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Rapid population aging is transforming societies around the world, and the Asia-Pacific region is on the frontlines of this unprecedented demographic shift. Life expectancy in Japan, South Korea, and much of urban China has now outpaced that of the United States and other high-income countries. With this triumph of longevity, however, comes a host of health, social, and economic challenges.

Longer lifespans will necessitate working to older ages, “but extending work lives will only be feasible if the added years are healthy ones, and will only be equitable if the least advantaged also benefit from healthy aging,” writes APARC Deputy Director and Asia Health Policy Program Director Karen Eggleston in her new book, Healthy Aging in Asia. “The great blessing of longer lives dims when clouded by pain, disability, and loss of dignity.”

[Listen to our conversation with Eggelston about the book and continue reading below. To receive stories like this directly in your inbox sign up for APARC newsletters]

Shorenstein APARC · Healthy Aging In Asia | Karen Eggleston

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Poster featuring the book Healthy Aging in Asia


Societies around the world must reduce disparities in health outcomes and address the older age-associated rise in the burden of noncommunicable diseases (NCDs) such as diabetes, hypertension, and cancer. Indeed, the COVID-19 pandemic has underscored the vulnerability of older adults suffering from NCDs to newly emerging pathogens and the importance of building long-term, resilient health systems.


How are health systems in Asia promoting evidence-based policies for healthy aging? What strategies have they used to prevent NCDs, screen for early disease detection, raise the quality of care, improve medication adherence, reduce unnecessary hospitalizations, and increase “value for money” in health spending?

The concise chapters in Healthy Aging in Asia examine these questions, covering multiple aspects of policy initiatives and economic research on healthy longevity in diverse Asian economies — from cities such as Singapore and Hong Kong to powerhouses such as Japan, India, and China — as they transform their health systems to support wellbeing in older age. Eggleston edited and contributed multiple chapters to this new volume, now available via Brookings Institution Press. This publication is part of APARC’s in-house series with the Brookings Institution.

Dr. Karen Eggleston

Karen Eggleston

Senior Fellow at the Freeman Spogli Institute for International Studies, Director of the Asia Health Policy Program, and Deputy Director of the Shorenstein Asia-Pacific Research Center
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Asia health policy expert Karen Eggleston’s new volume, ‘Healthy Aging in Asia,’ examines how diverse Asian economies – from Singapore and Hong Kong to Japan, India, and China – are preparing for older population age structures and transforming health systems to support patients who will live with chronic disease for decades.

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COVID-19, combined with the effects of ongoing civil conflicts, hotter and drier weather in many areas, and an unfolding locust invasion in Africa and the Middle East, could cut off access to food for tens of millions of people. The world is “on the brink of a hunger pandemic,” according to World Food Program (WFP) Executive Director David Beasley, who warned the United Nations Security Council recently of the urgent need for action to avert “multiple famines of biblical proportions.”

(Watch Beasley’s conversation on food insecurity as a national security threat with his WFP predecessor, Ertharin Cousin, a visiting scholar with Stanford’s Center of Food Security and the Environment.)

Understanding how these conditions – alone or in combination – might affect crop harvests and food supply chains is essential to finding solutions, according to David Lobell, the Gloria and Richard Kushel Director of the Center on Food Security and the Environment. Below, Lobell discusses the connection between immigration and U.S. food security, a counter-intuitive effect of COVID-19 and more.

 

How could COVID-19 affect global food security?

I think the biggest effects will probably be related to lost incomes for many low-income people. Even if food prices don’t change, potentially hundreds of millions could be pushed into a much more precarious food situation. I’d be especially worried about remittances – the money immigrants in wealthy nations send home to developing nations – falling, since these are a surprisingly large source of stability for many poor people. Beyond the income effects, there are definitely prospects for reduced supply of foods, but I think these are secondary, especially because global stocks right now are quite large.

Another counter-intuitive effect is that the drop in gasoline demand due to social distancing may be a big driver of changes in food prices. A lot of corn demand is for use in ethanol fuel, and corn prices can affect the prices of many other crops. The price of corn has dropped by about 20 percent since February.

 

What are the biggest risks in terms of food supply?

Three things come to mind. First, for crops that require a lot of labor, there are some indications that planting and harvest activities are being affected. Even though these are usually included as essential activities, they often rely on migrant populations that can no longer cross state or national borders. California is going to be a prime case study in this.

Second, some countries, like Russia, have started to restrict food exports in an effort to calm domestic consumers worried about food shortages. Even if there is enough global supply, there is a risk that supply for importing countries could be curtailed. This was a big part of the food price spikes a decade ago. Now, we have the added potential that exports will be limited by a lack of mobility to get products to the port – for instance, there are reports from South America that towns won’t let trucks through for fear of the virus.

Third, COVID-19 could really limit the ability of governments and international groups to address other crises that emerge. Nearly every year there are at least a few surprises around the world affecting food that are usually handled before they make big news. Things like livestock diseases and crop pest outbreaks, for example. But without the ability to deploy people to assess and fix problems, there is more scope for issues to go unchecked. Right now, the biggest example of this is the desert locust outbreak in Eastern Africa.

 

What current and/or likely future weather conditions might have significant impacts on food production?

As the globe warms, we continue to see more “surprises” in most years in terms of record hot or dry growing seasons. It’s a bit too soon to say if and where those will emerge this year. Since global food stocks are high, we have some ability to cope with a shock, but if governments are already nervous it may take less to induce export bans and all of the negative effects those entail.

 

Ahead of the summer harvest, what is the prospect for controlling locust swarms in threatened countries, and how might the swarms further complicate the global food security picture?

If not for COVID-19, this would likely be the biggest development related to food this year. My understanding is that they are spreading fast in Africa and the Middle East, and while they haven’t yet had big effects in the main production regions, the next couple of months will be critical. The hope is that the winds change and drive them back toward the desert areas they came from. If not, there are at least 20 million people at risk of major food security impacts in the region.

 

Could we see locust swarms in the U.S.? What can we do to prevent them?

Locusts can occur anywhere. A few years back there was a major outbreak in Israel. They haven’t been a big issue in the U.S. because control methods are available, such as widespread spraying. But again, in a time of COVID-19, these types of responses are harder.

 

What does history teach us about the situation we are in with multiple threats to food security, and how to deal with it?

I think it comes down to a combination of investing in science-based solutions to avoid problems to begin with, and then having good social safety nets for when problems arise. At that level, it’s not really any different than dealing with infectious disease. The absence of any problems is our goal. At the same time, that absence always seems to breed complacency and neglect. Hopefully, the experiences of 2020 will help strengthen support for a society based on facts, science and compassion.

 

Media Contacts

David Lobell, Center on Food Security and the Environment: (650) 721-6207; dlobell@stanford.edu

Rob Jordan, Stanford Woods Institute for the Environment: (650) 721-1881; rjordan@stanford.edu

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COVID-19 and other looming threats could make it much harder for people to access food. David Lobell, director of Stanford’s Center on Food Security and the Environment, outlines likely scenarios and possible solutions.

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Cover of Healthy Aging in Asia that shows an elderly woman in a Chinese village.
Life expectancy in Japan, South Korea, and much of urban China has now outpaced that of the United States and other high-income countries. With this triumph of longevity, however, comes a rise in the burden of noncommunicable diseases (NCDs) like diabetes and hypertension, reducing healthy life years for individuals in these aging populations, as well as challenging the healthcare systems they rely on for appropriate care.  
 
The challenges and disparities are even more pressing in low- and middle-income economies, such as rural China and India. Moreover, the COVID-19 pandemic has underscored the vulnerability to newly emerging pathogens of older adults suffering from NCDs, and the importance of building long-term, resilient health systems. 
 
What strategies have been tried to prevent NCDs—the primary cause of morbidity and mortality — as well as to screen for early detection, raise the quality of care, improve medication adherence, reduce unnecessary hospitalizations and increase “value for money” in health spending? 
 
Fourteen concise chapters cover multiple aspects of policy initiatives for healthy aging and economic research on chronic disease control in diverse health systems — from cities such as Singapore and Hong Kong to large economies such as Japan, India, and China. 
 

Desk, examination, or review copies can be requested through Stanford University Press.

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Background: There is a substantial body of evidence supporting the association between maternal active smoking during pregnancy and child development, but the association between prenatal exposure to environmental tobaccos smoke (ETS) and early child development has not been well documented. This cross-sectional study examines the association between prenatal exposure to ETS and the development of children in their first two years of life. 

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