proportion of the US population aged 65 and older will double to about 71 million older adults, or one in every five Americans. The far-reaching implications of the increasing number of older Americans and their growing diversity will include unprecedented demands on public health, ageing services and the nation’s healthcare. Although there may be unjustifiably pessimistic views of what is before us, an ageing population does present severe problems. But there are also great advantages.
An analysis of the consequences of increasing life expectancy must include the economic implications of changed population age structures, especially changes in the ratio of those in the labour force to those outside it, mainly children and elderly, which is known as the support ratio. In the early stages in which life expectancies rise, the proportion of the population within the labour force age range rises significantly, providing a substantial boost to economic growth. However, as people live longer those extra years will have to be financed, and there are only a limited number of ways to do this. These include working longer, increasing social security or other taxes, increasing immigration, and reducing consumption.
In order to reap the economic benefits of longer lives, some of the extra years of life will probably have to be spent working productively. In the UK one in five over the age of 55 can expect to work till they are 70 and even older. This is because of their limited finance. At 55 many still have a mortgage and less than
The number of people supporting pensioners is decreasing, and it will go from four workers for each pensioner at present to two workers for every pensioner in 2050. A major problem of the ageing of societies is that people are having fewer children. The current global average is 2.6 children per woman, while in rich countries it is 1.6. One reason is that women are having babies later in life. This means that in some rich countries the population is beginning to decrease. In ageing countries, the economy can shrink as more retire and there are fewer young to take their place, and the older workers may be less productive. Japan has a very low ratio of workers to pensioners, just three to one, and by 2050 the number will probably halve. Such changes can reduce economic growth significantly. In some countries immigration is filling this labour gap; another solution is to encourage people to have more children, as has been done in France and Japan. There is also the problem of finding enough young adults for the armed forces.
Pensions raise serious economic issues. The official retirement age for most developed countries has remained the same even though the population is ageing. Many have even retired before the official retirement age. Retirement pensions are the largest component of age-related spending, and the cost of state pensions in rich countries will probably double by 2050 and reach more than 15 per cent of GDP. Payments to the pensions of retired civil servants in the UK which are based on final salary are very expensive—the pensions can be as large as two thirds of final salary. Each one-year increase in longevity increases costs
Part of the problem is that men can now look forward to between 14 and 24 years in retirement, much more than anticipated. Older workers also want a less onerous workload. The UK government’s decision to abolish the compulsory retirement age, currently 65, wll increase the number of the workforce. Retiring later will help financially, but will not the young then be deprived of senior appointments? It is estimated that unless urgent action is taken there will be a
The Big Question: ‘Is the world’s population the wrong age?’ In some countries there are too many old people, while in others the population is very young. While the developed world is facing up to the challenges of an increasing number of elderly citizens, some developing countries are facing the strain of populations in which a third of the people are under the age of 15. Neither situation is ideal, but the challenge is to find ways of adapting to cope with the economic demands of differing population ages.
According to a UK survey, most individuals approaching old age had not yet thought about how they would be cared for. I myself am guilty of this. At least 13 million, according to the government, are not saving enough to retire on a decent income. Some 70,000 people have to sell their homes each year to cover the cost of long term care. When asked about the supposed worries they would have when 75, about half those aged 45 to 75 were rightly worried about money for long-term care. At 65, the government says, a woman can expect to face average care costs of
The health of the elderly remains a major issue. Health spending on the elderly in the EU is about one third of the total health budget. In the UK more than 40 per cent of the NHS budget is currently spent on people aged over 65. The estimated number of people in the UK living with the effects of stroke, which mostly strikes people over the age of 60, will rise significantly, and the number of people with dementia will increase to around a million in 2025 imposing a major burden on social services and families. The cost of looking after them has been predicted to increase to
According to the Institute of Medicine report in 2008, the elderly in the US account for more than one third of all hospital stays and of prescriptions, and more than a fourth of all office visits to physicians. The average 75- year-old American has three or more illnesses and takes at least four medications. Delivering optimal geriatric care has become a costly medical and ethical priority. Medical and nursing schools are, it is claimed, training far too few doctors and nurses on how to care for the elderly. At the same time, other workers, such as nurses’ aides and home health workers, remain under-trained and underpaid, the experts say. The number of doctors specialising in geriatrics has been falling. The US government has recently announced a new initiative to assist with housing costs for elderly and disabled people.
Despite the best efforts of any government, the cost of the elderly is going to leave a gap in funding. Spending on care for the elderly will have to double over the next 20 years to cope with a surge in the numbers of sick and disabled old people. It was previously believed that the amount of time that pensioners spent being sick or disabled would remain constant or even shrink with the help of medical advances, but this is unlikely. Instead, many of the extra years will be spent being unwell and in need of care. Increases in the number of years of good health have not kept pace with improvements in total life expectancy. The number of sick elderly people, or those with disabilities, will increase by around two thirds over the next 20 years. The costs are frightening.
Around 700,000 people in the UK spend more than 50 hours a week caring for a relative, according to Carers UK. A lack of facilities means one million family members already take time off work to care for aged or disabled relatives, while another six million take some ad-hoc responsibility for caring. By 2033 the number of people aged 85 and over is projected to more than double again to reach 3.2 million, and to account for 5 per cent of the total population, and so the number of carers needed will have to soar as well. Britain faces a care time-bomb within seven years, with the number of elderly needing full-time help outstripping the number of carers. Free personal care at home is available in Scotland but not in the rest of the UK.
Public transport systems, especially fixed-route bus services, face important challenges in meeting the needs of the elderly for convenient transport. There is a need for wider pavements to make the roads and streets safer for older pedestrians. This could include dedicated pathways for electric wheelchairs, improved access points to public transit and commercial areas, along with special ramps or expanded parking spots for the ageing population. Yet more costs.
In China, meanwhile, an enormous population is also ageing rapidly. By 2050 about one quarter of all Chinese will be aged over 65. This is one of the consequences of the country’s ‘one couple, one child’ family planning policy
