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There are a number of things to consider when exploring Ageing and Longevity issues.
We must first recognize that the unprecedented age diversity in society today is a net positive. The speed, strength, and zest for discovery common in younger people, combined with the emotional intelligence, prosocial tendencies, and wisdom prevalent among older people, create new possibilities for families, communities and workplaces that haven’t existed before.
Rather than dwelling so anxiously on the costs incurred by an “aging” society, we can instead measure and reap the remarkable dividends of our increasingly age-diverse world.
Financial Security and Ageing
Governments must ensure that social security programs are solvent, sustainable, and dependable. The advent of longer lives has added additional “longevity risk” to retirement planning, now that healthy people retiring at 65 can expect to live at least another 20 years, and many live to 100.
As income disparity and uncertainty increase in many places, more people face difficulties in terms of retirement.
According to studies published by the Organization for Economic Co-operation and Development and other sources, a significant portion of adults are concerned about their financial situation and worry about financial problems.
Financial security is strongly connected to levels of health, happiness, and longevity. But as much of the world experiences unnerving increases in income disparity and uncertainty, many people face serious financial issues particularly as they near retirement - if they are indeed able to retire at all.Every related institutional pillar is being challenged by ageing demographics and changing practices, while risks and burdens are divided differently depending on the country; in those with relatively generous defined-benefit programs and early retirement ages, it is the government that bears most of the risk, while in places like the US it is individuals.
The institutional pillars that support financial security include social protection systems, social security programs, pensions (both defined benefit and defined contribution), and personal savings. In most of the developed world, there is a mismatch between people’s expectations for the age at which they want to retire, and the amount of money needed to fund that retirement. Amid these growing concerns, and increasing individual responsibility for preparing for retirement, financial literacy has become an even more important skill set.
Financial literacy education should start early, and should be offered throughout active work years - including instruction on health and wellness, managing medical issues and costs, and developing realistic expectations regarding the role people must play in financing their increasingly long lives.
Pension and savings programs need to be as simple and understandable as possible; information should be easily accessible and transparent. Programs and policies should meanwhile encourage the use of “nudges” and “defaults” - proven methods of increasing savings behavior - and should be portable in the sense that they can easily follow people as they transfer to new employment.
Healthcare and Long Lives
Focusing on healthspan offers a fuller picture of national health, and it could well be a better metric than lifespan for determining the relative merit of potential national healthcare investments. In addition, the measurement of healthspan can help healthcare providers opt for the right intervention at the right moment, imbuing healthcare services with maximum benefit at different points during a patient’s lifetime.
Healthspan measurement may also provide important new insights into healthcare disparities because socioeconomic factors have long played critical roles in health-related outcomes. Currently, multiple measures exist for assessing health span; each has its own limitations, however, and further research into their respective effectiveness is needed.
The pandemic-related growth of telemedicine could expand access to health span-improving services, particularly for the elderly.
One related trend accelerated by the COVID-19 pandemic has been an increase in telemedicine infrastructure and use. This involves providing healthcare remotely, whether, through video visits, telephone calls, websites, or even smart devices equipped to measure biometrics. The ultimate impact of this transition to more remote delivery of healthcare remains to be seen, though prior research indicates that telemedicine can be beneficial, cost-effective, and the source of high levels of patient satisfaction.
While the nature and quality of healthcare systems varies widely around the world, access to high-quality, affordable healthcare is a universal must for ensuring longer and healthier lives. While average life span has long been considered a viable measure of the health of a nation, more recently attention has turned to the measurement and promotion of health “span” - or, the duration of one’s time on Earth that can be considered active and healthy. While average lifespans have increased in part due to improvements in the treatment of acute diseases, this has meanwhile led to an increase in chronic diseases where age and lifestyle choices are risk factors that play out over decades.
While it will not completely replace in-person doctor visits, advances in telemedicine coupled with a buildout of global access to high-speed internet connectivity hold the promise of delivering high quality service in ways that reduce healthcare inequality. This could be especially valuable for older people, who often find that mobility and transportation issues negatively impact their ability to access healthcare.
Technology & Longevity
New digital and physical tools can help expand healthcare access and mitigate loneliness
Outside of the digital realm, more physical devices are needed to aid caregivers and greying workforces. Devices that promote personal mobility increase independence, even in the face of chronic disease; these range from personal robotic and assistive devices to major technological trends such as self-driving cars. In all cases, innovators and governments need to keep scalability and affordability in focus, so that benefits accrue to all segments of all populations.
Technology and innovation have created some of the most promising opportunities for both improving the quality of life throughout a life span and reducing inequality - via increasingly pervasive, low-cost solutions.
Innovation should be encouraged at all levels - global corporations play an obvious role, though solutions developed at the local level are also necessary in a world where one size does not fit all. There is a reason for optimism on this front: the 2021 Stanford Center on Longevity Design Challenge showcased a virtual global army of young designers recognizing the need to design for longer life spans, with more than 200 university teams from 37 countries answering the call for related ideas.
The prevalence of mobile phones, now owned by well over half the global population, illustrates the ways technology has seemingly reached every part of the world. To realize the full potential of this, governments must ensure access to reliable power sources and ubiquitous broadband connectivity (the foundation on which the digital revolution has been built). They must also address the need for education and training for all ages so that older and poorer people do not get left behind.
Under the right conditions, technologies under development can improve matters on the health front - particularly through remote care that can reach virtually anyone. New, wearable, and low-cost health monitoring devices can remotely provide doctors with constant measurements that may be more informative than an office visit. While there is no way to fully replace personal interaction, social technologies and virtual reality can mitigate at least some of the loneliness increasingly impacting many societies. Voice-based interfaces can be particularly useful for crossing the digital divide and making technology more user-friendly and intuitive. A caveat that comes with all digital solutions, however, is that they need to be developed and deployed in ways that preserve privacy and dignity.
Governments need to encourage and support greater work opportunities for older people. And also create policies and practices that encourage and support greater work opportunities for older people and enable them to work longer if desired. They can start by addressing the barriers to keeping older people in the workforce, such as age discrimination and the cost of healthcare and retirement plans. In general, people will likely have to be more realistic about their personal role in ensuring they are well prepared for retirement. As many societies age, the ability and willingness to put the systems and structures in place to help navigate the shifting dynamics of work will be a major factor in enabling well-being.
Many countries, faced with ageing demographics, are looking to raise retirement ages and expand working lives. Some people are working longer because they find themselves ill-prepared for retirement, while others continue because they find purpose in their jobs. Still others leave the workforce early, due to disability or unanticipated job losses. All of these seismic shifts have blurred the lines between education, work, retirement, and personal life.
In the past 50 years, the average working life in developed countries has changed drastically. Once-predictable career patterns have shifted dramatically, re-drawing the traditional route of education, work, child-rearing, and retiring. While most people still complete their education in their late teens or early twenties before entering the workforce, many now find periods of retraining and reskilling necessary.
Women have entered the workforce in larger numbers, shifting societal norms as they become essential income providers, and people who once could have planned on a 30-to-40-year career with one company now frequently work for multiple employers. The gig and informal work economies have grown rapidly, potentially becoming the preferred (or necessary) mode for larger portions of workforces.
As a result, governments, employers, and workers themselves have struggled to find a reassuring way forward. More and more career paths will likely require increasingly frequent periods of adult education and reskilling, and while family-friendly work environments are not a new idea, the concept needs to become standard practice. However, the gig and informal work economy raises questions about how best to provide people with access to benefits including training - which have been traditionally provided by full-time employers.
Longevity and Education
Lifestyle, fitness and Longevity
Governments anticipating longer life spans should invest in continuing education opportunities for adults.
Around the world, the people who are able to complete more years of schooling tend to live healthier and longer lives, regardless of their country’s level of development. Since schooling around the world tends to be largely financed with public resources, governments anticipating greater longevity should be cognizant of the importance of continuing education in helping people live longer, healthier lives.
The OECD survey of adult skills found that countries where people have relatively more years of schooling also have higher general rates of numeracy and literacy, and more prevalent problem-solving skills among adults (and correspondingly higher wages). Fortunately, life-long learning is now more accessible than ever.
Online and hybrid models abound, with millions of students having been enrolled in online classes even before the advent of COVID-19. These help re-skill workers as job markets change; research indicates that training for older learners enhances their self-efficacy, strengthens cognitive and emotional capacities, and has immediate relevance.
Education can promote healthy lifestyles; highly-educated people tend to use their knowledge and skills to access information that helps them avoid health-related risks and adopt behavior such as quitting smoking, reducing alcohol intake, and getting physical exercise. In addition, education can provide socio-psychological resources that aid health and extend longevity. Investing in education systems improves health at the population level and education rates generally, and literacy rates have been increasing worldwide.
Schooling develops basic cognitive functions like reading, writing, and communicating, and can help people think logically, critically analyse data, solve problems, and put planning into practice. Higher education is often the key to stable and well-paid jobs, which in turn help pay for nutritious food, better-quality housing, and high-quality medical care.
One reason for this is the better nutrition and disease prevention that prolong lives, while also lowering student absences and raising enrolment rates and completion levels - though rates of schooling vary tremendously by region. For example, people in North America, Japan, South Korea, Israel, Australia, New Zealand and most of western Europe and Scandinavia generally complete about 13 years of schooling. Meanwhile people in most of Central and parts of South America complete about seven years of schooling, and people in sub-Saharan African complete about four years. These early education gaps translate to troubling gaps during adulthood.
Research shows that health campaigns successfully motivate people in the short-term, but often fail at long-term behavior change. Workplace programs targeted at health improvement are often adopted most readily by people who are already living relatively healthy lifestyles.
To motivate real change requires an understanding of habit psychology, as well as the environmental contexts that encourage and discourage healthy practices. Cue disruption, environmental re-engineering, and vigilant monitoring are strategies that can help break habits; and repetition, associated context clues, and intermittent rewards can help form habits.
Another potential approach is to shift people towards a “play” mindset, rather than viewing workouts as a chore. This is especially important early in life, because children naturally gravitate to active movement and play. Physically active lifestyles are crucial, and systemic issues related to food access need to be addressed.
Lifestyle choices are strongly correlated with nearly every health outcome - including heart disease, diabetes, and cancer. Evidence-based guidelines can help people make healthy decisions and optimize their well-being over long lifetimes.
Healthy lives start with movement; a physically active lifestyle is crucial. Unfortunately, obesity and sedentary behavior have reached crisis proportions in many developed countries. Given that even simple exercise programs can measurably improve health outcomes, systems that can prompt people to add just small amounts of activity to daily routines are key. More innovation is needed to encourage healthier choices among more people, however, with special attention paid to health disparities related to race, socioeconomic status, gender, and education level.
The best results are achieved with a balance of aerobic and muscle-strengthening exercises; activities such as running or biking provide cardiovascular benefits, while weightlifting can increase health resilience and decrease sarcopenia (loss of muscle tissue due to ageing) and osteopenia (the loss of bone mass as one ages). Nutrition is also key - though more understandable and actionable guidelines are needed and, perhaps more importantly, systemic issues related to food access need to be addressed. In fact, social factors should be primary considerations when designing nutrition programs - because improving collective habits is more effective than asking individuals to contravene norms. Breaking old habits to create new ones is difficult, however.
Political discussions must focus on how to more evenly distribute power and responsibility, rather than viewing things as a zero-sum game between young and old. Harnessing the benefits of age diversity could add a sense of purpose and belonging to century-long lives and could potentially make societies more productive and equitable.
If we want societies to genuinely cherish and celebrate longevity, more intergenerational understanding is key.
For example, research shows that when older adults help their children and grandchildren, they in turn are less depressed, more engaged, and more physically healthy. Developing social ties with older adults is also good for young people. Adolescents in particular benefit from the mentorship of older adults in terms of mental well-being, high school graduation rates, and positive life outcomes.
For the first time in human history, five different generations are routinely alive at the same time. As more people live to advanced ages, societies around the world are becoming more age-diverse; and people have increased opportunities to live and interact with others from a wider range of age groups. This change may be a welcome one, given research suggesting that intergenerational relationships are generally beneficial to overall health, well-being, learning, and productivity.
Cultural standards for what “age” means to people can actually produce barriers to meaningful connections. Many societies remain structured in ways that make it unlikely for young and old people to come into meaningful contact with one another, whether at school, at work, or at home. This means people rarely make connections in their social networks with others much younger or older than they are, and many maintain relatively ageist beliefs.
Many workplaces have become increasingly age-diverse, and the intergenerational relationships former there may be good for economies; some research suggests that age-diverse workforces are relatively more innovative and productive. While there is plenty of reason to believe that more generational mixing is a positive trend, however, there are also darker possibilities.
Some think growing financial inequities between generations will lead to competition for resources and even conflict. If we want to live in a society that genuinely cherishes and celebrates longevity, efforts to actively discourage ageism and encourage intergenerational understanding are necessary. Workplace practices should discourage age discrimination, through such measures as age-blind hiring processes and more structured performance reviews.
Life expectancy can vary widely according to geographical region, neighborhood, and even city block. In the US, for example, two children born in two different regions may have respective life expectancies that differ by up to 20 years, and within New York City children who live just 10 miles from one another can anticipate differences of five years.
Designing urban areas that provide equitable access to healthy opportunities could add decades to life expectancy.
Designing longevity-ready living environments is crucial; neighborhoods that enable us to feel supported in our community influence our success as we grow up and grow older. Unfortunately, neighborhoods are growing less connected over time - and the average household size in developed countries has fallen by half over the last century (as people feel lonelier, they are more susceptible to inflammation-related disease).
Access to green spaces and living in areas with less air pollution have been consistently associated with good physical and mental health for both children and older adults. Areas with high crime rates, on the other hand, limit access to outdoor spaces due to safety concerns.
The addition of neighborhood features that support community cohesion and bolster health is particularly important for people living in poverty, who can be at risk of low life expectancy based on where they live. One example that underscores the importance of addressing such disparities: while eliminating cardiovascular disease (the leading cause of death in the US), would increase overall US life expectancy by seven years, designing cities that provide equitable opportunities for everyone could add decades to some people’s longevity.
These disparities across even relatively small geographical areas underscore the importance of the environment on mental and physical health; household, neighborhood, and community characteristics are associated with risks related to cardiovascular and respiratory diseases and emotional well-being, in addition to overall life expectancy. Food deserts - where ready access to healthy food is limited due to a lack of retail options and general economic distress - make it nearly impossible for many people to improve their diets.
Well over a decade ago, the World Health Organization outlined the concept of ageing-ready cities. Truly longevity-ready cities augment this approach by not only including accommodation for the unique needs of older people, but also by proactively addressing elements of the urban environment that affect everyone’s life trajectory.
AGEING & LONGEVITY
Demographers predict that as many as half of the children born in the developed world since 2000 will reach the age of 100 and beyond. Once a rare event, century-long lives will become commonplace by 2050. The near doubling of life expectancy presents a range of challenges — along with yet unrealized opportunities.
Life expectancy in most countries has roughly doubled since 1900, marking one of the greatest accomplishments in human history. Now, scientific advances and new social roles are needed so that older people can live with purpose and dignity. Beyond simply adding years, we can improve the quality of life if we see things through the lens of longevity.
To the extent that we continue to live our lives according to the norms, institutions and policies based on lives half as long as the ones we now enjoy, we will surely face a crisis. However, if we act quickly to apply scientific and technological solutions and change the ways we live, the added years can improve quality of life at all ages.
We must first recognize that the unprecedented age diversity in society today is a net positive. The speed, strength and zest for discovery common in younger people, combined with the emotional intelligence, prosocial tendencies, and wisdom prevalent among older people, create new possibilities for families, communities and workplaces that haven’t existed before.
Rather than dwelling so anxiously on the costs incurred by an “aging” society, we can instead measure and reap the remarkable dividends of our increasingly age-diverse world.
The process begins by investing in today’s children — the future centenarians of the 21st century. Early childhood investments deliver big returns, as benefits can compound for decades, while allowing for more time to recover from disadvantages and setbacks.
Longevity’s “A New Map of Life” initiative has been examining how to change the very nature of education, recast work-life trajectories, and align our environments, lifestyles, and healthcare systems in ways that lead to more happy and productive years. Ultimately, we can get to a point where we see longer lives not as a burden, but as a benefit.