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The Challenges Posed By An Aging Global Population

SCOTT SIMON, HOST:

From time to time, NPR's Ina Jaffe joins us for a conversation we call 1 in 5 because one-fifth of the U.S. population will be 65 years or older in just 15 years. Ina joins us now from the studios of NPR West. Ina, thanks for being with us.

INA JAFFE, BYLINE: Hi, Scott.

SIMON: The U.S. population is aging, but it's not just the U.S., is it?

JAFFE: Oh, no, not at all. In fact, some other countries are ahead of us. Japan, for example, a quarter of the population there is already 65 years of age or more, and the populations of some Western European countries are already at that 1-in-5 level that the U.S. is headed for.

SIMON: Whatever else happens in this discussion, should we remind ourselves it's the result of some good news - that people are living longer?

JAFFE: Well, it is a result of people living longer, but only in part. In North America and Western Europe, people are living longer. But there's a bigger reason for the aging of populations and that's that people are having fewer children. That's what you see in Eastern Europe and Russia and Turkey. And sub-Saharan Africa is not aging as quickly as other places because reproduction rates are higher there.

SIMON: Now there's been a concern in the United States for years about what might happen as baby boomers retire and they're not replaced by new workers. What strain does having more people living longer and fewer people with an obligation to care for them put on a society?

JAFFE: Well, what you're talking about there, Scott, is what demographers call the dependency ratio. And that was a big topic of discussion last weekend at a two-day seminar I went to at the Aging Center at Columbia University in New York. There were journalists and experts there from all over the world. And the experts were saying that these days, just because someone is over 64, you can't automatically assume that they're dependent. So let's say that in order to accommodate an older population, a city timed their traffic lights so that would have more time to cross the street. Well, some of those older people slowly crossing the streets may be on their way to work. One of the experts at the Columbia event was Joel Cohen. He's a professor of populations at both Columbia and Rockefeller universities. He says these longer lifespans shouldn't be thought of as a burden, but as an opportunity.

JOEL COHEN: This means that there's a challenge to adjust our institutions, our employment practices, our pension plans, our family structures to take advantage of the fact that people will be living longer with longer functional lives - not just longer in misery, but longer with capacity.

SIMON: So the idea, Ina, is to see longevity as a resource, not just a challenge.

JAFFE: Well, that's right. But the issue is how uniformly that longevity dividend, as some people call it, will be shared across the globe. There's two things that researchers agree keep older people physically fit and mentally sharp and that's healthy lifestyles and education; both when they're young and as they grow older. So in the developing world, this is going to be a more distant goal. For instance, people here don't lose sleep over high cholesterol, high blood pressure anymore, not very often. You just take a pill. But in Mexico, for example, 70 percent of older people have high blood pressure, but just around 10 percent of them get treatment, even though the cost for that is about $40 a year. Blindness is another major disability of older people in poor countries simply because they don't have access to cataract operations, which are really common here.

SIMON: Is there a stronger tradition, at the same time, in some societies in the developing world for multi-generational families looking out for the older generations?

JAFFE: Well, there's certainly tradition of thinking that's the case. There was another expert at the Columbia event. Her name is Isabella Aboderin and she's a research gerontologist who works both in Nairobi, Kenya and at the University of Southampton in England. She says in sub-Saharan Africa, there's really a disconnect between this ideal of family care and the realities.

ISABELLA ABODERIN: Whilst families are still the mainstay of care for older people because there is no organized system of formal care with the exception of South Africa. We see that the level and the quality of family care is compromised because caregivers lack resources, they lack skills, and they lack the time.

JAFFE: Aboderin says that ideal of family care has actually been an obstacle to having a public dialogue about how there might be a balance between private institutions, public services and family-based care. And we know what a difficult conversation that can be, Scott, because we're still having it in this country.

SIMON: Yeah. NPR's Ina Jaffe covers aging for NPR. Thanks so much for being with us.

JAFFE: Oh, you're welcome, Scott. Transcript provided by NPR, Copyright NPR.