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Mystery Shoppers
Bernard Salt
Fortelling the future for pharmacy through the lens of demography.

Foretelling the future for pharmacy through the lens of demography.

There are a series of social and demographic changes that will impact the health and wellbeing of the Australian people over the coming decade. These changes partly stem from the ageing process but they also transpire from a broader range of geopolitical and technological developments that are shaping the way we live, interact and work. So what are my top four trends that will shape the future healthcare and pharmacy needs of the Australian people?



There is always a dispute about when generations start and end. And invariably as soon as you nominate a start year someone will say, “So if I was born in the previous year my behaviour and values would have been completely different? ” No. The point of generational slicing is to better appreciate the unique life circumstances that apply to different cohorts.

Baby boomers born in the 1950s were raised by Depression-era parents and often in households with a single breadwinner and several siblings. Boomers learnt early on about hierarchy and scarcity of resources. Perhaps this is why boomers indulged their own Generation Y

children who were raised in double-income households and often as a somewhat indulged only child. In this example, generations very much determine how you might see the world.

There are 5.3 million people alive today in Australia who were born between 1946 and 1965 and who are currently aged49-68. The preceding generation, the frugals born over the 20 years to 1945, currently number 1.3 million although 20 years ago when they were the same age as today’s baby boomers, they numbered 3.2 million. The issue for the healthcare and pharmacy industry is that whatever hospitals, pharmacy needs and healthcare services were required to manage the interests of 3.2 million people on the cusp of retirement a generation ago will have to be upped by 66% to accommodate the needs of the baby boomers as they enter retirement.


And that assumes that baby boomers express the same pro-rata demand for healthcare services as did the frugals. Somehow I don’t think that’s going to happen. “I’m not feeling well. I wanta blood test. I want a cat scan. I want an MRI scan. And I want it all provided just down the road preferably within a 24/7 facility and I do not want to see an account. I have paid taxes all my working life. Now it’s someone else’s turn to support me.”

The Number 1 challenge for the healthcare industry over the coming decade will be dealing with the volume surge of ageing boomers not to mention the, ahem, amped-up attitude that this group of pre-retirees might have about the services that they think they require and are entitled to.


Oddly, this idea of ‘the new teenagers’ has nothing to do with baby boomers mindlessly reverting to their glory days of youth. Rather it has everything to do with the mini baby-boom that emerged last decade. For almost 40 years from the early 1960s, the Australian birth rate plummeted as women went back to work and as households cottoned-on to the idea that if they had fewer kids they could lead a better, or a more material, quality of life.

This issue did not shape the thinking of the frugal generation who delivered the baby boom in the 1950s. It did not occur to those who fought in WWII, and who survived the Great Depression as kids, that scarce household income/resources would go further if there were only two children instead of six. The frugals were simply less materialistic than were their boomer progeny. The boomers scaled back family size partly because of the desire to have more income-per-capita but also because women in the 1980s and 1990s wanted to minimise their time out of the workforce.

But soon after the turn of the new century the birth rate started to climb. X’ers and Ys had jumped on the baby bandwagon. The number of babies born annually in the early 2000s was 240,000; today that number is closer to 310,000. Australia moved into the baby business in the 2000s. The birth rate has now stabilised but this nevertheless means that all those babies born last decade must now push into primary school and junior secondary school in this decade. This might lead to heightened demand for sports medicine over the coming decade for example.

Late in the coming decade we will see a surge in a new and exciting demographic profile, the teenager. Of course the teenager has been with us for some time but for many years only in moderate numbers. The teenage population has stirred, courtesy of last decade’s baby boom, and they are coming to your suburb. This will place pressure on healthcare services based around sensitive matters like contraception, skin care, cosmetics and sports. Juvenile delinquency, declining education standards, the cost of private schooling, and disrespect for authority figures, I am guessing, will be much favoured dinner-party conversation topics among pharmacists and others in the genteel professional classes by the end of this decade.


There really does need to be an independent body to determine the nomenclature of the new generations. The children of the baby boom generation born mostly throughout the 1980s were known initially as the Dotcom Generation. But with the tech wreck in 2001 the term dotcom lost its lustre and the dotcoms re-emerged as Generation Y. Much has been written about the Ys: they are indulged; they cannot settle to anything; they are demanding in the workplace. And to some extent I suspect that all of these generalisations are true. Just as boomers might be characterised as middle- aged middle-class and stuck in their ways. Perhaps.

But there is an argument to say that this flightiness of the Ys might be all part of a conspiracy by the economic world to breed a generation of workers that is fluid and agile which is the antithesis of the boomers. Ys do not want to remain in one job for life; they want diversity of employment.

However the fact is that this so-called flightiness of the Ys probably well suits the times in which we live. Nothing is permanent. Tomorrow’s workers and healthcare professionals will have to reinvent themselves and adapt to new working models and environments.

But there is another aspect of the lives and the lifestyles of Generation Y that is about to change. For a decade or more a new social phenomenon has been identified within the family home where adult children in their 20s have continued to live in the family home. The logic being that the cost of housing is so prohibitive that the next generation needs to be nurtured longer. Stay at home and save for a deposit for a house. Although this often translates as: stay at home and live a souped-up lifestyle with mum and dad picking up the basics.

Stay-at-home adult children are known as kippers: kids in parents pockets eroding retirement savings. At the 2011 Census some 27% of 20-somethings lived with their parents. At the 1986 Census this proportion was 19%. Living with “the olds” might be well and good up to the age of 26. But if you are still there at 32, then that’s just plain sad. At some point over the next decade the kippers will leave home and establish their own households. Presumably these shifting kippers will manage their own health insurance by that stage too. Although I suspect that what we will see will be a movement within a movement: the kippers might have moved out but this does not mean that they are, how shall I put this, completely independent of mum and dad. The financial pain for boomer parents never ends.

“The issue for the industry is that whatever services were required to manage the interests of 3.2 million people on the cusp of retirement a generation ago will have to be upped by 66% to accommodate the needs of the baby boomers as they enter retirement.”



The fourth trend that will shape the Australian population over the coming decade is not based on an age segment but on a shift in ethnicity. This is as important as it is exciting. For 150 years the Australian white population was dominated by a single ethnicity: we were an Anglo people; we were an amalgam of the people of the British Isles. Oddly, Australians of the 1950s were more mixed in their blood than

were the English or the Scottish or the Irish. These Anglo tribes mixed and mingled in the colonies. It gave the Australians such a – shall we say – colourful heritage?

Then came the Greeks and the Italians who added a Mediterranean element to the Anglo base. By the 1980s Aussies everywhere were eating pasta, drizzling olive oil and pronouncing arugula with a polished Italian accent. We even started kissing each other on the cheek! Anglos absorbed Mediterranean cosmopolitan culture and ideas of social sophistication. And of course this new fusion culture was most prevalent in the cities and in some suburbs especially. Many Mediterranean migrants arrived as labourers who measured their success in the New World through the professional education of their children: “My son the doctor”; “My daughter the pharmacist”.And rightly so. These migrants had a lot to be proud of: they worked hard and they made a wonderful contribution to this nation.

But there are new ethnic influences shaping the Australian population. At the 2011 Census the fastest growing ethnicities (of some critical mass) were the Chinese and the Indians. Australia’s famous Anglo-Mediterranean fusion culture is on the move once again. It is absorbing Asian, Indian and I suspect nascent Arabic influences. Do you speak Mandarin? Do you understand Hindi? Do you know what dukkah is? How about quinoa? The last two are Arabic culinary influences making their presence felt in smart Australian restaurants. Australia’s new fusion culture is not so much an issue of connecting in with the latest migrant groups that are populating the city; it’s about understanding how these influences might shape community values and behaviour over the coming decade. Are Chinese customers more at ease in a place that has been configured to reflect the principles of feng shui? Is signage bi-lingual?

If there is one thing I have learnt from my continual sifting and sorting of the Australian demographic profile it’ s that this community is always on the move. And I suspect this is more the case inAustralia than elsewhere. We are an immigrant nation with dedicated portals through which new migrants arrive. Our capital cities must be places where the community can plasticise around new influences. And to some extent the same logic applies to the new segment surges expected in the Australian population over the coming decade. The new teenagers, the kippers and the pre-retirement baby boomers are in many ways the Indians, the Chinese, the Filipinos, the Kiwis, the South Africans, the Iranians who are making their own contribution and who are shaping who we are as a nation.


The role and I suspect much of the joy of being in the pharmacy industry is being at the community coalface: Australia’s newest segments, our newest tribes, our latest age cohorts will in many ways surface first in the healthcare places including pharmacies before making their way into the mainstream Australian community. This is no doubt what makes pharmacy such an interesting occupation but it also explains why it can be extraordinarily challenging. The people and the issues that ultimately shape the nation are in many ways dealt with first by those on the frontline of this nation’s healthcare industry.