Tuesday, 14 October 2014

The best (and worst) countries to grow old in-Alexander E.M. Hess and Thomas C. Frohlich


People enjoy the sunshine on the bank of the lake of Geneva in front of the Swiss Alps near the Chateau de Chillon (Chillon Castle) in Veytaux near Montreux, Switzerland, Sunday, April 20, 2014. (AP Photo/Keystone/Salvatore Di Nolfi)

People enjoy the sunshine on the bank of the lake of Geneva in front of the Swiss Alps near the Chateau de Chillon (Chillon Castle) in Veytaux near Montreux, Switzerland, Sunday, April 20, 2014. (AP Photo/Keystone/Salvatore Di Nolfi)
The global population is aging rapidly. Today, there are roughly 868 million people who are at least 60 years old globally, or about 12% of the world’s population. By 2050, more than 2 billion people will be 60 or older, or 21% of the projected global population. In the United States, 27% of all Americans will be at least 60 years old.
HelpAge International’s “Global AgeWatch 2014 Index” ranked the social and economic well-being of older residents in 96 countries. The report rated each country on four broad factors important to an aging population: supporting income security, fostering good health, employment and education, and the overall environment for older residents.. Norway was rated as the best country for older people to live in, bypassing Sweden, last year’s top-rated country. Meanwhile, Afghanistan was rated the worst country for older people for the second consecutive year.

Generally, wealthy countries are better able to provide for their residents than poor countries. All but one of the top 10 countries had a GDP per capita of at least $30,000. At the other end of the spectrum, just one of the 10 worst-rated countries had a per capita GDP of more than $5,000.
However, Kate Bunting, CEO of HelpAge USA, told 24/7 Wall St. that being a wealthy nation alone is not enough for a country to rate well. “We focus on a multidimensional look at being older,” Bunting said. The ability of older people to continue working and ensuring that they do not feel socially isolated are examples of important factors not necessarily captured by GDP, Bunting added. Despite the challenges of crafting policies to help an older population, “We feel that global aging is really a triumph of development.”
Wide-ranging pension coverage is one factor that can help the elderly population of a country. In many of the 10 highest-rated countries, 100% of the population 65 and over receives a pension. According to HelpAge International, only half of the global population can expect to receive a pension of any kind in old age.
Providing for older residents’ long-term health is also a critical factor in a country’s ranking. In each of the top 10 countries to grow old in, a resident who is 60 years old can expect to live at least another 23 years, on average. However, in all of the worst countries to grow old in, the average life expectancy for a 60 year old resident is less than 20 years, with four of these nations reporting average life expectancies at 60 of just 16 years.
An aging global population creates new challenges -- and opportunities -- for policy makers. According to Bunting, “We can start thinking about this as an opportunity for us to think globally about the kinds of policies we need in place in order for people ... to age comfortably.”
Within the specific context of the United States, which ranked as the eighth best country to grow old in, improving access to health care is an important challenge. Additionally, while the U.S. has a strong social protection system, in the form of Social Security, “there are still challenges with that system,” Bunting said. The poverty rate among the American elderly is also an issue of concern.
To identify the best and worst countries to grow old in, 24/7 Wall St. reviewed HelpAge International’s 2014 Global AgeWatch Index of 96 countries. Each country was graded based on four measures: income security, health status, employment and education, and the overall environment for older residents. All data are for the most recent available period at the time the report was put together. We also reviewed figures from the IMF for population, inflation, debt, and other economic variables.

These are the best (and worst) countries to grow old in.
The Best Countries To Grow Old In:
5. Germany

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People enjoy a leisure day in downtown Duesseldorf, Germany.  (AP Photo/Martin Meissner)
People enjoy a leisure day in downtown Duesseldorf, Germany. (AP Photo/Martin Meissner)
> Total population: 80.9 million
> Pct. population aged 60+: 27.5% (2nd highest)
> GDP per capita: $34,620 (18th highest)
> Life expectancy at 60: 24 (tied-13th highest)
Germany currently has the second highest proportion of residents aged 60 and older, at 27.5% of the population, trailing only Japan. By 2040, this figure will rise to nearly 40% of the population. Germany’s population has grown little in recent years, with German Federal Statistical Office data indicating that immigration has offset the decline in the population of native Germans. Still, with 100% pension coverage for seniors, and a GDP per capita $34,620, among the better figures in the world, few nations few nations provide better income security in old age thanGermany. Additionally, Germans over 60 years old are generally well-educated and can expect to live quite long, making Germany one of the best nations to grow old in.
4. Canad.
People play a game of pickup soccer in downtown Toronto. (REUTERS/Mark Blinch)
People play a game of pickup soccer in downtown Toronto. (REUTERS/Mark Blinch)
> Total population: 35.5 million
> Pct. population aged 60+: 21.7% (29th highest)
> GDP per capita: $35,739 (15th highest)
> Life expectancy at 60: 25 (tied 2nd highest)
Few countries provided better health care for the elderly than Canada. A 60 year old Canadian could expect to live 25 years, 18.3 of which will be in good health, both among the highest figures in the world. Residents over 50 were also just as likely as younger adults to feel their life was meaningful -- an important indicator of mental well-being and a measure in which most countries performed far worse than Canada. Each province and territory in the country provided its residents with insurance for medically necessary care, although many Canadians also had private supplementary coverage.
3. Switzerland


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Downtown Bern with the Swiss Alps in the background. (REUTERS/Ruben Sprich)
Downtown Bern with the Swiss Alps in the background. (REUTERS/Ruben Sprich)
> Total population: 8.1 million
> Pct. population aged 60+: 23.6% (21st highest)
> GDP per capita: $39,301 (10th highest)
> Life expectancy at 60: 25 (tied 2nd highest)
No country generated a better enabling environment for older residents than Switzerland. The vast majority of Swiss residents over 50 surveyed said they had someone to count on in an emergency, had personal freedom in their lives, and were satisfied with public transit where they lived. Elderly residents in Switzerland were also among the healthiest in the world. A 60 year old Swiss resident could expect to live 19 more years in good health, more than almost any other nation. With a GDP per capita of $39,301, Switzerland is one of the world’s wealthier countries. All residents 65 and older also received a pension. Despite these facts, 17.6% of Swiss people 60 and older lived in poverty, a relatively high rate.

2. Sweden


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The sun sets over the Grand Hotel in downtown Stockholm. (REUTERS/Henrik Montgomery/Scanpix Sweden)
The sun sets over the Grand Hotel in downtown Stockholm. (REUTERS/Henrik Montgomery/Scanpix Sweden)
> Total population: 9.7 million
> Pct. population aged 60+: 25.6% (7th highest)
> GDP per capita: $34,862 (17th highest)
> Life expectancy at 60: 24 (tied-13th highest)
More than one quarter of Swedes are at least 60 years old, one of the highest proportions in the world. And while this figure is expected rise to 28.5% by 2050, this represents a far-slower growth in the elderly population than in many countries. Older Swedes are more likely than their counterparts in most countries to have income security, as 100% of the population 65 and older received a pension, and just 5% of residents 60 and older lived below the poverty line, one of the lowest rates in the world. Further, older Swedes were among the most likely people in the world to be capable of working at an advanced age. They were also among the most likely to state that they lived in an enabling environment.
1. Norway


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A woman walks her dog near the marina in downtown Bergen, southwestern Norway. (REUTERS/Stoyan Nenov)
A woman walks her dog near the marina in downtown Bergen, southwestern Norway. (REUTERS/Stoyan Nenov)
> Total population: 5.1 million
> Pct. population aged 60+: 21.8% (27th highest)
> GDP per capita: $46,733 (5th highest)
> Life expectancy at 60: 24 (tied-13th highest)
Norway is the best country in the world to grow old in, according to HelpAge. Older Norwegians had better income security than their counterparts anywhere else in the world, with a universal pension and GDP per capita of $46,733, fifth highest among countries reviewed. Just 1.8% of people over 60 lived below the poverty line, one of the lowest rates worldwide. Additionally, over 99% of residents 60 and over had completed at least a secondary education, the highest rate in the world. Further, nearly 96% of residents over 50 said they were happy with the level of personal freedom in their lives, the second highest percentage in the world.
The Worst Countries To Grow Old In:
5. The United Republic of Tanzania


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A destroyed house that was hit by a rocket in the capital Dar es Salaam (Khalfan Said/AP Photo)
A destroyed house that was hit by a rocket in the capital Dar es Salaam (Khalfan Said/AP Photo)
> Total population: 47.7 million
> Pct. population aged 60+: 4.9% (36th lowest)
> GDP per capita: $1,331 (24th lowest)
> Life expectancy at 60: 18 (tied-63th lowest)
While nearly 93% of 55-64 year old Tanzanian residents were employed -- the second highest rate worldwide -- many of these jobs were likely low-skilled. Just 3.1% of country residents over 60 had completed at least a secondary education, one of the lowest attainment rates in the world. Further, less than 40% of residents over 50 were satisfied with the country’s public transportation options, worse than in the vast majority of nations worldwides. Like many countries in the region, Tanzania is quite poor, with a GDP per capita of just $1,331, one of the lowest in the world. Despite poor economic output, Tanzania has managed to avoid violent internal turmoil that is often common in African and Middle-Eastern nations.

4. Malawi


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Villagers walk to a local market in Galufu, Malawi (Per-Anders Pettersson/Getty Images)
Villagers walk to a local market in Galufu, Malawi (Per-Anders Pettersson/Getty Images)
> Total population: 17.6 million
> Pct. population aged 60+: 4.9% (35th lowest)
> GDP per capita: $667 (6th lowest)
> Life expectancy at 60: 16 (tied-11th lowest)
Malawi is exceptionally poor, with an economic output of just $667 per capita. The U.S., by contrast had a GDP of nearly $45,000 per capita. Nearly all of Malawi’s 55-64 year old population worked, with an employment rate of 96.6%, by far the highest among countries reviewed. Yet, like in several other nations in the region, elderly residents are poorly educated. Just 4.5% of people over 60 had completed at least a secondary education, much less than in most countries. While the high employment rate may help some older residents feel independent, less than half of people over 50 said they had someone they could count on when in trouble, one of the worst measures of social connectivity. Nearly 18% of Malawi residents over 60 also lived in poverty, one of the higher rates worldwide.
3. West Bank and Gaza


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The destroyed houses in an area east of Beit Hanoun in the northern Gaza Strip. (AP Photo/Adel Hana)
The destroyed houses in an area east of Beit Hanoun in the northern Gaza Strip. (AP Photo/Adel Hana)
 > Total population: N/A
> Pct. population aged 60+: 4.6% (28th lowest)
> GDP per capita: $2,465 (48th lowest)
> Life expectancy at 60: 18 (tied-63rd lowest)
The West Bank and Gaza, separated by miles of Israeli territory, are nearly the worst regions in which to grow old. Palestinians and Israelis have been in a nearly continuous conflict, and tensions may worsen as Hamas recently renewed its political presence in the West Bank. While nearly three-quarters of people over 50 felt safe walking home and approved of the public transport system -- both among the higher rates reviewed -- just 30% of residents aged 55 to 64 had a job, nearly the lowest rate. Poor employment and political turmoil may have also contributed to only 41% of Palestinians over 50 feeling freedom in their lives, one of the lower rates among countries reviewed.
2. Mozambique

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Mozambique (Getty Images)
Mozambique (Getty Images)
> Total population: 26.5 million
> Pct. population aged 60+: 5.1% (40th lowest)
> GDP per capita: $842 (8th lowest)
> Life expectancy at 60: 16 (tied-11th lowest)
Located on the Indian Ocean in southeastern Africa, Mozambique has struggled with a long history of colonialism and civil war. While the country has stabilized considerably since its independence in 1992, Mozambique is still quite poor. The nation’s GDP per capita was just $842 last year, among the lowest economic outputs worldwide. The country’s weak economy is likely having some effect on the well-being of elderly residents, as nearly 20% of people over 60 lived in poverty, considerably higher than in most other countries. Less than a third of Mozambique residents over 50-years old felt safe walking home at night, nearly the worst rate.

1. Afghanistan


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A man pulls his handcart in Kabul. (REUTERS/Omar Sobhani)
A man pulls his handcart in Kabul. (REUTERS/Omar Sobhani)
> Total population: 31.3 million
> Pct. population aged 60+: 3.9% (11th lowest)
> GDP per capita: $1,225 (8th lowest)
> Life expectancy at 60: 16 (tied-11th lowest)
Afghanistan is the worst country for the elderly. At 60 years old, Afghan residents could expect only 9.2 years of good health -- one of the only nations in the world where healthy life expectancy at 60 was less than a decade. While older Afghans were more likely to work than older residents in other countries, people over 60 were very poorly educated. Just 5.2% had completed at least a secondary education, among the lowest rates worldwide. While the U.S. and its allies have considerably reduced its military presence in the country, Afghanistan has been the site of conflict for decades. The withdrawal of the U.S. from the country could also further imperil the nation’s political and economic stability.

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