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Kunin: Aging Population

The world is getting older. Imagine a graph that looks like a steep mountain trail. We’re climbing at a rapid rate to an unprecedented increase in the aging population. The world will contain one billion people over 60 by the year 2020.

These facts were spelled out for me at a recent symposium on aging at Oxford University.

On one hand, this is a huge humanitarian achievement. People are living longer because of better education, nutrition and health care. This demographic shift is further influenced by the decline in fertility rates. Many families used to have six or seven children. Now women have two or three because of access to education, the move towards emancipation, and the decline in infant mortality rates.

The ratio of the young working population to the old dependent population has tilted towards the old and the most rapidly growing group are those over 80, the old, old. Fewer taxpaying workers are being asked to support no longer taxpaying elders. The challenge is how do countries provide adequate care, housing, and health care for parents, grandparents and great grandparents?

This population shift has occurred in the last twenty-five years in the emerging market world - while it took the developed world one hundred and fifty years to reach the same place. The decline of kin based care in countries such as China and India adds to the problem. Children move to the cities for work, leaving their children and parents behind.

Visit any nursing home, and you can observe gender differences. Women outlive men in every part of the world. But they may not live as well into old age as men. They are poorer, less educated and more dependent. And women are the majority of caregivers - caught in the sandwich generation, caring for both children and aging parents.

The most effective initiative to improve the lives of the elderly is to reduce poverty in every country,including our own . Before social security, Medicare and Medicaid the poverty rate for the elderly was twice that of children.

Since these programs started, poverty rates have been turned upside down - the elderly have half the poverty rate of children. Good news for the elderly, not good for children.

The keys to achieving the so-called golden years are clear: access to health care, and a livable income. But to assure that our growing elderly population enjoys a dignified and secure old age, we’ll have to do considerably more than that.