What does a world with billions of old people look like? Asian countries are searching for answers

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Global Aging 360 OVERVIEW

And it is a change with far-reaching consequences.

“The fundamental institutions of our societies — and by that I mean work, retirement, education, healthcare, housing, transport — were not designed to support the population age distribution of our future society,” Rowe explained. “They need to be re-engineered in order to adapt.”

To understand what this “future society” might look like, Grid spoke with demographers and health experts to see how shifting demographics were playing out in different parts of the world. While aging poses a collective challenge, interviews and a survey of the data show that the problems of aging, and the way societies are dealing with it, vary greatly.

Back in 1980, the U.N.’s list of top 10 “grayest” places was dominated by Europe; Sweden topped the list, with 16 percent of its population aged 65 or over. Germany, Austria, the U.K. and Norway were close behind.

Last year, Japan led the world, with a much higher percentage: Nearly a third of its citizens are aged 65 or over. By 2050, Hong Kong is expected to top the chart, with more than 40 percent of its people in that age bracket. Meanwhile, the percentages of elderly residents will rise dramatically. In the 1980s, the elderly made up a quarter of the population in those top-ten “grayest” nations; at midcentury, the comparable figure will be one third.

“I think the world is just now catching up to (the way demographics are changing), and it’s becoming a global concern because we seem to be at a tipping point,” Joshua W. Walker, the head of the New York-based Japan Society, told Grid.

That tipping point has the potential to fundamentally remake our world. Take the question of pensions. As things stand, public expenditure on pensions in advanced and emerging economies is forecast to climb to an average of 9.6 percent of total economic output by 2050, up from around 7 percent in the 1970s and 8 percent in 2010. That’s an increase of hundreds of billions of dollars, and it will have a profound bearing on government spending on everything else — from infrastructure to education to healthcare and more.

The good news, several experts told Grid, is that tackling these and other challenges is possible. There is a mountain of studies, reports and proposals to deal with global demographic shifts. “After all, we’ve known about these changes for decades,” Rowe explained.

The bad news: The world hasn’t been paying enough attention. In many ways, the experts say, there is a comparison to be drawn with global warming — that other colossal human challenge, long talked about, long ignored and still lacking the concerted action needed to solve the problem.

“We tend to deal with the urgencies immediately in front of us, and oftentimes we are looking, frankly, in the rearview mirror instead of at what’s coming. And demographic shift has been a long time coming, we knew it would come, and we are now in the midst of it.”

Global Aging 360 THESIS

THE BOTTOM LINE

Not long ago, demographers worried about a global population explosion. The fear was that skyrocketing birth rates would leave billions of people poor and hungry and competing for scarce resources. In many parts of the world, that concern still holds true. But more and more countries are now confronting the opposite challenge: Their populations are shrinking, and they are growing older. And unless current trends are reversed, within a generation, the number of elderly people on earth will challenge governments’ ability to care for them. In some countries, the challenge is already here.

Japan & Korea Lens

Shrinking populations, grayer citizens

By Nikhil Kumar - Deputy Global Editor

When the subject is an aging world in 2023, the primary case studies are two neighboring countries in East Asia. In Japan and South Korea, the issue has reached a critical juncture.

And so for successive governments, the focus has been on driving up the birth rate, something that Kishida also highlighted as he sounded the alarm. “In thinking of the sustainability and inclusiveness of our nation’s economy and society,” he said, “we place child rearing support as our most important policy.”

To help, the government has boosted support for child care and slowly started reforming its famously restrictive immigration system, allowing in more workers in sectors suffering labor shortages.

“You have to pair (the demographic problem) with an immigration problem,” Walker told Grid. “Because if you’ve got a very large number of old people, then you need somebody to take care of them. You have to bring in more people and you have to bring them in from outside, and Japan has one of the strictest immigration policies in the world.”

But in both cases, an East Asian economic juggernaut is threatened by a simple and not easily reversible trend: Its population is older than ever.

China Lens

When one country’s problem is a global problem

By Lili Pike - China Reporter

The case of China stands apart for two reasons.

This month, China made it official: For the first time since 1961, when the country was in the grip of famine, its population fell last year.

China’s leaders are trying to reverse the trend. Having used the one-child policy to engineer the population slowdown, the country has embarked on a campaign to engineer a demographic reversal.

It isn’t going well.

China announced a two-child policy in 2016 and relaxed the rules again in 2021, not only allowing but encouraging families to have three children. Ten years ago, a couple in China could have been fined for having a second child; today, a family would receive cash benefits for having a third. But as Grid has reported, the new measures have brought “more of a baby blip than boom.” China’s birth rate rose slightly in 2016 before dropping again.

The trend lines are causing China’s demographic pyramid to invert. Where once there was a huge group of under-thirty men and women, by 2050 retirees will far outnumber those under 30. According to United Nations data, the percentage of Chinese aged 65 and over will increase from 14 in 2022 to 30 by 2050.

An aging China is also different because it carries global implications, given China’s sheer size and weight on the world stage. China’s economy is likely to suffer; the U.N. data shows what that inverted pyramid will mean for manufacturing. From 2022 to 2050, China’s working-age population will contract by 22 percent — that’s 217 million fewer people to power China’s factories, farms and service sector. The government has tried to get ahead of the problem by offering education programs that might make young workers more productive and by introducing an unpopular reform: raising the country’s low retirement age in the coming years.

When asked about China’s demographic challenges, Tianlei Huang, a research fellow at the Peterson Institute for International Economics, put it bluntly. “There is no denying that what is in front of the Chinese policymakers is a very tough situation.”

Europe Lens

Two old civilizations, growing old

By Nikhil Kumar - Deputy Global Editor

The problem is acute in a handful of countries — Italy and Greece in particular.

In the past decade, Italy’s population has begun to shrink, a trend that is expected to accelerate. If the trend persists, the country’s population will drop by more than 10 million people to around 48 million by 2070.

The country faces “a much faster aging of the population compared to the rest of Europe,” Gian Carlo Blangiardo, the head of Italy’s national statistics agency, told Parliament.

Greece, too, is aging at a rapid rate. Last year, 22.5 percent of the population was aged 65 or over; the forecast for 2050 is almost 35 percent.

The trends mean that Greece and Italy both show up in projections for the top 10 grayest countries in 2050, replacing European counterparts such as France and Germany, which were among the oldest populations back in 1980. Other parts of Europe have fallen off that top-ten list for a variety of reasons, including higher birth rates and far higher levels of immigration than the Asian nations that have replaced them in the rankings.

India Lens

A “demographic dividend”

By Nikhil Kumar - Deputy Global Editor

If Japan and South Korea are the standard-bearers for aging nations, India is a major example of the opposite phenomenon.

Successive leaders have talked about the benefits of these trends. Politicians and officials often wax lyrical about the country’s “demographic dividend” — the economic potential of this giant cohort of working-age people. Certainly India has no shortage of young citizens to fill its labor force or to care for its elderly. Compared to the other nations mentioned here, those really are “dividends.”

Longer-term demographic change is likely to magnify these pressures. As they grow wealthier, Indians are likely to benefit from changes seen in other parts of the world — and that, in turn, will trigger a demographic reversal, much like those that have come in Japan and South Korea and other wealthy countries.

“The same things that have driven demographic change in other parts of the world — increased prosperity, the advancement of women, lower infant mortality rates, later and fewer marriages, later decisions to have children and obviously access to birth control — those same things will change things in places like India over time,” Irving, from the Milken Institute, told Grid.

Global Aging 360 CONCLUSION

What can the world’s aging nations do?

In many cases, experts say dealing with these trends will mean more than just dealing with pensions or healthcare. It will also mean re-engineering entire systems.

Case in point: The lessons learned during the early stages of the covid-19 pandemic about nursing homes. Think back to the summer of 2020 and the avalanche of news stories about viral outbreaks and deaths in healthcare facilities in different parts of the world.

“Covid-19, in some ways, laid bare some of the fundamental deficiencies that we were building into our health and social systems,” Rowe, from Columbia University, pointed out. “The best example of that is long-term care. The design, the staffing and the function of nursing homes was such that it was a death sentence to be in a nursing home at that time if you were a frail, older person. We need to redesign that system. There needs to be more home care, more education, there needs to be smaller nursing homes, more training of staff.”

For those nations already grappling with aging societies, these needs are urgent.

And in nations such as India, Irving and other experts say governments should start thinking about aging “while they still have the time.” On the far end of the spectrum — the nations with the youngest populations — is sub-Saharan Africa, where roughly 70 percent of people are under 30. But even in many of the countries in that part of the continent, the trends will shift over time.

“For those countries that still have young populations,” said Irving, “they should be placing the reality of population aging at the top their policy agendas and preparing for it now.”

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