My own research interests in population ageing began when I was Associate Professor at the University of Copenhagen in Denmark. As one of the first (if not the first) governments in the world, the Danish Government established its first Commission on Ageing in 1979 to develop a joined-up response to the ageing of its population. Denmark has since had its second Commission on Ageing. Other governments have been woefully lacking in any kind of response to the challenges and opportunities of population ageing, although the UK government has carried out its own Foresight programme on the ageing of the UK population recently, headed up by my Co-Director, Professor Sarah Harper and just last week there was an easily overseen note in The Times stating that the UK government was looking into how it should react to the predicted increase in the number of centenarians in the country over the coming decades – something we at the Institute have been researching.
Back then, as a young demographer, I was asked to contribute to the Commission’s work. My task was to apply the stochastic models I was developing for the description and prediction of population movements to carry out alternative population forecasts for the Danish population – alternative to the official forecasts from the Danish National Office for Statistics, whose own forecasts were seen very much as being provided for local and regional governments to help them with their own planning.
Why this interest in alternative forecasts?
At the time, there was a strong belief among demographers that mid- and late-life mortality would not decline significantly – a belief linked to beliefs that there was a maximum human life expectancy well below that which we have since attained. However, in Denmark, and elsewhere, this mortality had been declining, leading to substantial increases in the number of older people, begging the question “where had all of these older people come from?” The answer was that they had always been there, but they had not died on time. Hence the Danish government’s interest in scenarios rather less conservative than those of the Danish National Office for Statistics. The rest is history, as they say, and we now know that mid- and late-life mortality in the high income countries of the world has continued to decline with most of the current gains in life expectancy attributable to these declines.
This – together with equally dramatic decline in levels of childbearing – has changed the age structures of our populations from young to old. But why is age structural change so important? It is important to adopt a multi-pillared approach to tackle the issues raised by age structural change, ranging from pensions and health and social care to transport and housing, all of which to some degree will apply to all nations of the world as we move deeper into the 21st century. These demographic changes impact and will continue to impact across societies around the world. Growing old in societies dominated demographically by young people is fundamentally different from growing old in societies dominated demographically by older people. There are implications for individuals with respect to planning for old age; for families comprising more and more generations; for communities with increasing numbers of extreme aged people needing care and support; for workplaces short of younger skills. And governments will need to rethink how public services are planned and delivered across all government departments. These global age structural changes will everywhere require a co-ordinated response across government in order to reflect the inter-connectedness of policies affected by the ageing of populations.
Unless there are significant improvements in health as we move deeper into the 21st century, population ageing will increase the amount of ill-health and disability. Globally, chronic conditions, multi-morbidities, and cognitive impairments will become more common and in societies where the family plays a pivotal supporting and caring role, family members will at the same time face increasing pressure to balance this role with other work responsibilities. There is therefore a danger going forward that demand and supply of care will diverge, as more and more people need support (also financial support) while the pool of (younger) workers decreases and families feel the strain.
Population ageing brings with it an ageing workforce. In the more developed economies of the world, productivity and economic development will be increasingly linked to the ability to retain and reskill older workers. Retaining and reskilling older workers for longer will enable societies to support the increasing numbers of older dependents. At the same time, work beyond traditional retirement age will become an increasingly important pillar of financial security in old age. Radical changes to our workplace mentality will be fundamental to the economic wellbeing of societies and populations in the 21st century.
Lifelong learning, training and re-training will become important as populations age as this will allow us to remain active in the workplace and community, which in turn will enhance individual health and wellbeing. Our homes will play a major role in our future lives, and not just as places to live. Our homes will become places of work, play and care, and appropriately designed and adaptable housing will similarly enable us and contribute to our health and well-being as we age.
As I began, European populations were surprised by the fundamental changes brought about by the ageing of their populations in the latter part of the 20th century – a combination of demographic resistance to the idea that human longevity could exceed expectations and the decline in mid- and late-life mortality as the prevention and treatment of life style diseases such as cardiovascular diseases improved. The future will also present surprises and challenges if the evidence is ignored of the significantly increasing number of extremely long-lived individuals in our societies. The 21st century as the century of centenarians will be challenging in both the developed and the emerging economies of the world. Regardless of location, the trend has fundamental consequences for the way in which individuals view and live these extending lives, but also for the way in which societal infrastructures (education, workplace, housing, transport, health and social care) will need to be adapted to the needs of these extreme aged populations.
I have just returned from a trip to Mexico where I have a Visiting Professorship at the University of Guanajuato-Leon. On this trip, I lectured students, post-docs and faculty about the demographic development we can expect in the 21st century. There is an increasing awareness of these issues in countries like Mexico, and local, regional and national government are keen to hear of the experiences of Europe and learn from these.
So yes, we are waking up to ageing both in the UK and in Mexico and elsewhere……but it will take time to adapt, and the sooner the issues are addressed and policies implemented to make the most of the opportunities of ageing populations as well as tackle the challenges, the more individuals and societies will get out of the success story of extending human life.
About the Author
Dr George W. Leeson is Director of the Oxford Institute of Population Ageing, University of Oxford.
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Comments Welcome: We welcome your comments on this or any of the Institute's blog posts. Please feel free to email comments to be posted on your behalf to administrator@ageing.ox.ac.uk or use the Disqus facility linked below.
