Tomorrow's Tourist: Scenarios & Trends

Ian Yeoman

• Publisher: Routledge
• Year: 2009
• Topic: Business
• eBook ISBN:
  9781136354885
• Subtopic: Business General
• Index: Business

By 2030, China will be the world's largest tourism destination, holidays in Outer Space will be the ultimate luxury experience, extreme Swedish ironing will be an Olympic Sport, embedded technologies will be the norm in future tourists and skiing in the Alps will be no more. These are some of the changes that will occur between now and 2030 that will change world tourism. Tomorrows Tourist: Scenarios & Trends enables readers to imagine what a future tourist might be, where they will go and what they will do. This is the most comprehensive analysis of how world tourism is changing and what it means for destinations.

Each chapter consists of a scenario about a future tourist, which is then is backed up with evidence and trends plus a number of assumptions about the future.

The book is accompanied by its own website at http://www.tomorrowstourist.com which is owned and regularly updated by the author.

SECTION II

Chapter 6

The Health Tourist — Searching for the
Fountain of Youth in Incredible India

‘If you're looking for plastic surgery, correction of congenital malformation, teeth-whitening services and other beauty-enhancing cosmetic surgery, Kerala offers highly specialised departments and expert surgeons to take care of your needs’ reads the Joan Collins’ advertisement on the official Indian Tourist Board website. Michelle Harris is one of those consumers who are looking for first-class medical services at a third-world cost and wants to combine it with a holiday. Kerala in Southern India with its secluded hotels, relaxing backwaters, coconut groves and majestic beaches seems the perfect choice. Michelle, a recently retired teacher, wants to enhance her figure and feel young again. Friends have tried it, so she wants to do it. So, let the story begin.

This is Michelle's story in 2022

Introduction

An affluent and ageing society allows consumers to refine their approach to health because they now have the choice of striving for perfect health, as opposed to merely living disease-free. The elderly are the most frequent users of health-related goods and services. Consumers have begun to realise their capacity for longevity and to demand a fit and active lifestyle in their golden years. This means that consumers are searching for ways through which to slow down the ageing process or even discover the fountain of youth. It is not surprising, therefore, to note the rise of medical tourism holidays in South Africa or the greater use of alternative approaches to health, such as yoga, Chinese herbal medicines and spas.

This chapter sets out to

• Show why health and beauty tourism is important for the future

• Analyse the trends and drivers which shape health in society

• Demonstrate how a country's tourism product is using this trend, with India as an example

• Study the prospects for health and beauty tourism

Travel to enhance one's health is not new; Durie (2006) writes about ‘taking the waters’ in the 1800s in the hydro towns of Scotland or German spas such as Baden-Baden. In the late nineteenth century, the emerging urban middle class sought the healthy benefits of fresh sea water or mountain air as an antidote to the overcrowding and pollution caused by industrialisation. Many flocked to spas in pristine mountain locations or by the sea, particularly in Europe and the United Kingdom. In the early twentieth century, ‘health farms’ or ‘fat farms’ emerged, with an emphasis on fitness and a healthy diet. According to a report by Mintel on Health and Wellness (Mintel, 2004b), the modern era of health tourism is considered to have begun in 1939 when Deborah and Edmond Szekely opened a US $17.50-a-week, bring-your-tent spa and healthy-living retreat, which became the renowned Rancho La Puerta fitness resort in Mexico. In the same vein, Mel and Enid Zuckerman opened the Canyon Ranch, Tucson, Arizona, in 1979. Today, both locations still provide pampering, fitness activities and medically supervised wellness programmes to their high-paying clientele. They have established important models which have been copied and modified around the world. Today, health and travel have become global phenomena, to the extent that a trend has emerged, giving new meaning to the idea of going on holiday and returning ‘a new person’. Whether this is a nip and tuck in a Beverley Hills’ clinic or accruing a new set of teeth in Costa Rica for US $6000, health and beauty as the main reason for travel is a burgeoning market because travellers like Michelle search for the fountain of youth.

What Are the Key Trends Shaping This Phenomenon?

Over the past two decades, society has witnessed a steady growth in disposable income and further growth is anticipated over the next 20 years.

Figure 6.1 shows that staying fit and healthy has been consumers’ top priority since 1983, according to the Future Foundation's Changing Lives Survey, and it will continue to be so in the future. The World Health Organisation predicts that ‘health’ will be the world's number-one industry by 2022 (Lister, 1999). Today's society is aligned between the consumers’ strong interest in health and the rising affluence, resulting in a plethora of consumer products, whether anti-ageing creams or medical procedures.

Two of the measures of society's well-being are life expectancy and rates of infant mortality; when combined, these measures paint a picture of the age structure of society as it will be in the years to come (Figure 6.2). Living longer means that consumers have more time to do the things that they want to do. Part of this is as a result of advances in medicine, but it also has to do with affluence and looking after one's health. These health-related trends affect the demographic composition of UK society. Declining infant mortality, increased life expectancy and couples deciding to have children later in life have led to a shift in the age composition of society at large — fewer young people and more old people.

Between 2005 and 2030, the proportion of the UK population aged 50+ will increase by more than 40% whilst there will be negligible, and perhaps even negative, growth in the population aged under 50. It can be anticipated that advances in science will play a greater role in shaping the demographic structure of UK society through the increased success of IVF treatments, new treatments for cancer, the role of genetic engineering and, potentially, an HIV vaccine. All of these point in the same direction — increased longevity. Therefore, it is anticipated that in the future health care will become even more dominated by the needs of the elderly and also by the people's desire to remain fit and active for longer in life. By 2030, health will be a core driver of tourism experiences. In fact, the World Health Organisation has forecasted that health care will represent 12% of the world GDP by 2022, followed by tourism at 11% (Lister, 1999).

Figure 6.1: Concern for staying fit.

Figure 6.2: Life expectancy at birth in the United Kingdom.

Health Behaviour and the Consumer

Figure 6.3: Total health expenditure per capita in Europe and the United States, by country.

The centrality of health in modern society is demonstrated by the progressive increase in expenditure in both public and private sectors, and rising insurance premiums. Across the developed world, healthcare spending is rising and will continue to do so as population ages, new treatments are demanded and price inflation in the sector remains high. Since 1970, the average real growth in spend in rich countries outside America has been 4.0% a year. The OECD (2006) data in Figure 6.3 show the annual, per person healthcare spend in purchasing power parities (PPP) varies from around US $700 in Poland and Slovakia to above US $3500 in Switzerland and Norway. Continental Western Europe and the Nordic countries fall between US $2300 and US $2800. Spain and Portugal rank at the bottom of the EU 15 countries, with figures around US $2000. In America, expenditure has now reached almost 15% of the GDP, by far the highest share anywhere.

Our Perception of Our Own Health

Are we satisfied with our own health? Figure 6.4 shows that women are less satisfied with their health than men are. Moreover, satisfaction with health naturally declines across the age groups, with older Britons being less satisfied than younger ones. Bodies fail as people get older and, as a result, satisfaction with health declines. Accordingly, as expectations of perfect health increase in society, people perceive that their bodies are failing to conform to this standard. Therefore, consumers will search for the fountain of youth and the resultant consumer trend is that healthcare expenditure will exponentially rise.

Figure 6.4: Satisfaction with own health.

Incidence of illness increases significantly as people get older. The conditions that account for the majority of the diseases in Europe are primarily related to age, such as cancer and cardiovascular diseases. Success with preventive measures and advances in treatment for hypertension, cardiovascular diseases and diabetes have had the effect of blunting mortality from these diseases. Yet these same advancements may leave more elderly people — by virtue of the longevity which has been created by medicine — experiencing increased disability and dependency.

Living Longer

People are living longer. However, do people live longer and better or only gain years of life in poor health? Figure 6.5 shows the healthy life years’ expectancy (HLYE) indicator. It measures the number of remaining years that a person is expected to live in a healthy condition. Data show that as time passes and society gets wealthier, the number of healthy life years tends to increase. This means that although one may live longer, most of this incremental time will be spent in active health. Yet the period of ill health at the end of an active life will remain the same length. This phenomenon is sometimes discussed under the term ‘compressed morbidity’. Currently, in Europe, at the age of 65, one can expect to have another 18 years left, of which, on average, around 10 should be disability-free. By 2030, this is forecast to rise to 25 extra years of life for 65 year olds.

Figure 6.5: Healthy life years’ expectancy.

Over the past decade, substantial lifestyle changes have led to variations in causes of death. Mortality rates from heart disease, strokes and cancer have declined, while behavioural changes have led to an increased prevalence of obesity and diabetes. In 2006, 22% of the British, 20% of the German, 13% of the Spanish and 10% of the French populations were considered to be clinically obese. This is defined as the proportion of people with a body mass index (BMI) of over 30. Childhood obesity is of most concern looking at the socio-demographics of obesity across Europe; observations can be made about obesity amongst people in the lower social classes and those who have terminated their education at an earlier age, that is, below 18 years. In some cases obesity is due to genetic defects, yet the stresses and strains associated with economic disadvantage have the potential for creating food dependency as a type of addiction. It is important to remember that mass affluence, knowledge of health issues and interest in being healthy can be unevenly distributed, leading to a polarisation of health within European societies. Those who can afford better healthcare are likely to pay for it.

Lifestyles

The growth of sedentary jobs from physically demanding occupations to more desk-based ones means a shift to less physical activity for many people, leading to a more sedentary lifestyle overall, which partly explains the rise in obesity over recent years. A healthy body craves physical movement and consumers, who now have a less active working life, are actively searching for new outlets for that urge, such as visit to the gym, alternative medicine or diet.

Whilst diet, nutrition and alternative medicine seem to be the domain of women, physical activity through sport remains a solid interest for men. Still, since 1970, women have made notable gains, with women's participation in sports doubling (Figure 6.6). However, for women regular participation in organised sports clubs is less frequent than taking part in sports as individuals. This suggests that the qualitative nature of physical activity is changing, which seems to mirror the transformation of the health and fitness industry in the past few years. Participation in sports club activities is just one of many leisure pursuits from which to choose.

Smoking is both expensive and physically damaging. It has been estimated that, at today's prices, a 20-a-day smoker will spend more than $120,000 over the next 20 years. In the European Union alone, smoking-related illness causes 500,000 deaths per year, 10% of them are non-smokers killed by passive smoking (Future Foundation, 2006b). Hence, the governments of several Western countries have launched initiatives to ban smoking in public places. One thing that is certain — there will be fewer smokers in the future.

Over the last decade we have witnessed heightened public concern about alcohol consumption levels. There has been particular anxiety in many countries about the phenomenon of binge drinking associated with anti-social behaviour, to the extent that the Scottish Parliament has passed legislation to curb this problem (PA, 2005). Growing health worries about the effects of alcohol, combined with an increased interest in ‘staying fit and healthy’, are clearly going to have an impact on the consumption levels of alcoholic drinks in the future. Some of these health concerns have been driven by government communications, pressure groups and the media, all trying to do something to alleviate the health and social problems caused by alcohol abuse and binge drinking.

Figure 6.7 shows data on overall levels of alcohol consumption, measured in litres per person per capita by year. At an EU level, data indicate stable levels of consumption over the last 15 years. Remarkable variations can be noted between countries. In some countries, such as France, Germany and Portugal, consumption levels have fallen. The trend has been stable in other countries, such as Denmark, Netherlands and Poland, whilst in some — Ireland, Latvia and Lithuania — people have increased their alcohol intake in recent years. There does not seem to be any geographical pattern to explain these trends.

Figure 6.6: Sports participation in the United Kingdom since 1970.

Basic health care is available to all who live in the United Kingdom. However, this does not mean that there is no consumer activity in the area of healthcare and maintenance. The health of society is paradoxical — despite being healthier, we are less happy with our image and are likely to report more health problems than in the past. This paradox seems to encourage us towards preventing ill health through better nutrition and more exercise, whilst at the same time opting for alternative treatments which are unlikely to be covered by either private medical insurance or the NHS (e.g. acupuncture, homeopathy) and other Eastern medical practices.

Searching for an Alternative?

More and more people are choosing alternative medicines as a way of augmenting conventional medicines or as an alternative to mainstream healthcare, as shown in Figure 6.8.

Figure 6.7: Alcohol consumption trends in Europe.

Considering that women report more health problems than men, are more likely to be clinically obese or overweight and are more likely to report the conditions, it is not surprising that key health behaviours show a gendered pattern. Women are more likely than men to try alternative medicine and treatments, including acupuncture, homeopathy, osteopathy and Chinese medicine. Furthermore, a higher proportion of women have used alternative medicine in the recent past than women did before. Also, increasing use of alternative medicine is more noticeable among younger Britons. For example, in 1992 about 2% of Britons aged 20 to 24 used alternative medicine. By the time this group reached the age of 25 to 29 in 1997, about 5% of them used alternative medicine. Seven years later, in 2004, over 5% of those aged 35 to 39 — the same cohort — used alternative medicine. Examining cohorts in this way across time, we are able to note that, within cohorts, younger Britons tend to be more likely to turn to alternative medicine and ...

Table of contents

• Cover
• Half Title
• ADVANCES IN TOURISM RESEARCH
• Title
• Copyright
• Dedication
• Contents
• Acknowledgements
• Foreword
• Section I
• Section II
• Section III
• Section IV
• References
• Subject Index