 Welcome everybody to our first fall installment of the Canadian Longitudinal Study on Aging Webinar Series. My name is Mark Orimas and I'm one of the associate scientific directors of the Canadian Longitudinal Study on Aging. And today it gives me great pleasure to introduce Dr. Birgit Pianosi. Birgit is an associate professor and the former chair of the gerontology department at Huntington-Lorentia University in Sudbury. Birgit holds a PhD in psychogerontology from Germany and she's completed two master's programs in human development and in psychogerontology. She is a credentialed professional gerontologist with the National Association for Professional Gerontologists. And she is a certified coach for gentle persuasive approaches in dementia care. Birgit is chair of the Ontario Interdisciplinary Council for Aging and Health. And she's an executive board member of the seniors health knowledge network here in Ontario. Birgit is going to be speaking about aging today, opportunities for tomorrow. Before I turn the floor over to Birgit, just a couple of procedural notes. If during the course of the presentation you have a question, please type your question into the chat box which should be located in the lower left part of your computer screen. And I will read the question to Birgit after she's completed her presentation. If we have time for discussion at the end of the presentation, what's going to happen is our IT expert who's monitoring the presentation will enable the talk feature. If you look at the top left of your screen, there is the talk button. And if we have again time for discussion and you wish to say something, press the talk button before you speak, but turn it off after you've finished speaking to prevent feedback. So without further ado, Birgit, the floor is yours. And thank you very much for agreeing to participate today in this presentation. Thank you so much, Marcus. I appreciate it. I would like to thank you and the Canadian Longitudinal study on aging to be able to do this presentation today. So just for participants to know, I have a very strong German accent and especially when I'm nervous, it's even worse. So please, if you don't understand some things that I'm saying, just again, like Marcus said, put some comments in the comment box on the bottom there. And I can clarify, I'm not insulted at all. So I decided to talk about aging to the opportunities for tomorrow. And the reason for that is that I always feel that, you know, we look at aging often in a very negative way. When I teach gerontology to students, I often have nursing students and social work students in my class and they, you know, always are surprised to see that there are a lot of other adults who are actually healthy and do not need to be admitted to hospital or long-term care. So I thought it would be a good idea to talk to you about aging from a positive perspective but also to give you an idea of what kind of opportunities the older generation will give us in the future. So I have divided my presentation in two parts. I will give you some demographic data and I'm not a demographer but in order to talk about some of the opportunities we might have in the future, I wanted to give you just a snapshot of how aging is, you know, what the reality of aging is today in Ontario but also worldwide. And then as I said, I will talk about some opportunities that we as a society but also all the adults may have in the future. So let's look at the older generation today in Canada. In Ontario, we all know that life expectancy is increasing. We will have more older adults in the future. So in 2005, we had about 4.2 million older adults and that will increase to 9.8% in 2036. And that means it doubles from 13.2% to about 24.5%. If you just look at older adults 65 years and older, we can also see that in 1951, we had about 7.8% of older adults. Just on the side note, I'm not calling these 65 and older seniors. I'm calling them older adults as a respect and also to indicate that they are often very healthy older adults. In 2006, we had about 13.7% and that is projected to go to 22.7% in 2031. If we now look at some international statistics, and I will show you some in a minute, but just think about Japan for instance, who had in 2012, so two years ago about 23.9% of older adults. And we are projecting here that in Canada in 2031, we will have 22.7%. So we are still quite a bit behind other developed countries. So when we look at the population 65 to 74 years old, we also know that from 1.5 million in 1981, it will increase to 2.2 million in 2005, so that's an increase by 0.9%. I might not look much, but it is quite an increase. So I also gave you here an aging population permit. And I wanted you to look at, that's the one from 2010. I wanted you to look at especially the age group of 45 and 50, as you can see here, as the highest percentage of people in the age group. So these are all baby boomers who are of course aging as we speak. This is just another graph to show you how aging population is increasing. You can see here, especially on the right-hand side, when we look at the different age groups, the 65 to 74 are the young old, 75 to 84 are the middle old, and then we have the old, old 85 plus. You can see that especially in 2031 and then later in 2041, the old, old will have a very large increase of proportion. So we will have much more old, old, older adults in the future. In order to look at how our society is changing, we also need to look at the natural increase of our population. And it is estimated that our population is declining, and that is true for many developed countries. The only reason why Canada is doing so well is because we do have quite a couple of immigrants, like myself, that come to Canada. So as you can see here in 2096, we had a very short decline in increase, and that could be in 1996 there was quite a change in Canada, political change, and so I remember the times it wasn't very secure, you know, there were a lot of things going on. And then we have a sharp increase in immigration in 2001, and then we see the decline really from 2001 on in the natural, in the change of the population, but our immigration numbers are increasing. So that helps us to sustain our population here in Canada. It's very different from some of the European countries where the immigration is very low, and therefore the increase of the population, of course, is not increasing, it's declining. So we are lucky that we have policies that really favor immigration, and I will talk about this in a little bit again. So an estimated one of three older adults here in Canada were born outside Canada. Many have lived here for 35 years or longer. We have about 3% of immigrants who are arriving each year in Canada. Our older adults who often join the family members come to live with their children, for instance. Many of these older adults who live here in Canada and are from elsewhere do speak one of the official languages, but there is about 12% of older adults who do not speak English nor French, and that, of course, has implications for policies and for future regulations and what we're doing and how we offer some of our programs to our older population. Next slide is looking at the geographic distribution within Canada. Just to give you an idea, and I always find it very interesting when we look at the Northwest Territories, especially you can see that the change and increasing older adults is especially pronounced in these two provinces and territories. The lowest change will take place in New Brunswick, and Ontario, Quebec has about average change in the proportion of older adults. So, again, the territories, of course, better health policies, younger people also moving out from the territories are increasing therefore the older population. So, here the next slide is very similar to the previous one. Just gives you another perspective on how many older adults are in each of the provinces, and it's always nice to see the graph because it makes it very clear that, especially in the new year, the proportion of older adults in 2021 in New Poundland will be the highest followed by New Brunswick. But the change is not as large in these provinces, whereas in Northwest Territories in Nunavut, the change, and you can really see that in the Northwest Territories that the change of proportion of older adults increases is crazy. So, they will really have to look at policies and procedures and see how they can accommodate similar older adults proportionately. The next slide is looking at the demographic dependency ratio, and I wanted to put that here because it is still a very much used tool to indicate how populations or generations are dependent on each other. And I'm very critical about the use of this tool as I think it does not really reflect reality, but the graph shows you that the dependency ratio is increasing and it will in the next years, as you can see here on the top, it's going up. When we look at the younger population, the darker line there, the dependency ratio is going down. And when we look at the senior, the older adult dependency ratio can see that it's going up again. This is a very controversial use of displaying the usefulness, I think, of older adults as I believe, but not everybody who is over the age of 65 is dependent and not everybody under the age of 14 is necessarily dependent. But there might be adults with the changes in, you know, education. Many adults before the age 40 are, you know, living with their parents might not have a consistent job. So they are maybe still dependent on their parents or grandparents, so it doesn't really reflect reality of today's times. So really this ratio supports the notion of a rolling tsunami that I'm trying to really work against. I don't think that we can look at older adults as dependent just because of their age. And that's true actually for any age group, but especially for older adults. So the ratio really fails to account for the benefits older adults bring and sees all older adults as a burden. However, it would be much more interesting and a much better predictor to look at race, ethnicity, wealth, level of education to predict how dependent a person is. So I really believe that this formula for today's times it's not a right formula to use to display how generations are dependent. Okay, so now let's go to some international statistics here. Some of you may have seen this one from 2012. I just pointed out earlier, Japan has already in 2012 had a proportion of older adults 23.9 percent, so almost 24 percent. In Canada, the prediction was when we go back to our beginning slide in 2013, we are predicted to have 22.7 percent. So even in 2031, we won't even have the percentage that Japan already has at this moment. Many of the European countries, of course, very similar. Germany, Italy, and Sweden followed by Greece and some other countries that are listed here. And then we see on the other side the countries with the lowest percentage of older adults and those are, of course, developing countries most often in Africa who have very low proportions of older adults as you can see here, Qatar 0.8 or United Arab Emirates 0.9 percent. What a difference. But all of these countries including the developing countries will have an increase in proportion of older adults in the next years. Let's move on now to some other data looking at labor force. So when we talk about some of the opportunities in a little bit, we have to consider what retirement age generally our population has and if this retirement age is appropriate. This has been a discussion for a long time. It should be change retirement age and it is changing many of the European countries that increase their retirement age to 67. So you can see here that since 2009 the retirement age in Canada has increased from 61.9 percent in 2009, not percent age, 61.9 to 63 the average retirement age in 2013. When we then look at different sectors we can see that these in the public sector are still the ones who would retire at the earliest age 61.1 and followed by the private sector and then lose to our self-employed have the highest retirement age at 66.8. That has been increasing but the public sector employees have still the lowest retirement age. And that really raises the question do we need to have a low retirement age? I think that we can see when we look at the self-employed there are probably different reasons for that. Financial probably one but also when we look at health I believe that all the adults are a very healthy group of people and especially when we look at the baby boomers and we know that they're able to work much longer than they're currently in the workforce. And of course it's very, you know, we all would like to retire at an early age but when we look at when for instance retirement age was introduced to me that this mark he was a German politician in the First World War introduced to retirement age of 65 at that time. And today we're still using that age. So it really, I think the time has come that we change that because life expectancy as we all have seen now has increased drastically and especially looking at the healthy life expectancy to people who are expected to live a healthy life is much higher than it used to be. So people are able to contribute to the society until a higher age and many of those people of those older adults do but often volunteer positions rather than in actually workforce. A full-time workforce sometimes part-time workforce they retire and might go back and do some part-time work and so on. So housing arrangements, you know, students are always surprised to see when I tell them about, you know, how many people actually live in Longchamp here and we really can't believe it that out of our older populations in Canada it's only 7% who live in institutions. Most of our older adults are living independently in their own households. So that's 93% of the older adults out of those 69% live with their families and then we have 24.6% of older adults who live by themselves. This is a little bit different to some of the European trends where older adults often live in apartments rather than in homes. And that's not just for Europe but also Asia because of space. All the adults are less likely to own their own home but rather live in bigger buildings. And that can have also some positive implications if they might not live even though they live alone they might have a lot of people around them in the apartment building. I recall my grandmother living in an apartment building and I think there were nine apartments and only one was occupied by a young person all the others were older adults and they all really looked out for each other helped out when one person wouldn't show up one day they would investigate what is going on. So we really supported each other and I think that has something good so they didn't depend on their families but really could depend on each other. So I now want to go to some of the health indicators and just again to reinforce some of the things that I have talked about previously all the adults today are a very healthy group of people. We can see here the comparison between 2003 and 2011 data and I just picked a couple of these health indicators that I thought might be interesting to look at. So we can see here that high blood pressure is increasing it's not surprisingly when I show you in a minute that I'll go back to the other slide but here we also see that diabetes has increased and obesity also has increased since 2003 so these all relate to each other. Arthritis has a little bit lower percentage or had a lower percentage in 2011. Also interesting to see that immunization in the past year has declined a little bit and I think some of the reason behind that is that not a lot of older adults might think that immunization doesn't have really a benefit. Seeing the doctor has slightly increased very similar from 2003 to 2011 about 90% of older adults do see a physician regularly and it's also very interesting to see that adults do perceive their health as good to excellent and that's here almost 80% and it has increased since 2003. A sense of belonging is very strong or strong again in the 70% and that's also increased since 2003. So you can see very positive kind of attitude towards their own health and towards their life for pain prevention so even preventative activities has increased since 2003. It's about 22% who are using pain preventive activity less we have less smokers, less asthma. A little bit almost same in COPDs and as I said before increase in diabetes and obesity and that I think has to do with the lifestyle and our changes in how we do each day and what are of course nutrition intake. And we do see some of the things that have to be watched I think for the future because we will have more and more of these kind of problems occurring especially of course amongst the native population. So now I have talked and you probably have seen demographics elsewhere but I wanted to now take a step back and really look at or use these data to think about what kind of opportunities that that gives us for tomorrow. So I've talked about we will have more older adults they will be healthier we know that many of the older adults who are retirement has very good financial security many of our older adults especially when we look at the baby they must be very well educated they are much much better educated than previous generation and that is when we look at university education today and college education so many you know the majority of younger people is getting educated so this will even change more drastically in the future especially when we look at females the education of females is really changing and it really had an impact on the baby boomers whereas with generation before that many of the females weren't as well educated even though we do have healthy and healthy and that you educated older adults there are still inequities in service we provide in the support and the gift to older adults and assistance they need so it really depends on you know how what kind of resources they have and it's really there is still a big difference between males and females females are often in need of more services and they might not be there and especially the older adults today where women are still disadvantaged because they don't have the retirement plans that males often have and because they don't have the education that their new counterparts had so policies promoting and economic growth distributing income influencing individual behaviour such as getting more food shorts for instance but also to get educated even better educated each healthy also to all the demographic age sex structure will have an impact on our future so what we do how we what we give to the older or to the adults today is the have jobs for our adult population for males and females and if we give them health promotion and educate them about how to live healthy then we will be able also to create a much better older adult population in the future and of course we know that they are still financial associated with healthcare long-term care and pension income so there are we need to look at how can we change some of these things and we can discuss that in a minute when I'm done with my presentation maybe you have also some ideas on how to do that so why should we be optimistic about the change and why is it great to have more older adults who are healthy and it's not considered to be a tsunami but rather something positive to look at first of all due to declining fertility we have much more women in the labor force which is great so if there are women better opportunities they are better educated as I said they also are financially more secured than the retirement because they take part in the labor force having fewer children means that the ones that we do have are often healthier they are smarter and they are better educated children because we can afford to send them to schools and educate them demographic projections indicate further gains in longevity including gains in healthy life expectancy so not just living longer but also living a healthy long life and that is really expected to increase in the future so we will have a compression of morbidity where we do get sick but probably only last couple of years of our life and that's really what everybody wants we don't want to be dependent on other people for a long period of time we want to stay healthy, be independent and then get sick and pass on and it might be necessary to increase the change of the pension policies to entice people to work longer and to be involved but as I said before even though other people might not be involved in the work force specifically they do volunteer and contribute in many other ways that might not be you know outlined in some of the demographics we looked at before so Robert Bagler said many healthy older people with reliability but a great asset of experience skill drives that a country should learn how to exploit so we should really look at the older adults and see what they can do and use their knowledge and their experience and use it to advance our own societies and they want that they want to feel needed and also so what are some solutions and as I said we can talk about that in a little bit more the first one is really when we look at policies and be using the graphic data we need to make sure that we use the correct correct data so using a dependency ratio as we have done in the past I don't believe it's useful I think we have to look at our different and I will give you in a minute a couple of websites you can look at and talk about some of the changes that should be considered and looking at the dependency ratio so we are using this measure to say you know all the adults we have more and more people who are dependent but we don't change the way we measure that so not everybody 65 and older is dependent and not everybody in the age group of working age between the 15 and 65 are independent so it's important to look at the ratio and make some changes to that it's important to emphasize the generational interdependence so not one generation is dependent only on the other but I think that generations generally are dependent on each other so we can't list without all the adults or the adults can't list without younger people we need to really look at how can we benefit from each other and I think that really needs to you know we need to think about that really through social change we need to change our thinking we need to support better education I just read in the paper today that the tuition fees will increase even more in the next couple of years unfortunately you know how can we promote better education than the education system or education, university and college education is so expensive you know we look at other countries from Germany where I'm from education, higher education is free students don't have to pay anything except for registration fee which is $100 a year so that really shows you how societies put emphasis on on different things so education in Germany is considered very important so people do get to go through no matter what their financial situation is health promotion I think we have began to really look at health promotion in the last couple of years but we are in a long way there's a long way to go we need to focus more on promoting health rather than dealing with the issues when they are there and that really needs again we need to start thinking in different ways as individuals but also as a society and then we need to look at financial security for all and that is especially true I think for females and older women we tend to have inequalities people should have the same security no matter who they are and where they are from so it's really important that we make a change and make a change in our thinking and it needs to happen to do we can't wait anymore we have procrastinated for years and even though we knew this will happen I've shown you the percentage of older adults in European countries and in Japan I mean we knew this was coming this is nothing new but it is not a tsunami it's something to look at in a very positive way we can benefit from having more active healthy older adults so here are these two websites I mentioned earlier that talk about the dependency ratio and I think if you would like the slides to have sent you, you can do that you can check them out it's quite interesting to look at how can that be reevaluating and how can we make changes to the dependency ratio that we are using at the moment so thank you so much that was my presentation I really would like to open up the floor for discussion this was meant to provoke in a way I want people to think about some of the demographics and some of the implications that we have in our aging population and so I don't know, Marcus, if you wanted to open the floor for us thank you very much for the presentation very good, very informative and yes, so if anyone has any questions please don't hesitate to use the chat feature to type your questions if anyone would like to make a comment, maybe you could just type in the chat so that we know and then our IT person can activate the talk feature I've got one question and that has to do with labor force participation and healthy aging so we talk about healthy aging as being positive and a good thing are there any indicators that we can glean from the labor market in terms of healthy aging so are people staying in the work for longer because they're more healthy as they get older etc so I'm just wondering I guess does the labor market and labor force participation tell us anything about healthy aging and what might be the implications of healthy aging on the labor market so I think I remember one study that's now a couple of years old that looked at one of the reasons why older people decided to retire or not and it was interesting to see that one of the reasons was they might not retire because of financial reasons they might retire because they feel they are not healthy enough to work anymore but one very important thing was that they actually indicated if they could work not full-time but part-time and in a much more regulate their own working hours they would actually consider to stay in the workforce I think that we have to rethink about some of the jobs to all the older adults I mean they have been in the workforce for so long or older women might decide when they get older they didn't work and they now have time because their children are out of the house grandchildren going up they have the time they would like to participate but they are unable to find work so I think we have to be more flexible and how we promote some of our jobs and to not put everybody in the same kind of box and say you have to work from 9 to 4 and that would I think increase the workforce of older adults I don't know if that answers your question Marcus. Yes, thank you we have a question that was typed in and by the way the talk feature is open so if you want to make a verbal comment or ask a verbal question go right ahead but after you have asked the question please turn off the talk feature someone wants to know was body mass index over 30 used to define obesity in both 2003 and 2011 and this individual is also asking if we would consider them obese so Ellen can type in her answer or talk but Birgit, do you know anything about the BMI? I actually don't know but that's a good question I hope they use the same index but I don't know what they use to define obesity I can find out news that can which is still there here's a question it's in the chat, I'm going to read it with so many older adults aging in place why do you think there is a belief that long-term care is an inevitable part of aging how do we change that stereotype? Yeah, I like that I think we really don't it's a wrong I think it's a yes it's a stereotype it's a misconception I think older adults in the future will not be living in long-term care the majority of older adults as they do now will live independently we know that the baby boomers are healthy, independent they want to live in their own place they want to choose where they live they will not move into long-term care if they don't have to and even if they're sick we have options for them out there maybe shared housing where they support each other and I don't know why we're thinking that we need to create more long-term care I really think that's not necessary we need to put more emphasis on home care because people want to stay at home and they know that they are healthier if they stay home, they're happier they recover in fear so I really like that question it really shows the ages and these behold in our society that we believe we need to put them into institutions when they no longer can live independently or even before that I don't know if the person who wrote that has a comment on that I'm not sure it was somebody from the CLSA's National Coordinating Centre so if they have follow-up they're certainly welcome to present and sorry Marcus and I think the question was how do we change that stereotype I think that we need to I hope that with talks like this introducing more and more people to healthy aging we can one by one hopefully show people that our older adults are very different from generations before and so we can combat some of the stereotypes that are out there and we all can do our part by living healthy lives and showing others that as we get older we are healthy and we are independent great you mentioned in your response to the question that more and more seniors are choosing to live independently is that in part maybe let me rephrase the question why is that happening is it because healthcare has gotten better so they're staying healthier longer and thus can maintain their independence or are there other factors at play we talked about the built environment making it easier for people to get around age-friendly cities and stuff not just healthcare but is it also things like age-friendly initiatives in cities that provide people with the ability to remain independent I think Marcus made a good point I think the environment is very important age-friendly communities initiatives are very important we provide environments in our cities not only for the older adults but for any age group so I think it's a mindset our babies are very independent especially women they are now well educated in the past they didn't have as much education but now they are educated they want to be independent they have their own very successful careers those women will not let other people tell them what to do we still think that we can be realistic and say I believe you should be in long-term care they will say no I will be living alone with a friend after my husband passes away and I am refusing to go into long-term care I want to be independent and as I said there can be very different models of how those older adults will live they might share how it's together they live with younger generations and it could be friends it doesn't necessarily mean it's a family because families live so far apart you know when I always I like to when I talk to my students I always give them an example of older women that I experienced in Germany when I grew up during the war most of the men were killed I never had grandfathers and because they had to they were very independent ladies they would never ever raise their children they worked full-time all their lives until they were about 7 years old they never complained and they lived independently in their home until they died one had an apartment the other one had a home and the older generation we will see now women in Germany it was due to the war because women were left so they had to be more independent but I think we will see more of these kind of women in the future so that will really impact how the general population ages because we do have of course always more women in the older age groups do you have any parting thoughts? I hope I can I was able to raise some discussion points I hope that people will start to think a little bit more about aging in a positive way I know that I preach to the people who are listening in are probably all converted already but just to raise awareness and to have a deeper conversation about how we perceive our older adults and how can we promote the opportunities that older adults should have in the future great we are getting another comment here I hope the media interviews your speakers about this important information so let's hope that that does happen I think that's a very good point great all right so Birgit thank you so much for taking the time to present this very interesting information to us we really appreciate it on behalf of everyone at the Canadian Longitudinal Study on Aging and our listeners thanks again and I'd just like to conclude the webinar today we have another webinar coming up and it is on December 4th from 2 to 3 p.m. Eastern Time and Professor Heather Keller from University of Waterloo will be talking about older Canadians food intake and nutritional status how the CLSA will advance knowledge so once again Birgit thank you very much and everyone please take note of the next CLSA webinar we will endeavor to schedule one or two more webinars before Professor Keller's December talk thank you very much again everyone and Birgit and have a great afternoon