Ageing Population to More than Double by Middle Century

Currently, geriatric healthcare services are available in tertiary care hospitals. Urban areas have the most facilities. As majority of the elderly population stay in the rural region of India, the need of the hour is to integrate geriatric healthcare into primary healthcare services.

With the number of people aged 65 and over to more than double by the middle of the century, the rights and well-being of older people must be given priority in efforts to achieve a sustainable future, the United Nations said in a new report.

Noting that population ageing is a defining global trend of the time, the World Social Report 2023 calls for concrete measures to support the greying global population, amidst escalating pension and healthcare costs. The report comes from UN Department of Economic and Social Affairs (DESA).

“Together, we can address today’s inequalities for the benefit of tomorrow’s generations, managing the challenges and capitalizing on the opportunities that population ageing brings,” said Li Junhua, UN Under-Secretary-General for Economic and Social Affairs.


In the report, the UN says that the number of persons aged 65 years or older is expected to double by 2050, surpassing 1.6 billion. It further said that a child born in 2021 could expect to live, on average, to age 71, with women living longer than men. This is nearly 25 years more than a baby born in 1950, it added.

Region wise, the authors said that population ageing is furthest along in Europe and Northern America, Australia and New Zealand, and most of Eastern and South-Eastern Asia. In most countries of those regions, the proportion of older persons – by convention, those aged 65 years or older – exceeds 10 per cent and in some cases 20 per cent of the total population. Most parts of sub-Saharan Africa and Oceania (excluding Australia and New Zealand) are still in an early stage of this transition, while most countries in Central and Southern Asia, Western Asia and Northern Africa, and Latin America and the Caribbean are at an intermediate stage.

The authors said that women live longer than men on average in almost all societies. This is the same with rich people living longer than the poor. These differences stem partly from poor nutrition and exposures to environmental and occupational hazards that are more common among men and people with limited income and education, the UN said.


Pointing out that life expectancy is strongly influenced by factors such as income, education, gender, ethnicity and place of residence, the DESA said several older people still encounter obstacles that limit their contributions. “Age-based discrimination in the labour market, for instance, undercuts their full participation in the economy, “the authors said.

The UN also maintained that older persons should have the option of continuing to work for as long as they desire and are able to do so. Nevertheless, the ability to work and generate income wanes sooner or later at advanced ages, they added. 

Moreover, they said that the means of financing goods and services for older persons differ across countries. In more developed regions, public transfer systems, including pensions and health care, provide over two thirds of the consumption by older persons. In less developed regions, older persons tend to work longer and rely more on accumulated assets or family assistance. Countries at all stages of population ageing should take proactive and forward-looking measures to adapt and innovate in their labour markets and pension and health-care systems to ensure that support for older persons is both adequate and fiscally sustainable, the authors said. .

“Some combinations of these factors have too often led to systemic disadvantage that begins early in life,” the authors noted. 

They warned that without policies to prevent them, these systemic disadvantages reinforce one another throughout peoples’ lives, leading to gaping disparities in old age. 


The UN report states that poverty levels at older ages are typically higher among women. Lower levels of participation in formal labour markets, shorter working careers and lower wages compared to men leave many women struggling with greater economic insecurity later in life. Given women’s longer life expectancies, older women are more likely than older men to be widowed, less likely to remarry and more likely to live alone, the report stated.

Women also bear the brunt of deficiencies in caregiving. The unequal distribution of care and domestic work within families curtails women’s working lives and constricts pension incomes


The Report mentioned that the demand for long-term care is soaring in several countries, as the population of older persons grows larger, especially at ages 80 and higher. It said that public spending in most countries has not been sufficient to cover the growing demand for long-term care. The average expenditure by countries of the Organisation for Economic Co-operation and Development(OECD) was 1.5 per cent of GDP in 2019, down from 1.7 per cent in 2017. Insufficient funding means caregivers are undervalued, underpaid and inadequately trained and often work in difficult conditions. A shortage of welltrained caregivers leads to poor quality care. Many countries, even wealthy ones, continue to rely on informal services by paid or unpaid caregivers.


The UN report highlights two sets of actions to build societies for all people at all ages. The first set can be taken throughout people’s lifetimes to promote labour market participation and increased productivity, uphold good health and prevent poverty. The second set consists of policies to reduce inequality and promote economic security at older ages in a fiscally sustainable manner, taking into account both pensions and health care.

The report highly recommends that countries rethink long-held policies and practices associated with livelihoods and work. It said that with appropriate foresight and planning, Governments could manage the challenges from population ageing while enhancing opportunities for all people to thrive and ensuring that no one is left behind. Many governments are already introducing opportunities for life-long learning, as well as strengthening and taking full advantage of intergenerational workforces. They are also introducing flexible retirement ages to accommodate a broad range of personal situations and preferences.


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