Senior African American swimmer, active at old age

Weekend Reads | On Healthy Aging

by Kevin Schofield

This weekend’s read is a white paper from the McKinsey Health Institute on “healthy aging.” 

Improvements in nutrition and health care around the world have led to dramatic increases in the average life span over the past several decades. Combined with lower birthrates in most developing nations, the overall demographics of our world are shifting toward an older population. By 2050, experts predict there will be 1.6 billion people older than 65. That’s about 16.5% of the total world population, a big increase from 9.4% today, and it has several important repercussions. 

A big one is the change to the workforce. Back in 1950, there were 11.7 working-age people on the planet for every person age 65 or older. Today, it’s dropped to 7.7, and by 2040, it will be 4.4. That suggests there may not be enough workers to keep the global economy running, especially with the increase in services for elderly populations that will be needed. It will also probably change the ideal mix of housing as an older, less mobile population will likely want to live close to amenities and services. They may also need to live near their employers, if the workforce trends force societies to ask their older citizens to put off retirement.

Graph showing the evolution of old-age dependency ratios
Graph showing the evolution of old-age dependency ratios. “Some ‘super aged’ societies will see old-age dependency ratios increase substantially through 2040.” Courtesy of McKinsey Health Institute.

The United States will feel this play out in its cities and towns, but there are some “super-aged” nations where it is already their reality. Japan, for example, had 12 working-age persons for every individual over 65; today, that is down to 2, and by 2040, it is expected to be around 1.5.

As elders become a larger portion of the overall population, the health of that population will be an increasingly important issue, and keeping elders healthy and active — and potentially still employed — will be both a social and economic imperative.

The McKinsey team has developed a “healthy aging framework” that takes into consideration individuals’ physical, mental, spiritual, and social needs as they age. They identified six key factors that impact how well those needs are met:

  • Physical and cognitive fitness;
  • Financial empowerment;
  • Social and spiritual engagement;
  • Basic needs, such as housing, food, transportation, and physical safety;
  • Living and care, including access to care, support, and health care; and
  • Inclusion: social, cultural, and digital.

There are, of course, some overlaps among these factors; for example, we know physical activity improves mental health.

Diagram illustrating McKinsey Health Institute’s healthy aging framework
Diagram illustrating McKinsey Health Institute’s healthy aging framework. Courtesy of McKinsey Health Institute.

McKinsey also identifies six shifts it believes need to happen to prepare for the “healthy aging” of a tidal wave of elders in the coming years. The shifts include the promotion of therapies and treatments that can prevent or at least delay the onset of health issues that are increasingly common as people age, such as dementia, sensory impairments, and depression. The list also includes finding ways to scale up interventions that promote healthy aging to match the growth of the elder population: exercise programs; technology and programs to sustain and extend independence; and humanistic approaches to care for those who need assistance with everyday tasks. The smaller working-age population will undoubtedly be a challenge to delivering on some of these at the required scale, and we may find ourselves more reliant on technological solutions than we would ideally like.

McKinsey also suggests there are important roles for both the public sector and private corporations to enable healthy aging. Industry, it argues, can look at adding elder care to employee benefit and retirement packages, create new “second career” pathways, and work to eliminate age discrimination in the workplace. Governments, for their part, can make services for elders more accessible and rethink delivery around “stage” rather than “age.”

The McKinsey report is an interesting look at how our society will need to adapt to an impending — and, at this point, inevitable — demographic shift that will shake up societies around the world. Fortunately for us, it’s a change that will happen gradually over years, so we still have time to prepare for it.

Living longer in better health: Six shifts needed for healthy aging

Kevin Schofield is a freelance writer and publishes Seattle Paper Trail. Previously he worked for Microsoft, published Seattle City Council Insight, co-hosted the “Seattle News, Views and Brews” podcast, and raised two daughters as a single dad. He serves on the Board of Directors of Woodland Park Zoo, where he also volunteers.

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