The “Aging Man in Asia”

A recent article in the International Journal of Urology caught my attention.  Titled “Managing the Aging Man in Asia:  a Review”, it emphasized the growing need for properly designed healthcare strategies reflecting the needs of Asia’s aging male population.  As the article notes, “The majority of the world’s aging population is in Asia and this will continue in the future.”  This is obviously one of the many reasons I am very bullish on the investment and business opportunity for senior healthcare in Asia; China specifically, but more broadly across the APAC region as well.  The article makes the latter point forcefully when the authors write, “the rate of aging in Asia countries (of which the majority are developing nations) is much faster than developed nations.  An increase of more than 250% in the number of people older than 65 years old is expected in many Asia countries, such as Singapore, India, Malaysia, Bangladesh and the Philippines.”

It was a temptation while reading the article to think that the issues in Asia will be no different than those faced in the developed West, at least in terms of the types of disease and the stereotypical male reluctance to get healthcare; however, What the article makes clear is that the needs of Asia’s “aging man” are going to be unique.  First, the article points out the impact of smoking on male health.  It notes “The prevalence of smoking men in Asia ranges from 24% to 70%.  Russia, Indonesia and Lao People’s Democratic Republic have a very high percentage of men smoking, accounting for 70%, 66% and 65% respectively.”  These high smoking rates mean that absent large social programs designed to discourage smoking, head, neck and lung cancers are likely to be common across Asia’s male population.

The authors also note that diabetes “has been increasing throughout Asia and the speed of increase is much faster than it is in Western countries.”  As Lua has written about here, the changing diet of Chinese in particular is setting in motion a number of ailments, diabetes most commonly.  In this article, the authors note, “The westernization of Asia dietary intake as well as the sedentary lifestyle associated with a more developed world is a contributing factor.”

Beyond cancer and diabetes, the authors note that male-specific disorders like erectile dysfunction are becoming more of a problem in Asia, as evidenced by studies of hypogonadism, diminished fertility rates, and lower urinary tract problems.  Perhaps most surprisingly, the authors write, “Psychosocial problems are also prevalent in Asia.  A study comparing elderly (aged 75 years or more) suicide rates in Asian and English-speaking countries found that for men, the general population suicide rate (GPSR) was highest in rural China (227 per million population) … Elderly men had a higher Elder/GPSR ratio than elderly women in all eastern Asian countries selected in the study.”

The diagnostic and procedural techniques for treating many of these maladies are well known, but what the authors focus in on is what they call “mean’s health care utilization and health-seeking behavior.”  Here, they note that the traditional male stereotype in Asian cultures looks down on men that cannot bear their disease with stoicism.  This inevitably leads to higher costs later on when preventative care could have pre-emptively dealt with a problem.  It is the design and delivery of healthcare services for men’s needs – not only physical but cultural – that is where the most attention is needed, as the authors well know.

They suggest that health care must be “tailored to men’s needs.”  As they see it, this means getting men to view healthcare as a partnership with their doctor, ensuring privacy, making it easy to discuss private matters especially, and organizing community-level programs that engage men in a context they are comfortable responding to.  How this is done in the various countries this article’s data covers is going to be very difficult, but will be essential if Asia’s aging man is to receive the care he needs.