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Article

As a result of rising life expectancies, America’s older population is itself aging. The U.S. Census Bureau projections suggest that, by the middle of the 21st century, more than 40% of Americans aged 65 and older can expect to live to at least the age of 90. Although the oldest-old (often defined as persons ages 80 and older or those ages 85-plus) is a diverse population, advanced old age is associated with a greater risk of experiencing economic hardship, disabling illnesses or health conditions, and social isolation. A growing public policy challenge will be ensuring the economic well-being, the health, and the dignity of society’s very oldest citizens.

Article

Jennifer D. Sciubba

The late 20th century brought the dawn of global population aging, the culmination of decades-long shifts to lower fertility and longer life expectancy. These novel age distributions—larger proportions of older persons relative to working-age or youth—bring with them a plethora of questions about the political, economic, and social causes and consequences of such aging. There are multiple theoretical perspectives and ways to measure population aging, and decisions about approaches, definitions, and measurements can make a dramatic difference on the results of studies of its impact. Some scholars approach the study of aging through a generational lens, others through chronological age, dependency ratios, or other measures of age structure. Studies of the implications of population aging fall into three major categories: political, economic, and social. Political demography studies often focus on the political power of various age groups and attempt to assess the degree to which intergenerational conflict is emerging as the sizes of age groups change and their demands on services like entitlements shift alongside. Political demography studies also look at voter behavior and preferences to assess possibilities for reform of age-related policies, like retirement, healthcare, and education. A separate branch of political demography examines the military implications of population aging, particularly its effect on the willingness and ability of a state to use force. Of the few studies that show a link between aging and war, empirical results are inconclusive, meaning that it is just as likely a state with a high median age will be belligerent as not. Studies on the economic implications of population aging look at the changing nature of the labor market itself and on the possibility of macroeconomic growth in the face of demographic change. Finally, research on the social impact of population aging is mostly concerned with individual- and family-level well-being, as the care demands of an aging population create pressures on individuals, families, and social safety nets. There are many controversies and debates over the impact of aging, including debates over the relative weight of demographic factors and whether population aging is a trend warranting celebration or alarm. In all, there are far more questions about the implications of aging than there are answers, and the projected development of this trend means that more questions constantly arise. Lingering questions surround historically rapid demographic aging, new sets of aging states at different speeds, shrinking populations, the intersection between migration and aging, and the intersection between aging and climate change. The field is ripe for more comparative aging work in general.

Article

Allison R. Heid and Steven H. Zarit

Individuals are living longer than they ever have before with average life expectancy at birth estimated at 79 years of age in the United States. A greater proportion of individuals are living to advanced ages of 85 or more and the ratio of individuals 65 and over to individuals of younger age groups is shrinking. Disparities in life expectancy across genders and races are pronounced. Financial challenges of sustaining the older population are substantial in most developed and many developing countries. In the United States in particular, employer-based pension programs are diminishing. Furthermore, Social Security will begin taking in less money than it pays out as early as 2023, and the debate over its future in part entails discussions of equitable distribution of resources for the young in need and the old. Living longer is associated with a greater number of chronic health conditions—over two-thirds of Medicare beneficiaries in the United States have two or more chronic health conditions that require complex self-management regimes partnered with informal and formal care services from family caregivers and institutional long-term services and supports. Caregiver burden and stress is high as are quality care deficiencies in residential long-term care settings. The balance of honoring individuals’ autonomous wishes and providing person-centered care that also addresses the practicalities of safety is an ever-present quandary. Furthermore, complex decisions regarding end-of-life care and treatments plague the medical and social realms, as more money is spent at the end of life than at any other point and individuals’ wishes for less invasive treatment are often not accommodated. Yet, despite these challenges of later life, a large percentage of older individuals are giving financial support, time, and energy to younger generations, who are increasingly strained by economic hardship, the pressures on dual earner parents, and the problems faced by single parenthood. Older individuals’ engagement in society and the help they provide others runs counter to stereotypes that render them helpless and lonely. Overall, the ethical challenges faced by society due to the aging of the population are considerable. Difficult decisions that must be addressed include the sustainability of programs, resources, and social justice in care, as well as how to marshal the resources, talents, and wisdom that older people provide.

Article

Gunnar Almgren and Ji Young Kang

This entry provides a brief overview of the field of social demography, the components of population change, projections for future population growth, and recent transformations in population composition pertaining to age, race, and ethnicity. Trends that shape family household structure (for example, marriage, divorce, cohabitation, and nonmarital child bearing) are also considered, as are trends pertaining to the distribution of income, wealth, and poverty. Population trends given particular attention include the growth of class-based disparities in marriage and nonmarital child bearing, the contributions of immigration to population growth and diversity, and a disturbing increase over recent decades in the prevalence of poverty among children of immigrants.

Article

Robert M. McCann

Research into age and culture strongly suggests that people of different adult generations, regardless of culture, typically regard others and act in ways that display bias in favor of one’s own age group. While people across cultures share some basic patterns of aging perceptions, there is considerable variance in views on older people from one country to the next. Over the past two decades, the tenor of communication and aging research has shifted dramatically. Traditional research into aging across cultures painted a picture of Asia as a sort of communicative oasis for elders, who were revered and communicated to by the younger generations in a respectful and mutually pleasing manner. Compelling evidence now suggests the opposite, which is that (interregion variability in results notwithstanding) elder denigration may be more pronounced in Eastern than Western cultures. Accelerated population aging, rural-to-urban shifts in migration, new technologies, rapid industrialization, and the erosion of cultural traditions such as filial piety, may partially account for these results. Additionally, there are well-established links between communication and the mental health of older people. Specifically, communication accommodation in all of its forms (e.g., over accommodation, nonaccommodation, accommodation) holds great promise as a core predictor of a range of mental health outcomes for older people across cultures.

Article

Jack A. Goldstone

Population movements can affect security in a variety of ways. Aside from altering a society’s overall balance of population and physical resources, they exert a considerable influence on the institutions of society—the state, elite recruitment and social status, the military, labor organizations and peasant villages—in a way that undermines political and social order. The consequences of population movements for security can also be seen in differential population growth and migration, differential aging of different populations, and issues of resource allocation and climate change. The work of T. R. Malthus in the early nineteenth century advanced the argument that more people would put an undesirable burden on societies, and weaken them. Julian Simon turned the Malthusian argument on its head with his claim that people were the “ultimate resource,” and that the more people were around to work on solving the globe’s problems, the more likely it was that powerful solutions would be found. The debate between Malthusians, represented by Paul Ehrlich, and Cornucopians, represented by Simon, from the 1960s to the 1990s was primarily about the impact of population on economic growth. In the 1990s, a new direction emerged in the debate on population and security. This was the argument that population growth would lead to local shortages of critical resources such as farmland, water, and timber, and that these could trigger internal conflicts and even civil wars. These conflicts arise only where states and economies are relatively weak and unable to respond to population growth.

Article

Over the past three decades, economic and political demographers, using various measures, have discerned that increased age-structural maturity makes significant statistical contributions to levels of per capita income, to educational attainment, to declines in the frequency of onsets of intrastate conflict, and to the likelihood of achieving and maintaining liberal democracy. Some of the stronger statistical relationships have been used in forecasts. For example, using the United Nations Population Division (UNPD) demographic projections, political demographers have relied on the strong statistical association between age structure and stable liberal democracy to forecast the rise of democracy in North Africa more than two years in advance (in 2008)—at a time when regional experts believed that forecast to be absurd. Whereas critics remain skeptical of the murky causal connections of age-structural theory, its proponents counter that causality in the development of state capacity is complex and is less important than the theory’s positive qualities (namely, that it is forward-looking, its statistical findings are easily repeated, its forecasts have outcompeted regional experts, and its predictive products can be readily adapted to the needs of intelligence foresight, defense planning, and foreign policy analysis). Perhaps most important, the age-structural theory of state behavior has yielded a surprising number of “novel facts”—new knowledge concerning the observed pace and timing of state political, social, and economic behaviors.

Article

Norman Bannenberg, Martin Karlsson, and Hendrik Schmitz

Long-term care (LTC) is arguably the sector of the economy that is most sensitive to population aging: its recipients are typically older than 80 years whereas most care providers are of working age. Thus, a number of ongoing societal trends interact in the determination of market outcomes in the LTC sector: trends in longevity and healthy life expectancy interact with changing family structures and norms in shaping the need for services. The supply side is additionally affected by changes in employment patterns, in particular regarding the transition into retirement, as well as by cross-regional imbalances in demographic and economic conditions. The economic literature on long-term care considers many of these issues, aims at understanding this steadily growing sector, and at guiding policy. Key economic studies on long-term care address determinants of the demand for long-term care, like disability and socio-economic status; the two most important providers: informal family caregivers and nursing homes; and the financing and funding of LTC.

Article

Martin Karlsson, Tor Iversen, and Henning Øien

An open issue in the economics literature is whether healthcare expenditure (HCE) is so concentrated in the last years before death that the age profiles in spending will change when longevity increases. The seminal article “aging of Population and HealthCare Expenditure: A Red Herring?” by Zweifel and colleagues argued that that age is a distraction in explaining growth in HCE. The argument was based on the observation that age did not predict HCE after controlling for time to death (TTD). The authors were soon criticized for the use of a Heckman selection model in this context. Most of the recent literature makes use of variants of a two-part model and seems to give some role to age as well in the explanation. Age seems to matter more for long-term care expenditures (LTCE) than for acute hospital care. When disability is accounted for, the effects of age and TTD diminish. Not many articles validate their approach by comparing properties of different estimation models. In order to evaluate popular models used in the literature and to gain an understanding of the divergent results of previous studies, an empirical analysis based on a claims data set from Germany is conducted. This analysis generates a number of useful insights. There is a significant age gradient in HCE, most for LTCE, and costs of dying are substantial. These “costs of dying” have, however, a limited impact on the age gradient in HCE. These findings are interpreted as evidence against the red herring hypothesis as initially stated. The results indicate that the choice of estimation method makes little difference and if they differ, ordinary least squares regression tends to perform better than the alternatives. When validating the methods out of sample and out of period, there is no evidence that including TTD leads to better predictions of aggregate future HCE. It appears that the literature might benefit from focusing on the predictive power of the estimators instead of their actual fit to the data within the sample.

Article

Patricia A. Fennell and Sara Rieder Bennett

There is a paradigm shift occurring in medicine, from models focused on treating acute illnesses to those concerned with managing chronic conditions. This shift coincides with the higher prevalence of chronic illnesses resulting from factors such as lower mortality from formerly fatal illnesses and an aging population. The chronically ill do not fare well in an acute care model, and as a result, it has become imperative to develop new models effective for these chronic conditions. These new care models will require comprehensive, coordinated case management, an activity in which social workers can play a significant role.

Article

Most of the world has experienced a revolutionary and unprecedented development over the course of the last century and especially since the end of the Second World War: significant population aging. By any standard measure—median age, the number of 60- or 65-year-olds and over as a percentage of a population, or old-age dependency ratios (the ratio of seniors to working-age adults), most of the world is significantly older today than in the middle of the 20th century, and the trend is accelerating. The world’s great powers have not been immune to this trend. To the contrary, many of these countries have been leading the way, aging faster and to a greater extent than most other countries. By 2050, the median age of China, France, Germany, Japan, Russia, the United Kingdom, and the United States will be at least 40. Germany and Japan are currently two of the oldest countries in the world, and China is likely aging faster than any other country in history. How is the near worldwide phenomenon of population aging likely to affect international relations (IR)? Most scholars who have examined this issue have linked the potential effects created by aging to established IR theories. Most analyses that have developed around the issue of aging, in other words, have not created new theoretical approaches to the study of international politics. They have instead argued that aging is likely to affect key variables associated with existing IR theories, which will then tend to generate particular outcomes based on these theories’ predictions. The IR theories that studies of populating aging have most frequently tied into include ones from realist, diversionary war, and constructivist research programs. Many of the arguments that link the effects of aging to these theories reach opposite conclusions, with some predicting a much higher probability of international conflict due to aging, others the reverse. There are, however, very few empirical analyses that test these competing hypotheses, largely because aging is such a new phenomenon.