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Turns out, demography really is destiny.
The neighborhood I grew up in was amazing. There were 33 children in 13 houses—an endless supply of playmates and "creativity" (read: blowing stuff up and making a playhouse from a frig packing box). We sort of took it all for granted because families with three or four children—or even five—were not uncommon. Fast forward a few decades. Surprise!
In the 1960s, the "total fertility rate" was 3.58, meaning the number of births was more than sufficient to replace the population. But since 1975, that total fertility rate has hovered at 2.0 and below. Now we see the long-awaited consequences: a significant shortage of workers. Who knew that a reduced number of births 40 years ago would mean fewer 40-somethings today? Apparently not the people charged with keeping an eye on population and workforce trends. And, of course, rolling demographics don't impact only health care and not just employers. (Don't look now, higher education, but you are headed straight for a post-recession enrollment desert.)
Here's why you should care: When there are not enough auto mechanics, which there are not, you may go past the recommended mileage for an oil change. When there are not enough doctors, nurses and direct care workers, you may go past your "use by" date. Health care is the exception to all the rules of economic substitutes, because there aren't any. If medical care is not accessible when, where and how it's needed, self-preservation is in jeopardy.
Just 30 seconds more
In a civilized society, there is little we can do to stop or even slow aging in patients or their providers. Our doctors are getting older right along with us. But we can address threats to health care access by reducing demand and learning how best to self-advocate. To have the health care you need and deserve, become a more engaged and health literate consumer. Baby steps: Establish a relationship with a primary care provider today, and make a list of all your prescriptions and existing medical conditions. It's just a start, but a very important one.
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