You’ve heard it a million times: in developed nations, populations are ageing.
But what does that mean? At the extremes, it could mean either of two quite different things. It could mean a host of frail elderly people stuck in nursing homes for 20 years, or it could mean a bunch of 80-year-olds who act like the 60-year-olds of years gone by – getting on, but essentially still vital and functioning.
The nursing-home alternative is, I suspect, the option that most people think about when they hear of “our ageing population”.
The good news is that the 80-is-the-new-60 alternative seems to be the way things are actually heading. As life expectancy rose in the US up to 2008, researchers saw a reduction in “end-of-life morbidity”. This is that lousy period at the end of many people’s lives where they find themselves unable to take care of themselves, do their normal daily tasks like cleaning up the kitchen, and generally stay independent.
This cheery phenomenon, called “compression of morbidity”, has only been established in the past few years, because data on healthy life expectancy has been hard to get. And it hasn’t really yet impacted the public discussion on population ageing.
But eventually it will.
At a public policy level, it gives support to the Rudd Government’s 2009 decision to raise the pension age to 67 by 2023, and probably also to the Coalition’s unimplemented plan to raise it to 70 by 2035 (Australian pension age summary here). It will also start impacting estimates of things like the amount of nursing home care and other support that our elderly will need over the next 50 years.
Meanwhile, at a personal level … well, if you currently plan to be old someday, this should make you very happy indeed.
In the US, two-thirds of the compression of morbidity has been driven by two big changes. Firstly, more people have been surviving heart disease in good shape. This matters, because cardiovascular conditions are one factor in whether you are able to stay healthy and independent in old age. (Two other factors are arthritis and dementia.) Second – and this was new to me – treatment of vision problems is getting better.
I lay this out in more detail in my latest column for The CEO Magazine. But if you want details of how this is playing out in the US, try Understanding the Improvement in Disability Free Life Expectancy In the U.S. Elderly Population. Its main point:
[H]ealthy life increased measurably in the US between 1992 and 2008. Years of healthy life expectancy at age 65 increased by 1.8 years over that time period, while disabled life expectancy fell by 0.5 years.