Abstract:

Demography is usually analysed as a derivative of economic and political developments. Further, public health as a sector is influenced by population statics and dynamics. Where is the key to sustainable healthcare policies in a post-communist country with an ancient history, restrictive population pyramid and rich cultural traditions? The universal key to future progress is education. The overall aim of this article is to make a short but sharp overview of demographic developments in Bulgaria and to relate them to the possible educational strategies for future public health reinforcement.

Bulgaria is a native country for 7 050 034 people. Since 2007 the country is a European Union (EU) Member State. In 2017, the Crude Birth rate (CBR) in Bulgaria was 9.0 ‰; Total Fertility rate (TFR) remains below the replacement level – 1.6. The processes of population change due to emigration have a significant negative impact on the population growth. The emigrants for 2017 are 31 586 (mainly ages 25 to 44). By 2020, people aged over 60 will increase by one third and will exceed 28% of the Bulgarians; and more than 50% of the population will live in the cities. Bulgaria is among the five “oldest” countries in EU. However, these are global trends. Therefore, low CBR, ageing and urbanization are natural processes, which need public health awareness and adequate strategies.

Herewith, some misleading interpretations of the demographic facts are refuted:
1) The main reasons for the demographic crisis in Bulgaria are the low CBR and TFR – Not true! In 2017, CBR and TFR in Bulgaria are the same as in many EU countries. The real problem is that Bulgaria has been with a negative natural growth for 29 years because of sustainably high brain drain process. The Demographic replacement rate is around 60% for 2017. The young people go to study abroad and don't come back.
2) Ageing is a demographic tsunami and a fast-on-going social crisis - Not true! Demographic aging is not a sudden event, and many countries are already able to cope with it successfully. How can these processes be managed in Bulgaria?
The key strategies are education developments at all levels. The social need for attractive forms of continuous training aimed at transferring skills for active aging is growing.
3) People stop learning when they become 60. Old people do not understand new technologies- Not true! Worldwide, people over 60 are one of the fastest growing Internet communities. In Bulgaria these processes are slower due to language and economic barriers. However, more and more adults are using computer technologies.

The sustainable strategy is the lifelong education. The lifelong learning framework emphasizes that learning occurs during the whole course of a person’s life and it has the social potential to support and to empower older adults. Thereafter, the seniors can be a valuable intellectual and economic support for their community if an adequate education is provided.

Conclusion:
Demography is also a derivative of education. The presented demographic challenges could be managed and the key strategy is education. Public health training should also adapt. Moreover, jobs that provide care and cure will exist forever. A researcher could be substituted by a computer, but a healthcare worker partially. Public health professions, which provide social and psychological support, will be among the future professions. Lifelong educational programs have to be adapted to these trends.

Keywords:

Demography, education, public health, Bulgaria.