essay about aging population

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Global Population Aging: Facts, Challenges, Solutions & Perspectives

The rapid aging of populations around the world presents an unprecedented set of challenges: shifting disease burden, increased expenditure on health and long-term care, labor-force shortages, dissaving, and potential problems with old-age income security. We view longer life spans, particularly longer healthy life spans, as an enormous gain for human welfare. The challenges come from the fact that our current institutional and social arrangements are unsuited for aging populations and shifting demographics; our proposed solution is therefore to change our institutions and social arrangements. The first section of this essay provides a statistical overview of global population aging and its contributing factors. The second section outlines some of the major challenges associated with widespread population aging. Finally, the third section of the essay describes various responses to these challenges, both current and prospective, facing individuals, businesses, institutions, and governments.

DAVID E. BLOOM, a Fellow of the American Academy since 2005, is the Clarence James Gamble Professor of Economics and Demography in the Department of Global Health and Population at the Harvard T.H. Chan School of Public Health. His many publications include recent articles in such journals as  JAMA: The Journal of the American Medical Association, Finance & Development , and  Science .

DAVID CANNING is the Richard Saltonstall Professor of Population Sciences and Professor of Economics and International Health in the Department of Global Health and Population at the Harvard T.H. Chan School of Public Health. His many publications include recent articles in such journals as  Journal of Political Economy, Journal of Applied Statistics , and  Journal of International Development .

ALYSSA LUBET is a Research Assistant in the Department of Global Health and Population at the Harvard T.H. Chan School of Public Health. Her research interests include economics, women's health and reproductive health, and population studies.

We are in the midst of an unprecedented transition in global demography. The world’s population is aging rapidly, and older adults compose a larger proportion of the world’s population than ever before–a share that will only increase over the next century. By 2050, the percentage of the United States’ population that is aged sixty years and older will grow from the current figure of about 20 percent to 27 percent. The global number of centenarians worldwide–those aged one hundred years and older–is expected to more than double by 2030, with projections of nearly 3.4 million by 2050. 1  Three major factors are driving this transition: decreasing fertility, increasing longevity, and the aging of large population cohorts.

Falling fertility rates are the main determinant of population aging. Low fertility rates lead to smaller youth cohorts, which create an imbalance in the age structure: older age groups become larger than their younger counterparts. Thanks to accessible and effective birth control, increased child survival, and cultural changes, birth rates have dropped dramatically in the past century. In 1950, the global total fertility rate (TFR), or the average number of children per woman, was about 5; by 2010, that number had dropped by 50 percent. By 2050, the TFR will have dropped even further to about 2.25 children per woman. In many countries, fertility rates are now well below the long-term replacement rate of just over two children per woman.

Changes in fertility rate are accompanied by increased longevity, another driver of population aging. Averaging for sex and location, a child born in 1950 had a life expectancy of only forty-seven years, while an adult who had survived to the age of sixty could expect to live another fourteen years. In contrast, by 2010, life expectancy at birth had increased to seventy years, and continued life expectancy for those aged sixty increased to twenty years. In a number of populations, recent increases in longevity have been attributed to falling rates of tobacco consumption, as well as improvements in medical technologies. 2 By 2050, life expectancy at birth is expected to have risen to nearly seventy-seven years, while life expectancy at age sixty will increase to twenty-two-and-a-half years.

Meanwhile, large population cohorts, such as the United States’ postwar baby boom generation, are moving through middle age and older adulthood. This movement can be seen in Figure 1, which depicts the population of more-developed countries (MDCs) broken down by sex and age group. Males are on the left side of the pyramid and females are on the right. The shifting shape of the population pyramid between the years 2010 and 2050 illustrates the baby boom cohort’s movement from middle into older ages.

These global phenomena–decreasing fertility, increasing longevity, and the aging of large birth cohorts–combine to drive up the percentage of older adults as a share of the global population. In 1950, only 8 percent of the world’s population was sixty years or older; this number increased to 11 percent by 2010. Over the next several decades, this proportion is expected to rise dramatically, reaching a projected 21.2 percent by 2050. The change is even more dramatic for the share of the world’s population aged eighty years or older. This proportion climbed from just 0.6 percent in 1950 to 1.6 percent in 2010, and is projected to make up 4.1 percent of the global population by 2050.

While the population of virtually every country is aging rapidly, there remains considerable variation at both regional and country levels, with strong correlations to differing income levels. MDCs trend toward low fertility and high longevity, and less-developed countries (LDCs) trend toward the opposite. At the low end of the fertility range are the MDCs found in Eu - rope and East Asia, with Bosnia, Herzegovina, and Singapore tied for the lowest TFR of 1.28 children per woman. Meanwhile, Sub-Saharan Africa has a regional TFR of just over 5, while also hosting the highest country-level fertility rates: Somalia (6.61), Mali (6.86), and Niger (7.58). As for longevity, Japan is in the lead with a current life expectancy at birth of eighty-three-and-a-half years, in stark contrast to Sierra Leone, where life expectancy at birth is slightly over forty-five years.

Tables 1 and 2 depict the percent of the elderly population in the world’s most and least population-aged countries, now (2010) and projected in the future (2050). The 2050 figures are based on a medium fertility projection, which assumes that fertility in all major areas will stabilize at replacement level (at slightly over two children per woman). This comparison reveals stark differences in age profiles between countries. For example, currently 23 percent of Germany’s population is aged sixty-five years and older, while the corresponding figure for Qatar (with its large expatriate worker population) is only 1 percent. These rankings are projected to shift considerably in the next half century, with only Japan holding over in the top five most population-aged nations. . . .

Access the full volume here . 

• 1 Unless otherwise stated, population figures are drawn from United Nations Department of Economic and Social Affairs Population Division, Population Estimates and Projections Section, World Population Prospects: The 2012 Revision (New York: United Nations Department of Economic and Social Affairs, 2014), http://esa.un.org/unpd/wpp/index.htm.
• 2 Colin D. Mathers, Gretchen A. Stevens, Ties Boerma, Richard A. White, and Martin I. Tobias, “Causes of International Increases in Older Age Life Expectancy,” The Lancet 6736 (14) (2014).

Global Issues: Addressing an Aging Population Essay

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An important issue that is currently facing the world community is aging due to the increasing number of older people. Various countries in the world have experienced significant growth in the number of older people within their population. This has had a great impact on labor and financial markets while also affecting the demand for products and services. The issue is also threatening to upset existing family structures and intergenerational ties. Aging exposes a human being to significant health risks because of a weaker immune system. Countries that have large immigration flows tend to have a low number of older persons since many immigrants are of younger working ages (United Nations, 2019). Migration leaves the countries in which people are moving with a significant number of older people. The increased concern about ageing has led to the organization of various conferences seeking to come up with a solution for the issue. This is aimed at ensuring that older people do not suffer from the negative consequences associated with the ageing process.

One of the ways how the United States can work with other countries in addressing the ageing issue is by engaging in collaborative research and development activities. The US can work together with other nations to carry out scientific and medical research related to aging. This will enable professionals to identify innovative solutions needed to deal with age-related health problems (Runde et al., 2021). The United States should also consider teaching other nations across the world its most effective strategies for dealing with the aging population. In this case, the US can educate other countries on what is needed to provide quality care to older persons and strategies to use in fostering age-friendly societies.

Runde, D. F., Sandin, L., & Kohan, A. (2021). Addressing an aging population through digital transformation in the western hemisphere . CSIS. Web.

United Nations. (2019). Ageing . United Nations. Web.

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Article contents

Population aging as a global issue.

• Jennifer D. Sciubba Jennifer D. Sciubba International Studies, Rhodes College
• https://doi.org/10.1093/acrefore/9780190846626.013.559
• Published online: 27 August 2020

The late 20 th century brought the dawn of global population aging, the culmination of decades-long shifts to lower fertility and longer life expectancy. These novel age distributions—larger proportions of older persons relative to working-age or youth—bring with them a plethora of questions about the political, economic, and social causes and consequences of such aging. There are multiple theoretical perspectives and ways to measure population aging, and decisions about approaches, definitions, and measurements can make a dramatic difference on the results of studies of its impact. Some scholars approach the study of aging through a generational lens, others through chronological age, dependency ratios, or other measures of age structure. Studies of the implications of population aging fall into three major categories: political, economic, and social. Political demography studies often focus on the political power of various age groups and attempt to assess the degree to which intergenerational conflict is emerging as the sizes of age groups change and their demands on services like entitlements shift alongside. Political demography studies also look at voter behavior and preferences to assess possibilities for reform of age-related policies, like retirement, healthcare, and education. A separate branch of political demography examines the military implications of population aging, particularly its effect on the willingness and ability of a state to use force. Of the few studies that show a link between aging and war, empirical results are inconclusive, meaning that it is just as likely a state with a high median age will be belligerent as not. Studies on the economic implications of population aging look at the changing nature of the labor market itself and on the possibility of macroeconomic growth in the face of demographic change. Finally, research on the social impact of population aging is mostly concerned with individual- and family-level well-being, as the care demands of an aging population create pressures on individuals, families, and social safety nets. There are many controversies and debates over the impact of aging, including debates over the relative weight of demographic factors and whether population aging is a trend warranting celebration or alarm. In all, there are far more questions about the implications of aging than there are answers, and the projected development of this trend means that more questions constantly arise. Lingering questions surround historically rapid demographic aging, new sets of aging states at different speeds, shrinking populations, the intersection between migration and aging, and the intersection between aging and climate change. The field is ripe for more comparative aging work in general.

• intergenerational conflict
• second demographic transition

Introduction

Because of revolutions in family planning and life expectancy, in the late 20th century humanity reached age distributions never before seen in our history as a species, providing a rich set of puzzles about the political, economic, and social causes and consequences of population aging. Technically, any country in which fertility is falling and median age is rising is aging, and nearly all the world’s countries fell into this category at the turn of the 21st century . But analytically, this pattern becomes interesting and novel questions arise after these trends have continued for several decades and the proportions of young and old in the society shift—as is the case in a much smaller group of countries. At no time has aging been more remarkable to study than it is in the 21st century and the certainty that aging will intensify in many countries means it will only grow more important over time. In the discipline of International Studies, research mostly focuses on the consequences of such demographic change and its influences on broader questions of interest to the field, such as economic development, conflict, and political power. At the same time, it is impossible to understand population aging without also considering the causes of the trend itself, particularly low fertility, so research on population aging draws heavily on sociology, demography, and economics.

As a global issue, population aging is relatively new—for most of human history fertility and mortality were both high. The Demographic Transition Theory describes a society’s transition away from these high levels to low fertility and mortality. In the theory, a society transitions through four phases: high fertility and mortality in the first, pre-industrial stage; declining mortality in the second, industrializing stage; declining fertility in the third, industrial phase; and stable, low fertility and mortality in the fourth, postindustrial stage. In the world’s most developed states, mortality began to fall in the late 18th to 19th centuries , which improved chances of infant and child survival and yielded gains in life expectancy. Primarily in the 20th century , fertility followed suit. As our knowledge and implementation of health practices has continued, record societal life expectancy continues to increase, more than doubling since the 19th century . Globally, average life expectancy at birth has greatly improved as well: in 1950 it was only 47 years but in 2020 it was 72 (UN DESA, 2019 ).

Today, many countries have completed the demographic transition; others seem to be barely beginning. Thus, the set of countries scholars focus on when studying aging as a global issue is typically limited to those which have completed the four stages of the demographic transition and have moved to what some demographers call the fifth stage of the transition, and others call the Second Demographic Transition. Both terms capture the shift to a very low fertility society, with the concomitant changes to an older age structure (Lesthaeghe, 2014 ). Research on the Second Demographic Transition explores the influences on changing preferences about family size to rates far below the typical replacement rate of 2.1 children per woman, namely changing marriage patterns, secularization, incompatibility between motherhood and work outside the home, and changing family formations. The replacement rate refers to a level of fertility needed to maintain a steady population size, one each for the parents and a margin for those females who do not make it to reproductive age. Among the countries with the lowest fertility in the world around 2020 were South Korea, with 1.1 children born per woman on average, Singapore and Taiwan with 1.2, Bosnia & Herzegovina, Spain, Italy, Greece, and Ukraine with 1.3 (UN DESA, 2019 ). Many of these very low rates appear to be due in part to distortions arising from deferments in marriage and childbearing.

Globally, population aging is intensifying and spreading--states that are already considered “aged” are reaching record proportions of older persons. In 1950 , the median age of developed countries was 29 years; in 2020 , the median age of developed countries was 42. In the intervening years, Western Europe and Japan led the way with below-replacement fertility and low mortality, and thus the most extreme population aging. Japan has had low fertility since the 1970s, and by 2035 , using the United Nations’ (UN’s) medium variant, Japan’s median age is projected to reach a remarkable 52.4 years (UN DESA, 2019 ). Aging is also spreading in the sense that more countries are achieving median ages over 35 years in geographic areas well outside of Europe and Japan. As this article will show, there are far more questions about the implications of population aging than there are answers, so researchers will find this a young and fruitful field, particularly when it comes to newly aging states. While the majority of studies of aging as a global issue are based in sociology, economics, demography, and their related disciplines, aging research is relatively underdeveloped in political science. There is much room for new analyses and new insights.

The following sections first describe typical methods and measurements for the study of population aging, then the major research themes involving political and military, economic, and social implications and disciplinary connections to economics and law. The article then describes the many controversies and debates over the impact of aging, including debates over the relative weight of demographic factors and differing perspectives as to whether population aging is a trend warranting celebration or alarm. The article concludes by outlining lingering questions in the study of aging, including interactions with migration and climate change.

Methods and Measurements

There are multiple theoretical perspectives and ways to measure population aging, and decisions about approaches, definitions, and measurements can make a dramatic difference on the results of studies of its impact.

Some scholars approach the study of aging through a generational lens. They may focus on cohort effects and assume that individuals are shaped by a shared life experience, such as a war or technological revolution. Other scholars may focus on period effects (examples include economic cycles, wars, droughts, or epidemics), which are experiences that shape all individuals alive at that time, regardless of age. Life-course theories examine how exogenous processes and events shape individuals in different periods of their lives, whereas life-span theories look at micro-level processes within an aging individual. In its most simplistic formulation, individual aging begins at birth. Both life-course and life-span theories encourage contextualizing “old age” by recognizing how it is shaped by experiences throughout life. Thus, most scholars who use these approaches argue that longitudinal data and multilevel analysis are needed to capture the changes throughout an individual’s life, rather than focusing on only what happens in a person’s oldest ages (Fulle-Iglesias, Smith, & Antonucci, 2009 ). In this sense, scholars recognize that each person passes through various ages—aging, with luck, is process that every individual can expect to experience.

Although much of the International Studies research on aging focuses on the state and societal level of analysis, such research still relies on assumptions about what aging means at an individual level—a person’s place in the family, the workforce, and the polity, just to name a few. Measures of chronological age can be problematic, though, as what it means to be 65 today is different than what it meant to be 65 in a different time (Sanderson & Scherbov, 2008 , p. 4) or in different contexts, even at the same time. Globally, life expectancy at birth in the year 2020 ranged from 52 years in the Central African Republic to 84 years in Japan, with the lowest life expectancies driven by high infant and child mortality (UN DESA, 2019 ). Even in the least developed countries, some people live to reach their 70s and 80s. How might concepts like retirement, grandparenthood, or senescence differ in these contexts?

In addition to chronological age, researchers often use dependency ratios as measures of population aging, particularly old-age dependency ratio, which measures the proportion of those aged 60 and over (or 65 and over) to those of working ages, typically defined as 15 or 20 to 60 or 64 years. These ratios are meant to capture the economic effect of population aging, implying that the proportions of those who “contribute” to the economy—prime-age workers—are shrinking at the same time that the proportions of those who “take out”—older persons assumed to be retired—are growing. However, use of dependency ratios requires a firm age boundary and the assumption behind dependency ratios is that those under or over a certain age are dependent on those of middle ages, which may be empirically false. Cross-nationally, retirement ages can vary by at least a decade. In many cases the effective age of exit from the workforce differs significantly from the official retirement age, being either much younger or much older. In both cases, arbitrarily defining dependents at age 60 or 65 and above would be empirically inaccurate.

To skirt the problems with dependency ratios, some scholars have argued that median age is a better way to compare countries’ age structures over time or cross-nationally. Cincotta, in the article “ The Age-Structural Theory of State Behavior ,” introduces the concept of the age-structural transition and argues that “median age provides a simple and intuitive means for analysts to estimate and visualize the three most important analytical qualities in age-structural theory: a state’s position in the age-structural transition, its direction of movement, and its rate of change.” Cincotta defines the age-structural transition as “the continuous path of cohort reconfiguration that leads from a youthful population to one numerically dominated by middle-age adults and seniors.” However, as Cincotta concedes, focus on median age does not reveal potential differences in age distribution among populations. For more detail, scholars examine the “shape” of populations by looking at the various sizes of age cohorts—easily visualized in population pyramids or trees. As an example, there is a robust literature around the “window of opportunity,” when a society has an abundance of population in the middle parts of the age structure.

Another way scholars have added nuance to studies of aging is through the National Transfer Accounts (NTAs) approach, which measures aggregate intergenerational transfers, accounting for the economic flows among children, workers, and the elderly (Mason, Lee, Tung, Lai, & Miller, 2009 ). Although this approach still assumes that those in the youngest and oldest age brackets are out of the workforce and consume more than they produce, it does recognize that flows are multidirectional. Grandparents, for example, may be officially retired but provide occasional, unpaid childcare for their grandchildren, allowing their adult children to be more economically productive.

Although old age is culturally constructed and variable across place and time, most large- n quantitative studies, such as those in political economy, ignore this variance to simplify analysis, and there are few qualitative studies of societal-level aging. Thus, the field often lacks nuance. Scholars who have shifted away from using dependency ratios in favor of median age or other measures of age structure are able to correct for some of these shortcomings, but still may miss details about the distribution of population among various age groups when aiming for a single, comparative measure. Finally, measurement is a challenge because there is reason to believe that it is not the demographic trend itself that shapes an outcome, but perception of that trend that matters (Winter & Teitelbaum, 2013 ). Some studies of the intersection of migration and aging, for example, attempt to account for societal fears that as the majority population ages and dies, ethnic minority populations will become more prevalent and powerful, and trace how this plays out at the voting polls.

Implications

Studies of the implications of population aging fall into three major categories: political, economic, and social. Political demography studies often focus on the political power of various age groups and attempt to assess the degree to which intergenerational conflict is emerging as the sizes of age groups change and their demands on services like entitlements shift alongside. Political demography studies also look at voter behavior and preferences to assess possibilities for reform of age-related policies, like retirement, healthcare, and education. A separate branch of political demography examines the military implications of population aging, particularly its effect on the willingness and ability of a state to use force. These studies assume that aging affects both manpower and budgets and most of this scholarship focuses on the world’s most powerful states—the United States, China, Russia, and those in Europe—all of which are aging. Studies on the economic implications of population aging look at the changing nature of the labor market itself and on the possibility of macroeconomic growth in the face of demographic change. For example, countries may attempt to increase female labor force participation to make up for a smaller workforce. Finally, research on the social impact of population aging is mostly concerned with individual- and family-level well-being, as the care demands of an aging population create pressures on individuals, families, and social safety nets.

Political Implications

The major theme of political demography studies of aging is the political power of various age groups. Much of this work has concerned political dynamics in democracies with aging populations. As people are living healthier longer, their voting lives are longer, too (Matsubayashi & Lu, 2019 ), and to the extent that researchers believe the size of political influence moves in tandem with the size of voting blocs, they may also assume the aged are growing in political power at the expense of other generations. Scholars also examine the voting behavior of various age groups, and the feasibility of such groups being mobilized by political rhetoric surrounding age-related issues.

To some, population equals power and reforms to social welfare policies that favor the aged are politically infeasible. One camp expects more generous welfare policies in an aging electorate. A rational choice model assumes that seniors will only vote in their immediate interest, and much of the work on this research question is in political economy, which assumes this perspective, and indeed finds evidence to support it. Epple, Romano, and Sieg ( 2012 ) find a relationship between education funding and the age of voters in particular communities, starting from the perspective that older voters have less of an incentive to vote for generous education funding. Galasso and Profeta ( 2004 ) use the same perspective to argue that an older electorate means more generous pensions systems because it raises the profile of the issue on politicians’ agendas. Jäger and Schmidt ( 2016 ) find that because seniors tend to discount long-term investments there is a negative relationship between share of elderly people and public investment rates. Empirically, public-pension fiscal issues are related to 1930s definitions of pension eligibility ages—since that time life expectancy had risen greatly, particularly the remaining years of life left once someone reaches age 65. Because pensionable ages were set long ago, efforts to increase them can result in protests, as has happened in Russia and France. To minimize the electoral penalty to politicians, raising pensionable ages can be done only gradually, with substantial fractions nearer to retirement grandfathered into the old system.

But do older people vote only in their own interests? Others have looked beyond a rational choice model and found that seniors’ voting preferences are more complicated. More micro-level analyses show different findings. For example, Goerres and Tepe ( 2010 ) find that seniors’ experiences with other generations within their own families shape their attitudes toward public childcare, an issue not directly of interest to them.

There are also more nuanced and varied findings among studies that place emphasis on context: economic context such as the extent to which women are integrated in the labor market; cultural context such as attitudes toward working mothers; and political context, especially the extent of state spending on the family (Lynch & Myrskylä, 2009 ). Institutions partly determine how generous policies toward the aged are both within Europe, where the majority of research has been done, and in other contexts (Breyer & Stolte, 2001 ; Sciubba & Chen, 2017 ; Tepe & Vanhuysse, 2009 , 2010 ). For example, differences between federal structures may explain patterns of old-age care in Germany and the United States (Campbell, 2003 ). In comparisons of various welfare states, Esping-Andersen and Sarasa ( 2002 ) find a lot of variation in bias toward the aged even among aging states because of differences in the institutional designs of their welfare states.

Certainly, there is little consensus in the literature on the relationship between demographic aging and politics; this is partly because data has been limited, as population aging is so new. In an early attempt to theorize about aging and politics, Binstock and Day ( 1996 ) were concerned about whether the political attitudes of older people would differ from younger generations and whether the generations would inevitably conflict. Although their studies found little reason to expect intergenerational conflict, they cautioned that this could change in the future. Taking this caution to heart, it is important to note that, arguably, the countries under study during the time frames of most of the studies published before 2010 were not “aged” at all, in the sense that their median ages were still relatively young. Such studies should be repeated since aging has intensified, and regularly in the future as aging continues to progress.

Not only have the data been limited, but researchers’ measures of aging have prevented a clear consensus from emerging in the literature. Fullerton and Dixon ( 2010 ) find that cohort effects, not age effects, explain American attitudes toward education, health, and Social Security spending, and thus fears of intergenerational conflict are overblown. Similarly, Goerres ( 2008 , 2009 ) finds that generational effects, not age effects, determine party preferences in Germany.

The studies that start from a rational choice perspective often assume more generous policies toward the elderly. Other studies use a completely different set of assumptions and argue that aging can lead to more austere social spending because of the pressure on the median voter, who is of working age, and their desire to avoid higher taxation to pay for generous spending on the elderly—this is what some have termed the “fiscal leakage” hypothesis (Razin & Sadka, 2007 ). Sometimes contesting pressures within a society can cancel each other out: Sanz and Velázquez ( 2007 , p. 917) find that aging “is the main driving force of the growth of government spending, followed by relative prices and population” but other age groups work to counter increases in benefits to retirees. They go on to note that “institutional reforms have been successful at reducing the impact of ageing on pensions in recent years.” There is still much work to be done in this area, particularly if age divisions supplant class divisions in some postindustrial societies and as demographic aging reaches countries without democratic institutions, such that the size of voting blocs ostensibly matters less (Sciubba & Chen, 2017 ).

Two areas of research on the politics of aging are relatively new but have fascinating early results. The first of these is the links between populism and population aging (Auerswald & Yun, 2018 ). The 21 st century return of populism to Western Europe in the midst of the continent’s dramatic demographic changes has led some scholars to surmise that immigration and aging have played a role in shaping attitudes toward European integration (Coleman, 2016 ). This dynamic comes together with aging because increasing immigration is often proposed as a solution to population aging and shrinking without adequate attention to possible social and political consequences of large-scale immigration into low-fertility societies. From this perspective, Brexit may not have been primarily about economic competition and sovereignty, but about “competition for the cultural values of traditional England” (Harper, 2016 , p. 184).

The other potentially fruitful area for research is on social movements, global governance, and law, particularly the influence of the “old-age lobby.” There is very little work on elderly social movements (Pratt, 1976 ) but the existence of a social movement around the proposed UN Convention on the Rights of Older Persons has sparked a body of scholarship. One part of this looks at potential legal gaps on elderly rights at the international and national levels (Doron, 2006 ; Doron & Apter, 2010 ; Rodriguez-Pinzón & Martin, 2003 ). Another examines the discourse and dynamics of the social group surrounding the push for institutionalized elder rights (Herro, 2017 ; Sciubba, 2013 , 2014b ).

Military Implications

While the previous section, “ Political Implications ,” showed that there is a budding literature on the politics of aging, there is very little research on the national security implications of population aging. Typically, research on demographics and security focuses on youthful populations and their link to conflict, of which there is plenty of empirical data to study given the prevalence of states with youthful age structures. The dearth of work on aging is partly because the set of countries with advanced societal aging is so small. There are insufficient numbers of observations for quantitative studies that require a large n ; even qualitative studies have only 10–20 years of data, and that is only for very few states. Given the limitations, many of the handful of studies in this area are prospective, based upon hypotheses about potential future effects rather than evaluations of empirical evidence to date. Of the few studies that show a link between aging and war, empirical results are inconclusive, meaning that it is just as likely a state with a high median age will be belligerent as not. Findings in the few empirical studies conflict, with one quantitative study finding that older societies are indeed more peaceful (Brooks, Brooks, Greenhill, & Haas, 2019 ), and one qualitative study finding the opposite (Sciubba, 2014a ).

Theoretical links are also underdeveloped. Early International Relations literature discussed population as one of several foundations of national power (Sprout & Sprout, 1945 ), but all of the major International Relations theories of war were developed during a time of relative population youth and abundance. Scholars simply are not sure whether to expect an aging world to be more peaceful or more turbulent. Thus far, states with mature age structures have been some of the most peaceful in the world. Is this correlational or causal? We should also consider issues of operationalization. As we broaden our definition of conflict, we see more evidence among aging states. Aging China is militarizing the Indo-Pacific; aging Russia cut off gas supplies to Europe in 2009 , invaded Ukraine in 2014 , and began conducting airstrikes in Syria in 2015 . Likewise, the United States, which is entering a mature age structure, has a large military footprint around the globe, involved in both overt and non-declared wars.

The majority of research concerns the influence of societal aging on willingness and ability to fight. Manpower and budget are the biggest concerns with population aging—namely, that there will not be enough of either. Some argue that aging states will be the most peaceful because they have lower capacity for conflict as defense spending is crowded out by spending on seniors. They surmise that aging societies have high per unit soldier costs as the number of age-eligible soldiers shrinks and the money invested in individual soldiers rises. States will therefore be wary of expending their valuable resources. Some also argue that aging states will be averse to military casualties because the personal and political costs of losing a child is higher the smaller the family (Brooks et al., 2019 ; Luttwak, 1994 ). Others, however, use power transition theory to argue that aging states may be more aggressive in the face of aging as a last gasp to grab global power (Sciubba, 2014a ). Along these lines, alliances could, to some degree, help states compensate for declining manpower by providing “strength in numbers” and shared investments in personnel-saving technologies, which allow them to project power even in the face of aging. Yet some argue that alliances like the North Atlantic Treaty Organization (NATO) are set to implode because of internal demographic changes, which weaken their ability to effectively respond to threats (Ceccorulli, Fassi, & Lucarelli, 2017 ).

Given both the rapidity of population change as global aging intensifies and that aging is an issue shared by all of the world’s most powerful states, this research area is ripe for growth. The emphasis that scholars place on population as power has waned the more that the nature of conflict has changed to give the edge to advanced weaponry—at least in potential great power conflict—and the growth of cyber capabilities as a potential low-manpower arena is another way states might compensate for demographic changes. Studies that look comprehensively at the tradeoffs between guns and butter in an aging society are sorely needed.

Economic Implications

Studies on the economic and social implications of population aging are less connected to political science and thus will just be briefly discussed. On the economic side, these studies mostly question potential for economic growth, primarily because of shifts in both the labor market, which shrinks and ages, and in numbers above arbitrarily defined ages of “dependency,” those whom many analysts assume to be out of the workforce and beneficiaries of social welfare and high healthcare spending. Certainly, the number of youth entering the workforce declines over time in an aging society. Populations of “working age” have peaked in most aging countries, including China’s; the annual number of new entrants to Mexico’s labor force have peaked as well. However, the age boundaries of “working age” may be better understood as variable rather than constant, as mortality and morbidity are also declining. In addition to dependency ratios and other measures of age structure, how a researcher measures economic variables, whether by per capita or aggregate figures for example, affects results.

Early on, Coale and Hoover ( 1958 ) explored how fertility decline changes age structure and how that age structure affects economic growth. Following this, perhaps the most influential line of research has been that of the “demographic dividend,” stemming from Bloom, Canning, and Sevilla ( 2003 ), who argue that those of the youngest and oldest ages who are outside the workforce consume more than they produce, and economic growth is in part driven by an abundance of those in the working ages. Their models of “demographic dividend” attribute part of East Asia’s economic boom to dependency ratios that provide a favorable combination of labor supply, savings, and human capital. Of course, the validity of such a model depends on what proportion of economic growth is attributed to population growth (Matsutani, 2006 ).

Many macroeconomic and microeconomic questions remain. Scholars have tried to understand whether older workers must exit the workforce for younger workers to take their place. Many label this the “lump of labor fallacy” and argue that there is no fixed amount of work within an economy. Other research in this area concerns microeconomic issues with financial solvency in retirement, potential ways of bringing in large, underutilized segments of the potential workforce, including women and older people, and conditions that affect early retirement (Merkle, Schreiber, & Weber, 2017 ).

Although there is a strong research tradition on whether economic growth is possible in an aging society, there has been very little questioning of the economic growth model in general. This lack of reflection is certainly due to the neoclassical assumptions that drive much research in economics and political economy. From this perspective the ultimate goal of market economies is economic growth—continuous expansion in the aggregate. But there is room for a normative debate: should the goal continue to be economic growth even when a population is shrinking? While some environmental scholars have raised the issue, very few experts in aging have taken on this important question.

Research on the social implications of population aging mostly focuses on individual well-being. We know that individuals without a strong government safety net or family structure will have to provide for their own care and security in old age. Individual characteristics matter as well, such as good physical and mental health, and occupation, including self-employed status (Wahrendorf, Akinwale, Landy, Matthews, & Blane, 2016 , p. 270). There is some research on the broader implications for social relations. For example, shortages of caregivers have spurred immigration schemes, which change the ethnic composition of receiving societies and introduce another element of complexity to demographic change.

Key Controversies and Debates

Concerns about demographic aging appeared among the French elite in the mid- to late 19th century as competition with Germany intensified (Teitelbaum & Winter, 1985 ), and policymakers in other countries and contexts have occasionally voiced similar worries. On the whole though, widespread population aging is new. Because of that newness and because scholars are studying a moving target, there are quite a few controversies and debates around the issue. At a foundational level, scholars continue to debate whether demography is destiny, or rather, to what degree aging is deterministic. States can overcome geography and project power—can they also overcome demography?

There are also debates over perspective, particularly whether population aging is inherently positive or negative. People are living longer than ever, but instead of celebrating this positive milestone, many express concern and even alarm. Aging is portrayed in the media, policy, and often in academic circles as challenging and even catastrophic. Both low fertility and long life expectancy are actually signs of societal progress. If people are living longer and having smaller families, that means they have the confidence to have fewer children and feel more assured those children will live to adulthood. But because widespread demographic aging is a new phenomenon there is substantial uncertainty about the implications, as this article has shown, and that creates fear.

A related debate is over the characteristics of an aging society, particularly whether or not an aging society can still be an innovative one. Those who are pessimistic about aging societies seem to dominate the debate. On the one side are those like Magnus ( 2009 , p. 77), who says that “Today’s information economy . . . demands flexibility, innovation, and continuous improvement in skill levels and education standards; it rewards merit and achievement as opposed to seniority; it prizes individual creativity rather than machines—and it may be a tougher world into which to integrate millions of extra retired and old people.” On the other side are those who point out the economic opportunities of an aging society, and argue that they can spur innovation—partly out of necessity (Coughlin, 2017 ). Terms such as “young,” “youthful,” “aging,” “aged,” and “dependent” can lead to distorted interpretations when applied to populations as shorthand terms to describe shifts in age compositions resulting from fertility differentials or trends. Characteristics of “aging” individuals, that is, less energy, dynamism, or creativity, are often ascribed to populations that are “aging.” Yet some populations that have “aged” are the most energetic, dynamic, and creative—witness the technological superiority of Germany and Japan, for example. Conversely, populations that are “youthful” may be seen as having the characteristics attributed to “youthful” individuals: a high level of energy, optimism, creativity, enthusiasm. Yet, too frequently, such populations are mired in sclerotic and corrupt governance and an inability to break away from factors that impede development.

Finally, scholars are divided over whether or not demographics are influential at all. For example, scholars disagree on whether the demographic dividend is a real phenomenon or whether other factors that tend to accompany this stage in development, like investments in education and infrastructure, or growth in governance capacity, are actually responsible for driving the economic growth that these middle-age structures exhibit. Lutz et al. ( 2019 ) find that human capital, in the form of education, matters far more than age structure for economic growth. This debate is relevant for studies of population aging because if we cannot be sure that demographic structure drives economic growth, we similarly cannot be confident that when the “window of opportunity” closes and there are more old-age dependents relative to prime age workers, economic growth will come to a grinding halt.

Lingering Questions: The Future of Aging

As this article has shown, there are far more questions about the implications of aging than there are answers, and the projected development of this trend means that even more questions constantly arise. Lingering questions surround historically rapid demographic aging, new sets of aging states at different speeds, shrinking populations, the intersection between migration and aging, and the intersection between aging and climate change. The field is ripe for more comparative aging work in general.

First, while we look to Japan, Germany, and Italy as global leaders in population aging, they are certainly no longer alone as aged states. Increasingly, population aging is a worldwide phenomenon, touching more continents than ever and intensifying in places where the trend began decades ago. Just as researchers start to figure out what aging means in the vanguard of states, two trends are occurring: first, those countries are reaching record-high median ages and proportions of elderly; and second, a new set of countries with different histories, cultures, and institutions are experiencing demographic aging. Scholars will have to continue to trace the political, economic, and social implications of aging in both new contexts. One question that will drive this research is whether or not the past is precedent. While scholars have extensively studied aging in Japan and Europe, there is little work on aging elsewhere (Coulmas, 2007 ).

Second, population aging is happening at a much faster rate today than it did historically. The European demographic transition lasted at least 150 years, “giving societies and governments time to address and adjust as their populations transitioned from young to old” (Leeson, 2018 , p. 112). Today’s transitions are much faster and are in part because of external interventions that change both fertility (through family planning access) and mortality (through health programs like vaccines). Some scholars point out that differences in the nature of the demographic transitions, whether from internal developments or external interventions, can affect the way a state prepares for resilience in the face of demographic aging and the health challenges that come along with it (Bollyky, 2018 ). With regard to China, many in the media—and a few scholars—have questioned whether it matters that the country will “grow old before it grows rich,” but China certainly is not alone on this path and many middle-income countries are following in its wake. Scholars would do well to consider context: the various cultures and institutions in these newly aging societies are likely to produce different political, economic, and social effects from demographic change than they did for the vanguard states.

Third, just as we are getting used to the issue of population aging, societies now have to confront the inevitable outcome of the second demographic transition: a shrinking population. Barring extremely high levels of immigration (Harper, 2016 ), aging countries will go the way of Japan and Italy, whose populations are already shrinking from low fertility and mortality. How might the fiscal consequences of population shrinking be different from an aging, but still growing, population (Clements, Dybczak, Gaspar, Gupta, & Soto, 2015 )? What factors determine the outcome? To connect to a previously mentioned issue, Coleman and Rowthorn ( 2011 ) take a historical look and assume that the pace of decline matters, as does decline relative to others, particularly political or economic rivals. There is much more work to be done in this area.

Fourth, there is little work on the intersection of migration and aging, particularly of the aging of migrants themselves. There is some research on those who have retired internationally, and some on those who migrate even at older ages, mostly to take jobs in the care or home industries. There is even research on those left behind when younger people migrate (Toyota, Yeoh, & Nguyen, 2007 ). But the number of older people with a migration background is increasing in some countries, and given the diversity of younger generations, will continue to do so. Given the different characteristics—preferences, education background, and even citizenship status—of migrants versus non-migrants, more research needs to be done comparing differences between the two populations, as Anja Steinbach ( 2018 ) has done with native Germans versus those of a migration background.

One fruitful area for research is high-migration, low-fertility societies. Teitelbaum and Winter ( 1998 ) conducted an early study of this dynamic in relation to fears about population change and concomitant questions of citizenship and national identity in states including Germany, Russia, France, and the United States. To do such research well, one needs to trace the historical flows of migrants in relation to changes in age composition and examine issues specific to both older people and those with migrant backgrounds. The issue is also relevant to intergenerational transfers, if older generations differ from younger ones in terms of national origin, race, ethnicity, or language. Cultural context matters as well: origin and destination countries might have different ideas about age and aging. This might mean they have different value systems, collectivism versus individualism, ideas about family versus government support. As King, Lulle, Sampaio, and Vullnetari ( 2017 , p. 182) discuss, the aging process is “socially constructed and culturally embedded.” As they move internationally, migrants will encounter different aging models, including at what age someone becomes elderly, or what it means to be retired.

Finally, there is room for research on the intersection between aging and the environment. How is population aging likely to change consumption patterns, and thus carbon emissions? What does the potential end of population growth mean for sustainable development (Lutz, Sanderson, & Scherbov, 2004 )? How do patterns of human settlement, like urbanization and land change from urbanization, affect environmental degradation (Liddle, 2014 ; Weber & Sciubba, 2019 )?

In general, although research on political, economic, and social implications of population aging is increasing as the issue grows more widespread, there is a dearth of comparative aging work (Silverstein & Attias-Donfut, 2010 ). The field has much room for growth and many questions that will only be answered as more states experience aging and as aging intensifies. This is good news for quantitative researchers, whose datasets will grow larger with observations. As the world annually sets records for high median age, there are developments we cannot anticipate. The field of political demography is growing, and given the interdisciplinary nature of the questions about demographic implications, there is ample room for collaboration across disciplines and specialties.

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Two solutions to the challenges of population aging

Subscribe to global connection, milena nikolova milena nikolova nonresident fellow - economic studies.

May 2, 2016

Population aging—the increase of the share of older individuals in a society due to fertility declines and rising life expectancy—is an irreversible global trend with far-reaching economic and socio-political consequences. By 2050, the number of people aged 60 and older will more than double from its current levels, reaching around 2 billion. While Europe was the first global region to embark on a demographic transition, most of the expected growth in the number of older people by 2050 will come from developing countries . Population aging will likely lead to declining labor forces, lower fertility, and an increase in the age dependency ratio, the ratio of working-age to old-age individuals. To illustrate, while there were 10 workers for every person older than 64 in the world in 1970, the expected number in 2050 is only four ; it will even be less than two in some European countries.

Aging populations pose a challenge to the fiscal and macroeconomic stability of many societies through increased government spending on pension, healthcare, and social benefits programs for the elderly. This may hurt economic growth and overall quality of life if governments need to divert public spending from education and infrastructure investment to finance programs for the elderly. In addition, the recent economic crisis not only increased the demand for social protection but it also drew attention to population aging issues as many countries faced unsustainable public debts. In many nations, the already-high public spending limits the fiscal possibilities for increased aging-related spending in the long run. Therefore, pertinent and prompt policy solutions are necessary to ensure fiscal and macroeconomic sustainability as well as the health and well-being of citizens of all ages.

A Two-Part Solution Focused on Work

For monetary and non-monetary reasons, work is a pivotal element of one’s well-being. Recognizing this could be an essential part of the solution. Paid work contributes not only to material well-being but also to psychological well-being through social interactions and opportunities for personal and professional growth. And unpaid work, like volunteering, care work, and artistic work, can provide these same psychological benefits. Given these positive effects, encouraging and rewarding paid and unpaid work among the elderly could be a pivotal part of the solution to the aging-related fiscal and social challenges.

To enact such a strategy, policy-makers could consider: (i) a gradual retirement scheme allowing older individuals to lower their working hours yet remain in the workforce and pay taxes until a later age ; and (ii) furnishing options for and rewarding volunteering, care, and artistic activities among older society members.

Phased-in retirement, fiscal sustainability, and well-being

Encouraging older workers to remain longer in the labor force is often cited as the most viable solution to fiscal pressures and macroeconomic challenges related to population aging. Phased-in retirement entails a scheme whereby older workers could choose to work fewer hours yet remain longer in the labor force, including after they retire. And gradual retirement can be beneficial to societies, employers, and workers:

• First, phased-in retirement allows continuity in tax revenues and reduced expenditure on pensions, which holds particular importance for fiscal and macroeconomic stability;
• Second, older workers can be valuable to organizations and younger colleagues due to their knowledge and experience;
• And third, late-life work has positive health and perceived well-being consequences for older employees .

Promoting and rewarding volunteering, care, and artistic work among the elderly

In cases where individuals are unable to take advantage of phased-in retirement—due to health issues, family obligations, or skills mismatch—governments could promote and reward volunteering, care work, and artistic work among the elderly. Such unpaid activities improve the quality of the social fabric, help the well-being of those engaging in them, contribute to the economy, and reduce healthcare and welfare costs.

Volunteering is among the most important pro-social behaviors with many social and individual benefits. For example, about 25 percent of U.S. residents volunteer , providing 7.9 billion hours of service and contributing $184 billion of service . Additionally, late-life volunteers have lower rates of deteriorating mental and physical health and delayed mortality. Because of these benefits, national policies should seek to facilitate, reward, and adapt such opportunities for older individuals. And care work undertaken by older people—such as childcare, preparing meals, cleaning, and helping the elderly or disabled—should be recognized for its value and rewarded financially.

Further, providing incentives and encouraging the elderly to engage in creative work related to painting, music, or creative writing can also be beneficial to society and prevent social isolation. Governments can promote such activities by financing arts and crafts courses in social clubs or community centers for older participants.

In Conclusion

Providing opportunities for the elderly to remain in the workforce longer as well as engage in volunteering, care, and artistic activities can provide both social and economic benefits and relieve some of the fiscal pressures related to aging societies. However, work activities for the elderly do not automatically translate into social welfare gains. Policies should be arranged in a way that recognizes the dignity and autonomy of older individuals as opposed to providing them with meaningless or degrading tasks merely to keep them occupied. In addition to furnishing meaningful and rewarding opportunities, activities should be adapted to the physical and mental aptness of older individuals. And while paid and unpaid work activities are beneficial to society and the elderly, allowing for choice and autonomy is key.

It’s also important to recognize that implementing these programs and schemes may have short-term costs. Employers and older workers may face bargaining costs related to negotiating phased-in retirement options. Employers could also incur expenses related to restructuring or adapting tasks, while local governments may need to open community centers to accommodate volunteering and other activities for the elderly. Nonetheless, the long-run welfare benefits to society will likely exceed these short-run costs and improve fiscal and macroeconomic health.  

Global Economy and Development

Georgia Nabors, Louise Sheiner

September 23, 2024

Quinn Sanderson

July 9, 2024

Stuart M. Butler

May 23, 2024

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The advantages of an ageing population

• What ageing means for society
• What does ageing mean for development?

Sarah Harper, Director of the Oxford Institute of Population Ageing, discusses the advantages of an ageing population.

Older people are people too – able to adapt to their changing circumstances and wishing to contribute to the societies they live in for as long as they possibly can.

From across developing countries, there is evidence of the productivity, creativity, vitality and participation of older adults in workplaces, communities, households, and families.

1. Continued economic productivity

Pictured: Erina, who is 81, works in the fields next to her grandson in Mozambique 

We find examples of the economic activity of older adults in all parts of the world. For example, farming in developing countries is increasingly dominated by older workers, and a significant proportion of global food comes from small-holdings managed by older people, including many women.

Worldwide, an estimated 450 million small-scale farms support a population of roughly 2.2 billion people and represent 85 per cent of all the world’s farms.

Evidence from a number of developing countries shows that farm workforces are ageing rapidly: some 70 per cent of farmers in Mozambique, and 80 per cent in Indonesia are already over the age of 45.

It is essential that we recognise this, as evidence from Thailand suggests older farmers continue to play an important role in adopting new technology and cropping patterns, given the right support.

2. Many older men and women remain employed

In urban areas, many older men and women remain employed in the formal labour market: half of those in their 60s in the Philippines and Vietnam; 40 per cent in Mexico and Brazil and one third in India and Thailand.

In the informal labour market, there is widespread evidence from Africa, Asia and Latin America of older men and women’s ongoing productivity.

A recent study from Ethiopia highlighted the labour of older men in construction, and trading; of older women as housemaids, traders and craft makers. Similarly, in India, older men often run small businesses including trading, while older women undertake domestic support work.

Crucially, older adults also free up the time of younger people from household responsibilities, enabling them to undertake paid labour.

3. How older people contribute to the wider community

A recent study of community work in Asia found that more than a quarter of Indians and Taiwanese and a fifth of Filipino and Chinese men and women in their 60s and 70s regularly helped in the wider community, providing assistance to individuals of all ages.

Other studies have highlighted the importance of the local knowledge and community-organising skills of older people’s associations in disaster relief efforts.

In the Philippines, older people’s associations were invaluable to implementing disaster risk reduction programmes after Typhoon Ketsana hit in 2009 and played an important part in reconstruction efforts after Typhoon Haiyan in 2013.

4. Providing family support and care

Older adults can also be the mainstay of many families and households – providing financial assistance, care and support to all generations – yet this is rarely recognised.

A recent analysis of family roles and relationships across the globe, found that two-thirds of those in their 60s and 70s in South Korea, and one-third in India and the Philippines regularly support or care for a member of their family.

The same study showed that the majority of older people in their 60s and 70s in the Philippines, South Korea and Mexico regularly provide financial support to a family member.

Evidence from Latin America reveals that where older people live in multigenerational households, old age benefits are shared with other family members, while in Asia grandparents may transfer financial assistance directly to their grandchildren.

5. Grandparents caring for grandchildren

Pictured: Grandmother Theresa is caring for 6 children in Sierra Leone 

In particular, older men and women are primary caregivers for many children and grandchildren.

This has become particularly significant as poverty, migration and the loss of the middle-adult generation due to HIV have changed family structures and resources across developing countries.

Far from being a burden on the local community, these older people are providing care and struggling to provide the necessary food, shelter and emotional support to younger generations and their extended families.

Their personal sacrifice is often acute. Grandparents in Cambodia, for example, caring for their grandchildren following the death of their own children from an AIDS-related illness have had to deal with the additional stress of the loss of their spouses and other older adults under the Khmer Rouge.

The old will soon outnumber the young

Population ageing is not driven just by increasing life expectancy. As the 21st century progresses, most countries will experience a fall in the number of children born to each woman and by the end of the century the median age of the whole world will have shifted so that the old outnumber the young.

It is thus important that we acknowledge the role that older adults may play in current and future societies and economies; and ensure that institutions and structures enable them to fully contribute to their families and communities.

This will only occur when we start to acknowledge that old people are people with the potential that all adults hold.

Sarah’s research  addresses demographic change focusing on the global and regional impact of falling fertility and increasing longevity, with a particular interest in Asia.

She was the first holder of the International Chair in Old Age Financial Security at the University of Malaysia and has advised the Governments of both Malaysia and Singapore on ageing issues.

Universal Health Coverage for All: An Agenda for Action

Despite a globally ageing population, older people's basic health needs are not being met. Our new report outlines how health coverage that is truly universal can help us to live better lives as we age.

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• Perspective
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• Published: 27 May 2021

Ageing and population shrinking: implications for sustainability in the urban century

• Marcin Pawel Jarzebski   ORCID: orcid.org/0000-0002-6016-4117 1 , 2 ,
• Thomas Elmqvist 3 ,
• Alexandros Gasparatos   ORCID: orcid.org/0000-0001-9323-1366 4 , 5 ,
• Kensuke Fukushi 4 , 5 ,
• Sofia Eckersten   ORCID: orcid.org/0000-0002-8768-8025 6 ,
• Dagmar Haase   ORCID: orcid.org/0000-0003-4065-5194 7 , 8 ,
• Julie Goodness 9 ,
• Sara Khoshkar 6 ,
• Osamu Saito   ORCID: orcid.org/0000-0002-0697-9593 10 ,
• Kazuhiko Takeuchi 4 , 10 ,
• Töres Theorell 11 ,
• Nannan Dong 12 ,
• Fumiko Kasuga 2 , 13 ,
• Ryugo Watanabe 14 ,
• Giles Bruno Sioen   ORCID: orcid.org/0000-0001-5180-0663 2 , 13 ,
• Makoto Yokohari 15 &
• Jian Pu 4  

npj Urban Sustainability volume  1 , Article number:  17 ( 2021 ) Cite this article

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• Science, technology and society

Population ageing and shrinking are demographic phenomena with far-reaching implications for sustainability in the current context of extensive and rapid urbanization. This Perspective rationalizes their interface by (a) identifying the challenges and opportunities that ageing and shrinking urban populations will have for implementing the sustainable development goals (SDGs), and (b) discussing some emerging interventions to capitalise on the opportunities and reduce the challenges to achieving sustainability. We argue that a diverse set of context-specific technological, socioeconomic, institutional and governance interventions would be needed to leverage effectively the opportunities and minimize the risks posed by ageing and shrinking urban populations for long-term sustainability.

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Introduction.

In many regions of the world populations have grown older and fertility rates have declined to very low levels, leading to simultaneously shrinking and ageing populations 1 , 2 . Globally, people above 65 years old are the fastest-growing segments of the population and in 2019, for the first time in human history, they outnumbered children younger than 5 years old 1 , 2 . Population change, and especially population increase, has always been central to debates over sustainability 3 . For example, the UN Agenda 2030 was mostly discussed in the context of a rapidly growing global population, focusing on the strategies needed to achieve the sustainable development goals (SDGs) in view of the ever-increasing population pressures 4 .

Yet the far-reaching implications of ageing and population shrinking for sustainability have so far received limited attention in policy and practice. For example, the dimensions, dynamics and consequences of simultaneous ageing and shrinking populations are by and large overlooked in the SDG documents (SDGs), with ageing mostly visible only in relation to that older people are a vulnerable group 5 . In other highly visible UN documents related to sustainable development such as the New Urban Agenda, the challenges posed by ageing urban populations are mentioned in only one sentence 6 .

This pattern is also visible in the main strands of the academic literature relating to ageing and sustainability. In one strand, ageing is mostly discussed through the lens of labour markets economics, saving patterns, pension fund policies, and the provision of health and welfare services 7 . However, sustainability is not present in this literature in the conventional sense, considering the deeper discussion on the possible environmental consequences of ageing and shrinking populations 8 . Furthermore, many studies on the economic and social ramifications of ageing have focused either at the scale of the individual/single household (mainly studies from medicine and social science) or on the national scale (mainly studies from economics) 7 , missing to address the urban and regional scale.

Urban studies have been the second major academic strand bridging ageing and sustainability, mainly through the phenomena of ageing and shrinking cities. While the overall urbanization and extent of larger metropolitan areas are expected to increase in the foreseeable future in many regions 9 , other regions and cities are simultaneously showing striking signs of shrinking and ageing. For example, there are ~350–400 shrinking cities worldwide, most of them in Europe (especially its Eastern parts), Japan and the United States 9 , 10 , 11 , 12 . However, even though this literature has touched more on sustainability, it has been more through the lens of local aspects of planning, livability, and well-being, missing the larger sustainability ramifications of an ageing and shrinking urban population.

The above suggest that ageing and shrinking populations are usually perceived as challenging obstacles for meeting sustainability objectives, and rarely as opportunities. It is highly possible, however, that rapidly ageing and shrinking populations will have at the same time multiple positive and negative ramifications for sustainability in terms of economic growth, public sector development, consumption patterns, land use change, and greenhouse gas emissions, among others 7 , 8 . Thus they will most certainly also have important implications for the implementation of many of the SDGs.

This Perspective first makes the case that ageing and shrinking urban populations will pose both major challenges, but also provide opportunities for implementing the SDGs. Second, it argues that different context-specific emerging interventions would be needed to reduce the challenges and/or leverage the opportunities offered by ageing and population shrinking to enhance urban sustainability in this increasingly urban century. We note that ageing and shrinking populations are, from a demographic point of view, two separate phenomena. However, as they are often very tightly interconnected, we will explore their sustainability implications simultaneously. The first section provides an overview of the main global patterns of ageing and shrinking population in the context of urbanization. The second section focuses on the first part of the thesis, outlining the new challenges and opportunities for SDG implementation from ageing and shrinking urban populations. The third and fourth sections focus on the second part of the thesis, highlighting some of the possible emerging interventions for reducing the challenges and/or leveraging the opportunities offered by ageing and shrinking populations, and well potential risks ahead.

Interface of ageing, population shrinking and urbanization

In 2020, 9% of the global population was above 65 years old, accounting for 728 million people. This population is projected to increase more than twofold, reaching 1.55 billion in 2050 and accounting to 16% of global population, at medium fertility rates 1 . People above 80 years old accounted for 143 million in 2019, and are expected to reach 426 million in 2050 and account for nearly 60% of the elderly population 1 , increasing particularly fast in high-income countries (Supplementary Fig. 1 ). However, there are major regional discrepancies in current and future patterns of ageing, with Europe expected to remain the most aged society in 2050, Asia experiencing large increases in aged population (especially in China), and most countries in Africa having a mostly young population 1 (Fig. 1 ) (see Supplementary Table 1 for examples from selected countries). Regardless of these trends, in both affluent and less affluent regions, older women generally greatly outnumber older men, with the oldest age groups in some regions being completely female 5 , 9 .

Note: For a and b the projected fractions of the population above 65 years old (in %) is based on the UN medium variant 1 . For b the proportion of urban population (in %) is based on 114 .

At the same time, there are major changes in fertility rates and population sizes. Currently, fertility rates are near or below the 2.1 replacement level in all regions apart from the African continent, and are expected to continue decreasing well below this replacement level in most regions except Africa in 2050 1 . Out of the 27 countries with the lowest fertility rate under 1.5 globally in 2018, 21 are in Europe or East Asia (Supplementary Fig. 2 ). Similarly, many countries and regions are expecting large population shrinking by 2050, with most of these countries located in Europe and Asia (Fig. 2 ) (see Supplementary Table 1 for examples from selected countries). Some of the current fertility, mortality, migration, and population models suggest that the UN figures can be still vastly underestimated 13 .

Note: The bars denote the projected fraction of population shrinking between 2020 and 2050 (in %) (Data source: 1 ); The purple figures denote the fraction of the urban population in 2018 (in %) (Data source: 114 ).

The above suggest the strong relationships between ageing patterns with fertility rates and population shrinking, which collectively represent a major demographic transition. This demographic transition seems to be currently mainly confined to Europe and East Asia as outlined above (Figs. 1 and 2 ). However, it is important to note that there may be strong interactions in that increases in the proportion of elderly in a country can put more economic and social pressure on working age population, further decreasing birth rates and/or postponing child births, thus driving fertility rates even lower 14 .

Before delving into the implications of an ageing and shrinking urban population for sustainability in the next section, it is important to understand the role of urbanization in this demographic transition, and the characteristics of ageing urban populations. Urbanization reportedly plays a major role in this interface, as it is a multi-dimensional process associated with increased affluence and access to jobs, improved health care and education, and cultural and behavioural change 14 . While initially urbanization may be partly driving mortality rates down due to increased affluence and access to health care, it later on may lead to women taking stronger control of their lives resulting in declining fertility rates (Fig. 3 ) 14 . However there is great variability in the relationship between fertility decline and urbanization between regions (Fig. 4 ). For example, low-income countries are often characterized by a steep decline in fertility rates with increases in urbanization, but the pattern may vary regionally (Supplementary Fig. 3 ). At the same time, livelihoods in urban areas are seldom dependent on adding members to the family, in contrast to many rural areas 15 . Instead, adding children may increase living costs and put constraints upon the often very mobile and career-oriented (yet underpaid) life of urban women 16 . It is worth mentioning that variation between countries may also be due to the different metrics and cut-offs levels for measuring urbanization, and a multitude of local and context-specific factors that in turn may influence variables underlying fertility rates, such as health, education, income and gender equality 17 . In any case irrespective of this variation, urbanization as a complex variable still seems to reasonably capture in an aggregate way the important mechanisms underlying declining fertility rates 18 .

Note: Based on 14 .

Note: Data source: 1 , 114 .

Finally, it is worth noting that many of these demographic transitions are made within the context of accelerating climate change. Climate change can and will intersect with these demographic changes in multiple ways. For example, it can impact fertility by changing human behaviour and affecting migration patterns within countries (e.g. from rural to urban areas) and between countries (e.g. from poor to rich countries) 19 . These climate change-related shifts in migration patterns can exacerbate ongoing population shrinking and ageing, for example by influencing younger people to out-migrate from already rapidly ageing areas, accelerating thus population shrinking in some areas 13 , 20 , 21 .

Sustainability challenges and opportunities

Interface of ageing and sustainability.

First, older populations experience specific challenges related to access to health, safety, capacity to deal with disasters, vulnerability to diseases/pandemics, and mobility, among others 5 , 22 . Such challenges increase the vulnerability of the elderly and require particular interventions 23 . The recent COVID-19 pandemic showed clearly many of these weaknesses for the elderly 24 . This implies some of the many challenges that an ageing population can pose for meeting many of the SDGs and their underlying targets.

Second, in the last few decades there have been significant changes in the health status and risks, activity and productivity patterns, and the socioeconomic characteristics of the elderly 2 . On the one hand, this has led to the development of alternative concepts and measures to offer a more nuanced perspective of what population ageing means in different contexts. This includes, for example, measures based on prospective age (i.e. years of life remaining), with a dynamic threshold of ‘old age’ that rises progressively with increasing life expectancy and health at old age, point toward a slower process of population ageing than what is indicated by the conventional measures 25 . Such measures can have significant implications for assessing the living conditions and living arrangements of older persons, their productive, experience-based and other contributions to society and their needs for social integration and health care. On the other hand, these shifts in the characteristics and capabilities of the elderly populations can offer real opportunities for meeting some SDG targets.

Third, although UN population projections are made at the country level 1 , cities represent both those areas where most elderly people will live in the near future and an arena, where the recent demographic transitions have unfolded and the new ones will emerge 26 . Thus an urban perspective is necessary when identifying the sustainability challenges and opportunities emerging through the demographic transition posed by an ageing and shrinking population.

The three following sub-sections explore in more depth how the ageing and shrinking populations may offer new opportunities or challenges in achieving the SDGs. We focus on 12 SDGs for which there is currently the clearest evidence to support this discussion in the context of ageing and shrinking population. We divide these SDGs across the three thematic categories of biosphere, society and economy 27 .

Biosphere-related SDGs

Ageing and shrinking populations are expected to offer major opportunities to achieve some targets associated with SDG6 (Clean Water and Sanitation), SDG14 (Life under Water) and SDG15 (Life on Land), and both opportunities and challenges to meet SDG13 (Climate Action), as discussed below.

Many studies have argued that ageing and shrinking populations will be beneficial for biodiversity conservation and ecosystem functioning (see an extended review in ref. 8 ). This is mainly through reduced environmental pressures from decreases in total consumption, considering that the growth of human population and consumption are both major drivers of global environmental change 28 , 29 , 30 , 31 . These possibly lower consumption rates associated with smaller and older populations 32 , 33 could reduce pressures to convert natural areas for agriculture or alter rivers to provide water for agriculture and growing cities 8 . For example, the projected population shrinking in Japan will possibly reduce pressure on land, opening possibilities for rewilding land that is no longer needed for agriculture, forestry, or other intensive human uses 34 . However, this might not be transferable and/or might differ among countries. The above offer real opportunities for meeting SDG targets such as 15.1 (conservation, restoration and sustainable use of terrestrial and inland freshwater ecosystems and their services), 6.1 (universal and equitable access to safe and affordable drinking water), or 14.4 (regulate harvesting and end overfishing, illegal, unreported and unregulated fishing and destructive fishing).

However, ageing will create constraints for meeting SDG13 and particularly target 13.1 (resilience and adaptive capacity to climate-related hazards and natural disasters), considering that the elderly are generally more vulnerable to climatic extremes and disasters through diverse mechanisms 35 . For example, the elderly are more vulnerable (and less able to adapt) to disasters such as floods, landslides, and typhoons due to mobility or connectivity constraints 36 , 37 , 38 , 39 . Furthermore, they are more vulnerable to heat 40 , with heat waves causing the highest death tolls to people over 65 years old 41 . The expected increases in the frequency and magnitude of climatic disaster will most likely increase the vulnerability of ageing societies, e.g. many European and Asian countries characterized by an ageing population will become highly or very highly vulnerable to heatwaves (Supplementary Fig. 4 ). Interestingly ageing and population shrinking can have rather variable effects for GHG emissions, and thus climate change mitigation efforts. For example, population shrinking can provide 16–29% of the emission reductions needed by 2050 to keep average global temperature increases below 2 °C, and as much 37–41% of necessary emission reduction by the end of the century 42 . Furthermore, ageing populations provide a potential for further emission reductions due to declining age-specific material consumption at older ages 32 . Although there are sector, timing, and scale-effect discrepancies, it is expected that in the long run population ageing would reduce overall emissions 33 , 43 , 44 . However, some studies have found that elder age groups can have higher carbon footprints compared to younger age groups, due to emission-intensive activities, such as higher personal car use, home heating and medical care and treatment 45 , 46 , 47 .

Society-related SDGs

An ageing and shrinking population will pose major challenges for meeting SDG3 (Good Health and Wellbeing). Further to the absence of disease, healthy ageing would also require the maintenance of functional ability throughout a person’s lifespan. As mentioned in the previous sub-section the elderly are more vulnerable to environmental stressors and disasters. Similarly, water-borne diseases such as norovirus, and epidemics such as the recent COVID-19 virus or recurring influenza outbreaks are especially dangerous to the elderly 48 , 49 . Thus, health and long-term care systems need to be able to meet the needs of ageing populations through appropriate integrated care and maintaining the intrinsic capacity of older persons. However, there is ample literature on the health care-related challenges connected to an ageing society, including the escalating costs in terms of care and medicine, and the lower ability of shrinking populations to meet 7 , 50 . The above suggest that ageing will pose challenges for Target 3.4 (reduce premature mortality from non-communicable diseases) and 3.8 (universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines), with the latter possibly exacerbated by population shrinking.

Similarly ageing will most likely reinforce old (and create new) inequalities 51 , which will pose challenges for meeting SDG1 (No Poverty), and especially the targets on poverty levels (Target 1.1–1.2) and social protection (Targets 1.3–1.4). In particular elderly people have a lower participation in employment and in most cases rely solely on pensions, with a substantial fraction of elderly falling below the poverty lines in their respective countries as pensions are not always enough to cover their daily needs 5 , 52 , 53 . Similarly in many of the rapidly ageing societies (especially in eastern Asia), the existing social protection programmes are not sufficiently strong and comprehensive to cover the needs of the increasingly elderly population (let alone a rapidly increasing one) with fewer people of working age contributing to them 51 , 52 , 53 . It is worth noting that there is a persistent gender gap in both the coverage and absolute levels of pensions 52 , which suggests also major implications for SDG5 (Gender Equality). However, the actual effects of inequalities in pension levels and coverage might be a bit more difficult to delineate for meeting SDG5.

Conversely, an ageing and shrinking population can offer both opportunities and challenges for meeting SDG2 (Zero Hunger). For example, theoretically speaking a shrinking population will require a lower amount of food, with this lower consumption reducing pressure on the food system and improving food security (see the previous sub-section). However, lower incomes for the elderly (see SDG1), might not allow the sufficient food access for all, as has been shown for elderly people 54 , 55 . Furthermore, an ageing and shrinking population might have an adverse effect on agricultural production due to the shrinking workforce in the agricultural sector (as has been observed in many ageing societies) 56 , but such effects might be offset partly or completely through automation 57 . Another possible challenge might emerge from the loss of traditional agricultural practices, local agricultural knowledge and local varieties, which has been observed in many ageing and shrinking communities, characterized by lower employment in agriculture. The above suggest that ageing and shrinking populations might pose challenges for meeting target 2.5 (maintain genetic diversity of crops), opportunities for target 2.4 (ensure sustainable food production systems and resilient agricultural practices), but possibly less clear outcomes for target 2.1 (end hunger and ensure access to food) and 2.3 (double the agricultural productivity and incomes of small-scale food producers).

Similarly, an ageing and shrinking population can offer both opportunities and challenges for SDG11 (Sustainable Cities and Communities). On the one hand, shrinking populations would ease up pressure on housing markets and make it easier to access affordable housing in urban areas. However, there is a need to be mindful of socioeconomic and sociospatial inequalities, and the challenges they might pose 58 . On the other hand, older people spend comparatively more of their time at home, which makes housing an important component of age-friendly cities 59 , 60 . Evidence suggests that many existing homes are not suitable for the varied needs of older people 61 , 62 , 63 . With most existing housing stock likely to be still in use by 2050 in ageing regions such as Europe, many homes will need to be adapted so that older people can continue to live in them 59 . Thus an ageing and shrinking population offers both challenges and opportunities for meeting target 11.1 (access to adequate, safe and affordable housing and basic services and upgraded slums).

An ageing population would most likely increase policy demand for designing accessible and safe public spaces (see the section “Boost innovation for health care and mobility”), which will have major implications for Target 11.7 (universal access to safe, inclusive and accessible, green and public spaces). On the one hand, green spaces can promote physical activity and improve the physical and mental health among older people 64 , 65 , paying clear dividends for other SDGs (see the section “Boost innovation for health care and mobility”). However, there are many barriers preventing older people from using green spaces, for example due to safety concerns 66 or their design that often prioritizes other users (e.g. children). At the same a shrinking urban population might reduce the available financial resources for developing and maintaining age-friendly public spaces (e.g. through municipal taxes) 67 , putting an extra challenge for meeting target 11.7.

Similarly ageing and shrinking populations would make a strong case for reconfiguration and added investments in public transport 26 , but at the same time increase the risk of declining revenues and reducing public transport service provision where elderly fares are subsidized. Similar to public spaces, if transport services cannot meet the mobility needs of the elderly, there is a high risk of social isolation or depressive symptoms 68 , 69 . Similar to the above a possible decline in available financial resources might challenge the development of age-friendly transport systems. The combined effect of the above would pose a major challenge for addressing target 11.2 (access to safe, affordable, accessible and sustainable transport systems…notably by expanding public transport).

Finally due to the expected reduction in material consumption ageing and shrinking populations can offer real opportunities for meeting Target 11.6 (reduce the adverse per capita environmental impact of cities). However, as also mentioned in some cases elder populations have a higher carbon footprint for some categories, which might pose some barriers (see the previous sub-section).

Economy-related SDGs

Overall it is expected that an ageing and shrinking population will pose challenges for achieving SDG8 (Decent Work and Economic Growth) and SDG9 (Industry, Innovation and Infrastructure). The major mechanism relates to the declining and comparatively lower number of young workers and taxpayers 7 . The dependency ratio is often used as a measure of societal capacity for economic growth, with a declining dependency ratio implying that the burden on the working segment of the population increases, creating fiscal pressures on developing and maintaining public health care, pension, infrastructure, and social protection systems for older persons 7 . For reference, currently Japan has the lowest dependency ratio in the world (1.8), and by 2050 more than 48 countries are expected to have ratios below 2 1 . Considering this situation it is widely believed that productivity can only be boosted through increased innovation and automation in all sectors of society (e.g. robots replacing workers in manufacturing, health and elder care centres). However, there are strong reasons to believe that rates of innovation may decrease in ageing societies, and thus slow down further economic growth and workforce replacement 70 . The above suggest that ageing and shrinking populations will pose major challenges for meeting many individual targets such as Target 8.1 (sustainable economic growth), 8.2 (diversify, innovate and upgrade for economic productivity), 9.1 (sustainable, resilient and inclusive infrastructures), and 9.2 (inclusive and sustainable industrialization), among others.

Conversely, ageing and shrinking populations might provide opportunities for achieving SDG12 (Sustainable Production and Consumption). The key entry point are the forecasted lower levels of consumption from both an ageing and shrinking population (see the section “Biosphere-related SDGs”), which is expected to provide opportunities for Targets 12.2 (sustainable management and efficient use of natural resources), 12.3 (halve per capita global food waste…and reduce food losses along production and supply chains), and 12.5 (reduce waste generation through prevention, reduction, recycling and reuse) 71 .

Emerging interventions

Capitalize on opportunities and reduce challenges.

As the previous section has outlined, population ageing and shrinking both pose challenges and offer opportunities for meeting a very diverse set of SDG targets (Fig. 5 ). We argue that in order to enhance sustainability there is a real need to put in place interventions or strengthen existing processes in order to capitalize effectively on the new opportunities and reduce the new challenges posed by ageing and shrinking populations. Arguably many of the interventions will be context-specific considering the major differences between countries (and areas within individual countries) in terms of the pace of ageing and shrinking (see the section “Interface of ageing, population shrinking and urbanization”), the socioeconomic and environmental conditions, and the ability to invest resources.

Note: The division of SDGs across the three thematic categories is based on 27 .

In our opinion three very different, but also very promising, emerging interventions discussed in the following sub-sections are to (a) boost innovation for health care and mobility, (b) increase the extent and improve the design of open and green spaces, (c) promote social inclusion through social participation and urban knowledge co-production.

While we acknowledge that these are only some of the possible emerging interventions, we believe that they offer a good cross-section of possible options. This is because they span very different domains (e.g. technology adoption, social innovation, urban planning), target very different SDG targets through different mechanisms (Fig. 5 ), and are amenable and transferable to different geographical contexts, environmental and socioeconomic conditions and abilities to invest resources.

Boost innovation for health care and mobility

Many emerging interventions seek to improve health care and mobility have been piloted or implemented across countries/cities experiencing an onset in population ageing and/or shrinking (Fig. 5 ). These interventions range from technological innovations, to social and institutional innovations.

Some of the technological innovations for health care include socially assistive robots and virtual entertainment for mental health 72 , 73 , roadside AI services for healthcare, and a series of innovations for house-based healthcare, digital nursing and monitoring 74 (Supplementary Table 2 ). More conventional approaches include, among others, care homes that bring together young and older people, volunteering in care homes, and day-care houses to occupy the elderly during the day (Supplementary Table 2 ).

Urban mobility plays an important role for the effective social inclusion of the elderly, and can include both conventional and innovative approaches. Central to these approaches would be to harness the potential offered by new patterns of urban mobility provision, which has been moving towards the concept of Mobility as a Service (MaaS) through the use of smartphones and ubiquitous internet connection, and the combination of transportation services from public and private providers 75 . It has been argued that MaaS could contribute to a better accessibility for the older population, given that they learn how to use the necessary technological interventions (i.e. smart phones) 76 .

This can be combined with age-friendly transport interventions including special fares, reduced barriers in transport hubs, and age-friendly vehicle functionalities (Supplementary Table 2 ), as well as active travel options such as e-bikes 77 . Other innovations that can improve mobility in the context of ageing and shrinking societies include autonomous driving, with different possible modes offering different advantages and disadvantages 78 .

Increase the extent and improve the design of green spaces

There is a strong evidence-base to suggest that public and green spaces (including urban agriculture) can have ripple positive outcomes for the physical, mental and psychological health of urban residents (Fig. 5 ) 79 , 80 , 81 . Green spaces can promote physical activity among older people, with cross-sectional surveys linking the engagement with (and quality of) open spaces to the increased life satisfaction, and reduced loneliness and social isolation of the elderly 64 , 65 . Green spaces have also played a crucial role as familiar escapes during the recent COVID-19 pandemic and other hazards.

Population ageing and shrinking open up numerous possibilities for new approaches to increase the extent and improve the design of green spaces, and open spaces more generally. Such approaches would need to put more emphasis on the multi-functionality of the urban landscape and create synergies among different age groups 82 , 83 , 84 .

At the level of the individual green or public space, new urban designs must consider principles of inclusivity to ensure both the accessibility/safety of the elderly, as well as integrate elements/functionalities that would increase their satisfaction (e.g. walking path routes, seating, plant species) 85 . Furthermore, green/public areas would need to be closer to residential homes and consider issues of social connection and mobility (see also the previous sub-section) 86 , 87 .

At the level of the neighbourhood or the city, many different planning approaches have been suggested that reflect and emphasize on different urban and cultural socioeconomic characteristics 82 , 83 . For example, the compact city approach is one potential intervention that has been applied in various countries for sustainable growth 88 , but has also been used in some ageing and shrinking cities to control further shrinkage 89 . The Compact City approach seeks to (a) transform low density urban land uses into green/spaces and prohibit urban development, (b) promote densification of the urban centres with convenient nodes for transportation, and (c) develop new housing and rebuilds aged infrastructure in designated zones 90 . This approach plans for the gradual urban shrinking by transforming one vacant lot at a time 89 , which requires long time-term thinking and transient or temporary green spaces (e.g. woodlands, urban agriculture) 91 , 92 . However, we should also note some of the possible negative feedbacks between densification and liveability for older people, such as through exacerbating urban heat island effect 93 , unsuitable housing 94 or gentrification 95 . Such factors would need to be considered when reconfiguring urban spaces in order to ensure sustainability in the context of ageing and shrinking urban populations.

In this context climate change considerations would need to be factored in urban green designs to ensure that they provide both adaptation and mitigation services to urban populations 96 , 97 . Some examples can be storm water collection in urban farms during intense rainfalls to avoid hygiene issues 98 , or trees providing shade that gives a cooling effect during extreme heat to reduce chances of heat stress 99 . This becomes particularly important considering both the increased vulnerability of elderly (see the section “Society-related SDGs”), as well as their different capacity to employ (and preference for) related coping strategies 100 . In this sense, investing in green infrastructure (and included green spaces) that caters to the elderly through multiple ecosystem services should be seen as a future planning priority in rapidly ageing urban contexts 101 .

Improve social inclusion

An ageing population presents a large untapped potential for sustainable development (Fig. 5 ). Specifically under appropriate conditions this growing population of skilled, increasingly healthy and active people, with lots of spare time can engage in various sustainability initiatives at the local level. There has been demonstrated interest of older people in many countries to continue working or they volunteer in their communities, the extent to which older people participate in the social, civic and economic life of the city is closely linked to their experience of inclusion 66 .

Some suggestions to facilitate social participation are to enhance the availability and variety of social activities closer to elderly residents and foster integration within the community and with other age groups and cultures 66 . Accordingly, communities should facilitate for elderly residents to choose among and to participate in cultural activities—such as music and dance, which have demonstrated physical and mental health benefits 102 .

Urban co-production processes, such as those reflected in SDG Target 11.3 (inclusive and sustainable urbanization and capacity for participatory, integrated and sustainable human settlement planning and management) that entail the engagement of multiple stakeholders to produce research and knowledge outputs to solve urban problems 103 , provide an excellent opportunity to involve meaningfully older citizens and incorporate their perspectives on urban sustainability challenges, including those affecting them directly, e.g. planning of city transportation systems, housing, and outdoor spaces 104 , 105 , 106 . While challenges exist to establishing and implementing co-production processes with older people 107 , evidence for successful examples is emerging 108 .

Avoid vulnerable states from coordinated mitigation actions

Considering the multi-dimensional nature of population ageing and shrinking, and the high context-specificity of the observed patterns across the world, it is expected that broad mitigation efforts would be needed by national and local governments to ensure the successful implementation of the SDGs. For example this would most likely need the implementation of emerging interventions such as the one discussed in the previous section, and broader policies that seek to prevent macroeconomic decline 2 such as to (a) increase in retirement age; (b) support continuing and lifelong education and health care for all; (c) encourage savings behaviour and healthy lifestyles throughout the life course; (d) promote employment among women, older persons and others traditionally excluded from the labour force; (e) support family-friendly policies to facilitate work–life balance and increased gender equality in both public and private life 2 , 52 .

In this sense, different ageing and shrinking countries and regions will very likely adapt through various context-specific social and economic measures. In some countries there are already discussions about the possibility of a ‘depopulation dividend’ through interventions such as the above linked to economic revitalization activities, i.e. ‘achievement from depopulation of positive gains that contribute to socio-cultural, political–economic, and environmentally sustainable living’ 109 (see example of ‘depopulation dividend’ for Sado Island in Japan, Supplementary Table 3 ).

However, it is also worth noting that in many countries mortality rates may not decline substantially further, but fertility rates may further decrease, creating thus a very skewed age pyramid (Fig. 6a ). In such cases it is possible that enormous efforts will be put in place through diverse sets of policies to increase fertility rate and/or promote migration 110 . Assuming this is successful, cities (and broader countries) may over time enter a new very vulnerable phase due to the previously skewed age distribution. This new demographic phase we may call the ‘vulnerable hour-glass’ (Fig. 6b ) and would represent further economic and social challenges with a very unfavourable dependency ratio (see the section “Interface of ageing, population shrinking and urbanization”).

Note: A stylised representation of a transition from a low mortality and fertility state of a given population, to low mortality and increased fertility state (i.e. vulnerable hourglass).

Even though this transition is hypothetical at the moment, some of its aspects have partly manifested in some urban contexts such as the formerly shrinking and until today also ageing city of Leipzig (see Supplementary Fig. 5 for Leipzig’s age pyramid). Some of the successful policy interventions used in Leipzig that might have been causing such types of transitions include the large investments in the housing estates in the inner city, which became further attractive to young adults and middle-aged that moved there due to its affordable urban life, nurseries/day-care facilities, newly equipped universities and high schools, and a certain openness for new ideas Germany 111 , 112 , 113 .

Even though the possibility of this hourglass-type transition and its eventual and long-term outcomes for urban sustainability are poorly understood at the moment, it is important that coordinated actions such as the above should seek to prevent it from manifesting.

Conclusions

This Perspective has critically discussed the opportunities and challenges that an ageing and shrinking urban population will have for long-term sustainability, and identified some of the possible emerging intervention to capitalize on the opportunities and reduce the challenges. In particular we find that this demographic transition will have major implications for implementing different SDGs, with some of the most promising emerging interventions including (a) innovations for health care and mobility, (b) improvement of green/public space design and extent, (c) social inclusion through social participation and urban knowledge co-production. Considering that the underlying mechanisms are highly variable between SDG targets and geographical contexts, there will be a need for combining context-specific policy and practice interventions to both leverage the opportunities and reduce the challenges posed by population ageing and shrinking for sustainability. Considering the quick pace of these changes, especially as the rate of ageing and population shrinking might be underestimated in official statistics, there is a need for urgent action.

Data availability

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Acknowledgements

Transdisciplinary Initiatives for Global Sustainability (TIGS) and the Alliance for Global Sustainability, The University of Tokyo, and JSPS-STINT international collaborative research (PI: K.T. and T.E.) for financial support to organize the workshop. A.G. and N.D. acknowledge the support of the Japan Science and Technology Agency (JST) and the National Natural Science Foundation of China (NSFC) for project SASSI. A.G. acknowledges the support of the Japan Society for the Promotion of Science (JSPS) for a Grant-In-Aid of Young Scientists (A) (17H05037). G.B.S. would like to acknowledge the International Research Fellow programme of Japan Society for the Promotion of Science.

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M.P.J., T.E., K.F. and A.G. conceived of the presented idea. M.P.J. and T.E. developed the theory. M.P.J. and J.P. worked on data presentation for global patterns, D.H. analysed situation in Europe, N.D. and J.P. analysed citation in China, O.S., R.W., K.F. examined situation in Japan. A.G., M.P.J., K.F., F.K., and K.T. worked on challenges and opportunities for SDGs. S.E., J.G., S.K., T.T., G.B.S., J.P. and M.Y. worked on the interventions and lessons learnt from ageing and shrinking cities. All authors contributed to the final manuscript.

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Jarzebski, M.P., Elmqvist, T., Gasparatos, A. et al. Ageing and population shrinking: implications for sustainability in the urban century. npj Urban Sustain 1 , 17 (2021). https://doi.org/10.1038/s42949-021-00023-z

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Ageing population and green space dynamics for climate change adaptation in Southeast Asia

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Income and Sex Moderate the Association Between Population Density and Reproduction: A Multilevel Analysis of Life History Strategies Across 23 Nations

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Ageing: Global population

WHO is working on three areas with a direct impact on ageing:

• prevention of chronic disease;
• access to age-friendly primary health care;
• creation of age-friendly environments.

WHO has developed guidelines that help countries to understand the types of programmes they can put in place to improve healthcare settings and cities so they are better suited to the needs of older people. WHO supports networks where countries can share technical information, discuss strategies and policies that have worked in their country to improve the lives of older people.

To increase our understanding of the health implications of ageing, particularly in less developed countries, WHO is undertaking the Study on global ageing and adult health (SAGE). This longitudinal follow-up of approximately 50 000 older adults is being carried out in China, Ghana, India, Mexico, Russian Federation and South Africa. The study links a related international network of health and demographic surveillance: the Demographic evaluation of populations and their health (INDEPTH). Comparisons with similar studies in high income countries will provide opportunities to understand similarities and differences in the health and well being of older adults globally.

Older persons work in a paid or unpaid capacity, care for family members and friends, and carry out after-retirement work in organizations and associations. They pass their experiences onto younger generations and by doing so, they help them strengthen their capacities. A high percentage of older people care for their grandchildren or other relatives and friends regularly and thus, in case of grandchildren, are supporting their children. In Africa, for example, family support of grandparents plays a particularly important role supporting children, as the parent's generation has been strongly impacted by the effects of HIV/AIDS.

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Ageing health topic

People Are Living Longer. Some People Think That It Causes Big Problems- IELTS Writing Task 2

Updated On Aug 02, 2024

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Discover how to tackle the IELTS Writing Task 2 essay on "People Are Living Longer. Some People Think That It Causes Big Problems." Check out sample answers, and outline to boost your writing skills.

Table of Contents

Ielts writing task 2 academic, sample essay, band 9 sample essay.

Effective IELTS Essay Connectors for Writing Task 2 & Task 1

In this article, we examine sample answers for the IELTS Writing Task 2 essay on the topic "People Are Living Longer. Some People Think That It Causes Big Problems." You'll find outline and band 9 sample answer to help you craft a well-structured and compelling essay in the IELTS Writing essay.

In an IELTS Writing Discussion Essay , you are required to explore multiple viewpoints on a given issue. Your task is to present and discuss different perspectives before concluding with your own opinion or a balanced view. Structuring your IELTS Writing Task 2 essay with a clear introduction, well-organized body paragraphs, and a strong conclusion is crucial for demonstrating your ability to effectively communicate and argue your perspective.

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People are living longer. Some people think that it causes big problems. Others, however, think the ageing population has many advantages for business, government and for society in general. Discuss both views & give your own opinion

Discussion essay

Introduction

Paraphrase the topic of the discussion.

Clearly mention what could be expected from the essay- In my opinion, I believe that this trend brings both advantages and disadvantages to society as a whole. However, I find myself more inclined towards the positive aspects of growing life expectancies. This essay shall deal with the same.

Paragraph 1- The ageing population can impose heavy pressure on the economy and the healthcare system as the more people retire, the heavier the pension burden the state has to carry. Hospitals will be flooded with frail and infirm elderly citizens searching for medical treatments while the labour force also suffers due to the shortage of productive workers who often make the biggest contribution to society.

The ageing population can impose heavy pressure on the economy and the healthcare system as the more people retire, the heavier the pension burden the state has to carry.

Paragraph 2- The benefits of this development should not be underestimated. First, they are able to contribute to some sectors such as teaching, management, scientific research and politics thanks to their extensive experience. We often see top executives in their 50s doing consultation sessions and help companies function more efficiently, or old teachers coaching students for contests because of their vast knowledge and hands-on experience.

As most people in modern times are busy with tasks at the workplace, elderly members like grandparents can do the babysitting, relieving parents’ worries of their children lacking in moral support or leisure activities.

Conclude the discussion by stressing over your side of the argument- In conclusion, for the reasons I have mentioned above, it seems to me that an ageing population has substantial benefits to the society that could work in its favour.

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There is little room for doubt that there has been staggering growth in the proportion of elderly people in many countries. In my opinion, I believe that this trend brings both advantages and disadvantages to society as a whole. However, I find myself more inclined towards the positive aspects of growing life expectancies. This essay shall deal with the same.

On the one hand, it is inevitable that the remarkable increase in life expectancy has some negative consequences for some reasons. Firstly, the ageing population can impose heavy pressure on the economy and the healthcare system as the more people retire, the heavier the pension burden the state has to carry. Hospitals will be flooded with frail and infirm elderly citizens searching for medical treatments while the labour force also suffers due to the shortage of productive workers who often make the biggest contribution to society. Secondly, the ageing population can impose heavy pressure on the economy and the healthcare system as the more people retire, the heavier the pension burden the state has to carry.

On the positive side, the benefits of this development should not be underestimated. First, they are able to contribute to some sectors such as teaching, management, scientific research and politics thanks to their extensive experience. We often see top executives in their 50s doing consultation sessions and help companies function more efficiently, or old teachers coaching students for contests because of their vast knowledge and hands-on experience. Second, as most people in modern times are busy with tasks at the workplace, elderly members like grandparents can do the babysitting, relieving parents’ worries of their children lacking in moral support or leisure activities.

In conclusion, for the reasons I have mentioned above, it seems to me that an ageing population has substantial benefits to society that could work in its favour.

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The medical and healthcare front has taken substantial strides in recent years owing to which the average life span has proliferated and increased. As a result, the mortality rate has been reduced and people are living for a longer duration. However, some people consider it to be having a negative impact on the population dynamics while others contend that it has a rather positive impact on the growth of society from all aspects. Moving ahead, we shall be discussing both the viewpoints and why the ageing population is beneficial to society.

People who consider the longer durability of humans as a menace to society put forth that increased life expectancies may be burdensome to the world as it increases and aggravates the competition for scarce and scanty resources to survive. It could exacerbate the relationship between the generations and could disgruntle the paradoxical ideologies that are understandably contrary to each other owing to the age margin. At times, this could sever the ties of households as older people are generally conservative and orthodox with respect to the new generations and hence their lifestyle incongruency often leads to pandemonium between them. Moreover, the middle age people are often seen getting drudged and hackneyed due to working more in order to provide for their children as well as the elderly of their families who often fall sick and are generally in constant need of medical aid.

In contrast, the longer life and sustenance of human beings has a positive side and if is harnessed vigilantly and logically, it could rather prove to be an oblation for the human diaspora. The best resource out of all i.e., the human resource is the most prime tool for the society that could sculpt its shape to the welfare of itself. Since, the more, the better, therefore, increasing lifelines could be utilized and availed to pave a way for the betterment of the world. On the work front, the experienced and seasoned professionals are often seen to be sitting at the consulting role as their dexterity and knack in their respective professions could be seen promulgating the businesses higher and faster. For instance, during the Covid-19 pandemic when a lot of businesses started to ramshackle, the seasoned employees were being hired intensively to have their drowning boats harboured. Similarly, for teaching, finance, people’s management, medical lines and research fields keep on turning to the counselling and consulting sessions of the experienced individuals in the related field of work as their experience is worth learning from.

In conclusion, it could be said that no matter how old one becomes, every other aspect and reason obliterates when experience comes and balances the equation. Therefore, burgeoning lifespan is indeed a positive development provided it is dealt with prudentially.

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Essay 44: The Aging Population: Exploring Advantages and Disadvantages

In many countries, the population is aging. What are the advantages and disadvantages of this trend?

Advantages and disadvantages of aging population: impact on healthcare, economy, and society.

In numerous countries around the world, the phenomenon of an aging population is becoming increasingly prevalent. This demographic shift has both advantages and disadvantages that impact various aspects of society. This essay will discuss the positive and negative consequences of this trend, focusing on the benefits it brings in terms of wisdom and experience, as well as the challenges it poses in healthcare and intergenerational dynamics.

One significant advantage of an aging population is the accumulation of wisdom and experience that older individuals bring to society. With age comes a lifetime of lessons learned and knowledge gained, which can be passed down to younger generations. This transfer of wisdom fosters personal growth, enhances decision-making, and promotes a more knowledgeable society as a whole.

Furthermore, an aging population often leads to a more experienced and skilled workforce. Older individuals who remain active in the labor market bring a strong work ethic, professionalism, and a deep understanding of their respective fields. This can positively impact productivity, innovation, and the overall quality of work, as their expertise can be utilized to mentor and guide younger employees.

However, there are also disadvantages associated with an aging population. One major challenge is the strain it places on healthcare systems. As people age, their healthcare needs tend to increase, resulting in higher demands for medical services and long-term care facilities. This places a burden on government budgets, potentially compromising the accessibility and quality of healthcare for all age groups.

Moreover, the economic implications of an aging population can be substantial. With a larger proportion of the population entering retirement, there is a decline in the working-age population. This can lead to labor market imbalances, skill shortages, and challenges in funding social security and pension schemes. Governments must implement policies that address these issues and ensure economic sustainability.

In conclusion, the aging population has both advantages and disadvantages. The wisdom and experience of older individuals enrich society, while their continued participation in the workforce can contribute to economic growth. However, challenges in healthcare provision and economic sustainability must be addressed through proactive policies. By recognizing the opportunities and effectively managing the challenges, societies can navigate the impacts of an aging population and foster a harmonious intergenerational balance.

Pros and Cons of an Aging Population: Exploring Wisdom and Challenges

The phenomenon of an aging population is increasingly observed in many countries across the globe. This demographic shift brings about various advantages and disadvantages that impact society, the economy, and healthcare systems. This essay will discuss the positive implications of an aging population in terms of knowledge capital and intergenerational relationships, as well as the challenges it presents in terms of healthcare costs and dependency ratios.

One significant advantage of an aging population is the increase in knowledge capital within society. Older individuals have accumulated a vast amount of knowledge and expertise in their lifetime, making them valuable assets to their communities. Their experiences and insights can be shared with younger generations, contributing to societal development and progress. Moreover, older individuals often possess historical perspectives that provide valuable context for decision-making processes, fostering a more informed and thoughtful society.

Additionally, an aging population can strengthen intergenerational relationships. With more elderly individuals present, opportunities for cross-generational interactions and mutual support are enhanced. Younger family members can learn from the wisdom and guidance of their elders, while older individuals benefit from the energy, enthusiasm, and new perspectives brought by younger generations. This intergenerational bond can foster social cohesion and a sense of belonging within communities.

However, an aging population also poses challenges, particularly in terms of healthcare costs. Older individuals generally require more extensive and specialized healthcare services to address age-related illnesses and conditions. This increased demand for healthcare can strain healthcare systems, leading to higher costs and potential difficulties in meeting the healthcare needs of the entire population. Governments must allocate adequate resources to support comprehensive and sustainable healthcare systems that address the unique requirements of an aging population.

Another challenge presented by an aging population is the dependency ratio. As the proportion of older individuals increases, there is a decline in the working-age population available to support and contribute to the economy. This can result in labor shortages, decreased productivity, and potential economic burdens. Governments and policymakers must develop strategies to address these imbalances, such as promoting active aging initiatives, supporting lifelong learning, and encouraging workforce participation among older individuals.

In conclusion, the aging population has both advantages and disadvantages. The wealth of knowledge and expertise possessed by older individuals contributes to societal growth, while intergenerational relationships strengthen social bonds. However, challenges arise in terms of increased healthcare costs and the dependency ratio. Governments must prioritize investment in healthcare systems and implement policies that support active aging and address labor market imbalances. By effectively managing these challenges, societies can harness the benefits of an aging population while ensuring the well-being and sustainability of future generations.

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• Overpopulation in many major urban cities around the world is a major problem. What are the causes of this? How this problem can be solved?

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The Impact of Population Ageing: A Review

Zainab ismail.

1. Faculty of Islamic Studies, Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia

Wan Ibrahim Wan Ahmad

2. Faculty of Health Sciences, Asia Metropolitan University, 81750 Bandar Seri Alam, Johor Bahru, Malaysia

Salasiah Hanin Hamjah

I komang astina.

3. Faculty of Social Science, State University of Malang, Jalan Semarang 5, Malang 65145, East Java, Indonesia

Background:

Population aging refers to the increase in number and percentage of older population aged 60 yr and above, and at the same time, decreasing in number and percentage of the young population aged 15 yr old and below. Starting in developed countries, population aging has now become a distinctive demographic phenomenon in developing countries. Nowadays developing countries have become the home to the largest proportion of older people in the world. This paper aimed to analyze the impact of population aging in Malaysia.

We employed a secondary data analysis related to the impact of population aging in Malaysia. In analyzing the data, the paper detailed, segmented, coded and, formulated the text into themes through a thematic approach. The themes that emerged from the data were family changes, migration of youth, support and care, health problems, financial security as well as housing problems. These emerged themes mapped the shared patterns of the impacts of the population aging.

With the increasing of the older population in Malaysia, there are various impacts of population aging emerged, particularly in terms of family changes, youth migration to cities, support and care, health, financial security and housing. The discussion in this article is revolved around these impacts.

Conclusion:

The growth of older people and the impact emerging from it has certain policy implications for the government of the country. Thus, the government needs to prepare for adequate policies and resources for future older people.

Introduction

While the discourse on senior citizens has long been developed in industrial nations in Europe and North America, the discourse on it, on the other hand, is a new effort in developing countries, including Malaysia. Before the 20th century, not many people reached old age eligible to be called senior citizens ( 1 ). The revolution in modern medical technology that took place in the early 20th century has caused many deadly diseases to be cured and reduced death rates in most nations of the world ( 2 ). Thus, the life expectancy of the population in many countries is fast increasing and the number of senior citizens increased. Many nations in developing countries have experienced a change from situations of high fertility and high mortality to low fertility and low mortality, a process called demographic transition ( 1 ). Observing demographic history, the growth of senior citizens is closely linked to the pace of the demographic transition of a country. The confluence of lowered fertility and improved health and longevity has generated growing numbers and proportions of older populations throughout the world ( 2 ). Declining in the proportion of young people and declining in mortality rates, particularly at older ages, lead to an increase in the number of senior citizens in the population structure. These changes coupled with an increase in longevity produce an increasing number of senior citizens. Continual increases in life expectancy at older ages have been the norm in most countries worldwide ( 1 ).

Thus, the aging of the population is a worldwide phenomenon. Malaysia is a country in Southeast Asia that is in the process of experiencing population aging. Although today, Malaysia still has a relatively small population of 60 and older and is still not be categorized as the aged nation as compared to industrialized countries in Europe and North America, the number and percentages of this category of the population are increasing. In 1970 the population of 60 and over in Malaysia was 539,118 only, and it has increased to 745,152 in 1980. By percentage, it increased from 5.2% 1970), to 5.7% (1980) and increased further to 6.6% (2000) and is expected to reach 11.3% by 2020 ( 3 ) ( Table 1 ).

Number of older population in Malaysia aged 60 + (1970–2020)

Sources: Department of Statistics Malaysia ( 4 – 11 ), United Nations ( 3 )

The objective of this paper was to analyze the impact of population aging in Malaysia. The aging of the population in Malaysia, as in other developing countries as well, by far is still not considered an urgent problem, but the increasing number of senior citizens in society has imposed new socioeconomic impacts for the country as the country right now is still struggling to attain a reasonable level of economic development. In other words, population aging will impose various impacts on the economy of the nations, because the sustained growth of older population will need enough resources to maintain their changing need and well-being. Like in other developing countries, Malaysia will also be facing various problems regarding the impact of population aging eventually. According to various reports, poverty, for example, tends to increase with age ( 12 ). Poverty is not only happened in developing countries, where report from HelpAge International ( 13 ), elderly people are the poorest population group, but poverty is also can be found in developed countries where over one in three elderly persons there, lives in poor, or near-poor family ( 14 ).

To discuss the impact of population aging in Malaysia, this study used secondary sources. The main source of the data and discussion for this article are derived from previous studies ( 1 , 2 , 15 – 17 ). While reviewing secondary sources from the above sources and other related sources, many secondary data regarding senior citizens have been collected. Data, such as the impact of the growth of senior citizens all over the world, carry very valuable information that is particularly very important for researchers of the older population. Because this secondary data carries very valuable information, an initiative to share this information is an urgent need. Secondary data analysis is a technique of research that analyzes the existing information from various sources collected by other researchers for another primary purpose ( 18 , 19 ). In recent years, researchers outside Malaysia tend to see that utilizing existing information for research is becoming more prevalent ( 19 – 21 ). This is because with technological advances, a vast amount of data successfully collected, compiled, and archived, is now easily accessible for research ( 19 ).

Data gathered from the various secondary sources of population aging in Malaysia on the issue, have been analyzed through a thematic analysis approach. In analyzing the data, findings were described by formulating the text into themes through a thematic analysis approach. The thematic analysis approach is a part of making sense of the information by distilling and describing the text and naming the essential features in themes ( 22 ). The developed themes would map the shared patterns of an attribute, descriptor, element, and concept in the study ( 22 , 23 ). The development of themes aims to convey appropriately the subjective meanings and social reality in the study ( 23 ). At this step, the researchers analyzed the various secondary sources on the issue to identify the major themes as well as sub-themes. The researchers discussed the emergent themes and reached concordance with the findings of the impact of population aging in Malaysia. These emerged themes mapped the shared patterns of the impacts of the population aging.

Results and Discussion

The results highlighted six major themes emerged. The first theme was the family changes. This theme had three subthemes, first the diminishing size of the family, second, the rise in single-parent families and third, the type of family has changed from extended to nuclear ones. The second major theme was the migration of youth to cities. This theme had two subthemes. The first was that the resources for care decline and second, the relationship between elderly parents with their adult children become problematic. The third major theme was the need for support and care. This theme had also two subthemes, first the physical ability and health decline and second, the ability to continue working declines. The fourth major theme was the health problem. This theme had three subthemes, first the need for healthcare support, second the high medical cost and third, the transportation problem or facilities to see a doctor. The fifth major theme was financial security. This theme had two sub-themes, first the deprivation of income and second, the need for financial support. The sixth major theme was the housing problems. This theme had three subthemes, first the poor quality of housing, second the highly crowded settlement and third, the homeless. All the changes have been affected the welfare and the quality of life of the senior citizens. All themes are shown in Fig. 1 , while subthemes in Fig. 2 .

The themes of the impacts of the population aging

The themes and subthemes of the impacts of the population aging

The aging of the population is a success story of the development process ( 2 ), but it also poses various problems to the elderly themselves ( 24 – 31 ). Various scholars believe that population aging has become a demographic reality that deserves serious attention ( 32 ). The impacts of population aging are generally related to family changes, migration of youth to cities, need for support and care, need for attention to health problems, need for financial security and, housing problems. All these impacts are not only exclusive to the impact of population aging in Malaysia, but also impacting all countries all over the world. Thus, the discussion on the impact of population aging in this paper will be aligned with this statement.

Family Change

Family institution all over the world has changed remarkably. Family in Malaysia is currently undergoing rapid changes as well. These changes are seen as having a detrimental effect on the well-being of senior citizens. Because of modernization and industrialization, and now globalization has forced the family institution to adapt to these changes. Among the notable aspects of these changes are the diminishing size of the family and the number of single-parent families that have been arisen. The accepted types of family also changed from extended to nuclear ones. Due to the decline in family size and the increasing number of single mothers in the community, the welfare of senior citizens can be affected. This is because the family is the foundation for support and care. Individuals in family institution are the primary source of care.

By decreasing the size of the family, the sources of care will be declined. At the same time, the norm of the extended family is becoming less popular. Adult children who have married will soon start their own lives that are far from their parent’s homes. Such changes have an impact on senior citizens because most of these senior citizens, due to lack of income, cannot still live independently. They are normally dependent on their children. Among the noticeable family, changes are the changes in the patterns of living arrangement of elderly people. Available data shows that the number of elderly people living alone is increasing, while at the same time the number of elderly people living with spouses, children and other family members is decreasing ( 17 ) ( Table 2 ).

Patterns of living arrangement of elderly people (%)

In Singapore as a comparison, 61.3% of elderly people were living with spouses and children, or with children only ( 33 ).

Migration of Youth

The migration of youth to cities is an inevitable phenomenon. In the past, the migration of the younger generation to cities was very rare. They, when establishing their own home, will live together in the same village. Today, younger generation is no longer involved in the traditional agricultural sector of the village. This, among other reasons, is due to its dependence on natural phenomena that making the agriculture sector as a sector with high risk and full of uncertainty ( 34 ). They need to secure a strong economic position for their future, and therefore they have to migrate to cities that offer a variety of employment opportunities. At the same time, the senior citizens in the village are losing resources for care. The older generation whose their children emigrated to the cities are facing care problems in the village. While certain types of support can be provided without the presence of the younger generation in the home, there are times when senior citizens need children to back home to provide the best care. Geographical distance plays an important role in determining how often young people visit the elderly in the village. Thus, with the rapid migration of youth to cities, the senior citizens in the village may be facing care problems; whereas care is an important element that enhances the well-being of these senior citizens. Several studies conducted in various places in Malaysia by Wan Ibrahim Wan Ahmad show that a lot of elderly parents in rural areas are left without care. He shows that not all married children who migrated to cities area visited their elderly parents during the week prior to the study conducted because of geographical distance. Many these married children are coming back to their village to see their elderly parents once a month, or at least once in more than two months’ time ( 17 ) and see Table 3 .

Frequency of visit of married children

Support and Care

Older people in developing countries are mostly poor in physical ability because old age is often accompanied by a decline in physical health. As the physical capacity of senior citizen decreases, their economic resources will also decrease. They are generally no longer able to work, and this has led to a decline in their quality of lives. Whenever there are older people in the families, the families are forced to dedicate their time not only to the work and care of their own children, but also to the care of their elderly parents ( 35 ). Senior citizens need support and care, whether from their own family members, friends, neighbors as informal supports, or supports from government as formal ones. Formal support will be functioning as providing services intended to supplement, complement or to replace informal supports from family and others ( 36 ).

The responsibility of providing support to senior citizens needs to be shared between the informal and formal support ( 37 ). The needs of senior citizens can be effectively met when there is a close and balanced cooperation between informal and formal support ( 38 ). Informal support itself is considered unable to function properly without the cooperation of formal support. In developed countries older people would rather live in their own homes rather than choose to live with their children. The elderly in there, because of the many resources they have and the friendly facilities available, prefer to live alone. With the exception of poor senior citizens, and in need of intensive care, healthy older people with their own financial resources prefer to stay independent, or at least with their spouses only.

Most senior citizens in Malaysia do not have an appropriate source of income as their old age financial security. They have to continue to work despite reaching the very old age ( 39 ), leaving children and family members fully responsible for the care ( 40 , 41 ). Not all senior citizens are well cared for by their family members. Many senior citizens are left behind without care. There is a tendency that more and more senior citizens are abandoned. The displaced senior citizens are facing various issues such as love, care, financial, health, accommodation, and security. Although many senior citizens are left behind without care, and living with children will not be a norm in the future, many elderly parents in Malaysia are still hoping that they can still be living with their adult children ( 17 ) ( Table 4 ).

Distribution of living arrangement in the future

Health Problems

The health problem is considered an important issue related to many other aspects of senior citizens. Healthy older people are generally more prosperous. Medical facilities are an important aspect in the context of addressing health problems of senior citizens. Although all the governments have a responsibility for the healthcare facilities and well-being, including disease prevention of elderly people ( 12 ), the accessibility of senior citizens as well as their family members to healthcare centers is also an issue that needs attention. Are medical facilities, public hospitals or government medical clinics in Malaysia adequate or appropriate for these senior citizens? Is this facility easily accessible to them? Nations with a lot of senior citizens are facing the question of health services to meet the growing needs of older people.

In terms of geographical distribution, most of senior citizens in Malaysia live in rural areas. From our experience with the life of rural senior citizens shows that the accessibility of rural senior citizens in modern medicine is low. If there is a health problem, these senior citizens may want to look for other alternative sources. Senior citizens who want to get treatment at a government clinic, may have difficulty seeing a doctor because of transportation problems and often they do not have children to send them to the clinics. Another problem is high medical cost. Many illnesses require a great deal of money, while elderly patients generally require them to get ongoing treatment.

In Korean community, chronic disease increases depression among senior citizens, and it negatively affects subjective health status and quality of life ( 42 ). While in Malaysia, kidney disease, for example, is a form of illness that often attacks senior citizens, costing them a lot of money, while the facilities at government hospitals are limited. Not many senior citizens have the opportunity to receive treatment at a government hospital for this disease. Due to the lack of such facilities, senior citizens have to receive treatment at a private hospital or a private hemodialysis center frequently needed a very high cost.

Financial Security

Financial security is another social welfare issue of senior citizens. This is because when people reach old age, they are no longer have the ability to continue working. However, most senior citizens in Malaysia, whether they want to or not, have to continue to work despite their advanced years. They will only stop working when they are no longer capable of doing any work. The opportunity for employment, if available, also offer less wages to senior citizens.

This situation is causing senior citizens to be deprived of income and to be trapped in poverty. Poor problems exist because these senior citizens have no financial guarantee to support their old age. Only a small proportion of senior citizens in Malaysia are eligible for a pension scheme for their old age security. The adequacy of income from these schemes is largely dependent on the deduction to the Employees Provident Fund. Due to low wages while in the public sector, retirement allowance received is also very low and sometimes insufficient for living expenses. Other senior citizens have to rely on their children for financial security in old age and allowance from the Social Welfare Department. The results of a study conducted ( 41 ) on rural senior citizens in Kelantan show that most of senior citizens there are having a relatively low income, with an average of RM298.00 per month (1 USD = RM4.047). Information on the role of family support can also be seen in other studies ( 43 – 45 ). From this information, senior citizens are poor, indicating that they need financial support from other sources, such as children or the government.

Housing Problems

Housing problems are another problem faced by most senior citizens all over the world particularly older persons in developing countries like Malaysia, especially in rural areas. Many senior citizens live in an old house and do not have adequate support facilities. Because they are poor, they do not have the ability to live in comfortable house. If we visit the village, we have the opportunity to meet such senior citizens living in poor quality houses. House is an important element to the life satisfaction and health, and thus, affect the well-being of senior citizens. The quality of the home is closely related to well-being of older people, and the relationship is strengthened when there are elderly people with health problems are present in such home ( 46 ).

Without a good and suitable house, it can also be affected the quality of life of older people. Most of the older people in rural Malaysia, particularly older people in island community lives in a highly crowded settlement ( 47 ). Many of them are also homeless. Homeless senior citizens are facing high risk and also will be facing a host of social, psychological and financial problems. The poor health of senior citizens requires a comfortable home. Housing problem is one of the reasons for older individuals’ decreasing quality of life and dependence on others’ help for survival ( 42 ).

People all over the world nowadays is living longer and many of them, healthier lives. The growing of the older population in the community produces a phenomenon referred to as population ageing. Population ageing refers to the increasing in number, percentage of older people aged 60 yr, above, at the same time the number and percentage of the young age population aged 15 yr old, and below in a population structure is decreasing. Demographers believe that the increasing of older person happened due to decreasing in birth rates and increasing in life expectancy. The structure of the population in these countries has undergone changes, and it is expected that in 2020, Malaysia will have a large proportion of older people in the population structure. The ageing of the population is a success story of the development process, but it also poses a number of problems to the elderly themselves. In the context of Malaysia, the country has to face problems such as family changes, youth migration to cities, support and care, health, financial security and housing. As a whole, the growth of older people and issues emerging from it have certain policy implications for the government of the country. Thus, the government need to prepare for the adequate policies and resources for the future older people.

Ethical Considerations

Ethical issues (Including plagiarism, informed consent, misconduct, data fabrication and/or falsification, double publication and/or submission, redundancy, etc.) have been completely observed by the authors. As no primary data collection was undertaken, no additional formal ethical assessment and informed consent were required.

Acknowledgements

We would like to thank Universiti Kebangsaan Malaysia for providing the Research Grant UKM-GUP-2011-094 “Developing Spiritual Intelligence Index for Elderly at Al-Jenderami Elderly Complex, Banting, Selangor, Malaysia” and Grant for Research Development of the Faculty of Islamic Studies (PP-FPI-2019).

Conflict of interest

The authors have no conflict of interest to disclose.

What America’s Aging Population Means for Family Caregivers Like Me

“Sir, may I know your daughter’s name?”

The customer service representative from the energy company was asking my father this question for the third time. We were trying to transfer the ownership of his account to me, but for the third time, he couldn’t answer.

This was a defining moment in our journey with Alzheimer’s. After five years of living with my father’s diagnosis, I had gradually taken over almost every aspect of his life management. But this was the first time I questioned if he could remember me.

The account still hasn’t been changed to my name, a stark reminder of the daily reality for those caring for loved ones with Alzheimer’s, and more broadly the 54 million Americans who care for aging relatives.

The United States is on the brink of a silver tsunami. By 2030, 24 million people will require long-term care—about double the number who need it today—and our healthcare system is ill-equipped to support them all. Family members and their communities—children, spouses, grandchildren, cousins, and friends—will need to fill the gap. But our system isn’t designed to support this shift in household decision-making. To give seniors a better quality of life, we’ll need to make a societal shift across government, businesses and within our own families. And practical, accessible technology is the glue that will hold it all together.

Read More: Why Americans Are Uniquely Afraid to Grow Old

Eight years ago, when my father was first diagnosed, I was just starting my career in tech in New York, while he was living in the Bay Area where I grew up. I was determined to maintain his independence for as long as possible, and I focused on using technology to do this from afar, a goal that allowed me to manage my own career and life in a different city.

According to an AARP survey, about 80% of American seniors wish to stay at home for as long as possible. Aging in place offers improved quality of life and better health outcomes than assisted living facilities. The challenge is that, apart from the occasional 15-minute doctor’s appointment, assisting someone who may not be able to accomplish all daily living activities on their own usually falls to families to figure out. This whole new job can often be stressful, costly, and emotionally overwhelming.

Early on, I discovered that with my father’s permission, and a smartphone, Wi-Fi access, a small investment in hardware, and a large investment of time and energy, it was possible to create a setup that worked. I found it effective to set up shared accounts with my father and safely store most of his usernames and passwords so I could easily coordinate his communications and access certain services. I helped him automate his health insurance and mortgage payments, switched most of his bills to online, and recorded as much key information as possible. Over time, I created remote access to his home with smart devices that allow me to drop in whenever I want and cameras that help let me know where my father is, and that he is safe. I found quality in-home help with two wonderful home health aides through an online platform in whose hands I felt confident leaving my father during the day.

But that wasn’t without trial and error. Even with access to all his online accounts, I often find myself fumbling between his and my own many online accounts and occasionally missing critical things. In one example from the beginning, I missed several of my dad’s credit card payments, which tanked his credit score. Because of that, I was unable to refinance his mortgage to take advantage of better interest rates until I added him onto my own credit card and rebuilt his credit over several years. I still have a hard time forgiving myself for this.

A few years into my journey as a family caregiver, I quickly realized that with all of these new responsibilities on top of my own life, I was burning out. There was an entire other dimension of caregiving I had overlooked–I had to find a way to take care of myself if I was going to adequately take care of my dad. I founded an online community of caregivers. We shared advice and tips for helping our parents on the day-to-day. It offered me a lifeline to the emotional support and empathy I needed when things got tough. And the experience I had with my online community and the universal problems those caregivers faced and shared gave me the idea for a solution to help not just me and my dad, but everyone.

For many people, setting up a complex arrangement of technology and paid health aides can be extremely daunting or even inaccessible. Getting to this point took a lot of time and energy and investment. Participating in online communities can take the time caregivers desperately don’t have. Paid help is often a privilege. This is why accessible technology, expert recommendations, and community resources are the crucial missing pieces in family caregiving. The struggle is real. It could be so much easier.

I’m hopeful that the current revolution underway in artificial intelligence will make a huge difference. We can already see this in action with Replika, the AI app that chats with you as a real friend would. By learning about you through your conversations over time, Replika creates a digital companion that can alleviate feelings of loneliness in the elderly and provide emotional support for caregivers in difficult circumstances. While chatbots can’t fully replace real human interaction today, they can still serve a helpful purpose for those who converse with them.

In fact, my journey with my dad has led me to design an app for family caregivers, partly because the caregivers in my community have asked for it, and partly because my dad would want our family’s experience to help others. We’re creating ways to leverage the collective wisdom of family caregivers—all the lifehacks, tips, and tricks—and building modern tools that can take over the heavy lifting for those who need it now, and all those yet to come.

There’s no doubt that caregiving in America presents a formidable challenge. With my own father, I know we’re in a slowly losing battle against Alzheimer’s. But eight years into this journey, I also hope we’re living proof we don’t have to simply resort to the old ways of taking care of each other. There are new, better ways for families to take advantage of and a path to more dignity and precious time with each other. With ingenuity and dedication, advanced technologies can and must rise to the occasion, giving family caregivers what they need to ride out the silver tsunami.

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Contact us at [email protected]

• DOI: 10.54254/2754-1169/90/20241943
• Corpus ID: 272580347

The Impact of Population Aging from the Perspective of New Productive Forces: Empirical Evidence from 30 Provinces in China

• Xiangru Zhao
• Published in Advances in Economics… 10 September 2024

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Age, Gender, and Urban-Rural Disparities in Non-Communicable Disease Mortality: A Comprehensive Analysis in China's Aging Population

36 Pages Posted: 17 Sep 2024

Huang Changquan

Chengdu Second Peoples Hospital

Chongqing Medical University

Wang Chengyue

Li yonghong.

Chengdu University of Information Technology

Qing Yongyi

Cheng aowen.

Background: Non-communicable diseases (NCDs), including cardiovascular diseases (CVDs), cancer, diabetes, and chronic respiratory diseases, are the leading causes of mortality in China, particularly in the context of a rapidly aging population. Although previous studies have documented the rising burden of NCDs, there is limited comprehensive analysis on age-specific mortality trends, gender disparities, and urban-rural differences. Additionally, the interaction between aging and NCD mortality, particularly for younger populations, has been underexplored. Methods: This study utilized data from China's Disease Surveillance Points (DSP) system, covering 324 million people from 605 sites nationwide. Mortality data from 2004 to 2021 was analyzed across five age groups (20-44, 45-59, 60-74, 75-84, and ≥85 years), stratified by gender and urban-rural residence. Statistical analyses, including independent samples t-tests, were conducted to compare NCD mortality across demographic groups and time periods (2019-2021 versus 2004-2007). An age-period-cohort (APC) model was applied to estimate annual percentage changes in NCD mortality trends. Findings: NCDs accounted for over 80% of all deaths, with CVDs and cancers being the primary causes. The NCD mortality rate increased significantly with age, particularly in individuals aged 60 and older. Rural populations had higher mortality rates from diabetes, lung cancer, and pancreatic cancer compared to urban populations. Gender differences were observed, with men experiencing higher mortality rates for most NCDs, although women showed higher mortality for cervical and ovarian cancers. The APC analysis revealed significant year-on-year increases in mortality for specific cancers, including colorectal and pancreatic cancer, as well as diabetes, particularly among rural males. Comparison of mortality rates between the two time periods indicated a significant rise in NCD-related deaths in individuals aged 20-44. Interpretation: China's aging population is at heightened risk for NCD-related mortality, necessitating a life-course approach to NCD prevention that begins early in life. The findings highlight the need for targeted public health interventions, particularly in rural areas, to reduce mortality from major NCDs such as cardiovascular diseases, cancer, and diabetes. Policymakers should prioritize improving healthcare access in underserved regions and addressing gender-specific risk factors to reduce the long-term burden of NCDs in China's rapidly aging society. Funding: This study was funded by the Sichuan Provincial Government (Project No. 24SYSX0142) with a grant of 400,000 RMB. Huang Changquan received the funding. The funds were primarily used for data acquisition and analysis. Declaration of Interest: We declare no competing interests.

Keywords: Non-communicable diseases (NCDs), Urban-rural disparities, Age-specific mortality trends, Chronic diseases prevention, Gender differences in mortality

Suggested Citation: Suggested Citation

Huang Changquan (Contact Author)

Chengdu second peoples hospital ( email ), chongqing medical university ( email ), chengdu university of information technology ( email ).

No.24 Block 1, Xuefu Road, Chengdu, China Chengdu, 610225 China

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