title: Macroeconomic implications of population ageing and selected policy responses.
abstract: Between now and 2030, every country will experience population ageing-a trend that is both pronounced and historically unprecedented. Over the past six decades, countries of the world had experienced only a slight increase in the share of people aged 60 years and older, from 8% to 10%. But in the next four decades, this group is expected to rise to 22% of the total population-a jump from 800 million to 2 billion people. Evidence suggests that cohorts entering older age now are healthier than previous ones. However, progress has been very uneven, as indicated by the wide gaps in population health (measured by life expectancy) between the worst (Sierra Leone) and best (Japan) performing countries, now standing at a difference of 36 years for life expectancy at birth and 15 years for life expectancy at age 60 years. Population ageing poses challenges for countries' economies, and the health of older populations is of concern. Older people have greater health and long-term care needs than younger people, leading to increased expenditure. They are also less likely to work if they are unhealthy, and could impose an economic burden on families and society. Like everyone else, older people need both physical and economic security, but the burden of providing these securities will be falling on a smaller portion of the population. Pension systems will be stressed and will need reassessment along with retirement policies. Health systems, which have not in the past been oriented toward the myriad health problems and long-term care needs of older people and have not sufficiently emphasised disease prevention, can respond in different ways to the new demographic reality and the associated changes in population health. Along with behavioural adaptations by individuals and businesses, the nature of such policy responses will establish whether population ageing will lead to major macroeconomic difficulties.
authors.affiliation: Harvard School of Public Health, Boston, MA, USA. Electronic address: dbloom@hsph.harvard.edu.
authors.forename: David E
authors.initials: DE
authors.lastname: Bloom
authors.affiliation: WHO, Geneva, Switzerland.
authors.forename: Somnath
authors.initials: S
authors.lastname: Chatterji
authors.affiliation: WHO, Geneva, Switzerland.
authors.forename: Paul
authors.initials: P
authors.lastname: Kowal
authors.affiliation: University of East Anglia, Norwich, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Lloyd-Sherlock
authors.affiliation: European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: McKee
authors.affiliation: European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Bernd
authors.initials: B
authors.lastname: Rechel
authors.affiliation: Harvard School of Public Health, Boston, MA, USA.
authors.forename: Larry
authors.initials: L
authors.lastname: Rosenberg
authors.affiliation: Rand Corporation, Santa Monica, CA, USA.
authors.forename: James P
authors.initials: JP
authors.lastname: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004467:Economics; D014943:Global Health; D005102:Health Expenditures; D006301:Health Services Needs and Demand / Q000191:economics*; D006299:Health Services for the Aged / Q000191:economics*; D006801:Humans; D008017:Life Expectancy; D008134:Long-Term Care; D011157:Population Dynamics