Social aspects of musculoskeletal ageing
In this article, Lesley explores how musculoskeletal ageing impacts not only the individual affected but the people around them too; families, friends, colleagues and the wider society. The consequences of musculoskeletal ageing are not always limited to the direct health effects of deterioration in musculoskeletal function.
Indirect effects on health and relationships
Although musculoskeletal changes may be the primary source of deterioration in an individual’s health, this can have such dramatic impacts on their lives that it leads to further health consequences. A lack of mobility, for example, can lead to obesity which worsens the original condition and increases the risk of developing other health complications such as diabetes, heart, and lung problems.
Lack of mobility may not simply be a result of the underlying condition, it may be due to limited accessibility to appropriate transport, inadequate changes to the home or place of employment, lack of access to suitable facilities e.g. sports centres, inappropriate urban environment and insufficient pedestrian crossings or lack of education regarding level and type of mobility. Lack of mobility can also lead to social isolation and loneliness. Indeed, the reduced ability to continue normal life and hobbies, no matter how small that change may be, can have devastating impacts on mental health and relationships both at home and work.
The diversity of economic effects
The impact of musculoskeletal deterioration in the world population is having a massive economic effect. For example, there can be an economic impact on the family if an individual takes many days off sick, is unable to continue in their usual work or has to stop working altogether. The economic burden of unemployment and sick days not only affects the individual and their families but also affects employers and society.
This burden is not limited to working hours lost, but includes the costs of health and social care. Depending upon the country in question, medical costs may fall heavily on the family e.g. having to pay medical bills. In other countries, such as the UK, the medical costs fall to the state, whilst in others, these costs fall to insurers which then results in increased cost of medical insurance for everyone.
Transportation and access to health care can also have a financial impact on family and society. In the UK, patients can request transport to medical appointments which is then paid for by the state. Other patients may have to use private or public transport, which has its own cost implications of fuel, parking and friends or family taking time off work.
Similarly, the cost of caring for individuals can have an economic impact both on the family and the state. If a family member is caring for an individual this may result in loss of a further source of income. If basic care is provided by someone outside the family, this will require the employment of somebody to carry out this role – a cost that will be covered either by the family, insurance, the state or a combination of these sources. Due to ageing world populations, there is an increase in the caring workforce but these tend to be low paid and undervalued workers, which has further financial impacts on society.
Is it all doom and gloom?
This all sounds very depressing, but there are solutions, although again some of these will have a financial impact on society, at least in the short term. We should not be afraid to talk about how musculoskeletal deterioration is impacting ourselves, our families and our society, and to try to find intelligent solutions. Education and communication are important for patients and carers but employers and society need to be involved too, this is not an individual issue - it affects us all.
Ageism in the workplace and society is probably something that needs tackling worldwide, as the problems of ageing populations will not go away. Just because someone can no longer do the job they were originally employed to do does not mean that they can no longer contribute to society, either in the workplace or volunteering.
Small changes in home, work and urban environments, combined with the use of assistive technologies can make life much more accessible, extending the working life of an individual, increasing mobility, reducing the increased health impacts, need for carers and other impacts on family and society.
Changes are probably also needed for both health and social care. Patients need access to health care particularly preventative health care which has the potential to reduce the impact on society of musculoskeletal ageing. In my opinion, those patients who do need carers need not only their basic care requirements met, by an appreciated, well trained and appropriately paid workforce, but they need to be supported so that can contribute to our society in whatever way they can.
Sources and further reading
Open Access Government. (2015). Musculoskeletal health in an ageing population. Available online [Accessed 19 December 2018]
Arthritis Research UK (2014) Musculoskeletal health: a public health approach. Available online [Accessed 19 December 2018]
Palmer, K. and Goodson, N. (2015). Ageing, musculoskeletal health and work. Best Practice & Research Clinical Rheumatology, 29(3), pp.391-404.
The Bone and Joint Decade – Global Alliance for Musculoskeletal Health (2016) Available online [Accessed 19 December 2018]
Woolf AD & PFleger B (2003) Burden of major musculoskeletal conditions. Bulletin of the World Health Organisation. 81(9): pp646-656. PDF available to download online. Look for the ‘Anthony D. Woolf & Bruce Pfleger’ link under Policy & Practice heading [Accessed 19 December 2018]
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