Health

New index shows you where it's best to be old

First-ever UN index says many countries not ready for rising population of elderly

New index released by UN says population of those 60 and older will be 2 billion by 2050.
John Stilwell/AP

The world is aging faster than many people realize.

In 2000, the population of people 60 and over first surpassed the number of children under 5. In less than a decade from now, people 60 and older will surpass the 1 billion mark.

And by the year 2050, people 60 and older will make up one-fifth of the world's population, or about 2 billion people, according to the first Global AgeWatch Index, which measures the quality of life and well-being of older people around the world.

In fact, the aging population is growing so swiftly that the United Nations cautions many countries in the world are not prepared to handle the transformation.

 “The continual exclusion of aging from national and global agendas is one of the biggest obstacles to meeting the needs of the world’s aging population,’’ said Silvia Stefanoni, chief executive of HelpAge International, a non-profit that produced the study with the support of the U.N.’s Fund for Population and Development.  

The index results, which will be released to the public on Tuesday, the U.N.’s International Day of Older Persons, finds that many wealthy countries – including the United States – lag in caring for their seniors.

Developed nations are cutting pension benefits and “the result is that older people … are going to be really poor,” said economist Sir Richard Jolly, who advised on the Index. “It doesn’t bode well.”

The U.S., the wealthiest nation, ranks 8th overall – after Sweden, Norway, Germany, Netherlands, Canada, Switzerland and New Zealand. And it comes second after Norway on employment and education of its older population.

But it ranks much lower on specific measures, such as poverty and health care.

“In economics, (the U.S.) is always ahead of the game but, suddenly, in terms of human development, it wasn’t,” Jolly said.

The reality of growing old

This chart shows how those 60 and older rise in percentage of the overall world population from 2012 to 2030 to 2050.
UNDESA Population Div., World Population Prospects, the 2012 Revision, 2013

China, for example, surpasses the U.S., in income security for the elderly. Its neighbor to the north, Canada, is No. 2 in health status while the U.S. is 24th. The U.S. ranks lower than Slovenia on “enabling environment” – social connections, safety, civic freedom, and access to public transport.

“It reflects the reality of growing old in the United States,” said Bethany Brown, policy director of HelpAge USA, which champions the rights of seniors. “The poverty rate is incredible for people over the age of 65 in America.”

Some measures put it at 9%, she said, but a recent Kaiser Family Foundation report, which uses a different standard for poverty, has it as high as 15%. The report shows that one in five over the age of 65 lives in poverty in the District of Columbia and in states such as Nevada, Hawaii and Georgia.

Brown cites the nation’s struggle with high health care costs – full implementation of the Affordable Health Care Act is still pending – as a big contributor to economic uncertainty for the old.

“We, as Americans, need to imagine what it means to grow old,” Brown said. “We need to decide how, as a society, we want to treat people who grow old … What kind of roads we’re going to put in. What kind of public transportation.”

The Index found that the elderly fare best in Nordic, Western European, North American and some East Asian and Latin American countries. People are living longer because of advances in health care and people are having fewer children as more of the world's population moves to more congested urban environments and more women work.

Sweden is in the top 10 by all well-being measures. But older people in some low- and middle-income countries (Sri Lanka at 36th, Bolivia at 46th) fare considerably better than older people in wealthier countries. Improved conditions for the old is often tied to social policies. In Bolivia, elderly get free health care and pensions even if they haven’t worked.

The Middle East offers a study in contrasts: Israel ranks 21st and the West Bank and Gaza at 84, Jordan at 88.

It’s often been said that other cultures value the elderly more than Americans but Brown said that is no longer true. In urbanizing nations, working-age parents are leaving the countryside to work in cities and leaving their kids in the care of their grandparents. And in countries where adult children are living with parents because of economic hardship, older people often become victims of domestic violence, Brown said.

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