Demographic trends and population change

Demographic Trends

There have been several demographic trends that have affected health care in the past century in the United States. Of these, one of the most important has been the baby boom generation, which came about in the years after World War Two. This generation is characterized by its unusual size compared with previous generations, and is even bigger than the generations that have followed. Socially, this manifested in the baby boomers being key drivers of consumer trends, and social change during the 1960s. They have also become a major driver of demand for health care. Boomers are now entering Medicare eligibility as well, which will bring more of them onto the government health plan. The Medicare plan was not enacted until after they had been born, so the full effects of implementing Medicare would have been known with respect to this generation, but that does not mean it is fully funded. The government, doubtless, will use its bargaining power as payer for this generation to drive down costs.

Immigration has become more diverse as well. In the 19th century and early 20th century, immigration tended to come in waves from different countries, but today the waves are smaller, except from Mexico, and from all continents. This has challenged the health care system in terms of handling the issue of customer service, because there are so many people for whom English is a second language, and they may require service in their native language. But when their native language is actually a smaller, obscure one, this can be quite difficult (Leclere, Jensen & Biddlecom, 1994). Furthermore, there are issues sometimes with respect to genetics. Different populations are more susceptible to certain things, and that has created a situation where everybody from pharmaceutical companies to health care practitioners needs to understand the different traits of each different ethnicity with regards to certain conditions or certain drug reactions.

Related to that is the increasing diversity of religions. Different religious traditions in society necessitates knowledge of some of the norms that these religions have with respect to medical care, which can be quite different from that of dominant society. Finding ways for religious accommodation is important as both employer and in patient care.

Urbanization is another demographic change that has affected the health care system. America has been urbanizing since the end of the First World War. While providing health care in cities is fairly easy, given the ability to build facilities that can accommodate size and scope, shrinking rural populations has made it relatively difficult to maintain high standards of service in rural areas. Such areas often do not receive the same standard as urban areas. Further to this trend is the move away from inner city areas in a lot of places towards the suburbs. This trend is particularly noticeable in the Northeast and Midwest. Again, serving the areas people are moving to is easy, but retaining service standards and fixed infrastructure in decaying urban areas that are experiencing slow population declines can be quite difficult.

As to the question of reducing the demographic trends, you cannot reduce the demographic trends. We're talking about birth rates from sixty-five years ago, immigration, and internal migration. I suppose we could institute a Children of the Corn-style regime to wipe out the baby boomers, and Soviet-style housing allotments to ensure that we curtail unwanted migration. But who has the power to "reduce the demographic trends"?