An aging society
It has been called a ‘demographic time bomb’: our society is aging. In virtually all countries, there is a shift in the distribution of the population towards older ages. The aging process is most advanced in Europe and Asia (especially Japan), but other regions are following the same pattern and many show an even steeper curve. The number of people aged 60 years or older has tripled since the 1950s, and the World Health Organisation expects that in 2050, almost a quarter of the global population will be 60 years or older (22% to be exact, versus about 12% at present). According to many, these figures present an alarming prospect. A smaller labor force will have to take care of a large and growing proportion of elderly people, with an increased care demand and increased costs. Future generations may struggle to meet the needs of the ever growing amount of retired people.
So why is our global population aging so quickly? Let’s take a look at the facts. The aging process is the result of two demographic developments: rising life expectancy rates and declining fertility rates (the average number of births per woman). Due to the higher life expectancy rates, older people tend to live longer and raise the mean age. The average number of births per woman on the other hand, is an indicator of the proportion of young people in the population. In high-income countries, fertility rates have dropped dramatically since contraceptives became widely available, but have been at a relatively stable low in the previous decades. The progression of the aging process in these countries is therefore mainly caused by the increased longevity of the elderly. Yet in many middle- and low-income countries, fertility rates were still up and are declining quickly, which has an even bigger impact on the age distribution than the fact that people also survive longer. These countries may not feel the impact of the aging population just yet, but will definitely experience the effects in the coming decades.
It is clear that population aging is a huge demographic change. And it does raise some serious challenges in terms of increased costs and care needs. But let’s not forget where this aging process comes from. The declining number of births per woman in lower income countries arises mainly from more effective birth control, empowering women to make their own choices. That is a truly positive development not just for these women personally, but also in a more broad perspective as a remedy for the excessive population growth some of these countries are facing. The rising life expectancy rate reflects an even more clear success story: better health care in general, more effective disease battling and better prevention of child and maternal mortality. So the causes which underlie population aging are in fact the realization of some very high ambitions our societies have been fighting for.
Let us take the prevention of child mortality as an example. Successful prevention will raise the proportion of young people in the population, but also significantly raises life expectancy. The last decades have shown great improvements in the under 5 mortality indicator (see picture). Even the wealthy Western countries have improved: the best scoring country in the world, Luxembourg, more than halved its number of deaths per 1000 children between the year 2000 and 2015 (from 4.9 to 1.9). On the other hand, Sierra Leone, in the year 2000 the worst scoring country with a depressing 236/1000 deaths (more than 1 in 5 children), managed to reach a number of 120/1000 in only 15 years. Still far too much, obviously, but it is moving quickly in the right direction. Comparing the present child mortality data to the figures which were normal around the world in the 1960’s, should make today’s parents feel even more relieved.
In life expectancy rates, there are huge differences around the globe as well, while the direction of change over time is similar: positive. While a baby born in Western Europe can expect to live up to eighty-something years, life expectancy in Sierra Leone is just 45,6 years. However low, it has actually risen from a shocking 38,1 years in 2000 while the country was in a disastrous civil war. Most Sub-Saharan African countries have rates below 60, but almost without exception, those figures have been steadily rising in the previous decades (see below).
Although the causes of the aging process are very positive, a high proportion of elderly in the population could still prove to be a time-bomb in the future. A lot depends on how people get older. If healthy, the elderly may have productive extra years. They could empower the workforce both formally and informally, being the most knowledgeable part of the population. But if the extra years are dominated by declines in physical and mental capacities, the implications may be more negative. According to the WHO (Report on Aging and Health, 2015) it is unclear. Some research has suggested the prevalence of serious disability is declining, yet this does not seem to account for less serious (but still bothersome) disability. Also, the current research is based on high-income country data and might be different in other parts of the world. Yet the recent data on Healthy Life Expectancy (HALE), are quite promising (see below).
In conclusion: although the aging of our societies is a serious challenge, let’s keep in mind that the increased average age in fact reflects a great achievement. For the first time in history, most people around the world can reasonably expect to live well into their sixties, if not longer, and probably be exceptionally healthy too. Our society has proven to be able to come this far; no doubt we will find a way to deal with the new, upcoming challenges.
written by Wieke ter Weijde