The Future of the Aging Society: Burden or Human Capital?

(Please note that this is my per­son­al take at the dis­cus­sions that took place in Dubai as part of the Glob­al Agen­da Coun­cil on the Chal­lenges of Geron­tol­ogy put togeth­er by the World Eco­nom­ic Forum, and builds on the work of my col­leagues, but it does not rep­re­sent a for­mal doc­u­ment or state­ment of posi­tion. Sim­ply put, we would like to engage your brain in defin­ing the chal­lenges and outlining/ exe­cut­ing the solutions).

Con­text: The Chal­lenges of the Aging Society

The world is aging. This is occur­ring in two ways: through shifts in the age struc­ture that will even­tu­al­ly lead to many more peo­ple reach­ing old­er ages than ever before, and through con­tin­ued suc­cess in extend­ing life. Less than 100 years ago, life expectan­cy was between 30 to 40 years. Today, close to 800 mil­lion cit­i­zens are 60 and over.

And aging in health­i­er ways. Aging has incor­rect­ly been asso­ci­at­ed with decline and decay, when in fact many peo­ple live healthy into old­er ages. There has been a syn­chro­nous exten­sion in life expectan­cy and qual­i­ty of life — the aver­age 65-year-old today is much health­i­er, phys­i­cal­ly and men­tal­ly, than the aver­age 50-year-old of 100–150 years ago — when most exist­ing insti­tu­tions were envi­sioned and created.

Healthy life can be fur­ther extend­ed with exist­ing knowl­edge. The fact is the onset and pro­gres­sion of fatal and dis­abling dis­eases, dis­or­ders, and dis­abil­i­ty can be post­poned using well-researched basic mea­sures of pub­lic health, envi­ron­men­tal and behav­iour­al changes, and med­ical tech­nol­o­gy inter­ven­tions. The same meth­ods may be used to improve or main­tain men­tal and phys­i­cal functioning.

Our health­care and retire­ment sys­tems are on bank­rupt­cy track — their premis­es are out­dat­ed. Exist­ing insti­tu­tions, poli­cies and atti­tudes do not reflect the points out­lined above, hav­ing been devel­oped for a soci­ety that no longer exists. We need to get on the right track: aging pop­u­la­tions rep­re­sent poten­tial resources that are cur­rent­ly untapped or underutilized.

The cur­rent dis­ease-based research agen­da com­pounds the prob­lem: emerg­ing bio­med­ical research holds the promise of slow­ing down the bio­log­i­cal process­es of aging — there­by con­tribut­ing to low­er preva­lence rates of a spec­trum of dis­eases. Yet, giv­en exist­ing fund­ing par­a­digms, there is not a well-inte­grat­ed and fund­ed research plan in place to dri­ve the agenda.

Solu­tion: Cap­tur­ing the Longevi­ty Div­i­dend with a Healthy Aging Agenda

Get­ting our insti­tu­tions and poli­cies in the right track ‑giv­en the grow­ing exten­sion of healthy life- can pay a series of eco­nom­ic, health, and oth­er life course div­i­dends. A course change can have a sig­nif­i­cant return on invest­ment, and the absence of this course change will have a series of neg­a­tive con­se­quences glob­al­ly. We need to cap­ture the longevi­ty div­i­dend to ben­e­fit peo­ple of all ages, as well as old­er adults- stop think­ing Bur­den, start think­ing Human Cap­i­tal to be main­tained and deployed.

To cap­ture this Longevi­ty Div­i­dend, we need to move the agen­da for­ward in three com­pli­men­ta­ry areas:

1) Pro­mote Healthy Lifestyles that help Main­tain Phys­i­cal and Cog­ni­tive Func­tion­al Abilities:

- Part­ner to Raise the Pre­ven­tion Agen­da: we need adopt a cross-sec­tor life course approach to health pro­mo­tion, engag­ing not only the health and insur­ance sys­tem but also the edu­ca­tion sys­tem and the media sec­tor. In health­care, we need to inte­grate med­ical care and pub­lic health approach­es to pre­vent and ame­lio­rate chron­ic dis­eases and con­di­tions — geri­atric med­i­cine offer a valu­able tem­plate for health care redesign that would be ben­e­fi­cial for all.

- Invest in Life­long Learn­ing: invest­ing in edu­ca­tion at every point in the life course, encour­ag­ing life long learning.

2) Redesign Envi­ron­ments to Fos­ter Health, Engage­ment and Finan­cial Security: 

- Redesign Retire­ment Poli­cies: redesign­ing the cur­rent retire­ment par­a­digm through enhanced flex­i­bil­i­ty offers a win/ win/ win sce­nario — for employ­ers, employ­ees, and soci­ety at large.

- Pro­vide oppor­tu­ni­ties for pro­duc­tive engage­ment: cre­ate new gen­er­a­tive roles and a host of oppor­tu­ni­ties for pro­duc­tiv­i­ty and engage­ment by elder adults. These would con­fer huge soci­etal ben­e­fits on unmet glob­al needs, and if designed cor­rect­ly, will pro­mote the health of an aging soci­ety. One exam­ple is the “experience corps” model.

- Redesign Cities: redesign­ing cities to sup­port healthy aging and inde­pen­dence and engage­ment. One of the tran­si­tions that will take place is that a sig­nif­i­cant por­tion of future cohorts will live in cities. Hence, we need to cre­ate nec­es­sary envi­ron­ments and trans­porta­tions that will accom­mo­date this trend.

3) Devel­op an inte­grat­ed Healthy Aging Research Agen­da: the dis­ease-spe­cif­ic mod­el needs to be sup­ple­ment­ed by advanc­ing research design to slow the bio­log­i­cal process­es of aging. We need to raise and inte­grate resources to invest in research for inno­va­tion in new social exper­i­ments, retire­ment and pen­sion poli­cies that work, con­tin­u­um of liv­ing cir­cum­stances that encour­age liv­ing in place, devel­op­ment of enhance­ments that encour­age phys­i­cal and cog­ni­tive func­tion­ing, basic bio­log­i­cal research on aging, all built on a strong social compact.

There are 2 promis­ing areas to start mov­ing this agen­da forward:

1) Pro­pose a new Mil­len­ni­um Devel­op­ment goal: Include these press­ing issues as one of the Mil­len­ni­um Devel­op­ment Goals, opti­miz­ing a full healthy life course and har­ness­ing the oppor­tu­ni­ties of an aging world, includ­ing build­ing effec­tive approaches.

2) Pro­pose a Healthy Aging agen­da for Glob­al 2000 com­pa­nies: in part­ner­ship with the appro­pri­ate Coun­cils, sug­gest research-based prac­tices and poli­cies: — Health pro­mo­tion in the work place.
— Flex­i­ble retire­ment policies.
— Defin­ing new roles for old­er adults and civic engagement.
— Invest in life long learning.
— Devel­op new tech­nolo­gies, prod­ucts and ser­vices for an under­served, and grow­ing, market.

Now, your turn:  can you help define the chal­lenges and out­line the solutions?