Critical Questions for Ageing Societies. Carney, Gemma
are major changes in a population over time. There are numerous such studies around the globe, and some are specifically designed to investigate population ageing. These studies recruit participants aged 50 or over and follow their progress for as long as they live. In the US, there is the Health and Retirement Study (HRS). The comparable study in Europe is called the Survey of Health, Ageing and Retirement in Europe or SHARE (www.share-project.org/). There are many country-level studies in Europe too, including The Irish Longitudinal Study of Ageing (TILDA) (https://tilda.tcd.ie/), the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA) (https://www.qub.ac.uk/sites/NICOLA/) and the English Longitudinal Study of Ageing (ELSA) (https://www.elsa-project.ac.uk/).
The architects of these studies had the foresight to design them to be comparable. This means that researchers can compare the physiological, financial and socio-economic status of older people in a number of different regional and national contexts around the world. Comparative longitudinal data is invaluable if we are to start adapting and changing our policies to adjust for an older population. So far, findings from these studies are revealing that older people are a more diverse and complex section of the population than envisaged. The stage of life known as ‘old age’ is proving to be more productive, and have a more varied experience, than previous generations could have imagined.
At the time these studies were launched (SHARE began in 2004, the HRS in 1992) researchers rather naively believed that adapting to an older population merely meant that we needed to find out more about that older population. Once we had the facts, it was thought that we could then use good quality social scientific evidence of the needs of the over 50s and adjust social spending accordingly. As with most things in social policy (and life) it turned out to be a tad more complicated than that. We will begin to discuss these issues by answering a common question asked by students: ‘Why is population ageing a big deal?’
Why is population ageing a big deal?
There are a number of reasons why policy makers and politicians are anxious about population ageing. Basically, any change in the demographic balance of a state’s population impacts on family structure, the labour market, the organisation of social welfare, the supply and demand of goods and services, and pretty much every aspect of resource allocation in society. In democracies which operate on the basis of ‘one person, one vote’, a changing demographic profile could also cause big shifts in voting patterns. We will deal with these issues in Chapter 8, which focuses on the politics of ageing. For now, let’s concentrate on what having an older population might mean for the political economy, or the financing and resource allocation decisions that produce the ‘welfare state’ – the social contract between state and citizens which provides publicly funded supports and services to citizens, including pensions, healthcare and education. In truth, ageing is only the latest in a series of incremental but seismic changes to the global population since death rates started to decrease, followed by a logical decrease in fertility rates. The overall process is referred to as the ‘demographic transition’ and is said to occur in four stages (Harper, 2016; 1); see Box 1.4.
Box 1.4: The four stages of the demographic transition
•Stage 1: ‘Life is nasty, brutish and short’ (Hobbes, 1651). High death rates from famine, disease, lack of hygiene and malnutrition, accompanied by high fertility rates. This was the situation in England up until about 1780.
•Stage 2: A rapidly expanding population because of improvements in public health, and a reduction in deaths from communicable disease, but fertility rates are still high. However, child mortality rates are also still relatively high. Examples include 21st-century Sudan and 19th-century UK.
•Stage 3: Mortality rates stay low, but fertility rates now also begin to drop. This is where we begin to see the ageing of the population. This was the situation in Europe or the US in the 20th century, or present-day Uruguay.
•Stage 4: By stage four, the fortunes of the European population have completely turned around from the time of Hobbes: life is now healthy, peaceful and long. Death rates and fertility rates are both low but the population is relatively stable, albeit at a high level. This is the stage we have reached in Canada, the US, and western Europe in the 21st century.
Source: Harper, 2016
The main point to note from Box 1.4 is that reaching stage 4 of the demographic transition is where we begin to see important implications for the welfare state. That said, the recent COVID-19 pandemic has given some of countries with the oldest populations in the world, such as Italy and Japan, a bitter taste of the past, when infectious diseases were widespread killers of vulnerable groups. However, if, as expected, a vaccine for COVID-19 is found and we return to low death rates from communicable and infectious disease, then we are likely to continue to have larger numbers of older people. Making the transition to an older population means that we will have to rethink some basic elements of the social contract that underpins the welfare state. One of the major points of contention is the ‘dependency ratio’ (the ratio of people of working age to those not of working age). Traditionally, working age in the UK is taken to mean those aged between 16 and 64 years. In Chapter 3, we will discuss why calculating a dependency ratio can be problematic.
At the beginning of the third stage of the demographic transition, it was thought that having more people aged 50 or over would have a major, negative impact on the public purse. Some people even thought that the onset of population ageing might lead to a ‘demographic time-bomb’ (itself a troubling phrase) whereby a disproportionate number of older people would demand healthcare and pensions, at the expense of younger populations. In some quarters, this deficit hypothesis still prevails. It is now recognised that the assumptions underpinning such a phrase are essentially ageist, as they work on the basis that being older automatically implies dependence and need rather than independence and productivity. However, more recently it has been noted that the ‘baby boomers’ of the early 21st century (those born between around 1946–64) have not been replaced. So, the increase in the proportion of over 60s in societies that experienced a strong baby boom will begin to reduce after 2030 or 2040 (Reher, 2015). Even so, demographers such as Reher (2015) argue that countries which experienced a strong post-war baby boom, such as the UK, the US and many western European countries, should prepare for a ‘tidal wave’ of growth in the number of cases of certain chronic or degenerative illnesses typical of persons of advanced age. Note that ‘tidal wave’ holds similarly negative connotations as ‘time-bomb’ and reflect the negative associations with older cohorts.
Perhaps the solution is for policies to be tweaked to serve an older demographic profile? Such an approach is preferable to blaming a growing minority of the population for simply living too long. This thesis is gaining traction in gerontology. For instance, Carney and Gray (2015) argue that the problem is not the age of the population itself, but rather how age is used to structure social, political and economic life. We will discuss these issues in more detail in Chapter 2 on ageism and again in Chapters 6, 7 and 8 on gender, solidarity between generations, and the politics of ageing, respectively.
Population ageing in the context of population change
For now, the main point to note is that population ageing is the result of the interaction of a number of drivers including declining mortality rates, decreased fertility rates and migration. The impact of migration should not be underestimated. It has been argued (Carney, 2017) that the issue of falling numbers of ‘working age population’ (aged 20–64) could be solved by opening up to inward migration. However, this approach may lead to new imbalances.