The longevity revolution - Gearing Up for the Granny Boom - includes related article on two big exceptions on longer life expectancy - Cover Story

In the coming century the human life span may rise as high as 120 years. What are the implications of an aging world?

Over the past hundred years a silent and unprecedented revolution in longevity has occurred: people living in the industrialized world have on average gained 25 years of life, thanks largely to reduction of deaths at childbirth and infancy, and to control of diseases associated with old age. This is nearly equal to life expectancy advances over the preceding 5,000 years. In many countries, the 85-plus age group is the most rapidly growing.

The next century may bring even more dramatic increases. Prevention and elimination of disease along with control over the aging process itself could push our life spans from a world average of 66 years today to closer to 110 or 120 years - what scientists believe to be our "natural life span" because many individuals have lived that long. Some scientists talk of pushing the boundaries further by gaining control over the genes that determine longevity.

But our enhanced life spans do not come without a price. As the demographic balance increasingly tips to the elderly, societies are seeing their cultural, political and economic orders put to the test.

Among the most basic questions facing us are: At a time when the welfare state is coming under attack, who will be responsible for the financial support of the aged, the state or the individual? Will the aging of societies lead to economic stagnation? Will the aged form a politically powerful minority and if so, what demands will that group make? In extending our time on this planet, will we also be able to maintain quality of life, or are we doomed to pass our later years in sickness, frailty and financial incertitude? Culturally, will some of the attention now concentrated on youth shift to the elderly? As women outlive men in most of the industrialized world, many of the challenges associated with old age are particularly pertinent to them.

Our greater longevity has brought fundamental changes to our lives in ways that we either take for granted or of which we are hardly aware. For example, in 1920, a 10-year-old in the US only had a 40 per cent chance of having two of his or her possible four grandparents alive. Today, that figure is 80 per cent. Thus, despite romantic images of a tighter-knit family of former days, in fact, today we have a much greater proportion of multi-generational families than ever before.

In many ways, life is improving for the aged. For example, in the 1950s the average age of admissions into nursing homes was 65. Now the age is closer to 81. Today, older people in industrialized countries also have more choices about how they live: assisted living, home care or community-based care, for example. Morbidity rates are falling as a result of progress against heart disease and stroke.

'Silver industries' to cater for the over-50s

One of the most fundamental issues is how to support the aged financially. Different societies have come up with different approaches. Despite its current economic difficulties, Japan adheres to a system under which the state provides for institutional and home care of the elderly. The United States is leading the way in a profit-oriented, managed care system, which emphasizes primary care, disease prevention and monitoring of distribution. However, the US is not going far enough nor moving rapidly enough given the trajectory of old age. Meanwhile, the former Soviet Union has made major cutbacks in health care while slashing pension benefits as well.

So far much of our thinking about the aged has focused on them as a financial burden. But that attitude ignores fundamental facts that suggest to some extent that the very opposite is true. Today in the US pension funds amount to $2.7 trillion. This is money that helps provide capital for investment in production of goods and services, everything from roads to computer software start-ups. Overall, in the US, pension funds account for a quarter of all capital formation.

We must also remember that the aged represent an important group of consumers with very specific needs. Thus, in Japan, for example, a range of "silver industries" has grown up to cater to the housing, travel, recreation and other needs of those over 50. Similarly, in the United States companies talk increasingly about the senior or mature market. In recognition of the potential of this market, a number of publishers and electronic community builders have set up Internet web sites targeted at the aged, complete with advertisements aimed at winning their custom. Meanwhile, in attempting to add to their bottom lines, pharmaceuticals companies increasingly concentrate on needs of the elderly: in industrialized countries those over 65 constitute roughly 15 per cent of the population but account for some 30 per cent of pharmaceuticals used.

Politically, the elderly will become a more powerful group with whom political parties in democratic countries at least will have to reconcile their policies. In the US, for example, the "baby boomers," born between 1946 and 1964 will begin to retire in the year 2008. In the decade beginning from 2020, they will constitute 20 per cent of the US population and as much as 30 per cent of the electorate. Political candidates will no doubt have to pay increasing attention to their needs.

As societies struggle to address the challenges of aging populations, mere reorganization of the services to the elderly is no longer adequate. We require a redesign of the way we approach the needs of the elderly. In order for redesign to take place, some of our basic assumptions about the nature and character of old age must be questioned. This is already happening. Beginning in the 1950s, industrialized society began to perceive old age not as a period of life that is biologically fixed, but as one that is mutable.

The feel-good factor

There are a number of reasons for these changing views. For one, the self-image of the aged has been changing. Increasingly, they now see themselves as vibrant and energetic and are not willing to let life end at retirement. Secondly, gerontologists now have a better understanding of the underlying mechanism of aging itself. This is leading to an appreciation of the possibility and reality of interventions, both preventative and therapeutic.

The growing demographic weight of the elderly is forcing us to reevaluate many of our old views. Since people are living longer, should they not work longer as well? To that question I would give a qualified yes. In the US, if we do not change our attitudes, we may by around the year 2020 have some 60 million idle people in retirement not contributing to society. We cannot afford to have so many people idle. Passage of the Age Discrimination Act in 1988 was a step forward as it no longer made retirement dependent on age itself. The market place has already absorbed millions of women and minorities, so there is no reason why jobs should not be found for older people as well.

Yet there are still many challenges ahead of us. The developing world has not generally enjoyed the same increase in longevity and decreased birth rates that have been seen in industrialized countries. Sixty per cent of persons over the age of 60 currently live in the developing world and this is expected to increase to 80 per cent by around the year 2025 .Thus, there will be profound social, economic and political consequences of the aging revolution in all world regions.

Life expectancy: two big exceptions

People are living longer in many parts of the world, but at least two world regions constitute an exception to this trend, according to a forthcoming United Nations publication, World Population Prospects - the 1998 Revision.

In sub-Saharan Africa, the Aids pandemic is raging. The worst-hit countries are mostly in the south - South Africa, Botswana, Malawi, Mozambique, Namibia, Zambia and Zimbabwe - except for Kenya and Rwanda.

More than 10 per cent of the population in this region is infected with H IV, the virus which leads to Aids. This means that life expectancy at birth is falling. It has already dropped from 53.4 years in the period 1985-1990 to 47.6 for 1995-2000, and is expected to fall further to 47.1 in the period 2102015. Without the pandemic, the figures would have been respectively 54.2, 58 and 63.4 years. So Aids will have caused a drop of 16.3 years in life expectancy over a quarter of a century.

A similar, though much smaller trend is developing in three Asian countries (Cambodia, India and Thai[and), where the pandemic is expected to cut life expectancy by an average 1.6 years over the same period, and in two Latin American nations (Brazil and Haiti), where the predicted drop is 1.4 years.

In the former eastern bloc countries, life expectancy has been growing more slowly than elsewhere and is now falling. The trend began in the fading years of communism and has since gathered speed mainly for economic reasons (the massive reduction in pensions) and because of social factors (loosening family ties). Life expectancy at birth in Russia, which rose from 67.6 to 69.2 years between 1980 and 1985, fell to 66.5 in 1990 and 64.4 in 1995. It is also dropping in Ukraine (from 70.4 in 1985 to 68.8 in (1995), Belarus (71.3 to 69.6) and Bulgaria (71.6 to 71.2), though the figure is stationary in Romania (69.5 years).

COPYRIGHT 1999 UNESCO
COPYRIGHT 2004 Gale Group