin, 2019, p. 23). It is noteworthy that in 2010 this indicator for men was over 62 years old and for women over 74 years old (Pomazkin, 2019, p. 23). Despite a significant increase in life expectancy, there is heterogeneity in Russia both in terms of age and depending on the region (Gietel-Basten et al., 2018; Pomazkin, 2019). Kossova et al. (2020) note that “alcohol consumption has a significant influence on the gender gap in life expectancy and reduces the life expectancy of men first and foremost” (p. 37). This situation also identifies social and health disparities among the inhabitants of the country, which differ from those presented in the United States.
Society’s Attitude Toward Aging
The increase in the life expectancy of the population, together with the increase in the number of older adults, also affects the attitude of society towards aging. In the United States, attitudes towards age are expressed in more social aspects, such as fear of aging and biases towards older adults (Berger, 2017). In this situation, such a view is formed from cultural aspects based on individualism and the desire for beauty. Donizzetti (2019) also emphasizes that in the United States, there is a significant gap in the perception of age between men and women. In general, women experience greater fear of aging and the potential pressures of society than men (Berger, 2017; Donizzetti, 2019). Thus, in the United States, the culture of ageism is widespread, which to some extent, creates a negative perception of older adults in society. At the same time, the gradual aging of the population in the future may negate this trend.
A similar situation is typical for Russia, where age stereotypes affect social and economic aspects. Dobrokhleb (2021) notes that in the country, “the access of older employees to paid employment is difficult, including due to the spread of ageist stereotypes” (p. 590). At the same time, in 2018 in Russia, the boundaries of the working age were legislatively expanded, increasing it by five years for both men and women (Dobrokhleb, 2021, p. 589). Despite this, bias is also widespread in the country in relation to the old population, while youth and health are seen as the preferred condition. Reduced labor opportunities, combined with these biases, according to Dobrokhleb (2021), lead to a decrease in the importance of the role of older people in the family and society. This factor potentially negatively affects their mental health and can result in an increased incidence of depression and suicide. Thus, both in the United States and in Russia, there is a trend of age discrimination, which is associated with social transformations.
Health Care for Elderly People
Due to the increase in life expectancy and, in general, the age of the global population, a rapid increase in demand for health is expected for the population of older adults. Even before the start of the rapid growth of these indicators, “older adults accounted for 26% of all physician office visits and 35% of all hospital stays” (Chiu & Pinto, 2018, p. 699). It is also noteworthy that in the United States, immigrants in some areas of this care take up to a quarter of the participation (Zallman et al., 2019). Together with declining retention rates, increasing turnover rates, and an increasing shortage of medical personnel, this factor has the potential to negatively affect healthcare for the older population. This is due to the already noted trends for a decrease in life expectancy for immigrants, as well as with migration policy. Fulmer et al. (2021) report that the government needs to build a long-term care infrastructure to meet the growing demand for it. Thus, the United States needs to focus on providing health care to the older population, which is currently not sufficiently effective.
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In Russia, the situation is similar to that in the United States, but it is also aggravated by older people’s economic and social situation. Davis (2018) notes that the country’s government is making mixed strides in providing affordable health care to the elderly. In particular, the effectiveness of healthcare for this group is reduced by “low quality and hidden informal charges for medical services” (Davis, 2018, p. 193). In general, within the framework of the whole society and in health care in particular, little effort has been made to adapt the country to changing conditions comfortably. While the United States faces challenges in developing relevant infrastructure, Russia needs to develop adequate socio-economic conditions for its older population.
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