Opinion: As a nation we are getting older, so how are we going to be looked after if or when we need care? Stats NZ reports that the number of people living in New Zealand aged 65 years or older is about 900,000 people, roughly one in six of the population, and is likely to pass a million by 2029. By 2040 roughly a quarter of Kiwis will be over 65, affecting the workforce, urban planning and healthcare.
Along with our ageing population, more people are leaving New Zealand than are arriving. Infometrics principal economist Nick Brunsdon said: “If we look ahead, we see an ageing population. We are going to need more migrants over the next five to 10 years to carry on doing what we are doing.”
The problem is that far fewer migrants want to come to New Zealand than have in the past: net migrant numbers have fallen from 108,400 in 2023, to 70,400 in 2024, and 13,700 in 2025. Although less population growth reduces pressure on the housing market, it also means there is less growth across all aspects of the economy, including healthcare.
Suggesting a new solution to the pressure from an ageing population collapsing the health system, founder of Orion Health and McCrae Tech Ian McCrae argued that AI offered the only cure.
AI tools certainly have their benefits; they enhance efficiency by automating administrative tasks thus reducing costs, and supporting clinical decisions with data analysis, improved diagnostic accuracy and personalised treatment plans. Tools such as medical scribe technology can automatically capture visit notes, store them in a patient’s medical record, and even flag key details and insights, freeing up medical staff to spend more time with their patients.
AI can increase surgical precision, accelerate drug discovery and clinical trials, and help with disease prevention. And as far as the hospital system is concerned, AI can be used to identify areas where drug errors are most likely to occur so staff can implement stronger safety protocols.
However, as Professor of Population Nutrition and Global Health Boyd Swinburn recently said, the cheapest, most effective way to reduce pressure on our healthcare system was the “implementation of prevention policies”.
As he writes, historical improvements in health and life expectancy have primarily been the consequence of improvements in sanitation, diet and growing wealth, for example, not improvements in the healthcare system. Current drivers of poor health such as poverty, poor housing, highly processed food and excess alcohol have the consequences of preventable conditions such as childhood respiratory infections, obesity, diabetes, and alcohol- and drug-induced trauma.
This is the same approach, or cry for good sense, found in the World Health Organisation’s new framework. Rather than depend on a healthcare system focused on treating illness, we could have a system that helps us thrive in good health from birth to old age: a life course approach to health.
This approach revises how health systems support people at all life stages. It recognises the mix of biological, social, environmental, and behavioural factors that shape health, and that these influences impact the whole of life, not just when things go wrong.
Inequalities that persist and compound over time can be reduced by early attention to health disparities. For example, ensuring all children receive adequate nutrition in their first five years can prevent cognitive delays. A child born into a nurturing environment with good nutrition and access to early learning is more likely to succeed in school, find stable employment, and enjoy better health later in life.
School-based counselling and peer support groups can reduce the mental-health risks among adolescents of depression and substance abuse and their consequences later in life. Support to manage stress and stay physically active for a mid-life adult may delay the onset of chronic conditions and enable independence well into older age.
Rather than turn to or depend on AI or immigration as the best solutions to the costs and care required for an ageing population, we could take better care of the population we already have.