Ageing in Europe: policies in harmony or discord?
International Journal of Epidemiology
The rest of the European Union (EU) shares with the UK the experience of population ageing and for the same reasons. However, the rates at which ageing is taking place differs considerably between the Member States and, especially, between regions of the EU. In a large number of European regions the population had already stopped growing by the end of the last century. This will extend to the majority of EU regions, which will see their population levelling off or declining before 2015. The
... efore 2015. The younger generation, the 0-24 age group, represented 31.1% of the population in 1995, and this will decline to 27% in 2015 (some 11 million less). The older generation (65+) will increase, significantly and unevenly, throughout the EU. In some regions of France, Italy and Spain the 80 plus generation will represent between 7% and 9% of the population (compared with an average 3.9% in 1995). As a consequence the average age of the population will increase from 38.3 years in 1995 to 41.8 in 2015. The additional impact of migration means that, in some regions in eastern Germany, northern Italy, central France and northern Spain, the average age will be between 44 and 50 years. The growth of the very old (80+) will be the strongest, in terms of intensity. A large share of the total increase in this cohort over the next 25 years (plus 62% between 1995 and 2025) is taking place within the 5-year period 2000-2005. Within those 5 years the increase will be above 25% in Belgium and France, and almost as much in Italy and Austria. The average increase in the EU will be 18.6%. Italy leads the way (yet again in demographic terms): in 2025, 7.1% or one in every 14 Italians, will be over 80. Germany comes next, due to the pre-war baby boom, and Denmark, Sweden and Ireland will follow after 2020. The eastern European countries are also experiencing demographic ageing. All of them, except Poland, will see a decline in the total population (and that of working age) before 2010. The EU shares demographic ageing with other world regions though, with Japan, it has the most pronounced trend over the next 20 years. Usually at this point in a demographic narrative some data showing age dependency ratios is presented. However, at best, such data are misleadingly crude and simplistic and, at worst, they may be harmful to the cause of rational policy debate. The policy implications of demographic change are not just a matter of the absolute numbers in different age groups. Firstly, it must be remembered that increasing longevity is an indicator of social and economic progress: a great triumph of civilization and, specifically, of science and public policy over many of the causes of premature death which truncated lives in earlier times. Therefore we should not bemoan the emergence of more balanced age structures but recognise that this unique phenomenon is one of the great achievements of the 20th century. At the same time it presents challenges to policy and practice in all sectors of society. Secondly, there is not a simple linear relationship between demographic change and the demand for spending on social protection, still less with the levels of such spending. For example, with regard to health and social care, the level of need for formal care depends on health status, marriage patterns, household composition and living arrangements. It is predicted that the number of disability-free years will increase in the next century 1 but the evidence so far is inconclusive. 2-5 Other population trends provide a more certain picture. Older people living alone tend to make greater use of formal services than those living with others (partly because of the correlation between advanced old age and living alone) and, in the EU, there is an increasing proportion living alone. Given the primacy of family care it is likely that the growth in family breakdown and divorce among both older people and their children will have an impact on the demand for formal care but, again, the evidence is inconclusive. Similarly the increased participation of women in the labour force is likely to have affected the ability of the family to provide care; certainly it has increased the strains experienced by the primary carers who are invariably women. Although more older people in the EU today have children than in previous generations family size has declined dramatically over the course of this century and, therefore, the pool of potential family carers has shrunk. Declining fertility is a global phenomenon and is closely connected with economic development. The EU as a whole was already below the replacement rate 20 years ago and Europe as a whole was equal to the rate. One indicator of the implications for social care of these changes in fertility, in combination with the universal increase in longevity, is the parent support ratio (PSR)-the population aged over 80 divided by the population aged 50-64. Because Europe aged earlier than other regions its PSR is the highest in the world and is likely to remain so for the next 25 years. 6 Turning to pensions, crude age dependency ratios would suggest increasing tax burdens on the working population. However that pessimistic scenario rests on the classic economic obfuscation ceteris paribus (other things being equal) which freezes present trends regardless of how far into the future the projections are being made. In fact the main issue for pension funding is not population ageing in itself but its combination with changes in birth rates, the structure of employment and the practice of retirement. In a very short space of time there has been a major restructuring of the life cycle in most EU countries resulting from the truncation of employment prior to pension ages. 7 In some EU countries this was a trend openly