Time for the world to invest in healthy ageing

Today, for the first time in history, most people can expect to live into their 60s and beyond. Longer lives, combined with marked falls in fertility rates, has led to an increase in both the number and proportion of people aged 60 and older around the world. This increase is occurring at an unprecedented pace and it will accelerate in coming decades, particularly in developing countries.

A longer life is an incredibly valuable resource. It provides the opportunity to rethink not just what older age might be, but how our whole lives might unfold. Yet the extent of the opportunities that arise from increasing longevity will depend heavily on one key factor: health.

If people are experiencing these extra years of life in good health, their ability to do the things they value will be little different from that of a younger person. If these added years are dominated by declines in physical and mental capacity, the implications for older people and for society are much worse.

It is often assumed that increasing longevity is being accompanied by an extended period of good health. Yet, there is little evidence to suggest this is the case and there are great variations within and across countries. For example, in 2017, 65-year-old females in Slovakia could only expect to live 4.1 years in good health, whereas those in Norway could expect 15.9 years.

Despite the predictability of population ageing—its accelerating pace and the gaps in healthy longevity—the world is far from prepared. COVID-19 has shed a light on many gaps, not just in the things we do, but in how we think about ageing and older people.

The pandemic has revealed how prevalent ageism—stereotypes , prejudices and discrimination based on age—is in society. Ageism means we fail to look at the second half of life with the hope, interest, creativity and rigour that we tend to look at the first half. When age is used as the sole criterion for access to care or for physical isolation, as seen during the pandemic, it can result in unequal access to treatment and increased social isolation with adverse health impacts.

Our health systems are ill prepared to respond to the needs of older people. They invest in people in the first half of life, over those in the second half,despite a higher prevalence of disease and need for care. Development assistance for health by age reflects this trend (see figure). They tend to value hospitals over primary health care, prioritize treatment over prevention, management of single diseases over integrated approaches and cures over caring.

Long-term care systems, where they exist, have been shown to be under-resourced, neglected and not well integrated with other parts of health and social care systems. The high number of deaths in long-term care facilities due to COVID-19 (which ranged from 40-80% across different countries) is but one indicator – albeit damming – of the lack of preparedness.

But the impacts of population ageing on society extend beyond health and social care and include labour and financial markets and the demand for goods and services (such as education, housing, health, long-term care, social protection, transport, information and communication).

People are less likely to feel they are learning new things as they age, with a sharper decline after 45. This reflects limited investment in work-based training and adult education. Increases in the age of retirement – a common policy response to population ageing – may not have the desired impact if poor health is a barrier to people working at older ages.

For decades, we have known that populations around the world are ageing. And yet, we have not made the investments that enable all of us to experience healthy ageing. If we want older age to be a time of opportunity and hope, we need to change how we think about ageing and take actions at all levels—local, state and national—to foster healthy ageing.

The Decade of Healthy Ageing provides a much need opportunity to improve lives. Leaders from around the world are fully behind the Decade (see video below). The WEF has set up a Global Future Council on Healthy Ageing and Longevity to provide thought leadership and catalyze action aligned to the Decade. The Platform is being developed to support all stakeholders to find the knowledge they need and to share the knowledge they hold and produce with others.

We will all benefit from reduced ageism, improved health and long-term care and more age-friendly communities: the actions prioritized in the plan for the Decade of Healthy Ageing. Given resources are limited, investing in evidence (i.e. what works to foster healthy ageing) will enable governments, civil society and the private sector to make sound investments.

These are likely to be the things that make people more functional and enable them to do the things they value. Hearing aids, adequate time from doctors, opportunities to learn and grow, flexible work that allows caring responsibilities, exercise classes that help reduce chronic diseases and home adaptations that increase the chance of independence.

While COVID-19 has affected everyone, it has disproportionately affected older people. To quote Henry Wadsworth Longfellow: “for age is opportunity no less… than youth itself, though in another dress”. Governments have committed to a Decade of Healthy Ageing. If there is to be a silver lining to pandemic, it must be that this commitment spurs collective and concerted action over the next decade by governments, international and regional organizations, civil society, the private sector, academia and the media to ensure that older age is indeed an opportunity.