The longevity revolution: challenge or opportunity?

Colin Milner, 28 Dec 2010

If we are to redesign policies and environments that respond effectively to the challenges of population ageing, we need to reorient ourselves to the opportunities that ageing represents.

Increased life expectancy is one of the most significant success stories of our times. Yet, this tribute to modern science is now considered one of the greatest global challenges as well, according to Laura L. Carstensen, founding director of the Stanford Center on Longevity [1]. How did this happen? Two words: age apathy. Simply put, the world has been slow to respond to the needs, dreams, desires, capabilities and expectations of the swelling ranks of older people. With the leading-edge Baby Boomers poised to turn 65 in 2011, “most people are not confident that we are prepared or will be able to handle the costs generated by an ageing population,” shows a recent Harris Poll [2].

Will a lack of preparation by governments, businesses, families and individuals lead to mismanagement of population ageing? If so, we can expect an unprecedented impact on global economies, personal finances, pension plans, social institutions, healthcare, housing, science, technology, and a multitude of other industries.

In the past four months I have participated in seven ageing “think tanks” on three continents. At the heart of these discussions has been concern for mismanaging not only the challenges associated with population ageing, but also the opportunities. This concern was loud and clear in the proceedings from the World Economic Forum’s (WEF) Longevity Roundtable in August.

Held at the Swiss Re Global Centre for Dialogue in Rüschlikon, Switzerland, this roundtable brought together leading representatives of the WEF, the World Demographic & Ageing Forum, and Swiss Re to discuss the impact of falling fertility and increased longevity on the global risk landscape. The following paragraph summarises the meeting:

“Humankind is experiencing the most dramatic demographic shift of its history. Fertility is falling. Longevity is rising. Societies are becoming older. This demographic change, in and of itself, is not a risk. What is a risk is the bad management of demographic change. That mismanagement has already started. As the baby boomers from the post-World War II fertility increase pass into retirement, societal and economic structures in many industrialised economies are ill-placed to cope; although the full effects of the demographic shift will take many decades to be fully evident."[3]

Managing the global risk

The issue before us is not just if we respond to the challenges of global ageing, however. It is also about how we respond and with what—and how we ensure we do not mismanage the process.

The United States’ healthcare system serves as an example. This system was designed to handle single conditions, not the multiple chronic health conditions that face many older adults today. Consider, for example, that only 9.3% of adults with diabetes have that sole condition, according to the Agency for Healthcare Research and Quality, a division of the US Department of Health and Human Services (HHS) [4]. What will it take to change the healthcare system in this area? On December 14, 2010, HHS announced a significant step, issuing the new Strategic Framework on Multiple Chronic Conditions, a private-public sector collaboration that will coordinate responses to this growing challenge.

Changing our systems is a start. We need to change the culture within systems as well to “increase the attractiveness of professions working on healthy ageing (doctors, nurses, physiotherapists, nutritionists etc.) through incentives, better remuneration, continued educational possibilities and higher recognition on the value of caring and treating older people."[5] Excerpted from a European Commission (EC) paper, this comment reflects one area discussed at healthy ageing workshops conducted in October by the EC Directorate General for Health and Consumer Policy. This response—making healthy ageing professions more attractive—is “the only way to address the looming future health workforce shortage in Europe,"[5] the paper states.

This is one suggested response to one area of risk. The WEF roundtable pointed out the following additional risks of mismanaged demographic change, which need to be addressed [3]:

1. Unreformed retirement legislation: States need to move away from a societal model of mandatory retirement ages.

2. Inflexible working patterns: In part as a result of mandatory retirement ages, many economies provide little opportunity for older workers.

3. Increased cost of treating and caring for those with chronic diseases: People living to advanced old age will result in an increase in certain chronic diseases.

4. Failure to adapt infrastructure for the elderly: There is a need to adapt public transportation networks, housing, etc., to enable people to live longer in their homes.

5. Insufficiently funded pensions: There are too few private pension assets to fund current pension expectations. Many pension funds cannot meet existing liabilities. Additionally, many workers do not yet have access to privately managed pension funds.

6. Excessive payments: Many countries have generous provisions for those in old age. These are generally not means based. People receive social security payments without personal income and assets taken into account.

7. Mismanaged migratory regimes: This is a highly politicised topic. Few states have consistent short-term goals and targets for migration and it is difficult and perhaps impossible for them to engage in long-term planning. Who can possibly know which mix of labour and skills will be needed in 15 to 20 years?

8. Low fertility rates: In part the result of outdated labour market and family policies, many countries are currently in danger of becoming trapped with low fertility rates.

9. Environmental pressures: There are numerous potential constraints related to climate change, coupled with the concern that population growth may outpace agricultural production.

If we are to redesign policies and environments that respond effectively to these challenges, we need to reorient ourselves to the opportunities that ageing represents.

Changing our view of ageing

At WEF’s Summit on the Global Agenda, which took place in Dubai at the end of November, the Global Agenda Council on an Ageing Society recognised that we need to change our current views of ageing to move forward. We need to go beyond the typical responses, this council proposes, looking at ageing in creative ways that take advantage of the situation and harness the potential in this shift.

How do we change our views of ageing? First, we need to realise that these views are typically based on our life experiences and what we have come to expect from ageing. Our beliefs are also influenced by others, such as the mass media and marketers, who in many cases have focused on decline and decay, “medicalising” the ageing process. In many cases, negative views can create low expectations of ageing that extend into all areas of life—from the workplace to healthcare to entertainment. What can be done to change the tide? One recommendation from the European Commission’s workshops follows:

“Creating a positive image of ageing was a dominant theme in many discussions. Our society is youth focused and based on being forever young. Youth is celebrated. Wisdom and experience needs to be given the same recognition. Older people need to be included in the cultural fabric of society. Some interesting ideas on how to shift society’s view about ageing were: to create and tell more stories by older people, make more films (e.g., Up, About Schmidt, Cocoon), TV programmes, promote the demographic dividend through role models or ambassadors. For example, Matisse painted well into his 80s. The European Year of Active Ageing 2012 can provide a good platform to further develop some of these ideas."[5]

It will certainly take a concerted effort to shift our expectations of ageing—but the possibilities are inspiring.

An example: Marketers point to the award-winning Dove “Campaign for Real Beauty” as a good example of effective marketing to older adults. In Western societies, the prevailing belief is that your value to society diminishes once you reach a certain age. Put another way: Your value to marketers and corporations is diminished—whether as a consumer or employee—once you reach a certain age. The Campaign for Real Beauty challenged these beliefs. One advertisement and billboard featured a 95-year-old model and posed the question, “Withered or Wonderful?” Viewers were invited to log on to the campaign website and cast their vote. The Dove campaign ad proved a tremendous success, largely by tapping into society’s negative expectations of ageing and making people reconsider them.

Ultimately, if we are to manage population ageing better, we too need to change our views and expectations.

Old opportunity, new twist

Each Think Tank I attended this year proposed many ideas, both unique and similar, as solutions to the challenges of demographic change. Some ideas included:

  • Reengineer the workplace environment and the work force, so older people will find it compelling to continue working—especially as three in four Boomers anticipate working past current retirement age [6]. If left unaddressed, this issue may potentially lead to a brain drain in the corporate world.
  • Recognise that ageing occurs over the life course, and that we need to educate and impact all segments of the population, not just older adults.
  • Shift the focus from an older person being a passive recipient of goods and services to an active user of goods and services.
  • Grow civic engagement opportunities, so older adults can continue to share their life and professional experiences in a meaningful way.
  • Recognise that educational institutions need to shift, as marketers do, from youth-centred learning to education for all ages, because lifelong learning will grow in importance as older adults get trained or retrained for the work forces.
  • Shift current thinking about neurodegenerative conditions such as Alzheimer’s disease, in order to address the needs of an ageing world.

Many of the strategies outlined at these meetings rely on one key component: Health.

Health = wealth

In 2001–2002, life expectancy in the US was 74.5 years for men and 79.8 years for women [7], according to Healthy People 2010, the government’s national health objectives framework. Over these years, men were expected to live 7.7 years in poor health and women, 9.4 years [7] —unsurprising numbers, given that 80% of adults over 65 have at least one chronic health condition and 50% have at least two [8]. The goal? Compress years of morbidity, while improving quality of life. This one element will have a profound impact on how an ageing population affects governments, businesses, families and individuals.

Strategies to improve health range from changing the environment in cities and communities to one that supports active, healthy lifestyles (e.g., the World Health Organisation’s Age-Friendly Cities initiative), to providing opportunities for engagement. The report from the European Commission workshops offers the following recommendations:

“There was consensus that keeping people engaged and feeling connected to friends, family and society was very important but very difficult to ensure. The built environment and the digital era can both help and hinder. Open spaces and meeting places need to be safe. We need to continue promoting physical activities such as dancing clubs. The internet can help to establish social contacts but should not substitute them." [5]

Bottom line: There are many recommendations on how to manage the challenges of an older world, as well as many opportunities to create meaningful solutions that will help people age well and lead a quality-filled lifestyle. But few of these will truly take root unless the following occurs:

1. We change the expectations we have of growing old, from those of decline and decay, to those of untapped human potential and capital.

2. We empower older adults to take better care of themselves through a variety of health and wellness solutions.

Simply starting with these two elements could lead to more change than currently forecast.

 

References

[1] Hayutin, A. M., Dietz, M., & Mitchell, L. (2010). New Realities of an Older America. Challenges, Changes and Questions. Stanford Center on Longevity. Retrieved from http://longevity.stanford.edu/files/New%20Realities%20of%20an%20Older%20America.pdf.

[2] Taylor, H. (2010, March 17). Most People Believe that We Are Not Prepared for Increase in Longevity and Number of Old People. The Harris Poll, 39. Retrieved from http://www.harrisinteractive.com/vault/Harris_Interactive_Poll_Lifestyle_Longevity_2010_03.pdf.

[3] Woodward, S., Perdian, R., Singleton, M. (2010, October 4). World Economic Forum Longevity Roundtable.

[4] US Department of Health and Human Services. (2010, December 14). Press release: HHS issues new strategic framework on multiple chronic conditions. Retrieved from http://www.hhs.gov/news/press/2010pres/12/20101214a.html.

[5] European Commission Directorate General for Health and Consumer Policy (DG SANCO). Reflections on Healthy Ageing: Health Systems – Innovations – Consumers. European Commission DG SANCO Workshops with experts on 11-12-18 October 2010, Brussels. Retrieved from http://ec.europa.eu/health/ageing/events/ev_20101011_en.htm.

[6] Age Wave and Merrill Lynch. (2005, February 22). Press release: The New Retirement Survey From Merrill Lynch Reveals How Baby Boomers Will Transform Retirement. Information available at http://www.agewave.com/research/landmark_retirementSurvey.php.

[7] US Department of Health and Human Services. (2006). Healthy People 2010 Midcourse Review. Executive Summary. Goal 1: Increase Quality and Years of Healthy Life. Retrieved from http://www.healthypeople.gov/Data/midcourse/html/execsummary/Goal1.htm.

[8] US Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. (2007, June). Improving the Health of Older Americans: A CDC Priority. Chronic Disease Notes & Reports, 18(2), 1, 3–7. Retrieved from http://www.cdc.gov/aging/pdf/CDNR.June.2007.pdf.

This publication was published in the Journal on Active Aging, November/December 2010.

 


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Author

Colin Milner

Colin Milner is the founder and CEO of the International Council on Active Aging® (ICAA), an association that supports professionals who develop wellness facilities and services for adults ages 50 and over. Milner’s efforts have inspired a broad spectrum of industry leaders, leading-edge publications, television networks and radio stations to seek his advice. Included among these are the World Economic Forum’s Network of Global Agenda Councils, European Commission Directorate-General for Health and Consumers, Canadian Special Senate Committee on Aging, US Department of Health and Human Services, and National Institute on Aging. Information about ICAA is available online at www.icaa.cc.

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The longevity revolution: challenge or opportunity?

Colin Milner, 28 Dec 2010

If we are to redesign policies and environments that respond effectively to the challenges of population ageing, we need to reorient ourselves to the opportunities that ageing represents.