Education And Debate

Population aging and health

BMJ 1997; 315 doi: (Published 25 October 1997) Cite this as: BMJ 1997;315:1082
  1. Robert N Butler, chief executive officera (
  1. a International Longevity Center (US), Mount Sinai Medical Center, New York, NY 10029, USA

    Trends in population aging

    People in industrialised nations are living longer than ever before. In this century alone, average life expectancy from birth has increased by more than 25 years, and nearly five of those 25 years has been added to average life expectancy from base age 65. Indeed, the most rapidly growing age group comprises those aged 80 and above, and in some countries people over the age of 100 are leading the way in the rate of population growth by age. In most parts of the world women tend to live longer than men—nearly seven years longer in industrialised nations. In addition, reports from Japan, the United States, and Europe show that people are living not only longer but more healthily. In the United States, for example, the rate of disability has decreased noticeably despite population aging (fig 1).

    Fig 1

    Number of chronically disabled Americans aged 65 and over, 1982-96 (total number of Americans aged 65 and over was 26.9 million in 1982, 30.8 million in 1989, 33.7 million in 1994, and 34.1 million in 1996). Reproduced with permission of Proceedings of the National Academy of Sciences of the United States of America from Manton et al1

    Unfortunately, the developing world has not enjoyed the same revolutionary increase in longevity. None the less, 60% of people aged 60 and older live in developing countries—which have huge populations—and this percentage is expected to rise to 80% towards the middle of the next century. The marked inequalities in life expectancy between the developed and developing worlds, as well as discrepancies in life expectancies within particular nations, correlate with inequalities of wealth and income, and these in turn are associated with how much or how little education and access to health care the populations have. Many countries already have at least 10% of their …

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