## Aging Is the Real Population Bomb

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### Demographic trends and projections
- Total world population passed the 8 billion milestone on November 15, 2022.
- Progression from 7 to 8 billion people took 12 years.
- World population growth has slowed and is projected to continue slowing.
- India’s average annual rate of population growth is projected at 0.7 percent during 2020–40; global average is 0.8 percent during the same period; India’s 0.7 percent is “just half its 2000–20 rate.”
- UN projections signal an increase in countries experiencing annual population decline from 41 in 2022 to 88 in 2050 (with China included throughout).
- Global life expectancy: soared from 34 years in 1913 to 72 years in 2022 and is expected to continue on that long-term trajectory.
- Fertility: between 1970 and 2020, fertility dropped in every country in the world.
- Between 2000 and 2050 the global share of people 80 and older is expected to quadruple to almost 5 percent.
- When the UN and WHO were established, there were seven times more children under age 15 than people 65 and older; by 2050 these groups will be about the same size.
- The pandemic had a modest overall effect on population size and growth despite an estimated 15 million direct and indirect COVID-19–related deaths and an almost two-year decline in life expectancy.

### Impacts and challenges of population aging
- Demographic shifts imply:
  - A dwindling workforce straining to support burgeoning numbers of retirees.
  - An explosion of age-related morbidity and associated health care costs.
  - Declining quality of life among older people for lack of human, financial, and institutional resources.
  - The heretofore unlikely prospect of widespread depopulation in some countries.
- Population growth remains disproportionately high among low-income countries and in Africa, and disproportionately low among middle- and high-income countries and in Europe.
- Indicators of population aging are muted in high-fertility countries, yet such countries face the dual task of navigating high fertility and population aging.

### Goals for demographic preparedness
- Attainable goals include:
  - Improving reproductive health and reducing the unmet need for family planning.
  - Equipping people with human and physical capital needed to be productive members of society.
  - Ensuring well-functioning labor and capital markets for realization of productive potential.
  - Establishing institutions and policies that limit environmental burdens.
  - Promoting healthy aging, disease prevention, and early detection.

### Behavioral and public-health recommendations
- Physical activity guidelines and gaps:
  - WHO calls for 150–300 minutes of moderate aerobic physical activity a week for adults ages 18–64.
  - WHO recommends that adults 65 and older augment physical activity with balance and strength training three days a week.
  - WHO’s recommendation for adolescent physical activity is 60 minutes a day.
  - One in four adults worldwide fails to meet the adult physical activity standards.
  - More than 80 percent of adolescents fail to meet the 60 minutes a day recommendation.
- Proposed initiatives:
  - Policies to support travel on foot or by bicycle.
  - Alliances of schools, communities, workplaces, health systems, and governments to provide incentives and safe spaces for greater physical activity.
  - Encouraging healthier diets (low in sugar, sodium, saturated fat, and calories).
  - Reducing tobacco use and unsafe alcohol consumption.

### Investments, institutional reforms, and labor-market policy
- Infrastructure and urban planning:
  - Create healthy, age-friendly spaces with well-ventilated buildings that rely on clean fuels to mitigate indoor air pollution.
  - Prioritize electrified mass transit and ease of access for mobility-constrained older people.
- Human capital and labor-force measures:
  - Reinforce training and skills programs to increase productivity and encourage participation of underrepresented groups, including mothers and older people.
  - Invest in primary and secondary education to shore up teaching of critical skills and cultivate innovators from a broad swath of society.
- Institutional and policy reforms:
  - Promote access to quality family planning supplies and services.
  - Allow more choice about the age of retirement.
  - Incentivize individual saving for retirement.
  - Promote economic sectors with opportunities for older workers.
  - Develop and strengthen long-term-care systems.
  - Relax restrictions on immigration to correct mismatches between jobs and working-age populations.

### Migration, remittances, and international considerations
- Over 96 percent of the world’s people still live in the countries of their birth, implying considerable scope for international migration to relieve demographic pressures.
- Increased migration could raise remittances and support economic development in origin countries, especially if the cost of international transfers declines.
- A World Bank estimate: lowering remittance fees by 2 percent would result in an annual savings of $12 billion for migrants from lower-middle-income countries.
- Liberalizing migration policies could magnify “brain drains” as skilled workers seek higher wages elsewhere.

### Technology and innovation
- Promising technological contributions to healthy aging:
  - Health technology: development of safe and effective vaccines and wearable health monitoring sensors.
  - Assistive devices: robots.
  - Information technology: interoperable electronic medical records and better population-level data to understand aging and design policies.
- Incentivizing further development and expansion of these technologies is a promising path for future gains.

### Lessons from the pandemic applicable to aging
- Need for enhanced preparedness given predictable demographic trends.
- Identify gaps in care for societies’ most vulnerable.
- Use technology to connect the homebound.
- Reevaluate work/home life balance for potential long-term health benefits.
- Renew focus on the importance of mental health.
- These pandemic lessons suggest pathways for rewiring the global approach to healthy aging.

*Source: David E. Bloom and Leo M. Zucker, “Aging Is the Real Population Bomb,” Finance & Development, June 2023.*

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_Source: https://www.imf.org/-/media/files/publications/fandd/article/2023/june/bloom-june23.pdf_