Demographic change is an age-old problem

People are living longer and having fewer children. These combined factors will have massive implications for healthcare, the economy and society at large

People are living for longer across the world. Getty

There is a famous saying that the only two things in life that we can be certain of are death and taxes. Living longer is not a given, but it now looks more likely on every continent on earth. More of us are living to a ripe old age, rather than dying young in wars, from malnutrition or disease. Many can expect to live into our 80s and beyond, and to be healthier for longer.

This is one of the most extraordinary advances and demographic changes in human medical and social history. A child born in a prosperous country right now can expect to live beyond 100 years, and to be healthy for much of that time. But there are serious consequences. There will be many more humans on earth. The pressures of population growth teamed with an ageing population are profound. The nightmare scenario is of a straight line graph pushing the world population up from 7.7 billion now into unsustainable figures of 12 billion or more by 2100, with the possibility of wars being fought over water, land and other scarce resources.

I recently attended a conference near London, where I listened to various experts speak on how our world might look in 2050 or 2100. I am happy to say that there are some reasons for optimism. Professor Sarah Harper from the Oxford Institute of Population Ageing pointed out that there is no reason to believe that the world’s population will continue to rise upwards in a straight line.

Quite the contrary. By 2050 up to 90 per cent of us will be urban dwellers. Assuming the cities we live in are reasonably controlled, urbanisation tends to make people less poor. More prosperity means fewer children. Bearing this in mind, the global population may level out sustainably at 10 billion.

But it will still be older. I once asked the Scottish comedian Billy Connolly about the pains and problems of growing old. He laughed. “Growing old,” he said, “is not so bad when you consider the alternative.” True. But an ageing population changes everything, from healthcare and work to how we design our lived environment.

In Japan for example 25 per cent of the population is over 65, a figure that that will rise to 40 per cent by mid-century. Japanese workers expect to be employed well into their seventies and even older. But, as Prof Harper points out, growing old is of less importance if we have a reasonable chance of being healthy.

Again, there is good news. Dementia rates in western countries are falling. A recent study by Harvard School of Public Health analysed data on 60,000 people in the US and western Europe and found that dementia fell 15 per cent every decade, linked to a decline in smoking and a corresponding drop in cardiovascular problems.

In Europe, however, planners are still thinking about how to redesign cities for people living with the condition. Some have created “dementia-friendly communities”, an initiative that the Netherlands has taken the lead in. Another experiment is the opening of “dementia cafes” which help people to live more “normal” lives. The bad news is that worldwide obesity rates are rising. Obesity – linked to diabetes, cancer and heart disease – is now one of the world’s biggest health risks.

An ageing population also creates an extra burden for those in work. Within a few years, at least half of the world’s workforce will be in Asia. But China faces an enormous demographic problem, with a declining percentage of working-age men and women supporting elderly relatives for longer, along with their own children.

Population changes are also politically sensitive. Africa is set to experience a huge bulge of working-age people. A lack of employment opportunities across the continent is predicted to drive migration towards richer countries, especially southern Europe.

Meanwhile, those countries that provide pensions for older people have encountered an enormous backlash when they try to adapt to demographic change. Vladimir Putin, for example, met with mass protests against his decision to increase the male retirement and pension age in Russia. France faced similar uproar on raising its retirement age from 60 to 62, and President Emmanuel Macron is now moving cautiously.

Perhaps a lesson may be taken from the late German chancellor Otto von Bismarck, the man who invented the idea of state pensions. From 1889 Bismarck introduced a welfare system for Germans over 70 years old. But as Prof Harper pointed out, a 19th-century German man’s life expectancy was about 46 years.

A similarly calibrated retirement and updated pension system for today would only kick in when we reach about 100 years old. To adapt that old saying, now it appears that the only certainties are death, taxes and working harder, for longer.

Gavin Esler is a journalist, author and television presenter