Aging societies: How can we design societies that benefit older and younger people?

The success of longevity interventions is putting countries on paths to becoming aging societies, in which the number of individuals aged 65 and older is equal to the number of people aged 15 and younger. This outcome may lead to resistance to investments in healthy longevity, according to aging experts, if concerns are raised that the needs of older individuals will overwhelm societies, exacerbate ageism, and divide populations.

The National Academy of Medicine in the United States addressed this possibility as its first-ever Grand Challenge, and in June 2022 published the Global Roadmap for Healthy Longevity, developed by an independent and interdisciplinary global commission co-chaired by Linda P. Fried, MD, MPH, dean of Columbia University Mailman School of Public Health and John Eu-Li Wong, Isabel Chan Professor in Medical Sciences and senior vice president of health innovation and translation at the National University of Singapore. A commentary in the Dec. 2, 2022  Nature Aging, by Dr. Fried, Dr. Wong, and Victor J. Dzau, MD, president of the National Academy of Medicine, reviews the findings and recommendations of the Global Roadmap.

“We are at a critical inflection point, perhaps even a precipice, between the realization of our negative assumptions or pursuing an optimistic future of healthy longevity, avoidable disability, and social challenges,’” says Dr. Fried, who is also Director of the Robert N. Butler Columbia Aging Center. “With most countries expected to be aging societies by 2050, the lead time to be fully prepared is short.”

“The health of a population is a priceless asset. A healthy society is far better prepared to face crises, be it extreme weather events or pandemics. Having populations able to continue contributing well into their older age will allow all to reap the investments in human capital made throughout life, which in turn will unlock the social and economic capital of older people to a degree which has yet to be realized,” says Dr. Wong, who is also senior advisor at the National University Health System. 

“Across the globe, investing in health, well-being, and sense of purpose of older adults has the potential to yield great rewards that benefit individuals of all ages and society at large,” observes National Academy of Medicine President Victor J. Dzau. “Enabling healthy longevity allows people to be productive, contribute to their communities, generates social and economic capital, and fulfills an individual’s sense of purpose. All of society - governments and leaders across sectors - must work in tandem to cultivate healthy longevity to build societies that support longer, healthier, meaningful lives.”

Global Roadmap’s findings and recommendations include:

• If health is realized in longer lives, older adults can bring unpercented assets at a potential scale that could create a longevity dividend good for all ages
• The costs of inaction to create health longevity have critical implications, including the high risk of young people aging with more ill health.
• The principles and vision (Vision 2050) for healthy longevity will allow for people to live long lives with health; for older populations to be valued; and for engagement in meaningful and productive activities, leading to intergenerational wellbeing and cohesion.
• Implementing Vision 2050 demands an all-of-society effort, an aligned transformation of multiple sectors of society, and governmental leadership.
• To initiate the transformation to healthy longevity requires social cohesion and the design of environments that are user-centered.
• The returns on investment would be high, measured in enhanced human, social, and financial capital and multigenerational wellbeing.

“Governments should work to build the dividend of healthy longevity in collaboration with the business sector and civil society. This includes developing policies and systems that encourage older adults who want to remain working to do so, improving broadband accessibility to reduce the digital divide, and supporting lifelong learning,” notes Fried. “We are at the forefront of an unprecedented opportunity to realize healthy longevity that we must not miss if we want a generation of substantial social and economic benefits for all ages. By contrast, the costs to society are extraordinary if we continue to increase our years of ill health and widening disparities.”

The authors declare no competing interest.

Columbia University Mailman School of Public Health

Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the fourth largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master’s and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu.