The writer is the author of ‘Extra Time: Ten Lessons for an Ageing World’
Is the rash of US presidential candidates aged over 70 a sign of weakness or strength? We hear that Bernie Sanders isn’t too left; he’s too old. Michael Bloomberg was alive when Harry Truman was in the White House. Joe Biden is surely as worn out as his shoe leather.
In reality, all of these characters seem in remarkably good shape. Despite being the oldest president ever to be sworn in (he was 69), Donald Trump still acts like a kid.
Today, the average 75-year old white man in the US can expect to live 11 more years, at least seven of those in good health — more if he’s a college graduate. For many of the rich and educated, way beyond the Oval Office, chronological age is decoupling from biological stage. As the world greys, we need to extend that new lease of life to everyone.
How well countries age will become a major source of competitive advantage in the next decade. China is growing old before it gets rich. Russia’s population is ageing, shrinking and ranks almost as low as Haiti in terms of health.
The US is still relatively young, with comparatively high birth rates and immigration. It also has a growing group of people in their seventies and eighties living in what I call “extra time”, an extended middle age. If it can tackle its growing health inequalities, it could yet retain its global pre-eminence.
Economists tend to assume that greying societies will be less productive and innovative. But it’s the capabilities of a population that matter, not simply its age.
In the US and UK, one in four people are now “unretiring” and going back to work. In Japan, the world’s oldest society, the gerontologists and geriatricians I’ve interviewed are not much interested in anyone under 75. Things have changed utterly in the past 30 years, they tell me.
That’s not to deny the challenge to the global economy, when more than 80 per cent of global gross domestic product is generated by countries with rapidly ageing populations. With former US Treasury secretary Lawrence Summers’s secular stagnation thesis — according to which the global economy is prone to sluggish growth caused by insufficient demand — looking ever more persuasive, governments must act urgently to keep people healthier for longer, and in the workforce for longer.
The good news is that this is possible, if governments work to keep healthspan in pace with lifespan. Japan long ago spotted this imperative. Between 2013 and 2016, the average Japanese man gained an extra year of healthy life, while life expectancy at birth rose by nine months. This has been achieved with a relentless focus by the government on diet, smoking and other lifestyle behaviours that foster chronic disease.
Other countries would do well to learn from Japan. Even as the richer and more educated bounce merrily forward into extra time, poorer citizens are falling behind in terms of both lifespan and healthspan. Life expectancy growth has slowed in many European countries since 2011, partly because the gains from tackling smoking are tailing off.
But in England life expectancy growth actually seems to be stalling because of a combination of poverty and obesity. A shocking new report suggests that the average English man and woman can now expect to spend slightly more than a fifth of their lives in poor health. There is now a 12-year gap in healthy life expectancy at birth between rich and poor.
The future of our economies, and the cohesion of our societies, depends on narrowing that gap — which is even wider in parts of America. The US has long lagged behind other rich countries in life expectancy, partly because its high rates of obesity mean it has made less progress in slowing deaths from stroke.
Moreover US life expectancy at birth fell from 2014 to 2017, and just ticked up in 2018, partly because of what the economists Anne Case and Angus Deaton have dubbed “deaths of despair”, many of them linked to opioids.
What path will China take? Under Mao Zedong, China had the world’s most sustained increase in life expectancy, from 35 in 1949 to 65 in 1980. That healthy, working-age population helped drive the country’s unprecedented economic growth.
But China is now ageing rapidly. The population is expected to peak at 1.44bn in 2029 before entering what the Chinese Academy of Social Sciences has called “unstoppable decline”.
Moreover, China seems to have acquired western tastes for junk food. It is growing old without America’s wealth or Japan’s health.
The Communist party has foreseen some of this. Pensions are modest and China’s state council has a plan for responding proactively to population ageing, which seeks to improve both health and skills.
Global ageing is unlikely to be reversed. Mass immigration on a sufficient scale is least acceptable to some of the countries that are ageing most rapidly. And having interviewed women in different countries about why they are having fewer children, I don’t think we will see much uptick in birth rates outside Africa.
Germany has had some success by offering more generous parental leave and day care. But progress is slow. And for the sake of the planet, falling birth rates are surely a good thing.
What all of us want, as we age, is to add life to our years, rather than just years to life. An extended middle age is not unique to US politicians. It should be available to everyone — and that will soon be a geopolitical imperative.
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