Abstract
Abstract Background Europeans are living longer than ever, and the age profile of society is rapidly changing. Despite the observed improvement in public health in the European region, for many people old age is accompanied by a high risk of social exclusion and poverty, limited access to quality health and social services, especially in countries with economies in transition. This poses serious challenges for individuals and society. This report aims to analyse the basic regional differences of ageing in Bulgaria. Methods Information from the World Bank Open Data was used to calculate the basic indicators: proportion of people 65+ and ageing index for selected European countries. To estimate the rate of change, the growth of ageing index (in %) was calculated on a constant basis in 1970. The regional differences of ageing for Bulgarian population were analysed based on the National Statistical Institute data. The absolute numbers for regions were regrouped and the main indicators for population ageing were calculated. Analysis and calculation procedures were performed by Microsoft Office Excel 2019. Results By 2019, in fourteen of sixteen selected European countries, the ageing index exceeded 100%, and in four countries, it was even over 150%: Italy (174.78%), Portugal (168.70%), Greece (157.89%) and Bulgaria (150.07%). In Bulgaria, the proportion of people 65+ was 21.64% with great differences by regions. The highest proportions were found for Vidin and Gabrovo (29,94% and 29.05% respectively) compared to 19.24% for Varna and 17.70% for Sofia. The ageing index varies from 109.40% for the region of Sliven, 126.38% for Varna and 119.91% for Sofia to 248.63% for Vidin, 248.17% for Gabrovo, and 227.98% for Kyustendil, which are the regions with lower availability of health care. Conclusions The profound regional differences in population ageing impose permanent monitoring and directing the regional social and public health policies to avoid unfavourable effects of this process. Key messages The change of health status with increasing age is a challenge for the capacity of the health systems, especially for provision of long-term care, to cover the needs of the elderly. It is of utmost importance to develop policies and conditions for long-term and palliative care and for improvement of services and living conditions to ensure a better quality of life.
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