The past century has seen major changes in the age structure of Western countries. For example, Americans and UK citizens live far longer than previously. Thus, a person born in the United States at the beginning of the twentieth century could expect to live to around 49 years, while the life expectancy at the end of the century was 76.5 years, a gain of over 27 years (Olshansky et al., 2001).
These changes have been brought about by an improved standard of living with better housing, clean water and immunisation programmes, together with better medical treatments, especially drugs. The past 50 years have also seen a major change in the age structure of the population. In 1951 the population of England and Wales contained 4.83 million persons aged 65 or over but by 30 years later the figure had risen to 7.57 million and now exceeds 8 million elderly people. More important is the number of old elderly persons (over 75 years), the number of whom has roughly doubled in the same time period. These trends over time are set to continue and it is forecast that there will be continued expansion of the elderly population over the next 30 years (Figure 7.1).
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