## THE LONG, GOOD LIFE

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**Canonical URL:** [THE LONG, GOOD LIFE](https://www.imf.org/-/media/files/publications/fandd/article/2020/march/the-future-of-aging-guide-for-policymakers-scott.pdf)

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### The new frontier of aging
- Over the past 150 years average global life expectancy rose from about 30 years in 1870 to 73 today (Deaton 2015).
- The proportion of life lived free of frailty or illness has remained broadly unchanged, so people spend most of these extra years in good health.
- Example: In 1960 the average Chinese newborn had a 27 percent chance of making it to age 65; today that probability is 83 percent and rising.
- Demographic scale:
  - In 1965 there were 129 million people over 65 in the world; today there are nearly 750 million; expected to reach 2.5 billion by 2100.
  - The number of centenarians rose from 20,000 in 1965 to a projected 19 million by 2100.
  - Share of population over 65: 5 percent in 1950; 9 percent today; expected to reach 23 percent by 2100.
- Conceptual distinction emphasized:
  - Chronological age (years since birth) versus biological age (how fit and healthy you are).
  - Laura Carstensen’s phrase: a “new map of life.”
  - Demography should account for longevity (extension of duration of life) and the malleability of aging via nutrition, education, behavior, public health, environment, and medical practice.
- Framing shift proposed: from “How do we afford an aging society?” to “How do we restructure behavior to make the most of longer lives?”

### Myths
- Myth #1: Aging is best measured chronologically
  - Reliance on chronological measures like the 65-year threshold and the “old-age dependency ratio” ignores age malleability; prospective measures yield a much smaller rise in the older population (Sanderson and Scherbov 2019).
- Myth #2: All countries are aging
  - Median age increases coexist with declines in average mortality (population deaths per thousand); when old age is conceived as proximity to death, some countries may be “younger” with larger futures despite higher median ages.
- Myth #3: Japan is a harbinger
  - Japan experienced the largest increase in life expectancy and deepest decline in fertility among G7 countries since 1950; the balance between aging-society effects and longevity benefits varies across countries.
- Myth #4: Aging is a rich-country problem
  - Many low-income countries are young now but will age in coming decades; policies should prepare 15-year-olds today so they age well by 2070. Aging does not begin at 65.

### Policies for longevity
- Overarching aim: address the whole life course to help people seize opportunities from longer lives; central policy areas are employment, education, and health.

- Supporting older workers
  - Workforce withdrawal typically starts at about age 50 and is often involuntary; policy must cover more than state pension age.
  - Employment evidence:
    - Between 2008 and 2018 people over 55 accounted for 79 percent of employment growth across Organisation for Economic Co-operation and Development countries and 103 percent in G7 countries.
    - Cross-country variation in employment of older workers is driven more by changes in their likelihood of working than by changes in the size of the older population.
  - Policy levers: pension generosity and availability, health and worker support, industrial structure, job types.
  - Technology: robotics and artificial intelligence should help support employment among older workers.
  - Work design: older workers value flexible and part-time arrangements despite lower wages; examples include Japan and Singapore.
  - Legal and cultural measures: tackle corporate ageism; extend disability rights; enact diversity legislation to support and protect older workers.

- Supporting longer productive lives
  - Lifelong learning is essential as the three-stage “learn, earn, retire” model will give way to multistage lives requiring retraining, family-care breaks, reorientation, recuperation, and repurposing.
  - Longer careers require greater flexibility for workers of all ages.

- Health and prevention
  - Disease burden shifts toward noncommunicable diseases (NCDs) with aging.
  - In 2016 NCDs accounted for 71 percent of deaths globally, with 78 percent occurring in low- and middle-income countries.
  - NCDs are expensively and poorly managed through intervention; a major shift toward preventive health care is recommended.
  - Public education is needed to change behavior on activity, diet, engagement, and purpose.
  - New monitoring and predictive technologies (artificial intelligence and big data) will be needed.
  - Because age itself is a dominant cause of many NCDs, efforts to slow the aging process should be emphasized over single-disease targeting (Ellison, Sinclair, and Scott 2020). Research into why we age and treatments to increase age malleability is growing (Sinclair 2019).

- Supporting diversity
  - Age malleability implies considerable heterogeneity in aging; chronological age is a weak predictor of needs and abilities.
  - Policies should provide support for those unable to continue working while incentivizing work for those who can; more nuanced, circumstance-dependent options are needed.

- Targeting longevity as a policy metric
  - Alternatives to GDP, such as healthy-life expectancy, could better measure welfare.
  - Improvements in healthy-life expectancy depend on income, job security, social purpose, environmental quality, and inequality—connecting longevity to a broad policy agenda.
  - Proposal: establish longevity councils (example: Japan’s Council for Designing 100-Year Life) to monitor progress and coordinate across government departments.

### Key takeaways
- Individuals are living longer and healthier lives; policy should maximize the number of people of all ages who benefit from the longevity effect while boosting productivity over a longer life.
- Policy priorities include:
  - Redefining age measures to account for biological age and prospective longevity.
  - Promoting lifelong learning and flexible multistage careers.
  - Raising labor force participation of older workers via pensions, workplace design, anti-ageism, and technological adoption.
  - Reorienting health systems toward prevention and research on aging itself.
  - Designing nuanced support systems that reflect heterogeneity in aging.
  - Considering healthy-life expectancy as a welfare metric and institutionalizing cross-government coordination via longevity councils.
- Quotation: Auguste Comte’s assertion that “demography is destiny” is undermined by changing patterns of how we age.

*Andrew Scott, “The Long, Good Life,” Finance & Development, March 2020.*

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_Source: https://www.imf.org/-/media/files/publications/fandd/article/2020/march/the-future-of-aging-guide-for-policymakers-scott.pdf_