A Nation of Caretakers

A Nation of Caretakers

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Campaigning across America, especially in the final days, means hitting those most likely to turn out. And those most likely to turn out have always been "seniors."  But the topic many seniors care about -- elder care –paradoxically is one for their grandkids. That is, how the next generation will pay for it.  That's the news from this year's 2010 World Population Data Sheet (WPDS) released this week.

The WPDS, normally a mind numbingly boring set of statistics, joins the thunderous and growing chorus of voices recognizing aging populations as a central political issue, which needs attention today before it hits crisis proportion in a few years.  Their basic point is that our rapidly aging world -- especially in developed regions like the U.S., Europe, Japan and South Korea -- will be unable to cope in light of the shift occurring between “…those elderly who will need care and those who can provide it…” 

If the trends data into mid century are to be believed we will need to act now: “In 2010, France, Italy, and Sweden have the lowest…support ratio, with 10 middle-aged people available to care for one oldest-old person, followed by Guadeloupe, Japan, Switzerland, Spain, and Norway with 11; the United Kingdom with 12; and Austria, Belgium, and the United States with 13…”  By mid century these proportions go down to 4 for the U.S. and many European countries, and 1 for Japan.  At these rates, who will be working to support all the care? 

However depressing this picture looks, it gets far worse as we account for the complications of health trends, as reported in the study, "The World Health Organization estimates a doubling of chronic disease in the 65 and older population by 2030," which covers diseases like Alzheimer’s, diabetes and cardio vascular disease. It doesn't even touch conditions associated with aging like sarcopenia – (decreased mobility due to loss of muscle) or vision impairment, which will place even further burdens on health systems, especially if the “oldest-old” are cared for by the “near-old.”

Longevity does represent a huge 20th century success, but must now be accompanied by a massive restructuring of our public policy, huge investments in innovation to find the cures for epidemics like Alzheimer’s, or mitigation of conditions like Sarcopenia. We also need a general shift in the view that some of us will be working while others are “caring.”

It’s not surprising that American politicians and their constituents are not mired in the details of the World Population Data Sheet.  But somewhere in between campaigning and governance we need to become serious about the fiscal impact of extending life. 


Executive director of the Global Coalition on Aging, Michael W. Hodin, Ph.D., is also managing partner at High Lantern Group and a fellow at Oxford University's Harris Manchester College.