Good Health and Well-Being

Worldwide, populations are ageing rapidly due to gains in life expectancy and declines in fertility. The trend towards a growing number and share of older persons is projected to continue in the foreseeable future. As the number of older persons grows, their socioeconomic and demographic characteristics will evolve as well, with implications for economies, societies and public budgets. While long-term trends are hard to predict, assessing the characteristics of current and future cohorts of older persons provides important insights into the future of our ageing world. On the one hand, future cohorts of older persons are likely to be healthier and more educated—and therefore more productive—than those of today, despite the impact of the Covid-19 pandemic. Continuing scientific and technological innovations, including medical and pharmaceutical advances, will allow many to enjoy healthier and longer lives. On the other hand, the information presented in this brief indicates that successive cohorts of youth and adults are increasingly insecure in the labour market and more and more unequal in both developed and developing countries with available data. Without swift and bold policy action to counter this trend, future cohorts of older persons may be more unequal than those of today.

The population of countries in the UNECE region is ageing, which is leading to the increase in the number of the oldest old — a group with a higher probability of becoming in need of long-term care. At the same time, the number of those making up the working age population, who will be able to provide care, will decrease. UNECE member States have committed themselves to coping with this growing demand in care services while securing quality and choice for patients and their families. Financial sustainability of long-term care systems and a qualified work force are key elements in securing a high quality of long-term care and protecting human dignity in an ageing society.

The way how persons age is determined by a variety of factors: biological pre-conditions, social circumstances, attitudes towards ageing, and life-style. The manner how an individual person ages may contribute to how long a person will live and how fit a person might be in the late period of life. Current policies on ageing may perceive 'old age' as a status rather than the result of a process. Some ageing policies may be aimed at providing services within this status rather than at empowering older persons to live independently. Here, a change of paradigm is needed. In order to gain the ability to remain active, the individual needs to invest in this process throughout the life course. Appropriate societal structures, incentives and awareness-raising would enable persons to live an active life-style as long as possible. Current societal and legal infrastructures may not fully provide those opportunities for active ageing.

While people are living longer, it is important to improve the quality of every stage of life. Therefore, UNECE member States have committed to implement health policies ensuring that increased longevity is accompanied by the highest attainable standard of health1. In the coming years and decades, the number of elderly people in the region of the United Nations Economic Commission for Europe (UNECE) will rise sharply, challenging societies’ ability to care for those in need.

Realizing a society for all ages is the declared goal of Governments in member States of the United Nations Economic Commission for Europe. To this end, achieving the integration and participation of older persons in society are important elements. This policy brief outlines the main strategies that may be considered to increase participation of older persons in political and economic life and to improve their access to transport, appropriate housing and cultural activities. It highlights the importance of balanced intergenerational relationships based on mutual respect. Efforts may be made to reduce ageism and to destigmatize old age. The potential of volunteering may also be used – both in support of older generations and by the older generations themselves.

The UNECE region is experiencing a steady increase in the number and diversity of retired labour migrants and migrant eldercare workers. The international mobility of older persons is also on the rise. Yet the participation of migrants in the host communities and their access to welfare remains a challenging issue. Compared to native-born peers, older migrants are often more vulnerable to poor socio-economic and health status, social isolation and exclusion. Lower income, poorer working and housing conditions, including their concentration in low-income neighbourhoods, are among the factors affecting the life trajectories of many migrants. Migrant elder carers – independent of their age – often work informally without proper employment contracts and with limited access to health and social protection. There is, however, heterogeneity and variation in older migrants’ vulnerabilities and needs across and within ethnic groups, with consequent important welfare implications, which call for targeted policy responses at local, national, and international levels. A sound evidence base for such policy responses is lacking as older migrants are often overlooked in research, mainly due to a lack of data.

The economic and societal implications that result from demographic change may have an impact on how certain generations or age-groups are perceived by the majority of the population or community. Often older family members or neighbours are respected and well integrated members of their community. They also often dispose of a considerable knowledge, experience and consumer power through life-long accumulated savings. Older persons are thus able to assist younger family members and their community with advice through gained experience. But in some cases older persons are faced with neglect and negative stereotypes. A displacement of older persons into segregated communities, an undervaluing of their contributions to society, and negative media portrayals, contribute to a decrease in face-to-face contact with older persons, foster the growth of a gap between generations and a general lack of empathy towards people of different age-groups.

Populations in the UNECE region are ageing rapidly. To maintain economic growth and standard of living, people would need to work longer before they can retire. Regarding people who are currently in their working age, demographic change may require to include those into the labour market who were previously not fully integrated, such as early school leavers, women and migrants. In a knowledge society, this all requires a good standard of basic education as well as vocational training, tertiary education, information and communication technology (ICT) and language skills.

In many UNECE countries the average actual retirement age is below the statutory retirement age, which means that the labour market is losing a great deal of resources in terms of experience and labour capacity of older workers. Ageing societies, however, cannot afford to lose the highly valuable resource of older workers. If there are people aged 55 years or older who want to work, but cannot due to unfavourable conditions in the labour market, UNECE member States may wish to address this issue.

Policy responses to population ageing to date have primarily focused on adapting welfare systems to the challenges of demographic change. Much less attention is being paid to the opportunities and potentials that living longer holds for individuals, economies and society at large, and to tackling the barriers that currently hinder their full realization. Perceiving longevity mainly as a fiscal pressure and an obstacle to economic growth may trigger reforms that result in rising inequalities. This can occur when the cumulative disadvantages stemming from difficulties in transitions over the life course, ill health and disability and unpaid caregiving are insufficiently addressed. It also feeds into age-based stereotypes and negative attitudes towards older people. To change this, it is essential to better recognize the potentials of ageing societies and to enable people to live active and fulfilling lives as they age.