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Costa geriatrica coming soon to a suburb near you

By Peter Curson - posted Tuesday, 25 November 2008


The world is currently undergoing a demographic revolution of historic proportions. At no time in our history have there been so many old people around. In many countries old people now outnumber young people, a state of affairs that has never before existed in human history.

Today, the world’s population includes more than 600 million people aged over 65, and by 2030 there will be at least one billion. Globally, old people are increasing at an annual rate almost twice that of the population as a whole and the fastest growing group are the oldest old, those aged over 80.

By 2050 more than 11 per cent of the world’s population or 1 billion people will be aged over 70 including 21 per cent of Europe’s population and 15.4 per cent in North America. The population of developed countries and many developing ones are ageing rapidly.

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As recently as 1950 no country in the world had a median age greater than 36. By 2050 27 countries will have a median age of 50 or more. Most will be in Europe but there will also be a number of Asian-Pacific countries. This represents a real global challenge.

By 2050, the age composition of nearly every country will have moved to a situation where the old outnumber the young. Some countries such as Japan are ageing at an incredible rate. Shortly after World War II only 5 per cent of the Japanese population were aged over 65, well below that of Britain, France and the USA. Today the figure is 20 per cent and by 2030 it will be 30 per cent. The main reason for this demographic revolution has been falling fertility. Many developed countries are now either close to or below the replacement level of 2.2 children per family.

But what defines old age? Although we tend to generally classify all those aged over 60 or 65 as old, there is no general agreement as to what constitutes a definition of old age. The UN has no standard definition, and most countries continue to use those aged 60+ or 65+ as their benchmark, With respect to the oldest old there is even less agreement, with countries variously describing them as being aged 70+, 75+, 80+ or 85+. This raises the question as to whether being over 60 or 65 can today be classified as “old”, when life expectancy in many developed countries is over 80 years and many 60+s remain healthy, active and in the workforce with a life expectancy of 20 years or more.

Can what was deemed “old” 100 or so years ago when aged pensions were first introduced, be considered as “old” today? Arguably not, and possibly yesterday’s “old” is now today’s “middle age” with only those aged over 75 or 80 considered “old”.

Whatever definition we adopt there seems little doubt that many societies are ageing rapidly and that the increasing numbers of old people will have sweeping social, economic and political consequences. Every aspect of our society will be affected including our work, healthcare, pensions, public services, housing, education and even perhaps our security.

Ageing populations mean that we are rapidly approaching a situation where an increasing number of health and pension beneficiaries are supported by a relatively smaller number of working age people. This may produce heavier tax demands on working age adults in order to maintain a steady flow of benefits to older groups. Many developed countries have faced this dilemma by importing large numbers of young migrant labourers, but the ageing of many parts of the world and the currently precarious economic situation may truncate such measures. Perhaps age pensions should be withheld until about age 70 or 75 given the substantial changes in life expectancy?

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Consider China. By 2030 about 16 per cent of the population will be aged over 65 and it will be the first country to significantly age without being in an advanced state. But it will be the growth of the oldest old that may well be the most significant demographic trend. The number of people in China aged over 70 will increase five-fold over the next 30-40 years. By 2050 there will be about 350 million Chinese aged over 65 and 240 million Chinese aged over 70 or 17 per cent of the total population.

The walking stick and wheelchair industries are in for a bonanza!

Yet this will create many problems about the support and care of the elderly most of whom will be forced to rely on state pensions. Traditionally, many Asian-Pacific societies relied on the extended family network to look after the elderly, but increasing migration, urbanisation and family fragmentation is rapidly eroding this. In the next few years possibly 25 per cent of older Chinese will have no living son to rely on for support. The implications for social and economic security are profound.

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About the Author

Peter Curson is Emeritus Professor of Population and Health in the Faculty of Medicine and Health Sciences at Macquarie University.

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