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Chapter 7

INTERNATIONAL COMPARISONS

The phenomenon of an aging society is not unique to the United States. With worldwide advances in medical care and population control, many nations around the world face the prospect of an increasingly older population. This worldwide aging trend raises concerns about the ability of the world as a whole to provide for the health and income needs of a population that lives longer in retirement.

In the debate over the future of aging policy in this country, public officials often lose sight of the similarities between our problems and those faced by other nations around the world. Yet in many ways, the changes that will occur in this country are mild by comparison to those that must occur in developing nations and even in other developed countries. This chapter presents some of the scant international data on aging trends to provide a basis for placing our experience in the United States in the context of the worldwide aging trend. The countries selected for comparison are a cross-section of European and non-European developed countries and developing countries from various continents.

(NOTE.-Except for the section on "Government Expenditures," the information for this chapter was drawn from the U.S. Bureau of the Census' report, "An Aging World". The Bureau's report contains a variety of population data items for 31 selected countries, including most developed nations but excluding the Soviet Union. Tables in this chapter, except table 7-1 and those in the section on "Government Expenditures," provide data for 11 of the 31 countries included in "An Aging World"-8 developed and 3 developing (China, India, and Mexico).)

AGE DISTRIBUTION

THE UNITED STATES HAS THE THIRD LARGEST ELDERLY POPULATION (AGE 65-PLUS) AND THE LARGEST "OLD-OLD" POPULATION (AGE 80PLUS) IN THE WORLD

In 1985, there were 23 countries with more than 2 million people 65 years or older; 11 countries had more than 5 million. The U.S. population of 28.6 million persons aged 65 and older that year was the third largest in the world after China and India. The number of countries with more than 2 million elderly is projected to grow to 50 by the year 2025, when the U.S. population 65 years and older (58.8 million) will still rank third behind China (178.2 million) and India (119 million) (table 7-1).

The 1985 U.S. population of 6.2 million persons 80 years and older was the largest in the world, with 500,000 more people than China had in this same age group. The number of countries with 1 million or more people 80 years or older is projected to grow from 9 in 1985 to 18 in 2025. By 2025, the United States will rank third in

the world in the size of its "old-old" population (14.3 million) behind China (25.2 million) and India (16.4 million).

Table 7-1.—Countries with more than 5 million elderly (65-plus) and 1 million oldold (80-plus): 1985

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Source: Unpublished data from the United Nations, 1984 Assessment of World Population Prospects, and the U.S. Bureau of the Census, Center for International Research, as reported in Torrey, Barbara Boyle, Kevin G. Kinsella, and Cynthia M. Taueber, U.S. Bureau of the Census. "An Aging World."

SWEDEN HAS THE OLDEST POPULATION IN THE WORLD. THE PROPORTION OF ELDERLY IN THE U.S. POPULATION IS IN THE MIDDLE RANGE OF DEVELOPED NATIONS-SMALLER THAN EUROPEAN COUNTRIES BUT GREATER THAN NON-EUROPEAN DEVELOPED COUNTRIES Sweden had the oldest population in the world in 1985, with 16.9 percent over age 65 (table 7-2). The elderly population in other Western European countries ranged between 12.4 percent (France) and 15.5 percent (Norway) of the total population. While only 12 percent of the U.S. population was 65 and older, this was a larger percentage than in all other non-European developed countries, whose elderly populations ranged from 10 to 10.4 percent.1

'The "developed" and "developing" country categories used in "An Aging World" correspond directly to the "more developed" and "less developed" classifications employed by the United Nations. Developed countries comprise all nations in Europe (including the Soviet Union) and North America, plus Japan, Australia, and New Zealand. All other nations of the world are considered to be developing countries.

TABLE 7–2.—ELDERLY POPULATIONS (65-PLUS AND 80-PLUS) IN SELECTED COUNTRIES: 1985

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Source: Torrey, Barbara Boyle, Kevin G. Kinsella, and Cynthia M. Taueber, U.S. Bureau of the Census. "An Aging World."

THE WORLD IS AGING. IN MANY DEVELOPED NATIONS, THE PROPORTION OF THE POPULATION AGE 65 AND OVER IS EXPECTED TO AS MUCH AS DOUBLE BY 2025

The elderly population will increase as a percentage of the total population throughout the world during the next 40 years. By 2025, in most developed countries, one in five persons will be age 65 and older. Japan and Canada will experience the greatest increase among developed countries in the percentage of the population that is elderly (chart 7-1). In the developing world, the concentration of elderly in the population by 2025 will begin to approximate today's concentration in the developed countries.

SWEDEN

UNITED KINGDOM

WEST GERMANY

ITALY

FRANCE

UNITED STATES

CANADA

JAPAN

Chart 7-1

PERCENT OF POPULATION 65 AND OLDER IN SELECTED COUNTRIES:
1985 (ESTIMATED) AND 2025 (PROJECTED)

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1985

2025

SOURCE: Torrey, Barbara Boyle, Kevin G. Kinsella, and Cynthia M. Taueber, U.S. Bureau of the Census. "An Aging World"

Although the oldest-old (80+) are expected to grow as a proportion of the population during the next 40 years, they are now only 2 to 3 percent of the population in most of the developed world, and will grow by 2025 to 3 to 5 percent in most developed countries. Of the developed nations, Japan will experience the greatest increase in the proportion of the population age 80 and older-from 1.7 percent in 1985 to almost 5 percent in 2025. The United States and Canada will also have a substantial increase in the proportion in this age group. In most of the developing world, the oldest-old will still account for less than 3 percent of the population by 2025 (chart 7-2).

Chart 7-2

PERCENT OF POPULATION 80 AND OLDER IN SELECTED COUNTRIES:

1985 (ESTIMATED) AND 2025 (PROJECTED)

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SOURCE: Torrey, Barbara Boyle, Kevin G. Kinsella, and Cynthia M. Taueber, U.S. Bureau of the Census. "An Aging World"

THE U.S. GROWTH RATE IN THE AGE 65 TO 74 POPULATION WILL BE AMONG THE WORLD'S SLOWEST DURING THE NEXT 20 YEARS BUT AMONG THE MOST RAPID IN THE DEVELOPED WORLD IN THE SUBSEQUENT 20 YEARS

Because of the low birth rates during the 1930's, the 65-74 age group in the United States will increase at a relatively low average annual growth rate of 0.3 percent between 1985 and 2005 (table 7-3 and chart 7-3). With the exception of Sweden and the United Kingdom, much of the rest of the world will have a more rapid growth in this young-elderly population. Japan's annual rate of growth in the young-elderly population during this period (2.7 percent) will be the most rapid in the developed world, about nine times that of the United States.

In the subsequent 20 years (2005 to 2025), the United States will experience a rapid rate of growth in its young-elderly population, as a result of the aging of America's "baby boom." Although Canada, Sweden, and the United Kingdom will experience a similar acceleration in the rate of growth of the young-elderly population, other developed countries will experience a slow-down in the rate of growth during this period. Japan will have a particularly sharp drop-off in the rate of growth in its young-elderly population during this period, but the oldest-old will continue to grow at a rapid rate. The average annual growth rate for the young-elderly in many of the world's developing countries-including China, India, and Mexico-will be greater than in the developed countries.

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