Imagine a future where seniors are not hospitalized for chronic issues but instead live in the comfort of their own digitally equipped smart home. A home directly connected to health care providers and their loved ones, offering safety, security and health monitoring. Imagine a future where seniors who have lost their ability to drive are now issued a new licence for an autonomous vehicle — restoring their independence. A future where the car not only helps seniors get around, but also serves as a diagnostic hub for personalized health care.

Imagine a future where this technology is used all over the world, and when people look at it, they see “Made in Canada.”

The world’s population is growing older for three primary reasons: people are living longer, birth rates have plummeted, and the baby boomer generation, which represents a unique population spike, is moving into its senior years. There are already likely a billion seniors worldwide (latest data showed 962 million in 2017). By 2050, nearly a quarter of the population in all regions of the world will be over the age of 60, and this number will rise to nearly 3 billion by the end of the century. From a national perspective, being prepared for this demographic shift will be the difference between experiencing it as a global economic opportunity or as a national crisis.

In 2012, one in seven Canadians was a senior and, as a whole, seniors accounted for nearly half of all public sector health care costs. By 2030, almost one in four Canadians will be a senior citizen. The implications of this demographic shift for health care costs are staggering, without even taking into consideration the other institutional pressures and market demands that will swiftly follow as a result.

Canada should actively prepare for our demographic changes, not only to curb unsustainable health care costs but also to reap the benefits of this global economic opportunity.

The challenge

The OECD’s 2019 report on fiscal challenges and growth in aging societies is clear:

The “silver economy” can be a powerful source of new products, services and jobs where policies encourage entrepreneurship and innovation…People over 60 are on track to generate more than half of urban consumption growth in developed economies, fuelled by spending on healthcare… [However,] absent policy changes, ageing pressures could increase the public debt burden by average of 180% of GDP…over the next three decades.

The increasing pressure on public debt that the OECD is warning about is already being observed in Canada. This was highlighted in the 2018 Fiscal Sustainability Report by the Office of the Parliamentary Budget Officer. This growing challenge resulted in Canada’s premiers unanimously calling on the federal government to increase funding by an annual escalator of 5.2 percent to the Canada Health Transfer. These pressures will only continue to grow unless Canada can bring innovation to bear, reframing the challenge of an aging population and its burden on our public health care system into a driver for economic growth and improved health outcomes.

The opportunity

Canada is uniquely positioned to seize a global competitive advantage over the “silver economy” if it pursues ambitious policy packages targeting the aging population, especially those related to long-term care (LTC). The domain of LTC is a low-hanging fruit for alleviating bottom-line pressures through innovation and is also a priority for transformation. The country will need 199,000 new LTC beds by 2035, at a cost of at least $130 billion to the health care system, according to the Conference Board of Canada. While more LTC beds are certainly part of the solution, the health system cannot continue to simply absorb the costs associated with our rapidly aging population. LTC is a distinct subsector within health care where funding is split between health services and accommodation services with a mix of private and public costing options. This blended funding model, in combination with the unsustainable demand for LTC, can serve as the necessary genesis for preparing Canada’s health care system and our economy for global aging. In other words, start with LTC and the rest will follow.

An emerging branch of health care technology known as “age-tech” is providing novel solutions for LTC, including assisted living technologies, the Internet of Things, sensors, digital home care and more. Age-tech for the silver economy will be a multi-trillion-dollar global market within the next half decade. It is estimated to grow to $8.5 trillion by 2025 in Europe alone, according to a European Commission study.

With Canada’s hallmark public health system, our country can leverage this brand to be a leader in age-tech. For example, using unique linked data sets in Canada, we know that older adult drivers drive at different times of day, drive on different roads, respond to environments differently and interact with automobile technology differently than their younger counterparts, yet companies still do not design cars to be inclusive of this growing and powerful market segment: seniors.

Companies interested in responding to this demand can work with organizations like Bruyère, a multi-site academic health care organization that is leading this field of research and reframing the way we think about aging — from smarter cars to smart homes and more personalized care options. The government of Canada is even offering funding for this type of collaborative work under the banner of Regional Innovation Ecosystems. This is important from a public health perspective, because a senior’s ability to access and use a vehicle is incredibly important for reducing social isolation and keeping seniors healthy, allowing them to live at home rather than in LTC.

The Great Lakes automotive manufacturing cluster could align its growing capacity and infrastructure to address this challenge and profit from this opportunity for the benefit of all Canadians. The global market for autonomous technology for vehicles is slated to be worth $86 billion by 2027. We believe Canadian data partnered with the Canadian auto industry will make us global leaders. The potential for our businesses and our health system to thrive during the rise of the silver economy is real.

Making sure that Canada is a top destination for businesses to invest, grow and create jobs and prosperity for Canadians is one of the government’s top priorities. Investments with a greater focus on age-tech can help achieve these goals. Bruyère provided a pre-budget submission to the Standing Committee on Finance to help Canada build a global competitive advantage and truly capitalize on the silver economy. To maximize quality of life and help people stay at and return home, it makes these recommendations:

  1. The government of Canada should continue to consult with industry and sector leaders through its Economic Strategy Tables, specifically with a focus on age-tech and the silver economy to better understand the perspectives of industry and health care organizations on this massive and growing opportunity. This will also demonstrate to our G20 partners that Canada is taking the challenges faced by our aging population seriously while also considering the economic opportunities these challenges provide.
  1. The federal government should renew funding — and triple the amount, from $50 million to $150 million — for its Strategic Investment Fund: Stream 4 (collaborative technology development and demonstration) in pursuit of the Health and Biosciences Economic Strategy Table goal of doubling the number of health/biosciences firms and their exports.
  1. The federal government should expand the Canadian Institutes of Health Research’s Institute of Aging to include more work on age-tech and how these technologies can support healthy aging. This will produce the national data necessary for evidence-based decision-making, allowing Canada to be less reliant on international bodies for this information. This important research will be of use to stakeholders and industry across all sectors, private and public alike.
  1. The federal government should build on the success of its Innovation Superclusters Initiative through the creation of an “age-tech supercluster.” This will position Canada as the world leader in technologies that benefit the aging population, creating massive economic and investment opportunities while curbing the costs of our health care system.
  1. The government should continue to invest in the CAN Health Network, of which Bruyère is a member, to jump-start Canada’s competitive advantage for the silver economy by leveraging this growing marketplace for health care technology.

Canada (and the world) needs a solution to runaway health care costs associated with caring for the aging population. Canada’s public health care system and its unique, split-funded LTC subsector provide fertile ground for local disruption through age-tech, which will enable the country to capitalize on the global silver economy. However, to unleash this potential, we must implement ambitious policy packages targeting the aging population, enabling Canada to become a leader in the global age-tech economy.

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Mitchell E. Kutney
Mitchell E. Kutney is director of innovation and development for Bruyère, an academic health-care organization. He is a board member of Big Brothers Big Sisters Ottawa and a trustee for the Harry P. Ward Foundation.
Kumanan Wilson
Dr. Kumanan Wilson is a senior adviser in digital health at Bruyère, an academic health care organization, and a general internist at the Ottawa Hospital. He is a professor of medicine at the University of Ottawa and a member at its Centre for Health Law, Policy and Ethics.

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