The proportion of the world population over age 60 is projected to increase from 11 percent today to 22 percent by 2050—see charts below (data from United Nations, 2012). Population pyramids, especially in Europe, the U.S. and Canada, reveal that the proportion of the elderly is increasing while that of young people is shrinking. As the population ages, more people will need care. At the same time, fewer people will be available to provide and pay for the patient-centered care characteristic of Western societies today. With fewer people available to provide care, new solutions will be needed. In recent years, researchers have developed technologies to assist in elder care (Peterson et al., 2012; Broekens et al., 2009).
Gendered Innovation 1: Assessing Women's and Men's Needs for Assistive Technologies
Understanding the characteristics of elderly populations is key to designing successful assistive technologies. While elderly women and men often have similar needs, understanding how sex and gender interact to impact aging can assist engineers in developing technologies that best fit user needs. Studies show that sex and gender interact to impact health in old age.
- • Dementia strikes women and men in equal numbers as they age, but because women live longer in most developed countries, they suffer more dementia (Plassman et al., 2007; Nowrangi et al., 2011).
- • Arthritis is more common in women than in age-matched men, and rheumatoid arthritis occurs 2-3 times more often in women than in age-matched men (Alamanos et al., 2005; Linos et al., 1980).
- • Dexterity impairment impacts men more than age-matched women (Desrosiers et al., 1995).
- • Hearing impairment is more common among men than in age-matched women (Cruickshanks et al., 2010)—see chart. These differences may depend on sex-specific biology, but gendered divisions of labor also mean that men are more likely than women to be exposed to occupational noise (Engdahl et al., 2012).
Analyzing sex and gender is important for engineering successful assistive technologies, and this will become even more important as the population continues to age. Data from the U.S. reveal that the majority of the elderly are women, and women make up an increasingly large proportion of older people at more advanced ages. About 53 percent of the U.S. population aged 65-69 are women; this increases to 65-80 percent among the "oldest old," aged 85 and over—see chart below. These data require special attention: When research for assistive technologies is sex- and gender-blind, the marketability, usefulness, and acceptability of such technologies can be limited.
Data also reveals important gender differences in partnering patterns, such as marriage age and age differences in partnerships. In Western societies, women tend to marry slightly older men. In England and Wales, where data are available, women on average marry men 2.6 years older; the most common age gap is one year (Bhrolcháin, 2005). Similar values are found in European Union countries and in the U.S. (Lakdawalla, 2003; Van Poppel et al., 2001). Marriage age gaps (a gendered phenomenon), combined with women’s greater longevity, mean that women are more likely to live alone than men. In the U.S., women make up 59 percent of people over the age of 65, but 76 percent of those living alone (Pew et al., 2004). Women are more likely than men to be widowed, and the death of a spouse is a major predictor of loneliness (Dragset et al., 2011). This may imply women have greater needs for assistive technologies that provide social connectivity.
Similar patterns hold for same sex marriages and partnerships: In Sweden, where same-sex marriages and registered partnerships are recognized (and data are available), age gaps are on average larger among homosexual than heterosexual couples. For example, an age gap of 10 or more years exists in 34 percent of homosexual male partnerships/marriages, 15 percent of homosexual female partnerships/marriages, and 9 percent of opposite-sex marriages (Andersson et al., 2006). A demographic study in Norway finds that the average age difference in gay and lesbian registered partnerships was 7.0 years, compared to an average age difference of 2.5 years for heterosexual couples (Kristiansen, 2005; Noack et al., 2005).