International Population Reports - Census

1 Department of Health and Human Services National Institutes of Health NATIONAL INSTITUTE ON AGINGAn Aging World: 2015 International Population ReportsIssued March 2016P95/16-1By Wan He, Daniel Goodkind, and Paul KowalAcknowledgmentsThis report was prepared by Wan He and Daniel Goodkind of the Census Bureau, and Paul Kowal of the World Health Organization's (WHO) SAGE, under the direction of Loraine A. West, Chief, Demographic and Economic Studies Branch, and general direction of Glenn Ferri, Assistant Division Chief, International Programs and James D. Fitzsimmons, former Acting Assistant Division Chief, International Programs Center for Demographic and Economic Studies, Population Division. Karen Humes, Chief, Population Division provided overall direction. The authors wish to give special acknowledgment to the following researchers who graciously contributed to text boxes that focus on special and frontier research topics in Population aging: Martina Brandt, TU Dortmund University; Robert Cumming, University of Sydney; Christian Deindl, University of Cologne; Karen I.

2 Fredriksen-Goldsen, University of Washington; Mary C. McEniry, University of Wisconsin-Madison; Joel Negin, University of Sydney; and Kirstin N. Sterner, University of for and production of this report were supported under an interagency agreement with the Division of Behavioral and Social Research, National Institute on Aging (NIA).The authors are grateful to many people within the Census Bureau who made this publi-cation possible by providing literature and data search, table and graph production, verifi-cation, and other general report preparation: Samantha Sterns Cole, Laura M. Heaton, Mary Beth Kennedy, Robert M. Leddy, Jr., Lisa R. Lollock, Andrea Miles, Iris Poe, and David authors give special thanks to Joshua Comenetz, Population Division, for his thorough review. Reviewers from NIA provided valuable comments and constructive suggestions, including: David Bloom, Harvard University; David Canning, Harvard University; Somnath Chatterji, World Health Organization; Eileen Crimmins, University of Southern California; Ronald D.

3 Lee, University of California, Los Angeles, Berkeley; Alyssa Lubet, Harvard University; Angela M. O Rand, Duke University; John Romley, University of Southern California; Amanda Sonnega, University of Michigan; and anony-mous reviewers from NIA. Statistical testing review was conducted by James Farber, Demographic Statistical Methods Division. For cartographic work, the authors thank Steven G. Wilson and John T. Fitzwater, Population E. Geter of the Census Bureau s Public Information Office and Linda Chen and Faye Brock of the Center for New Media and Promotion provided publication management, graphics design and composition, and editorial review for print and elec-tronic media. George E. Williams of the Census Bureau's Administrative and Customer Services Division provided printing Memory of Dr. Richard M. SuzmanThe Population Division of the Census Bureau wishes to express our deep gratitude and pay tribute to Dr. Richard M. Suzman, director of Division of Behavioral and Social Research, National Institute on Aging, who passed away on April 16, 2015.

4 A pioneer and champion for the science of Population aging, Dr. Suzman played a critical role in developing the aging research program in the Population Division. For over three decades he steadfastly supported numerous Census Bureau publications focused on Population aging trends and demographic, socioeconomic, and health characteristics of the older populations in the United States and the world. Enormously popular report series such as 65+ in the United States and An Aging World are a remarkable testimony to Dr. Suzman s dedication to research on Population aging which, in his words, is reshaping our Department of Commerce Penny Pritzker, SecretaryBruce H. Andrews, Deputy SecretaryEconomics and Statistics Administration Justin Antonipillai, Counselor, Delegated Duties of Under Secretary for Economic Census BUREAU John H. Thompson, DirectorP95/16-1An Aging World: 2015 Issued March 2016 Suggested Citation Wan He, Daniel Goodkind, and Paul Kowal Census Bureau, International Population Reports , P95/16-1, An Aging World: 2015, Government Publishing Office, Washington, DC, and Statistics Administration Justin Antonipillai, Counselor, Delegated Duties of Under Secretary for Economic Census BUREAU John H.

5 Thompson, DirectorNancy A. Potok, Deputy Director and Chief Operating OfficerEnrique Lamas, Associate Director for Demographic ProgramsKaren Humes, Chief, Population DivisionECONOMICSAND STATISTICSADMINISTRATIONFor sale by the Superintendent of Documents, Government Printing Office Internet: Phone: toll-free 866-512-1800; DC area 202-512-1800 Fax: 202-512-2250 Mail: Stop SSOP, Washington, DC Census Bureau An Aging World: 2015 iiiContentsChapter 1. Introduction .. 1 Chapter 2. Aging Trends .. 3 Growth of world's older Population will continue to outpace that of younger Population over the next 35 years .. 3 Asia leads world regions in speed of aging and size of older Population .. 6 Africa is exceptionally young in 2015 and will remain so in the foreseeable future .. 6 World s oldest countries mostly in Europe today, but some Asian and Latin American countries are quickly catching up .. 9 The two Population billionaires, China and India, are on drastically different paths of aging.

6 10 Some countries will experience a quadrupling of their oldest Population from 2015 to 2050 ..11 Chapter 3. The Dynamics of Population Aging ..15 Total fertility rates have dropped to or under replacement level in all world regions but Africa ..15 Fertility declines in Africa but majority of African countries still have above replacement level fertility in 2050 ..18 Some countries to experience simultaneous Population aging and Population decline ..22 Composition of dependency ratio will continue to shift toward older dependency ..23 Median ages for countries range from 15 to near 50 ..25 Sex ratios at older ages range from less than 50 to over 100 ..26 Chapter 4. Life Expectancy, Health, and Mortality ..31 Deaths from noncommunicable diseases rising ..31 Life expectancy at birth exceeds 80 years in 24 countries while it is less than 60 years in 28 countries ..32 Living longer from age 65 and age 80 ..35 Yes, people are living longer, but how many years will be lived in good health?

7 36 Big impacts, opposite directions? Smoking and obesity ..38 Change is possible! ..44 What doesn t kill you, makes you .. possibly unwell ..45 Presence of multiple concurrent conditions increases with age ..48 Trend of age-related disability varies by country ..48 Frailty is a predisabled state ..49 The U-shape of subjective well-being by age is not observed everywhere..50 Chapter 5. Health Care Systems and Population Aging ..65 Increasing focus on universal health care and aging..65 Health systems in response to aging ..66 Health system s response to aging in high-income countries ..69 Health system s response to aging in low- and middle-income countries ..70 Healthcare cost for aging populations ..70 Cost is one .. to pay is another ..73 Long-term care needs and costs will increase ..74 Quantifying informal care and care at home ..79 Other care options: Respite, rehabilitative, palliative, and end-of-life care ..81iv An Aging World: 2015 Census BureauFIGURESF igure 2-1.

8 Percentage of Population Aged 65 and Over: 2015 and 2050 .. 4 Figure 2-2. World Population by Age Group: 2015 to 2050 .. 5 Figure 2-3. Young Children and Older People as a Percentage of Global Population : 1950 to 2050 .. 5 Figure 2-4. Population Aged 65 and Over by Region: 2015 to 2050 .. 8 Figure 2-5. Percentage Distribution of Population Aged 65 and Over by Region: 2015 and 2050 .. 8 Figure 2-6. The World s 25 Oldest Countries and Areas: 2015 and 2050 .. 10 Figure 2-7. Number of Years for Percentage Aged 65 and Older in Total Population to Triple: Selected Countries .. 12 Figure 3-1. Total Fertility Rate by Region: 2015, 2030, and 2050 .. 15 Figure 3-2. Population by Age and Sex for China: 2015 and 2050 .. 17 Figure 3-3. Population by Age and Sex for Nigeria: 2015 and 2050 .. 19 Figure 3-4. Population by Age and Sex for Kenya: 2015 and 2050 .. 19 Figure 3-5. Percentage Distribution of Population Aged 50 and Over by Number of Surviving Children for Selected European Countries: 2006 2007.

9 20 Figure 3-6. Type of Support Received by People Aged 50 and Over in Selected European Countries by Child Status: 2006 2007 .. 21 Figure 3-7. Countries With Expected Decline of at Least 1 Million in Total Population From 2015 to 2050 . 22 Figure 3-8. Dependency Ratios for the World: 2015 to 2050 .. 24 Figure 3-9. Dependency Ratios for Indonesia and Zambia: 1980, 2015, and 2050 .. 24 Figure 3-10. Countries With Lowest or Highest Median Age in 2015: 2015, 2030, and 2050 .. 25 Figure 3-11. Difference Between Female and Male Populations by Age in the United States: 2010 .. 26 Figure 3-12. Sex Ratio for World Total Population and Older Age Groups: 2015 .. 27 Figure 3-13. Sex Ratios for Population Aged 65 and Over for Bangladesh and Russia: 1990 to 2050 .. 28 Figure 4-1. Mean Age of Death in Global Burden of Disease Regions: 1970 and 2010 .. 32 Figure 4-2. Countries With Highest and Lowest Life Expectancy at Age 65 by Sex: 2015 and 2050.

10 35 Chapter 6. Work and Retirement .. 91 Labor force participation rates vary sharply by age and sex .. 91 Older Population in higher income countries less likely to be in labor force .. 92 Gender gap in labor force participation rate is narrowing .. 95 Labor force participation among the older Population continues to rise in many developed countries .. 95 Share of the older, employed Population working part-time varies across countries .. 98 Unemployment patterns vary across sexes and over time ..102 Expectations and realities many workers uncertain about their lifestyle after retirement and many retire earlier than expected ..106 Statutory retirement ages vary widely across world regions, yet tend to lump at certain ages ..108 Chapter 7. Pensions and Old Age Poverty ..115 Number of countries offering a public pension continues to rise ..115 Earnings-related pension programs are still the most common ..115 Public pension coverage greater in high-income countries.