By Ben F. Belton
Editor’s Note: AARP Thought Leadership and International drives the creation of a marketplace for new ideas by advancing emerging issues, challenges the status quo and inspires new solutions that empower people around the world to make the most of a longer and healthier life.
The United Nations estimates that by 2050 the world will be home to 1.5 billion people ages 65 and older. From Naples, Italy, to Naples, Florida, and from Athens, Greece, to Athens, Ohio, our global society is changing. Human longevity is transforming markets and spurring innovation.
Here in the United States, people ages 50 and older already contribute $8.3 trillion in economic activity, which will more than triple to $28.2 trillion by 2050, according to AARP’s recent report, “The Longevity Economy Outlook: How People Ages 50 and Older Are Fueling Economic Growth, Stimulating Jobs, and Creating Opportunities for All."
Greater longevity is one of the most significant achievements of modern times. However, this progress must not stop with simply extending years of life. The question becomes one of how we can add well-being and value to those years. Ultimately, every sector has a stake in ensuring aging populations can reach their full potential. To harness longevity’s transformative power, investments in human capital must not have an age limit.
As part of achieving those outcomes, for people to age with dignity and independence, countries must improve the “health span” and “wealth span” of their populations. Too often and in too many parts of the world, a longer life span comes with worsening health, vulnerability to financial shocks and the risk of long-term economic instability. Older women are especially at risk, as they tend to have lower lifetime wages (resulting in less savings for retirement) and smaller pensions. They also are more likely to become impoverished. In developing countries where women tend to work in the informal sector with little social protection, these challenges are further exacerbated.
Thus, along with great opportunity, longevity brings great challenges. But solutions are available.
Global Examples of Innovation
In 2017, AARP commissioned the Aging Readiness and Competitiveness Initiative as a platform to highlight innovations from around the world that help people enjoy longer, healthier and more financially secure lives. The ARC measures how select countries—large and small—are addressing the challenges and opportunities of population aging. The 22 countries featured in the report were identified as regional leaders in aging policy innovation.
Many of these countries’ most interesting programs were created around a set of common themes. The programs were person-oriented—developed by directly engaging users. With national governments providing strategic direction and funding, programs developed from the bottom up through NGOs and frontline stakeholders. Programs also were holistic and interdisciplinary, taking an integrative approach to developing solutions; and the interventions were evidence-based, with clear metrics for success and data collection mechanisms.
Ideas highlighted in the ARC can benefit countries around the world—and the United States can learn much from other regionally and economically diverse countries. Two areas in which many ARC countries, such as Germany, Singapore and the Netherlands, have made significant progress are healthcare and community social infrastructure. Community social infrastructure can be described as the social foundation that supports independence and aging in place.
Progress in Healthcare: Many countries’ health systems are working to address fragmentation, inefficiency, accessibility, affordability and health outcomes. As countries move to expand health coverage, the World Health Organization (WHO) calls for innovative age-friendly reforms such as “investments in integrated health and social care for older people."
Greater Manchester, England, is an innovator in this area. The Greater Manchester Health and Social Care Partnership merged budgets for health and social care to “improve the health, wealth and wellbeing” of its 2.8 million residents.
From the beginning, the Partnership made tackling dementia a priority, and supports care homes to improve residents’ quality of life. Meanwhile, as the ARC highlights, under Australia’s Health Care Home model, general practitioners (GP) coordinate care for patients with complex needs, facilitating access to personalized integrated care. For example, GPs work with patients to develop personal care plans incorporating medications and daily strategies to manage chronic conditions and to identify local care providers.
In Africa, the small island nation of Mauritius has facilitated accessibility. The Ministry of Health designed a system of health facilities so that there is at least one such facility within 3 kilometers of all homes on the main island. Older residents on the main island are usually never more than 2 miles from medical care.
In Costa Rica, the delivery of primary care—especially to remote or poor populations—is understood to be a key factor in reducing mortality rates in the country. A network of primary care clinics is the first level of care, which provides primary and preventive care for all residents in a community, including integrated care for older adults.
Progress in Community Social Infrastructure: After healthcare, many ARC countries made the most progress in supporting independence and aging in place. Key elements of community social infrastructure are accessibility, social engagement and the existence of community-based services and supports. Municipalities and sub-national levels of government have used WHO’s Age-Friendly Cities and Communities framework to foster holistic and age-friendly communities.
In Norway, the Lindås municipality created the Interdepartmental Housing Team, in which a physical therapist, a construction expert and an economist work with older residents to develop personal plans to help them age in place.
Team members make a free home visit to perform needs assessments and then work with the resident to develop plans to improve accessibility and provide information on financial supports.
In Turkey, Muratpasa, a district in the city of Antalya, established social centers that are located in neighborhoods of different income levels. These centers are where older people enjoy activities such as painting, dancing and reading.
The municipality also runs a daycare center that provides social rehabilitation services for people with Alzheimer’s disease, as well as supports for their family caregivers.
Finally, in Taiwan, Age-Friendly Community Banks—first launched in Hsinchu—typically have barrier-free facilities, areas where older customers can socialize and also have access to wheelchairs and magnifying glasses. This model has been so successful that it was replicated for the postal network.
A Transformational Trend
This massive global demographic shift requires a change in how we leverage the opportunities and address the realities that accompany increases in longevity. Outmoded ideas associating longevity with decline and non-contribution must give way to a new vision focused on opportunity and possibility. AARP will continue to elevate aging in the public discourse, advance new research and engage global stakeholders to share promising innovations from around the world. As AARP founder Dr. Ethel Percy Andrus said, “It is vital that we pay attention to other important political systems—particularly those with a worldwide impact.”
Ben F. Belton is director, Global Partner Engagement, at AARP International, in Washington, D.C.