Longevity: Engine for growth — or fiscal nightmare?

SAN DIEGO — Keeping older people healthy so they can be independent and productive well into their 70s — and even 80s — isn’t just a medical challenge, it’s also an economic challenge, said Michael W. Hodin, executive director of the Global Coalition on Aging at a recent Gerontological Society of America workshop.

Due to the longevity revolution the world is experiencing, it’s a challenge that even developed nations aren’t addressing well.

Take the age of retirement here in the United States, for example. Back in the 1930s, the United States, still reeling from the Great Depression, created Social Security for older people (while other developed nations were creating their cradle-to-grave social insurance programs).

Increasing vitality beyond 65

In 1935, Social Security’s first actuaries calculated when people could begin collecting their government pensions and were surprisingly accurate in estimating the percentage of seniors in today’s American population. But they assumed that by the time people reached 65, they’d only live a few more years.

In 2013, though, someone reaching age 65 in the U.S. can expect to live another 17 years on average.

The vitality of the senior population has increased in every age bracket discussed by experts in aging, the young old (those 65-74), middle-old (75-84) and old-old (85 and up).

“It’s obvious,” Hodin said, “that 20th century ‘norms’ [for retirement] aren’t conforming to 21st century realities.”

It’s not just retirement “norms” that aren’t addressing the reality that we are aging differently than Social Security’s actuaries thought we would. Health care “norms” aren’t keeping up either.

For starters, said Hodin, in this longer-lived population, the U.S. needs to increase vaccinations, not just flu and pneumonia vaccination rates. The country needs to address hearing and vision loss — and develop cheaper drugs to manage the later. We need more dermatologists — there’s an explosion of skin cancer looming. We need better options for treating osteoporosis.

Also, we need to cure or slow the progress of Alzheimer’s disease. Hodin said, “No one saw that coming, and it’s a game-changer in health care.”

In his data- and chart-filled presentation, Hodin zeroed in on the major factors that have come together around the world to create either a health care fiscal nightmare or an engine for economic growth.

The first is the longevity bonus: Life expectancy has skyrocketed.

“By mid-century, 75 percent of those over the age of 60 will be living in developed nations,” said Hodin.

He added that due to migration to cities and other nations, rural areas all over the world will be “hollowed out, populated mostly by the elderly.”

The second key development is that women — all over the world, not just in developed nations — are having fewer babies. So, while more hands-on care providers and services will be needed, fewer younger people will be available to fill those roles.

Lag between policy and opportunity

The third factor is what Hodin called “structural lag.” We don’t have the political, societal and economic policies and infrastructure in place to grasp the opportunities that come with population aging.

“When policy lags,” said Hodin, “so does development of infrastructure and programs.”

To address that lag and turn this potential nightmare into an economic boom, Hodin suggests leaders, policy experts and those who work with older adults need to:

• Create opportunities for the marketplace to drive innovation and change.

• Find ways to improve health literacy.

• Create age-friendly cities and communities.

• Design financial instruments for retirement that provide and promote financial security for those benefiting from the longevity bonus.

• Align program development with government resources.

• Think about how the longevity bonus can and should alter the education-work-leisure life-course.

• Develop replicable and culturally appropriate — not one-size-fits-all — models for all the above.

That last item is key.

“Every nation has similar issues,” said Hodin, “but they have vastly different infrastructures for solving the challenges and taking advantages of the opportunities.”

Eileen Beal wrote this article for Reporting on Health with support from the MetLife Foundation Journalists in Aging Fellows program, a collaboration between the Gerontological Society of America and New America Media.