60-69 70-79 80-X 60 year old atxi older
Residenoe year old Tot a1 Males Feenales
AB per cent of the population
Budapest Baranya BBcs-giskun SlcrSs
Borsod-Abau j-Zempl6n Csongra
Fe jdr
Gy6r-Sopron H a jdu-Bihar Heves Km8som N6gra Pest Somogy
Ssabolcs-Seat&
Szolnok Tolna vas Veszpdm Zala
Tot al
Dr. Jdzsef KEPECS, Deputy Chief of Department of t h e Hungarian Central S t a t i s t i c a l Office
THE PROBLWS OF OLD POPCTLBTIOlV OlV W I S OF FMILY-
Am)
Hmm
STATISPICSThme-four decades ago t h e idea arose t h a t in demography t h e population should be studied not only by t h e age and ser of pereons and other c r i t e r i a but a l s o by t h e composition of t h e
narrower o r wider human c o l l e c t i v i t i e s , t h e families and haweholds.
The investigations concerning t h e b a s i c c e l l s of t h e s o c i a l -existence
are included more and more i n t h e d a t a c o l l e c t i n g and processing programmes of t h e population censuses as well as i n t h e surveys of s o c i a l s t a t i s t i c s and sociology a l l over t h e world. Almost upon t h e same consideration, with another purpose and on b a s i s of an already e a r l i e r perception t h e population censuses are often connected with a housing census, too. It i s not a chance t h a t they t r y t o examine together t h e persons, t h e smallest human c o l l e c t i v i t i e s and of t h e objective conditions t h e one which may be t h e most c h a r a c t e r i s t i c of t h e i r environment, which i s an important determinant of t h e manner of l i f e , l i f e conditions, i.e. the way of living. Therefore beside presenting t h e personal data, mortality conditions of old people it
is worth-while t o say some words a l s o about t h e household-, f a m i l p and housing conditions under which they l i v e , whether these
conditions a r e s u i t a b l e f o r t h e individuals and whether t h e i r placement i s equitable i n s o c i a l respect. Independently of t h e material f a c t o r s a l l these a f f e c t much t h e l i f e conditions of old people.
It is a b a s i c question whether they must l i v e alone, maybe, with an old spouse or in another composition. I n 1980 of t h e population over 60 years nearly 1.9 million persons lived in
hauseholds, of them more than 1.3 million belonged t o one- and
i s r e f l e c t e d a l s o by t h e d a t a which present t o what extent old people l i v e together with persons of similar age o r with other generations and t o what extent young and old people, middle-aged and old persons and t h r e e .generations, respectively, l i v e together.
Old persons i n t h e above composition l i v e i n 36 p e r cent of t h e t o t a l number of households. H a l f of these households only c a n s i s t s of old people. Young and old persons l i v e in 2 per cent and t h r e e generations i n 8 per cent of t h e households. The nearly 10 per cent proportion of t h e middle-aged and old people r a t h e r r e f l e c t s a demographic c h a r a c t e r i s t i c , namely t h a t a p a r t of t h e males over 60 years
-
taking i n t o consideration t h e marriageh a b i t s
-
has a partner under 60 years. Though d a t a are not available on t h i s difference in age but i f we suppose 4-5 years, even the&it i s obvious t h a t from t h i s stratum socmer o r l a t e r most persons e n t e r t h e old age. Thus this group does not d i f f e r much i n q u a l i t y From t h e households i n w h i c h only old persons l i v e together.
Beside t h e demographic, family-household c h a r a c t e r i s t i c s of t h e old population it may be i n t e r e s t i n g t o say some words
of t h e f a c t o r exerting a great influence a l s o on t h e l i f e conditions of t h i s stratum, i e e e t o present some c h a r a c t e r i s t i c 8 of t h e
dwellings occupied by old people, d e s p i t e t h e f a c t t h a t first of all t h e r e is only a p o s s i b i l i t y f o r a s t a t i c analysis characterizing t h e 1980 s i t u a t i o n and t h e changes occurred since t h e 1970s can be revealed only i n some cases.
The b a s i c c h a r a c t e r i s t i c of t h e l a s t decade was t h a t parallelly with t h e ageing of t h e population a l s o t h e number of dwellings occupied only by old people s l i g h t l y grew, by about 10 per cent, and at t h e end of t h e decade more than 800 000 old persons l i v e d i n these dwellings. Within t h i s t h e r a t i o of one- person dwellings increased, t h i s change was dynamical e s p e c i a l l y i n t h e urban areas.
A t t h e analysis of t h e housing s i t u a t i o n t h e special
mentioned t h a t a l s o s t i c k i n g t o t h e environment, t o t h e habitual
require t o afford t h e families by a l l means t h e p o s s i b i l i t y of
case of dwellings which are not situated i n housing e s t a t e s t h i s proportion does not even reach 50 per cent. But it can be also mentimed t h a t among the dwellings of old people l i v i n g together with other age-groups in housing e s t a t e s the r a t i o of one-room dwellings is by about 40 per cent lower as compared t o nan- housing e s t a t e dwellings with identical age-structtllce of the inhabit apts.
Maybe, all these factors canpleted the description of the s i t u a t i o n of old people as it can be i l l u s t r a t e d with figures a t the beginning of the 1980s. I have t o add t h a t first of all I f e l t necessary t o emphasize the problems because they also r e f l e c t the worries of the f i t u r e old generation and may indicate the directions of -her actions.
Dr. S t e r J ~ U M , Chief of Section of t h e Hungarian Central S t a t i s t i c a l Office
S W ASPECTS OF TRE MORTALITY OF' OLD POPULATION IN HUNGARY OH BASIS OF' XNTERITATIOBBL STATISTICS
I want t o complete Dr. IClinger9s paper i n two respects:
1. t h e proporticm of old people i n Hungary in an i n t e r n a t i o n a l comparison; 2. t h e present mortality conditions of t h e 60 year old and older population in Hungary according t o an adopted i n t e r n a t i o n a l standard.
In t h e majority of t h e Ehropean countries t h e "ageFng"
process of t h e population can be observed, though t o a various
extent. The proporticm of old people i s higher i n Ehgland, h a t r i a , . Belgium, t h e two German s t a t e s aud t h e t h r e e Scandinavian countries, it i s similar i n Csechoslovakia, France, I t a l y and Switzerland, while in Poland, in t h e southern countries
-
except f o r I t a l y-
as well as in t h e Betherlands, Finland and Ireland it i s lower as
aompared t o Enngary. Since 1970 in Hiangary t h e share of t h e 60 year old a d older population has been over 17 per cent, but i n
Sweden t h e r e l a t i v e weight of old people was 2 1 per cent, i n t h e neighbaaring Austria it was more than 20 per cent i n t h e second h a l f of the 19708.
In f a c t t h e worries and troubles of old age s t i l l appear only s l i g h t l y in t h e seventh decade, and i n many countries, mainly t h e males a r e economically active till t h e age of 65 years. But it i s r a t h e r a general experience t h a t over t h e age of 70 years t h e complaints g e t more frequent and t h e eighth decade is anyhow t h e period when people l o s e grsdually t h e i r c a p a c i t i e s and t h e reserve forces get exhausted i r r e t r i e v a b l y . What is t h e proportion
of these old persons requiring absolutelg a help azd care in t h e Ehropean countries? In Hungary t h e i r share is nearly 9 per cent.
It is similar i n Denmark and Switzerland. Their r a t i o is higher i n England, Austria, Belgium, France, Bonvay, Sweden and i n t h e two German s t a t e s . In t h e German Demooratic Republic t h e share of 70 year old and older populatian i s n e a r l y 11 per cant. In t h e countries of South- and East m o p e t h e r e l a t i v e weight of t h e 70 year old and older people i s lower than i n Hungary.
Thus Hungary can be found i n t h e middle amang t h e 'European countries i n respect of t h e age-structure of t h e populatian.
'ibis i s equally v a l i d f o r t h e sham of persons both over 60 and over 70 year60
In demographic respect at old age t h e study of m o r t a l i t z is of first importance, because r e s u l t i n g f r o m t h e character of old age t h e o t h e r demographic phenonmna e i t h e r do not occur at all o r only with a neglectable frequency. This i s not t h e case f o r mortality, A t t h e present age-structure of deaths in Hung- t h e development of mortality depends first of a l l on t h e deaths of old people. A t t h e beginning of t h e 1980s 76 per cent of t h e deceased were 60 year old and older, while 58 per cent of them were 70 year old and older. Therefore mortality can be decreased anly i n t h e case i f we a r e able t o reduce t h e age- and cause-specific mortality r a t e s of old persons.
Is t h i s possible? With other words: a r e there any r e a l chances a t old age f o r lengthening t h e l i f e expeotancies? Well, how i s t h e mortality of old people l i v i n g i n t h e 1 9 7 0 ~ ~ 1980s i n
Hungary in an i n t e r n a t i o n a l comparison?
To s t a t e it we calculated f o r t h e 1978 year t h e standardized mortality r a t i o s /hereinafter called S I R / of t h e 60 year old and older male and female subpopulations of 20 European countries,
as well as of Japan, Australia and New Zealand. This method pro-
was by 5-10 per cent lower than in Hungary. In eight countries: France, Greece, t h e Netherlazadgr, Iceland, Japan, Norway, Switserland and Sweden t h e SbW is by 34-41 lower than in Hungam.
whole coarse of l i f e m a n y deaths
-
which might have been prevented-
occur t o o soon, and in t h i s respect old age is not an exception either.
However, it cannot be emphasiaed s u f f i c i e n t l y t h a t
mortality w i l l decrease only i f purposeful, co-ordinated e f f o r t s w i l l be made
-
g r e a t e r than at present-
t o prevent and cure t h echronic diseases and pathological conditions. The s e c u l a r mortality trend of t h e 20th century has t h r e e s t a g e s in t h e i n d u s t r i a l
cotmtries. Of t h e second stage, i n which a l s o Hungary is at present, t h e decrease i n t h e extent of t h e lengthening of t h e
-
duration of l i f e which could be observed c l e a r l y e a r l i e r , t h e
possible etagnat ion and even a temporary r e g r e s s are characteristic.
This stage could be observed about twenty yeam ago i n t h e countries with a more developed h e a l t h culture aa compared t o Hungary. Thus t h e l a g i s about two deaades. The third stage i s t h e period of lengthening of t h e duration of l i f e at all ages, i.ee a l s o at old
The whole s t r a t e g g of t h e change in this d i r e c t i o n is developed.
This has t o be adopted and applied efficacionsly.
Dr. Likz16 C 5 S Z C M B X E E l Director of t h e Sociological Research I n s t i t u t e of t h e Eungarian Academy of Sciences
THE SOCIOLOGICAL AND SOCICbKILITICAL ASPECTS OF AGEING
1. The place of old people i n t h e s o c i a l s t r u c t u r e
~t t h e d a t e of t h e 1980 population census 92 per cent of t h e population over t h e pensionable age were i n a c t i v e o r dependent in Hung=. In t h e first f i v e years a f t e r t h e r e t i r i n g age t h e r a t i o of a c t i v e persons w a s s t i l l s i e i f i c s n t , among t h e 60-64 year old males 1 3 per cent, am- t h e
55-59
year old females19
per cent, but over t h i s age it already decreased r a p i d l y d among persons over 70 yeara it was only 2 per c d .The above d a t a show that it is sn u n j u s t i f i e d s i m p l i f i c a t i o n t o say i n general t h a t old persons don't p a r t i c i p a t e in t h e s o c i a l produotion though t h e r e is no doubt that t h e i r majority does not work anymore in fill time, regularly, and t h e pension is t h e b a s i s of t h e i r subsistence.
In t h e past decades f o r t h e study and presentation of t h e s o c i a l s t r a t i f i c a t i o n a model became predominant which includes t h e economioally a c t i v e persons in t h e individual strate by t h e i r occupation, occupational s t a t u s and t r e a t s s e p a r a t e l y t h e i n a c t i v e persons as a uniform block independently o f t h e fact t o which active stratum t h e y belonged during t h e period of t h e i r e a r l i e r work. Thus old people form two major groups: t h e group of a c t i v e persons who do not even form a sub-group within t h e i r own stratum, and t h a t of i n a c t i v e ones where they a r e not distinguished anymore by t h e s p e c i a l i z i n g c h a r a c t e r i s t i c s of t h e stratum but by t h e f a c t whether they have an own pension o r they are considered as dependents.
It is problematic t o place old people i n t h e scheme of
obvious t h a t much depends on the way and s t y l e of the r e a l i z a t i o n
s o c i a l r e l a t i o n s beside t h e family. Therefore it seems unreasonable t h a t t h e s t r a t i f i c a t i o n model does not take i n t o consideration the inner s t r a t i f i c a t i o n of the i n a c t i v e persons, one of t h e determinants of which i s t h e part-time employment o r its lack.
In t h e i r part-time employment t h e pensioners mostly do a work corresponding t o t h e i r e a r l i e r occupation, therefore they
seldom change t h e i r stratum. However, t h e r e l a t i o n t o t h e individual s t r a t a does not cease even at the end of t h e parGtime emplopent.
The m y e concerning t h e manner of l i f e show t h a t t h e manner of l i f e haa its stratum c h a r a c t e r i s t i c e , among others preference syeteme remaining a l s o under t h e p a r t l y changed conditions. Thus a f t e r r e t i r i n g even at a much reduced income people t q t o
maintain those c h a r a c t e r i s t i c s of t h e i r manner of l i f e which they deem t h e most important, and t h e value system adopted by them e a r l i e r p l a p a decisive r o l e in t h e i r judgement, i.e. what they consider aa t h e most importent. But these value systems depend much on t h e stratum. The f u r t h e r impact of the value syetem explains t h e d i f f e r e n t i a t i o n of t h e l i f e of i n a c t i v e persons by t h e i r e a r l i e r s o c i a l stratum, aa well as the maintenance of t h e important r e l a t i o n e between t h e manner of l i f e of t h e a c t i v e and inactive pereons within t h e same stratum, d e s p i t e t h e differences in income.
In respect of t h e old pereone it i s worth-while t o emphasize t h e work done i n t h e complementary farm-plot because of i t s two canseqtlencee: it is an important complement of t h e income and it provides an opportunity f o r a productive activ- i t y producing new values.
In Hungary t h e majority of persons with t h e lonest income can be found among t h e inactive old people. If t h e str*
t i f i c a t i o n model takes i n t o consideration t h e per c a p i t a income, too, we g e t a s c a l e of s o c i a l hierarchy on the lowest grade of
which t h e g r e a t e r part of t h e persons EUW i n a c t i v e pensioners, The occupation of t h i s lowest place of t h e s c a l e depends much on the persons' p o s s i b i l i t y t o complete t h e i r income, first of a l l an t h e f a c t whether they have a complementary farm-plot and by what sum does this farm-plot increase t h e i r income.
There i s a f u r t h e r d i f f i c u l t y in s t a t i n g t h e s o c i a l status of old people, i n t h e i r r a n g according t o t h e reality,namely a g r e a t share of them, about m e t h i r d l i v e s together with t h e children i n a common household, and t h e l e v e l of t h e i r consumption, t h e i r housing conditions, p o s s i b i l i t i e s of a c t i v i t y depend not only on t h e i r own income but a l s o an t h e f i n a n c i a l s i t u a t i o n of those l i v i n g together with these old people.
Summarizing t h e above mentioned I think t h a t 1/ t h e division i n "activen
-
"already inactiven i s no more s u f f i c i e n t t o form i n t h e s o c i a l s t r u c t u r e a separate category-
considered as b s h g uniform-
of t h e i n a c t i v e old persons, and t h a t 2/ i t is worth-while t o take i n t o consideration t h e ageing, more exactly t h e age f a c t o r at t h e more d e t a i l e d study of t h e s o o i a l s t r u c t u r e , and f i n a l l y t h a t 3/ at t h e study of the s i t u a t i o n of old people it i s necessary t o use a model which takes i n t o account beside the age a l s o the d i f f e r e n t types of economic a c t i v i t y , t h e family circumstances and t h e health conditions,Social t a s k s of ensureing adequate l i f e conditions f o r old
In t h e economically develop& countries everywhere it i s
an outworn concept t h a t society must care only f o r old persons no more able t o support themselves and have no spouse o r child who could be obliged t o support them. A M h e r change i n s o c i a l policy regarding old persons i s t h a t it is no more s u f f i c i e n t t o
ensure t h e subsistence but also other components of the old
s o c i e t y t h a t a l s o t h e pensioners must g e t t h e i r share from the
A t present a p a r t of old people is i n a b e t t e r f i n a n c i a l
The tasks of provision and care are very great. Projecting
on a long range. The experts examining t h e development of t h e l i f e
Another problem t o be solved by t h e s o c i e t y i s t o release temporarily t h e family from t h e problem, works of nursing.
Families providing f o r helpless old persons are not exempted from t h i s work often f o r years, they have no holidays, because t h e r e i s nobody t o charge with this work f o r ane-two weeks. Beside t h e s o c i a l homes providing f o r lonely old people a l s o homes of another type should be developed which would take upon themselves t o
provide temporarily f o r t h e old persons affording by t h i s an
opportunity f o r t h e regeneration of t h e family which would decrease t h e risk of g e t t i n g physically and mentally exhaaeted from t h e old person's care.
I, too, find t h e s o c i a l homes a s a final solution. But t h i s solution would be required muoh more f'requently than afforded by t h e present capacity of t h e s o c i a l homes. The s o c i a l homes must take i n first of a l l old people living alone and already needing a care. A t t h e d a t e of t h e 1980 population census t h e r e were 368 000 households in which ane old person lived alane. According t a t h e values calculated f o r t h e t o t a l populatian about 1&11 per cent of t h e old people cannot provide f o r themselves alane anymore. In case of lonely people this means about 40 000 persons. A t present it i s t h e merit of t h e service of care at home organized by the s o c i a l policy, as well as of t h e neighbours t h a t these old people can e x i s t somehow, but f o r a greet p a r t of them t h e mal solution would be t h e placement in a s o c i a l home.
No doubt, t h a t t h e assurance of t h e income and i n case of g e t t i n g helpless t h e total o r p a r t i a l solution of t h e care and provisicm represent t h e two main groups of t h e s o c i a l d u t i e s in mspect of old people. However, beside t h e above mentianed t h e r e a r e a l s o same other f i e l d s where t h e administration of t h e l o c a l council o r t h a t of t h e special branches
-
public health, oulture, etc.-
already f'ulfil important t e s k s of s o c i a l caxe in respectof old persons. In t h e f i r s t place I should mention t h a t a c t i v i t y of t h e health i n s t i t u t i o n s which, beside t h e treatment of t h e disease, deals very often a l s o with the general problems of t h e l i f e of old people g e t t i n g t o t h e physician or t o the hospital.
Also t h a t a c t i v i t y of t h e cultural i n s t i t u t i a n s i s important which i s focussed r e s o l u t e l y on old people and wants t o arouse, maintain t h e i r i n t e r e s t and amuse them. The council administration has much t o do when old people t u r n t o it with t h e i r d i f f e r e n t worries and problems, em%. with t h e i r housing problems carnmected with ageing, with questions of support, with t h e problems of t h e i r loneliness.
The adequate a c t i v i t y of t h e individual organs is hindered not only by t h e shortage in f i n a n c i a l means but a l s o by t h e lack of c c ~ . ordination of t h e worlca oancerning t h e s o c i a l provision f o r old people.
Thus t h e o r g a n i z a t i m s of public administration and t h e family play t h e leading role. Beside them a l s o at present t h e neighbours, t h e network of friends, t h e former working plaoe, t h e d i f f e r e n t s o c i a l organizations, f i r s t of a l l t h e services f o r old persone of Churches, especially of parishes axe important. Their a c t i v i t y w i l l be needed in t h e f'uture, too, p a r t l y becatme i f it is necessary, they can help mom rapidly, with a g r e a t e r e l a s t i c i t y and p a r t l y because t h e i n t e r e s t , concern from many s i d e s a r e valuable themselves: they strengthen t h e f a i t h in t h e society of people
advancing i n years beosuee i n t h i s way they s t i l l f e e l t h a t t h e sooiety cares f o r them. The a t t e n t i o n fiom several s i d e s i s t h e most valuable i f it does not t r e a t t h e old persone m l y as pas- sive p a r t i e s but gives them a l s o t a k e according t o t h e i r a b i l i t y , prevents them From dealing only with themselves and makes them an a c t i v e participant of t h e l i f e around them. I think t h a t t h i s i s t h e t h i r d t a s k of s o c i a l policy in a broader sense which can be realized only by means of t h e widest s o c i a l 0-operation.
Dr, 2 0 1 t h U Y , Deputy-Chief of Department of t h e Ninistry of Health
HEALTH- BND SOCIcbPOLITIcAL ASPECTS OF AGEING
An integrant p s r t of health provision is t h e therapeutic- prophylactic a c t i v i t y displayed among old people. The'number of diseases increasing n a t u r a l l y with age require8 f o r old persom a g r e a t
-
in same f i e l d s an overwhelming-
proportion of t h e t o t a l capacity of h e a l t h provision. Our t a s k s r e l a t i n g t o old people a r e widened by t h e f a c t t h a t a t t h i s age t h e majority of t h e diseases develops i n a s p e c i f i c-
often f o r a long period i n a concealed, l a t e n t-
form, t h e number of complications i s verg high and i n many cases t h e disease-process i s graver, t h e tendency f o r recovery i s worse than among younger people, The mostly chranic diseaaes require very much nursing, and t h e i r process, outcome are in a s t r i c t c o r r e l a t i o n with t h e psycho-social s i t u a t i o n c h a r a c t e r i s t i c of t h e individual old persons i n t h e p a r t i c u l a r cases. As t h i s sge m a y contain psychologically many disadvantageous e i t u a t i o n s , i n s o s i a l respect a l s o t h e desocialization /estrangement from work and i n some caaes from t h e family/ may exert a negative e f f e c t , thus i n t h i s f i e l d t h e therapeutic-prophylactic work i n a s t r i c t sense i s i n a verg close connection with many elements of t h e s o c i a l provision, with t h e various forms of concern and care,Recently in Hungary, too, tensions could be observed almost simultanausly i n t h e f i e l d of h e a l t h s e r v i c e and t h e care f o r old people, It i s comprehensible t h a t these problems cumdated in these i n t e r a c t i n g c r i t i c a l f i e l d s overlapping each other: i n t h e f i e l d of t h e health provision f o r old people, Our society reacted verg s e n s i t i v e l y t o t h e a r i s i n g problems,
The a c t i v i t y of public health carried out among old persons, t h e concrete t e s k s of provision can be judged only by revealing and analysing t h e presumable need r e s u l t i n g from t h e health condition of persons over 60 years.
In t h i s approach the mortality and morbidity s t a t i s t i c s may- give a good information but a l s o t h e d a t a maybe, l e s s r e l i a b l e , on t h e u t i l i z a t i o n of t h e i n s t i t u t i o n s and those obtained a t t h e screeningexaminations maJt help i n the analysis.
Studying t h e mortality by age-groups per 1000 populat'ion of the corresponding age we see an increasing trend also among people over 60 years i n t h e l a s t decade
a able
1/. This i s c h a r a c t e r i s t i c mainly o f t h e 60-74 year old age-groups of males where t h e growth i s e x p l i c i t l y dynamic-
by around 12 per cent during 6 years-,
but a s l i g h t increase can be observed a l s o i n a l l t h e age-groups of old females. The difference i n mortality between t h e males and females which i s almost the double t o the detriment of men a t t h e age under 70 yeam even among old people, decreaees with age but it remains t i l l t h e end. The comparison of deaths per 1000 population of the corresponding age presents a very exact view of mortality, and the method eliminates completely the impact of t h e f a c t o r t h a t once everybody must d i e because t h i s i s a process according t o the laws of nature. Thus t h e study of the Hungarian mortality d a t a i n time s e r i e s i n d i c a t e s the worsen in^ of the health condition of the old population.
It is advisable, however, t o make en i n t e r n a t i a n a l canparison, too. Comparing t h e Hungarian d a t a with t h e European figures we see t h a t i n the e l d e r age-groups, too, we are near t o the European maximum though here we don't represent the maximum /as i n case of persons
aged 40-50 ye-/.
The comparison of the 1967 and 1976 proportions of persons whose death was caused by the three major groups of diseases il-
l u s t r a t e s well t h e mortality s t r u c t u r e and i t s change i n t h e age- groups of old p a t i e n t s
able
2/. The incidence of deaths caused by t h e diseases of t h e c i r c u l a t o r y system, neoplasms and accidents i s very high a l s o at t h e age over 60 years, together they represent nearly t h r e e q u a r t e r s of t h e causes of death. With age t h e proportionof these diseases grows t o an ever bigger extent among t h e causes of death, between 1967 and 1976 a s l i g h t decrease can be found only i n case of t h e diseases of t h e circulatory system i n t h e eldest age- groups *
The incidence of deaths caueed by malignant neoplasms grows evenly i n a l l t h e age-groups of both sexes.
The most shocking i s t h e increase occurred i n t h e number and r a t i o of old persons died with accident during nearly t e n years.
In some cases t h e Hungarian d a t a were compared with t h e m o p e a n ones a l s o i n the major groups of diseases:
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the comparison of t h e diseaees of t h e heart and c i r c u l a t o r y system by age-groups indicate8 an unfavmrable s i t u a t i o n e s p e c i a l l y of females;-
i n respect of deaths caused by malignant neoplasms f o r females aged 30-40 our d a t a represent t h e maximum, our s i t u a t i o n i s almost as unfavaurable a l s o i n case of females over 70 years;-
deaths caused by accidents by age-groups show a very i n t e r e s t i n g s i t u a t i o n also f o r males: while i n t h e young age-groups our s i t u a t i o n i s very good, it worsens more and more i n t h e e l d e r age-groups and over 70 years it is again Hungary which has the maximum mortality rate. / ~ c c o r d i n g t o the part- s t a t i s t i c s mostly r e s u l t i n g from so-called household accidents/.Summarizing t h e mortality d a t a we f i n d t h a t i n t h e recent
the share of old persons in t h e number of days of h o s p i t a l i z a t i o n
d i s t o r t s the epidemiological information. The d a t a of some sample surveys /e.g. t h a t of ~ a l a s s a ~ ~ a n n a t / and those of t h e 2 per
thousand morbidity survey being i n t h e stage of processing already permit t o draw some conclusions. Thus the d a t a s e r i e s on t h e
incidence of long-lasting diseases per 100 pensioners w a s included i n t h e national material.
able
6/. Here as p a t i e n t s f o r a long period were considered those suffering from a chronic disease f o r at l e a s t three months as well as t h e invalids.Thus it is c l e a r t h a t t h e unfavourable m o d i d i t y and mortality s i t u a t i o n of old people determines more and more the u t i l i z a t i o n of t h e health i n s t i t u t i o n s .
Our next question i s how can public health with i t s present means meet t h i s increasing need?
The baaic medical service, f i r s t of all the a c t i v i t y of the d i s t r i c t doctor is a l s o t h e key issue of t h e health provision f o r old people. The old person p a r a l l e l l y with age requires more and more
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because of t h e changes in h i s / h e r h e a l t h condition o r even because of his/her ebbing physical condition-
t o be under acontinuous medical control and treatment ansuring f o r him/her at
continuous medical control and treatment ansuring f o r him/her at