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A World Gone Gray: Understanding the Global Aging Epidemic

December 20, 2010

It was nearly 500 years ago that Spanish conquistador Juan Ponce de León set out on an expedition in search of the legendary Fountain of Youth.  Since that time humanity has effectively proved with intelligence and ingenuity that a mythical youth-restoring fountain is not required to maximize longevity.  The burden of aging has been reduced due to various achievements of modern society in science, public health policy and socioeconomic development. Life expectancy has increased from a mere 35 years in the 18th century to a respectable 67.6 years at the start of 2005.

However, increased longevity is not equivalent to improved global conditions. On the contrary, if an aging population is not balanced by steady reproductive rates, affluent and poorer nations alike could find themselves unable to sustain their individual economic and social growth due to stagnant and aging populations. In 2010, the globalized world now stands at the precipice of discovering itself in this position; an extraordinary imbalance between the planet’s youth and seniors.  This demographic trend, continuing over the next century is forcing the nations of the world to enact changes in order to offset an unprecedented type of crisis, where lack of prospective workers, increasing health care and pension claims, human rights violations, and low global morale will be the norm.

Sixty Is the New Thirty?

According to the United Nations Population Division (UNPD), the world’s population overall will grow by roughly one-third over the next 40 years, from 6.9 to 9.1 billion. But this population wave is different than its predecessors because it is not driven by birth rates but by an increase in the number of elderly.  The proportion of people aged 60 years and over is increasing and will continue to accelerate faster than any other age group. Until about a century ago, the elderly (60 years and older) were never much more than 2 or 3 percent of the population. Today, in developed nations, they are 15 percent.  By 2050 the number of older people is expected to have risen from about 600 million to about 2 billion.  To break it down further, that means one in five people will be over the age of sixty, while the global population of children under five is expected to drop by 49 million by mid-century.

Perhaps another way to interpret the data is to examine the global median age. Currently, the median age is 28 years; that is, half of the world’s population is above this age, and half below. Over the next four decades the global median age will likely grow by ten years to reach 38 years in 2050.  In Japan where the median is already 45, the projection is ten years also, making 55 years the median for Japan and much of southern and eastern Europe. Several major countries in East Asia and Latin America, including China, South Korea, and Mexico are projected to reach developed world levels of old age dependency by the middle of the century.  Overall, wealthier nations are at a more advanced stage of the demographic transition, with a higher proportion of their population aged 60 years and over, than developing countries; although in time the others will catch up, leaving no country immune.

Despite less developed regions’ current low median age, for example Niger where the median age is the lowest in the world at 15 years, the aging process will continue to accelerate. The number of elderly living in the less developed areas of the world is expected to increase more than threefold, passing from 473 million in 2009 to 1.6 billion in 2050. In contrast to 264 million becoming 416 million in developed regions. Consequently by 2050 nearly 80 percent of the world’s older population is expected to live in developing regions. This is due to larger populations which characterize developing regions.

Boom Town

Global Aging is the result of two sweeping forces: reduced fertility rate (fewer births per women) and high life expectancy (longer lives).  A U.N. study reports that worldwide the fertility rate has fallen from 5.0 to 2.7 since the mid-1960s. In richer areas, it has fallen to 1.5, which is far beneath the replacement rate needed to maintain a stable population over time.

Immediately after World War II, veterans from the United States and Western Europe returned home to their wives ready to reclaim their marital privileges. This led to a dramatic surge in birth rates during the late 1940s and 1950s, known as the ‘Baby Boom’. In the 1960s and 1970s much of the developing world also experienced a baby boom thanks to the sharp decline in infant and child mortality. As these ‘baby boomers’ age, they will produce a population explosion of seniors. At present, western countries are seeing a skyrocketing of people turning 60 who will eventually cause another eruption of people turning 80 in 20 years. Developing countries will follow suit a few decades later.

According to the U.N. Department of Economic and Social Affairs (DESA), since World War II, global life expectancy has risen from around age 45 to around age 65, causing a greater gain over the past 50 years than over the previous 5,000. In wealthy countries, life expectancy has risen from the mid to high 60s to high 70s, and in a few countries, including Italy and Japan, it has reached 80.  As the Baby Boomers reach 80 and their numbers decline, with birth rates still plummeting, by 2150 the projection is that the global population could be half of what it is today. The overwhelming majority of those who will inhabit the planet 20 years from now are already alive, meaning there is a real possibility that there will not be enough people on the planet in the future to sustain global economic stability or support maintaining decent standards of living.

Better Things to Do Than Make Babies

In order for a country to maintain its population balance, the total fertility rate must be high enough to balance factors that reduce its population. If that is not the case, a condition known as sub-replacement fertility obtains. Globally, the total fertility rate for replacement is 2.33 children per woman. Two and one-third children per woman includes two children to replace the parents, and a third of a child to make up for sex ratios and early mortality. There have been a number of explanations for the general decline of fertility rates throughout the world, and the true explanation is almost certainly a combination of different factors; the obvious two being the growth of wealth and human development.

The first case of this was witnessed in Scandinavia in the 1970s, and then spread quickly through the rest of Europe, most of Asia, South America, the Caribbean, and into Middle Eastern countries.  As countless nations begin to urbanize, they started to have fewer children. Residents of urban areas tend to have fewer children than those in rural areas. The need for children to assist in farm duties does not apply to urbanites. Also cities tend to have higher property prices, making having a large family quite expensive. This turns children into an economic liability, rather than an extra set of hands.

Another explanation is that in the West, progress in women’s education began around the 19th century with the founding of colleges offering single sex education. After women achieved suffrage in 1920, colleges and universities began to enroll female pupils. This created a more secure foot-hold for women in society. Many women are deciding against having children, or at least delaying the birth of their first child until later in life. This is known as Advanced Maternal Age. Post-industrialized nations demand highly educated and flexible workers forcing men and women to pursue higher levels of education. For women, who now make up more than half of the graduate and post graduate students, this creates a conflict between employment and motherhood.

In developing regions work opportunities in manufacturing and farming, either as cultivators or agricultural workers, imbued women with a sense of self-sufficiency. The modern woman no longer needs a husband or lots of children to ensure her well being.

Also there is the changing of social mores and shifting attitudes towards familial roles, including the introduction of contraception, and alternate lifestyles portrayed on television and in film which shape family planning behavior. An intriguing study done in Brazil starting in 1971 showed that the rate of marriage dissolution rose and the number of children born to each woman fell more quickly, if the couple received the TV Globo channel, which aired daily racy telenovelas (televised soap operas).  One could ask: is it the plots of these risqué soap operas or the introduction of home entertainment systems that may have affected couples sex lives? Or possibly the concomitant appearance of easy contraception?

For some countries low birth rates could be contributed to policies of population control, such as the one-child policy for China, or family planning in Iran. India even introduced a forced sterilization program during the 1970s which resulted in an almost immediate decline in birth rates.

Fiscal Frustration

The most anticipated challenge posed by global aging is the mounting financial burden. In an essay in Foreign Affairs magazine, expert Nicholas Eberstadt asserts that when the current painful economic crisis is over, the global economy will start to see a long growth that is steady and sustainable. However, because of the demographic forecast, the predicted growth will be much slower given that there will be fewer members in the workforce.  As the number of prospective workers dwindles, rich nations may experience widespread shortages, leading to a “no growth” business cycle in which total output declines from one normal year to the next.

The U.S. Census Bureau estimates the absolute gain in the world’s working age population (15 to 64) between 2010 and 2030 will be around 900 million people; 400 million fewer than over the past two decades. The projected average rate of global man power growth for the coming decades is 0.9 percent per year, only half the rate for the period between 1990 and 2010.

A vital part of a healthy economy is its youth.  Young workers very often have higher levels of education and better knowledge of the latest technology. Fewer youth in the work force could quickly depress an economy. It is the young who will eventually purchase new homes, new furniture, and produce pending of a similar nature.  Also, young people tend to be risk takers, making them more likely to be innovative, leading to new companies and other entrepreneurial risks that could lead to future job creation. Older workers are often content with the status quo when it comes to working conditions, and therefore are less likely to create new businesses.

One could argue the Chinese are perhaps benefiting from the early stages of birth rate decline. A society with fewer children leaves more adults (particularly women) available for labor, which in recent years has morphed the country into an economic power house. But in the end, China’s one-child policy and exceptionally low birth rate will soon push Chinese society into one where one child will be responsible for supporting both of parents as well as possibly four grandparents. Demographers call this a ‘4-2-1’ society.

Beyond the desire to have children, Asian societies now face the harsh reality of being unable to sustain birth rates due to a chronic shortage of women. The habitual disregard for daughters, which influences China’s selective abortion practices, has created a country where there are 16 percent more boys than girls (120 boys for every 100 girls) leaving tens of millions of unmarried men with few prospects. In fact, by 2030,  25 percent of Chinese men will reach their late 30s without ever having been married. This will make for many single, sexually frustrated, childless men.

Work Until You Are Dead

Over the next 30 years the Global Aging Initiative projects that the rising cost of pay-as-you-go pensions and health care benefits to the elderly, is on track to push up government outlays. Increasingly, governments will face a choice between economically painful tax hikes and politically impossible benefit cuts, or face undermining national savings and economic improvement.

Many countries have already begun to raise, or have considered raising, the retirement age for their national pension systems, as can be witnessed by the massive protests staged by the French working class over the summer against President Nicolas Sarkozy plans for retirement reform. France has one of the lowest retirement ages in the world at 60.5 years. Unlike social security in the United States, the French pension system is based on the idea that money collected among active people is not invested but immediately distributed to the retired.

Salaried and government workers are granted 50 to 55 percent of their former income (if you have worked 40 years). In the United States the system is based on ‘capitalization’, the French pension system is based on ‘repartition’, making it independent from inflation and from the stock market. This explains why American retirees were concerned for their pensions and financial security during the crisis, while French workers went relatively unharmed; but its sensitivity to increasing longevity puts the French in line with other nations facing huge pension problems.

The average global retirement age was 64.3 years for men in 1949, but gradually shifted downwards until it reached 62.3 years in 1993. With the coming labor shortage, politicians are realizing that encouraging people to stay in the workforce could be the key to lightening a fiscal burden. Earlier pensions and retirement mean higher taxes and government contributions in order to pay for benefits. In the case of France whose pension system is losing money by the day, early retirement is simply not an option.

China offers a basic pension system for urban workers. It consists of a pay-as-you-go benefit and a personal retirement account covers the entire urban workforce, but that coverage only exists for workers at state and collectively owned enterprises, which accounts for a small percentage of workers. The fast growing private sector workforce, including China’s vast floating population of rural immigrants remains uncovered. Needless to say, the Chinese basic pension suffers from structural problems that make it a shaky foundation on which to build future retirement security.  Pay-go contribution rates are high and impose a heavy burden on workers. Although benefits for retirees are generous, (retirement age between 50 -55) the system’s relatively small coverage base, low rate of return on contributions and lack of portability, means that it cannot possibly provide adequate benefits in the future. Currently, only 31 percent of China’s total workforce is now earning a public pension benefit of any kind. The Chinese government is still deciding if raising the retirement age is the best solution.

Even if governments were able to successfully persuade workers to prolong their retirement, that does not ensure older laborers will be capable of performing their duties. According to a recent study done by RAND Health, a division of Rand Corp, more than 40 percent of Americans ages 50 to 64 already have difficulties performing ordinary activities of daily life, such as walking long distances or climbing stairs. If this is already the case for the current generation of middle-aged, what can we expect for future generations who will be even less physically fit? As it stands, more than a billion people worldwide are estimated to be overweight.

An argument often posed against retirement age increases is the older worker will be canceled out as the world modernizes and technology advances.  A more sophisticated society, makes finding a person of 60 with adequate job skills nearly impossible. To compare, think about how many people  over 60 you have seen using a Smart phone, Mp3 Player, Laptop Computer, etc…

Older Living is Not Better Living

As people age, their well-being and social support tend to dwindle. A U.N. study suggests developing countries in particular are poorly prepared for greater numbers of people living longer, with little in the way of long-term care facilities and social and health workers specially trained for the needs of the elderly. Craig Mokhiber, of the UN Office of the High Commissioner of Human Rights, said senior citizens in a number of UN member states are victims of multiple human rights violations. With family structure changing in many societies, there are fewer children; therefore, the older family member cannot rely solely on the younger family members to look after them, as it was decades ago.

Many organizations such as AARP and Help Age International have made it their mission to give older people political power to ensure their rights are defended. The elderly are often discriminated against in a number of ways, including: denied access to jobs or services, physical, verbal and sexual abuse, lack of financial protection, such as pensions and social security, refusal of medical treatment, and blocked inheritance of property of a deceased loved one.

In many African countries where the elderly have no social or political power,  older people are often evicted from their homes by younger relatives or greedy neighbors, and are forced to live in structural unsafe, insect infested shacks. Help Age International’s website lists a first-hand account from a 71 year old woman in Tanzania who was removed from her home by her family.  As a widow, she did not have the right to inherit her husband’s property. She was accused of witchcraft, convicted without any form of due process, and made to live alone on the outskirts of the city.

China is haunted by an alarming number of suicides among its elderly. Older people suffer from isolation and low levels of social integration within highly urbanized areas. Rising medical costs and economic hardship after relocation to the city has contributed to increased despair among the elderly. Faced with mass demolitions and modernization of older neighborhoods, many Chinese elderly find themselves in unfamiliar territory, farther away from family, and fighting over property rights. If living with their children, tradition-minded elders often become particularly distressed when their children fail to provide enough care. The current suicide rate among the Chinese elderly between 70 and 74 is 33.76 per 100,000.

Countries in South America and Southeast Asia share a common type of abuse among the elderly: the right to work and to a pension. Often, aging workers are sacked without explanation. When they try to ask for their pension, they are told that they do not have one. In other cases, workers have a pension but are never informed about it, how it works or how to access it, etc.

The United States is not without fault. Retirees often suffer from abuse and neglect in care-giving facilities, or they become victims of financial exploitation. The benefits received are often too little to support the rising costs of living.

Help Age International and AARP,  together with the U.N., in February, staged a two-day ‘Empowerment in Aging’ conference, where speakers emphasized that in many countries around the world, people over 60 have little if any legal and social protections, and virtually no political power. These groups are calling for an end to elderly abuse.

The Solutions

Not to worry. An aging world is not equal to a doomed world if action is taken. The United Nations has made it their mission to raise awareness of the scope and magnitude of the challenges ahead and to encourage timely reform. There have been conferences in Beijing, Berlin, Brussels, Paris, Seoul, Tokyo, Washington, and Zürich. Steps are being taken by various nations, in order to carry their share of the aging burden.

In Europe, a study by the European Commission, suggested providing more part time jobs. This would help encourage delayed retirement, as well as making the transition easier between work and family life. This type of stability could elevate birth rates, as couples would not feel the need to make a choice between their personal and professional lives. Although the success rate on this is still relatively moderate.

Also AARP is promoting healthier lifestyles with special attention paid to diet. If middle aged men and woman begin to integrate healthy diet and exercise into their daily practices, it will lengthen productive life spans. Developing and building more walkable communities should keep seniors fit mentally and physically. But there is still doubt, even with a healthy lifestyle, that current seniors will be capable of competing in a global economy.

Other countries, like Australia and Singapore are hoping to curb their low population problems by offering a ‘baby bonus’. A baby bonus is a government payment to parents of a newborn baby or recently adopted child to assist with the costs of child rearing.  Singapore’s government offers  a new mother up to $3000 for the first or second child,  $4,500 for a third and fourth, paid maternity leave, and other enticements to have children, including dating services for singles.

A temporary solution exists in the United States, which at this moment is the only country immune to the global aging epidemic. By U.S. Census Bureau projections, the United States will grow 20 percent (from 310 million to 370 million) between 2010 and 2030. Every age group is set to increase in the U.S. over the next 20 years. This is due to the country’s relatively high fertility rate, as well as its continuing influx of immigrants, both legal and illegal. While the rest of the world deals with population issues, the United States will assume the heavy burden of policing the world’s conflict areas, as well its economic trouble spots. But in the end, the United State will also face the same declining population problems as immigration in recent years has plummeted.

One last solution suggested, which might be a harder pill to swallow, is a return to traditional familial roles. This does not necessarily mean women return to the home, or that they lose their economic and social options. A return to traditional values would mean re-implementing the idea of family; finding a way to turn the reality of a large family from an economic hardship to a financial asset. Allowing people to view their children as an investment will improve educational quality of future workers, develop healthier lifestyles, and nurture innovative ideas.

Beyond economics, the nations of the world will need to create a wide-range of new policies in the social and cultural spheres also. If the world can face this new epidemic with the same tenacity in which we fought our meager life expectancy, an aging world will only reflect a wiser world. If not, perhaps man will need that magical healing water after all.

Joshua Grant is a freelance writer from New York City living in Paris where he teaches English.


The United Nations Department of Economic and Social Affairs Population Division (2010) World Population Aging 2009. United Nations Publications, New York, NY.

The United Nations Department of Economic and Social Affairs (2010) Strengthening Older People’s Rights: U.N. Convention Publication. United Nations Publications, New York, NY

Asghar Zaidi and Malgorzata Rejniak (2010) Fiscal Policy and Sustainability in View of Crisis Population Aging in Central and Eastern European Countries. European Centre Publications, Vienna, Austria

Richard Jackson, Keisuke Nakashima, Neil Howe (2009) China’s Long March to Retirement Reform: The Graying of the Middle Kingdom Revisited. Center for Strategic and International Studies Publication, Washington D.C., United States

Richard Jackson, Keisuke Nakashima, Neil Howe (2010) The Global Aging Preparedness Index. Center for Strategic and International Studies Publication, Washington D.C. , United States


One Response to A World Gone Gray: Understanding the Global Aging Epidemic

  1. [...] expectancy has risen from about45 to 65. In wealthy countries, life expectancy has risen from mid 60s to high 70s, and in a few countries, [...]

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