One of the next big challenges for all nations is aging, says Scott Currie. With a mushrooming generation of seniors who had fewer children than in the past to support them, adjusting to the lower dependency ratio presents stresses on healthcare delivery systems around the world. Scott Currie, a student in the Yale School of Public Health’s accelerated MPH program for students from Yale/National Singapore College (Yale-NUS), foresees a career full of opportunities focused on the challenges this creates.
At Yale-NUS Scott worked in a lab studying the molecular and cellular elements of aging. He began to see the ramifications of aging moving down a pyramid into biology of the body’s organs, how aging manifests for individuals and its effects on communities and nations. A native of Australia who spent half of his childhood living in several Asian countries, Scott chose to focus his MPH degree in health policy to contribute to meeting the needs of aging populations from a point of view that make cultural sense.
Cultural relevance is particularly interesting to Scott. In his work with Professor Phyllis Granoff, the Lex Hixon Professor of Religious Studies at Yale, he is developing ethics for age-related disease research in Asian countries. Many countries are not willing to invest in research, and not all research from the West is applicable to people from the East due to cultural and philosophical differences that shift emphasis from the individual to the family or community. For example, a basic tenet of western medical research is informed consent. However, in China an enshrined practice is to inform the patient’s families of a negative diagnosis and let them decide if the patient should be told. This familial approach to care is culturally rooted and has strong impacts on treatment. The case can be made for stronger patient rights, not by merely by appealing to the arguments of Enlightenment figures but rather to Confucian values as espoused by Mencius. This will have a much stronger impact on Chinese practitioners and permit diffusion into the social fabric.
In addition, all countries need to evaluate how the oldest generations will impact their infrastructure. Are there enough primary care physicians, cardiologists, orthopedists who perform joint replacements, nursing homes, Alzheimer’s units, visiting nurses, etc… to support people who are aging? Will communities be able to shift resources as people live longer and with smaller support networks without regressing on maternal child health and other successes of the 20th century? How can this glut of experienced, older individuals be best leveraged and what savings can be achieved through having fewer young people? How do needs change from country to country as a result of local laws that controlled access and funding for birth control in prior decades. “In China, the one child law required strong vertical generational investment whereas in Australia, there were more horizontal financial transfers. I see health policy as the key untangling what that means for the future.”