Intended for healthcare professionals


Population ageing: the timebomb that isn’t?

BMJ 2013; 347 doi: (Published 12 November 2013) Cite this as: BMJ 2013;347:f6598
  1. Jeroen Spijker, senior research fellow12,
  2. John MacInnes, professor1
  1. 1School of Social and Political Science, University of Edinburgh, Edinburgh EH8 9LD, UK
  2. 2Centre d’Estudis Demogràfics, Barcelona, Spain
  1. Correspondence to: J Spijker j.spijker{at}
  • Accepted 21 October 2013

Jeroen Spijker and John MacInnes argue that current measures of population ageing are misleading and that the numbers of dependent older people in the UK and other countries have actually been falling in recent years

Population ageing is a concern in all developed countries. For the first time, there are now more people over the age of 65 in the United Kingdom than there are children under 15 years.1 Over the past century, the proportion of over 65s has grown from about one in 20 to around one in six. Although declining birth rates and infant mortality formed the basis for this growth from the end of the 19th century until the second world war, since the 1970s increasing life expectancy has been an additional driving force (fig 1). This population ageing has worried policy makers because for every worker paying tax and national insurance there are more older citizens, who make greater demands on social insurance, health, and welfare systems and have increasing morbidity and disability.2 3 4

Fig 1 Change in life expectancy (in years) in England and Wales within each decade broken down by age group, 1950-2010 (data from Life expectancy increased by 2.6 years between 2000 and 2010, 0.1 years of which came from improved infant and child survival and, respectively 0.5 and 2.0 years from lower mortality among 5-64 and ≥65 year olds

The standard indicator of population ageing is the old age dependency ratio. It takes the number of people who have reached the state pension age and divides it by the number of working age (16-64 years) adults in order to estimate the proportion of older people relative to those who pay for them. Although the phased raising of the state pension age (from 65 for men and 60 …

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