Abstract

As we look to reform ageing and old age in the light of extreme longevity, it’s essential that we look to the institutions that currently define ageing and old age – not only to respect the experiences and realities of a growing proportion of our populations but also to ensure that our societies continue to distribute resources fairly across the life course.

We also need to recognise that 21st century living is structured by 20th century institutions, which may not be effective for the today’s dynamics. Our education systems, patterns of work, healthcare, legal systems, and even marriage and families were built during a very different demographic.

There are also deep stereotypes and preconceptions around the contribution and burden of older adults that are not supported by robust evidence, and these need to be revisited. That’s partly because many of them lead to unjust behaviour towards older people, but also because these institutions and perceptions influence the behaviour of older people themselves.

People are living longer, but how many of these extra years are being enjoyed in good health. There are challenges in measuring healthy life expectancy, with significant and large geographical variations. The evidence suggests we are pushing back the onset of disability and therefore if anything we can expect people in their 60s and even early 70s probably to have better health and therefore to be able to keep active for longer. However, the evidence also suggests an increase in time spent living with disability among the oldest members of the population.

As people age, many are also remaining active in the labour market, whilst others are often providing informal care services, not only for grandchildren but for other adults, either with family or other social links, so for many people it is a time of activity still.

Predicting the shape of our future populations is vital for installing the infrastructure, welfare, and provisions necessary for society to survive. There are many opportunities and challenges that will come with the changes in our populations over the 21st century. This keynote address will consider the future shape of our populations in light of demographic trends in fertility, mortality, and migration, and their national and global impact both on society and our healthcare system.

A professor of gerontology at the University of Oxford, Sarah
 was appointed to the Prime Minister’s Council for Science and Technology in 2014. She has chaired the UK government’s Foresight Review on Ageing Populations, and the European Ageing Index Panel for the UNECE Population Unit. Her research was recognised by the 2011 Royal Society for Public Health: Arts and Health Research Award. She is a fellow of the Royal Anthropology Institute and the Royal Society of Arts.