12
NEW POPULATION PYRAMIDS:
THE CHALLENGING RECONFIGURATIONS OF
1961 TO 2061,
A CENTURY OF TRANSITIONS
- Alexandre Kalache is the co-president of the International Longevity Center (ILC) Global Alliance and the president of ILC-Brazil. He has an undergraduate degree in medicine from the Federal University of Rio de Janeiro (UFRJ) and an MA and PhD in public health from the University of Oxford, where he has also lectured. Between 1995 and 2008, he led the World Health Organization’s Department of Aging and Life Course and he founded the Aging Epidemiology Unit at the London School of Hygiene and Tropical Medicine, where he lectured from 1984 to 1995. His publications include “Epidemiology in Old Age” (British Medical Journal Books, 1996) and “Active Ageing: A Policy Framework” (World Health Organization, 2003).
The world is currently experiencing extraordinary demographic contrasts that will intensify over the next 50 years. Some countries will age at an unprecedented speed, while others will see their populations rise steeply. These dissonant realities will have impacts on all aspects of society.
In 1960, Norway was the country with the highest life expectancy at birth (73.49 years), followed by other Scandinavian and Northern European countries, Australia and Canada. [1] No other nations reached the symbolic milestone of a life expectancy of 70 years, which has now been attained by more 121 countries, most of which are considered to be developing.
At the moment, more than 25 countries have a life expectancy of more than 80 years, led by Japan (83 years). [2] According to projections, however, we can state that by 2060, some countries will have exceeded the 90-year mark, such as South Korea and Hong Kong. Other countries – including Japan, Switzerland, Singapore, Australia and Spain – will have children who, born 50 years from now, will be expected to live for more than 88 years on average.
With regard to life expectancy at the age of 60 years, in other words the average time people live after this age, it has also increased significantly in the last five decades. In 1961, a 60-year-old person did not live more than another 20 years in any country; today, they are expected to live for at least another 23.8 years in the 10 countries with the highest estimated figures, rising to 25.51 years in Japan. [3] Additional gains are certainly foreseeable, but given the progress of health technology (through the early diagnosis of non-communicable diseases) and ever more effective treatment methods (such as surgical interventions and new drugs), the projections for 50 years from now become particularly risky.
In 1960, there were no surprises among the ten most aged countries: all were located in Central and Northern Europe, with Norway in first place once more. By 2010, however, Japan had become by far the most elderly country in the world, with more than 30% of its population made up of people aged over 60, and relatively poor European countries such as Bulgaria, Greece, Latvia, Croatia and Portugal had also joined the top 10.[4]
One interesting comparative fact is that Japan was the first country in which the proportion of elderly people surpassed under-15s – a reality since 1960. Among other countries with large populations, Germany and Russia repeated this experience in 1980 and 2000, respectively. The United States is expected to reach this same proportion in 2015, followed by China (2025) and Brazil (2030) – while India will do so in 2055, the same year in which this experience is projected to become global.5[5]
In contrast to the aging of the vast majority of the countries in which population growth over the next 50 years will be small or negligible, if not negative, the countries of the Middle East and Africa will continue to experience a rise in their populations – more than six-fold in some cases.
However, a country’s aging does not only depend on the number of people who reach “old age” (60 years, according to the United Nations’ definition). Its speed depends even more on the decline in total fertility rate (TFR), meaning the average number of children a woman expects to have at the end of her reproductive life. Fifty years ago, only five countries (Estonia, Latvia, Japan, Hungary and Ukraine) had reached a TFR of below the replacement level, 2.1 children per woman, meaning in practice that couples will not maintain their numbers. Around 1980, just 20 countries had this condition. At the moment, there are more than 80, and in 2060 it is estimated that the total will be 153 countries.
If today a growing number of countries (such as Japan, Germany, Italy, Spain, Russia and others in Eastern Europe) are concerned about their shrinking populations, in the 1960s the predominant discussion among demographers and society centered on the so-called “demographic explosion.” This reversal of perspective has changed the ranking of the world’s 10 largest countries in terms of population. Thus, Pakistan and Nigeria have replaced Germany and the United Kingdom on this list, and by 2060 Russia and Japan are expected to leave it, to give way to Ethiopia and the Philippines. Within the ranking, India is projected to overtake China as the largest country (and then to exceed its population by more than 300 million inhabitants), while Nigeria’s population is set to more than triple, to 537 million. We should also mention the case of Ethiopia, which may come to have nearly as many inhabitants as Brazil, despite being much smaller in area. [6]
In contrast to the aging of the vast majority of the countries in which population growth over the next 50 years will be small or negligible, if not negative, the countries of the Middle East and Africa will continue to experience a rise in their populations – more than six-fold in some cases. Comparing the demographics of the 10 sub-Saharan African countries with the highest populations in the 2010s with the projection for 2060, there is no doubt that this region’s population rose nearly four-fold between 1960 and 2010, from just over 220 million to around 831 million. [7] In turn, the United Nations’ estimates for this region in 2060 point to slightly slower growth, around three-fold, resulting in a total population of almost 2.5 billion. If this prediction is confirmed, the social, political and economic implications will be enormous, because precisely the poorest region of the world will be subjected to demographic pressures of immense magnitude.
However, a lot may happen in five decades, and just as people in 1960 did not predict such an accelerated decline in total fertility rates in so many countries, one may also speculate that the projections for Africa and the Middle East will not come true, as occurred with Brazil in recent decades and as some countries in these regions, such as Egypt, Tunisia, South Africa, Ghana and Botswana, have already indicated.
Not long ago, the aging process involved a very different story to the current one: developed countries first became wealthy, and then, over a longer period than we see today, they grew old. Countries such as Brazil, however, are aging very quickly and in a context of relative poverty.
Not long ago, the aging process involved a very different story to the current one: developed countries first became wealthy, and then, over a longer period than we see today, they grew old. Countries such as Brazil, however, are aging very quickly and in a context of relative poverty. A comparison with Canada shows this clearly. At the moment, 24% of Canadians are aged over 60, around two times higher than the rate in Brazil, but by 2060 this proportion will be higher in Brazil than in Canada.
In 1960, Brazil’s total population was less than 73 million. Fifty years on, it had grown 2.5-fold to more than 195 million. The estimated population in 2060 is 228 million people – in other words, a rise of less than 20%. This reflects a sharp fall in total fertility rates. In 50 years, Brazil went from a demographic explosion to a situation of low population growth, and is set to start a process of population decline over the next 30 years. [8] At the same time, the proportion of elderly people rose from 5.4% in 1960 to 10.2% in 2010 – and should exceed the current levels of Japan (the most elderly country) before 2060, when an estimated 32.9% of Brazilians will be aged over 60. There will be an even more pronounced increase in the proportion of people aged over 80: from just 0.4% in 1960 and around 1.5% in 2010, the current projection is 9% in 2060. Accordingly, the proportion of Brazilians under the age of 15 will have fallen from 43.3% in 1960 to 14.5% in 2060.
An interesting point in Brazil’s declining birthrate is the possibility that a new social model will be generated, valuing elderly people as qualified workers and promoting a revitalization of society. Growing old means becoming revitalized – provided that society permits this.
It is worth highlighting the concept of “functional capacity” or “functional age” as opposed to chronological age.9 Reaching the age of 85 with vitality and productivity will be ever more common. According to the World Health Organization, active aging is the process of optimizing opportunities for health, continued education, participation and security so as to improve the quality of life as we grow older. “Elderly-friendly” cities should avoid the rapid decline in the number of individuals below the threshold of functional incapacity, by keeping people physically, intellectually and economically active for as long as possible. Intergenerational solidarity ought to generate a goal of productive longevity from childhood in order to obtain the best results in the third age (including protection for those who, for health reasons, fall below the functional capacity level). Having health and knowledge is a guarantee of full participation in community life.
Technology Technology also has a decisive role in helping everyone with active aging and compensation for those who need support (whether concerning the use of devices that increase the level of capacity or genome manipulation, which could drastically reduce the number of people suffering from diseases such as Alzheimer’s and Parkinson’s). Thus, it is important to introduce the concept of Health Adjusted Life Expectancy (HALE), an indicator suggested by the World Health Organization. Unlike conventional life expectancy, which considers all years as the same, in calculating HALE, years of life are weighted in line with each individual’s state of health and quality of life. After all, one must take into account that elderly people, as they have accumulated an enormous variety of experiences during their life, are more heterogeneous than, for example, a group of teenagers.
In semi-desert regions, how can drinking water be provided to so many people? What contributions will technology provide – for example, by developing less expensive techniques for desalinating seawater?
Thus, numerous questions are posed for the coming years. What are the environmental implications of a sub-Saharan Africa with a vastly denser population? In semi-desert regions, how can drinking water be provided to so many people? What contributions will technology provide – for example, by developing less expensive techniques for desalinating seawater? This example suffices to illustrate the necessary interconnections between scientific and technological studies on the one hand and studies of population and the environment on the other. However, the list is much longer and we may ask ourselves what pressures there will be in regions that are already experiencing population decline in neighboring countries.
From a population point of view, how much of a rise will there be in the global number of immigrants, who in 2010 amounted to 250 million? If Japan, for example, were to adopt policies to proportionally stimulate the entry of as many immigrants per capita as Australia or Canada receive, what would its age pyramid look like in 2060? Will the economies of very aged countries continue to grow? What policies are needed for this to be put into practice? On the other hand, women are participating actively in the paid job market in a growing number of countries and their economies will come to depend more on this contribution. Will sustainability between countries become more interdependent? How can we develop and stimulate a culture of intergenerational social contracts and more cohesive societies?
One of the great contributions of the 20th century was to add more than 30 years to people’s life expectancy in the majority of countries. The 21st century’s contribution will be to bring a better quality of life to people of all ages. After all, we need to recognize that each country’s population pyramid is not rigid and that demographics are not an inevitable destiny, but rather a current reality based on which we can create solutions aimed at good planning of the future.
- [1] United Nations, Department of Economic and Social Affairs, Population Division, “World Population Prospects: The 2012 Revision”, DVD Edition, 2013.
[2] Idem.
[3] Idem.
[4] Idem.
[5] Idem.
[6] Idem.
[7] Idem.
[8] The TFR went from 6.2 in 1960 to 1. 9 in 2005. The latest estimate, made in 2013, indicated 1.77, and current projections are that it will remain at this level until 2060.
[9] Alexandre Kalache and Ilona Kickbusch, “A Global Strategy for Healthy Ageing”, World Health, vol. 5, 1997, no. 4, p. 4-5.