We are getting older and older, and long-term care for seniors is a disaster.

We're living longer and longer. And there's no turning back from this. Unless, of course, some natural or geopolitical cataclysm strikes, or medicine reverts to the dark ages of miasma. The former is harder to rule out, and the latter is as likely as me flying. We face serious challenges related to the progressive aging of society, the model of care for seniors, and the shortage of professional medical and care personnel.

Life expectancy in our country has improved over the past two decades. Between 2000 and 2019, life expectancy at birth increased by 4.2 years to 78 years. This was primarily due to a decline in mortality from cardiovascular disease. Later, the COVID-19 epidemic temporarily lowered the rate, but by 2023, it had reached 78.6 years. This means that a newborn born on this planet can statistically expect to die around the year 2102.

At the same time, compared to other countries that make up the Paris-based OECD, our situation isn't all that impressive. We're below the average for over 30 countries in the organization. It's little consolation that Americans are in an even worse situation, being the only country in the list below to experience a shortened life expectancy between 2000 and 2023. Poles are far from reaching the life expectancy of even the top tier, which includes Chileans, Japanese, Spaniards, Italians, and Koreans.

Source: OECD Health Statistics

The art is to live a long life in good health. Because "vegetating," meaning living a long life but in terrible health, brings no joy to anyone.

Poland is advancing civilizationally. Without a doubt, we're growing wealthier, we have access to increasingly modern diagnostic techniques, medical procedures, and medications, and public awareness of healthy lifestyles is improving. However, there's still a long way to go to reach the unattainable ideal.

Despite noticeable progress, circulatory system diseases remain a plague for Poles. Nearly half of all deaths are caused by this group of diseases – the situation is worse only in Latvia, Hungary, Slovakia, and Lithuania, while the best results are observed in countries such as Japan, South Korea, and Chile.

Cardiovascular diseases, including coronary heart disease, hypertension and stroke , occurring in Poland, are constantly taking a bloody toll.

" These diseases are 50% more common than the OECD average. Cancer accounts for about one-fifth of all deaths, and the cancer mortality rate is higher than the OECD average. Treatable mortality, meaning deaths that could be avoided with earlier detection and treatment, is relatively high for cardiovascular diseases. Furthermore, more than two-fifths of all deaths are related to smoking, alcohol consumption, and low physical activity and could be reduced by better public health programs that address these behavioral risk factors," the Paris-based economic organization diagnosed.

The OECD list of factors contributing to the development of cardiovascular disease includes even more. The five most frequently cited causes include hypertension (54% of cases) , an unhealthy diet (37%) , largely due to low fruit and vegetable consumption, high saturated fat content in foods, and excessive alcohol consumption (which is sometimes cited as a separate risk factor), high LDL cholesterol (24%) , a genetic predisposition, though dependent on diet, diabetes (20%) , and air pollution (19%) . Smoking, low physical activity, impacted by the rise of remote work, and stress also play a role.

The percentage variables given above should be treated as indicative, as there are many scientific studies on this topic that show some differences in the percentage of cases.

Source: OECD Health Statistics

Based on a longer time series (until 1990), prepared by the Central Statistical Office, a certain regression in deaths due to circulatory system diseases is visible, but they remain the most common cause of death among Poles.

Interesting observations emerge when we delve deeper into the topic of circulatory system diseases. Between 2000 and 2015, the highest number of deaths from this cause was recorded in the Masovian and Silesian Voivodeships , while the lowest were recorded in the Lubusz, Warmian-Masurian, Podlaskie, and Opole Voivodeships. The Warsaw and Upper Silesian regions are quite similar in some respects, as they are areas with the highest population density in Poland, high levels of environmental pollution, and a "faster" pace of life.

The relationship between the incidence of cardiovascular disease and environmental conditions has been demonstrated. The level of forest cover in the areas where we live and work is negatively correlated with cardiovascular disease – higher forest cover was associated with lower rates of disease. In contrast, an increase in overall environmental pollution was positively correlated – where the environment was dirtier, more deaths from cardiovascular disease occurred.

Source: Central Statistical Office

For this analysis, I have thoroughly researched OECD statistical resources to give readers of politykazdrowia.com the most complete picture possible of where we are demographically and, most importantly, where we might be heading according to the organization’s long-term forecasts (until 2070).

This may seem far-fetched, but I assure you, it isn't. It's actually only a gap of about two generations, primarily referring to today's youth and young adults.

So, dear Z-girls, I'd like to ask for a moment of your attention, because old man Marcin will be slowing down. The choices you make in your personal and professional lives can have a significant impact on your future as seniors.

And "the joyful life of an old man" may be the words from a funny chorus of one of the old songs, but it is definitely worth keeping your feet firmly on the ground, so as not to wake up one day with an "upside-down banana" on your face.

The following calculations may also be of interest to the Exes (generation X born 1965-1980) and the Laikas (generation Y born 1981-1994), but above all, they refer to the situation in which the Zs (generation born 1995-2012) may find themselves.

And Zs differ somewhat from older generations in their perception of the world, themselves, and their daily behavior. A joint study by EY and JA Worldwide (2021) showed that Zs are comfortable embracing the benefits of technology.

Their leading characteristics also included high self-confidence , just-in-time learning (Z-types want to know everything immediately, and the vision of building a long-term career seems overwhelming for them), emphasis on work-life balance (balancing the spheres of professional and private life), a lack of fear of taking risks and a strong need to be in a group (while emphasizing that some relationships translate into the online environment).

The calculations below are based on the OECD's long-term forecast, and for skeptics' consideration, I'll leave it to you to note that this is not unique, as there is unanimity regarding trends among the world's largest think tanks. Differences occur only in the scale of the phenomena.

According to the OECD, between 2024 and 2070 , Poland's youngest population (that is, from birth to working age, defined as 15-64 years old) will decline significantly . However, the oldest population will increase. In the case of "ultra-seniors," defined by me as those aged 80+, the population will almost double. This is significant because it is the oldest age group that experiences the highest incidence of life's difficulties.

Source: own study based on OECD

The data presented in the infographic above are expressed in absolute numbers (in people). Approaching the matter relatively, i.e., comparing individual age groups to the general population, it is clear that the percentage of seniors is becoming increasingly important over time. Over the several decades covered by the projection, it is expected to increase by over 12 percentage points – from 19.9% (2024) to 32.2% (2070) of the entire Polish population. Currently, one in five Poles is a senior citizen, and in decades to come, this figure is expected to rise to one in three.

This demographic age change will pose a significant challenge for, among others:

• public transport infrastructure systems - emphasis on equipping them with devices that are convenient and safe for seniors,
• city planning systems - a) more benches and waiting areas, b) more greenery, shade devices, water curtains and fountains, air conditioning installations for hot seasons, c) clearer street name markings, d) more traffic islands in roadways so that a not-so-handy senior can reach them when the green light is displayed, e) larger-print paper official forms, unless digitalization consumes the analog environment), and
• health care system (public and probably mainly private care, greater expenditure on voluntary and perhaps compulsory insurance, which we do not know now, but also longer periods of patient visits to doctors and dentists).

Source: own study based on OECD

Especially since not all seniors are created equal. The psychophysical status of the average 60-year-old and the average 80-year-old differs somewhat in age. I extracted some statistics from OECD data for the senior population. I divided the category into two age groups – up to 79 years old and 80+.

It turned out that, according to the organization's forecast, the percentage of people aged 80+ will grow dramatically, and due to gender-specific life expectancy, this applies primarily to women. At the end of 2024, ultra-seniors constituted 4.2% of the entire Polish population and 21.0% of all seniors. By 2070, these proportions will be 15.0% and 46.7%, respectively.

If these OECD predictions come true, in a few decades every sixth or seventh Pole will be an ultra-senior citizen (now it is about one in twenty) and almost every second senior citizen will be an ultra-senior citizen (now it is one in five).

Source: own study based on OECD

In my opinion , in a few decades Poland will look much different , and there will probably be a gigantic transformation in the thinking of decision-makers and society in terms of migration and procreation processes.

I have much greater faith in the former, as the government has only moderate influence on the latter. It's impossible to force people, even with the most outlandish ideas—like "bullseye"—to have higher fertility rates.

Data from the RFBerlin think tank indicates that Poland is among the countries least favorable to the assimilation of migrants from outside the EU. Indeed, after the Russian aggression against Ukraine, we saw a significant influx of people from our eastern neighbor, but this still seems insufficient. Estimates vary, but a rough estimate suggests that around 1.5 million migrants are permanently resident in Poland (not even 5% of the total population).

Well, in my opinion, it is a manifestation of preying on the worst human instincts , and above all, it is not supported by deeper reflection, confirmed by source materials, which are not selectively used, because then it is very easy to manipulate.

In whose interests are such people acting? One can speculate. I fear they are not acting on behalf of common-sense Poles, as such a discouraging narrative is simply acting to the detriment of one's own country. And Maskwa gawarit: Paljaki, eta Russophobes.

The infographic below shows a map showing the percentage of migrants (data for 2024) as a percentage of the population of European countries. Poland, along with Slovakia, Romania, Bulgaria, and Turkey, is among the countries with the lowest migrant population. The Swiss, Austrians, Irish, Icelanders, and Cypriots are the most open to accepting foreigners.

Unless there's a significant about-face in Poland's approach to assimilation from foreign lands, Poland's long-term economic prospects look bleak. From the current rate of real GDP per capita growth of around 4% annually in recent years (2006-2019), we'll soon "slide" to around 2.5% , simply because, in the face of a growing aging population, dramatically low fertility rates, and a mind-altering aversion to migrants, the working-age population will soon decline significantly. And GDP doesn't just fall out of thin air; it has to be created by someone.

Let's finally appreciate that, for various reasons, migrants from countries whose worldviews are similar to those of native Poles (Ukraine, Belarus) are drawn to us. With a little goodwill and pragmatism, this can mitigate the negative demographic outlook, which, as always, will require efforts from government agencies to prevent migrants who may pose a problem from arriving.

Source: RFBerlin

Let's assume we reach senior age despite the various setbacks described above, which await people if their lifestyle leaves much to be desired. Our bodies no longer function as efficiently as they did when we were young and capable of "moving mountains." We quickly become short of breath, or we forget things – examples of such deficiencies are endless. In such a case, the assistance of others would often be necessary for smooth functioning in everyday life. And this, to put it mildly, can be challenging.

And, more importantly, this will become even more important in the future due to the forecasted trends in the demographic age structure of society described above.

Source: OECD

Poland is grappling with a dramatic shortage of nursing staff, and it is they who are primarily at the forefront of caring for seniors. Their love and empathy for their fellow man cannot be denied. The problem is that many nurses are already advanced in age, and the young nurses in this medical profession face a truly serious challenge.

Let's take a look at the left graph of the infographic below, where the X-axis represents the nurse's age, and the Y-axis represents the percentage of all nurses for each age group. The trend remains flat until age 50, but then a sudden surge occurs. Most women in this professional group are between 50 and 70, yet the nursing profession requires a certain amount of strength in some cases.

We look terrible compared to the OECD in terms of the number of qualified nurses per 100,000 inhabitants (2022). Our figure is around 20, while the OECD's is over 40, while the top performers in this regard, Australia, Chile, and South Korea, have at least 100.

Source: own study based on OECD.

Specialists from the Paris-based organization, responsible for health care issues, provide several solutions that, in their opinion, may contribute to improving the quality of long-term care for seniors.

They point out that in Poland, nurses are trained, but there are no requirements for caregivers. This isn't the case everywhere in Europe. For example, in Austria, home caregivers must complete a home care course, and in Denmark, professional personal caregivers must have at least two and a half years of education in social and healthcare.