Successful Aging of Societies
Successful Aging of Societies
John W. Rowe
JOHN W. ROWE
, a Fellow of the American Academy since 2005, is Professor at
the Columbia University Mailman School of Public Health and Chair of the MacArthur
Foundation Research Network on an Aging Society. He is the author of Successful
(with Robert L. Kahn, 1998) and was the Chair of the Institute of
Medicine of the National Academies project the Future Health Care Workforce for
Older Americans, which authored the report Retooling for an Aging America: Building
the Health Care Workforce
Abstract: As America ages, policy-makers’ preoccupations with the future costs
of Medicare and Social Security grow. But neglected by this focus are critically
important and broader societal issues such as intergenerational relations within
society and the family, rising inequality and lack of opportunity, productivity
in late life (work or volunteering), and human capital development (lifelong education
and skills training). Equally important, there is almost no acknowledgment of the
substantial benefits and potential of an aging society. The MacArthur Foundation
Research Network on an Aging Society offers policy options to address these issues
and enhance the transition to a cohesive, productive, secure, and equitable aging
society. Such a society will not only function effectively at the societal level
but will provide a context that facilitates the capacity of individuals to age successfully.
This volume comprises a set of papers, many of which are authored by members of
the MacArthur Network, focusing on various aspects of the opportunities and challenges
facing the United States while it passes through its current demographic transformation.
This essay provides a general overview of the strategy the Network has used to address
the various components of this broad subject.
Policy-makers and pundits are increasingly preoccupied with the negative economic
effects of population aging on public health and pension entitlements, including
Medicare and Social Security. The enormous unfunded future obligations of these
programs, especially Medicare, tend to crowd out all other considerations. While
these entitlement programs surely require modifications to ensure their sustainability
and fairness, the current debate neglects other critically important issues related
to the aging of America: future intergenerational relations and tensions; socioeconomic
disparities and inequalities; changes in the structure and function of the family
and its capacity to serve the traditional safety-net role; the impact of technology;
and the critical importance of adaptation of core societal institutions, including
education, work and retirement, housing, transportation, and even the design of
the built environment (the supporting residential, recreational, commercial, and
transportation infrastructure). Equally important, there is almost no acknowledgment
of the substantial positive contributions and potential productivity of an aging
Our goal is to develop and help implement policies that assure our transition to
a cohesive, productive, secure, and equitable aging society. Failure to reach this
goal will leave us with a society rife with intergenerational tensions – characterized
by enormous gaps between the haves and the (increasingly less-educated) have-nots
in quality of life and opportunity – and unable to provide needed goods and
services for any of its members, especially a progressively older and more dependent
Gloomy though this scenario is, it is avoidable. We have time to put in place policies
that will help strengthen the future workforce, increase productive engagement of
older individuals, and enhance the capacity of families to support elders. Many
such policies may, at the same time, lessen the burden on Social Security.
How did we get here? Given the advance warning decades ago that an age wave was
coming, why has U.S. society been unable to prepare? Part of the failure to act
lies with a set of archaic beliefs regarding the true nature of societal aging.
Stakeholders failed to realistically assess challenges and envision opportunities
and squandered the time available to formulate appropriate public policy. The denial
continues: a recent Pew Research Center survey of global attitudes on aging shows
that less than 26 percent of Americans feel that an aging society is a “major
issue”! Only Indonesia and Egypt ranked lower on the survey.1 Contributing to this denial are two pervasive
and disabling myths about aging in the United States: the first myth concerns the
impact of the baby boom; the second assumes that an aging society is only concerned
with the elderly.
The influence of the baby boom on U.S. population aging is not temporary. Contrary
to what the popular myth suggests, the passing of the baby boomers through the age
structure will not terminate population aging or return us to the age structure
of earlier periods of U.S. history. Rather, the demographic changes that have taken
place over the last century are permanent. The age structure of all current and
future populations either have already been transformed or are about to permanently
shift, aggravated in part by the unusually large post – World War II birth
cohort, but driven primarily by the combined effect of unprecedented increases in
life expectancy and decreases in birth rates.
The second widely accepted myth is that an aging society is defined by and is solely
concerned with its elders. This belief tends to pit generations against each other,
overlooking the critical fact that the proper unit of analysis for policy-makers
is not one specific age cohort but rather society as a whole. Policy-makers must
consider the intergenerational effects of their policies and design solutions that
benefit all of society, not just any one interest group.
Whereas countries in Western Europe aged ahead of the United States – reflecting
their post – World War II baby bust and sustained reductions in total fertility
below the replacement rate – the U.S. baby boom and higher fertility rate
have combined to delay by a few decades the emergence of an aging society (defined
here as one with more individuals over age sixty-five than are under age fifteen).
For instance, the United States will not meet Germany’s current population
age distribution until 2030. And Germany’s age structure has not caused ruin
for its society or its economy. Thus, one would think that the experiences of the
Western European countries, which are like the United States in many ways, would
provide a clear road map for the policies the United States needs to adopt for a
successful transition to a productive and equitable aging society. But although
the United States certainly has much to learn from looking at the experiences of
older societies in Europe and even of Japan, differences across societies, cultures,
and policy strategies may limit the utility of these comparisons, thus requiring
the development of a uniquely American resolution to the issues presented by an
aging society. In short, international comparisons can be valuable, but we must
be cautious in generalizing experiences from other cultures.
The MacArthur Network has developed a set of closely related components that form
the core of a theory of adaptation in an aging society. Although there is substantial
overlap between these components, identifying each has value. To begin, a plan of
action must first:
1) Analyze society and its institutions. The unit of analysis should be
the society and the adaptation of its core institutions (such as family, work and
retirement, education, media, religion, and civic affairs) and should encompass
a multigenerational and intergenerational perspective, rather than focus solely
on individuals of any one age group (elders or youth).
2) Take a long-term view and consider structural lag. The primary focus
should be on adjusting and adapting core institutions – including education,
work and retirement, health care, the design and function of housing and cities,
and transportation – over the long term. It is important to keep in mind gerontologist
Matilda Riley’s concept of structural lag: the recognition that most societal
institutions are resistant to change and lag behind the shifting population of their
3) Adopt a life-course perspective. U.S. society needs to adopt a life-course
perspective that urges redistribution of life’s activities (such as education,
work, retirement, childrearing, and leisure) across the individual life span. Stakeholders
need to detail the impact of socioeconomic, racial/ ethnic, and gender differences
on life-course trajectories and specify how they influence the effectiveness of
various lifestyle related interventions.
4) Consider benefits and risks. Analysis of policy changes should consider
both the possible benefits and risks to an aging society and should develop a unifying
strategy that optimizes the balance between the two. As societies attempt to deal
with the many challenges derived from demographic transition, too little attention
is paid to its potential upside: the longevity dividend. This includes the previously
unimaginable capability of older individuals to participate productively in society
either through the workforce or through civic engagement. Older people have much
to offer, including accrued knowledge, stability, unique creative capacities for
synthetic problem solving, and increased ability to manage conflicts and consider
the perspectives of other age groups. As a society, the United States should harness
the life-stage-appropriate capabilities and goals of people of all ages, including
older adults, to enhance societal benefits and reduce social stratification.
5) Focus on human capital. Policy-makers should focus on strategies that
take advantage of all available talent in the population, employ social norms based
on ability rather than chronological age, and transition from an emphasis on investment
early in life to recognition that investments across the full life span can pay
dividends. These payoffs will be individual, intergenerational, and societal (with
both crossover and spillover effects); and because they can be positive or negative,
the outcomes must be monitored.
The MacArthur Network has developed three strategies for policy analysis. First,
it is critical to develop a toolbox of more sensitive and predictive economic and
social indicators – including lifestyle dimensions – that permit accurate
assessment of the current conditions and likely future trajectory of the population
and society along the principal policy dimensions of interest. We need an alternative
to the archaic old-age dependency ratio, which simply equates old age with dependency.
Metrics that express the full array of benefits-to-costs relationships of a long-lived
society, as well as alternatives for life-course trajectories, are also essential.
This toolbox can be used to model possible outcomes of societal investment in factors
that alter the impact of an aging population. Second, in order to encourage the
identification of effective solutions, researchers and policy-makers must present
and analyze multiple policy options, rather than advocate single proposals, and
should target multiple factors (such as the financial, social, life-course evolution,
behavioral, and physical). Further, policy-makers should consider and employ both
private and public involvement and federal and local approaches.
Finally, policy analysis must assess policy impacts. The MacArthur Network suggests
adopting a strategy similar to that used to assess the environmental impact of a
planned development. Specifically, Network members propose that all policies be
evaluated for the effects they have within each generation, as well as on the interactions
between generations (known as assessing intergenerational effects), in order to
be most effective.
In addition, the MacArthur Network has identified six high-priority domains for
policy analysis. They include:
1) Intergenerational relations. This general area requires understanding
at both the societal and individual family-unit levels. For society, the core question
relates to cohesion. What is the potential for the widening gap between the haves
and have-nots and for the increased competition over scarce resources being channeled
into entitlements to tear at the fabric of our society and create a “war”
between the generations?
The MacArthur Network prefers to use the term cohesion to describe the
issues related to intergenerational relations (or tensions) because it focuses on
age integration rather than age segregation and addresses intergenerational transfers,
attitudes, multigenerational strategies, and changes in family structure. Cohesion
can be viewed as the debate regarding the traditional social compact – which
we prefer over the more commonly used legalistic “contract” –
between the generations.
Substantial empirical evidence shows strong support by middle-aged and younger Americans
for older Americans and highlights social cohesion’s benefits; but, as many
observers have noted, the future increase of entitlement costs may place substantial
stress on this balance.3 Depending
on future economic and educational gaps, will future young-adult and middle-aged
Hispanics, for example, reflect the same support for elderly white Americans? Further,
what impact will future immigration policies, whose intent may be to eliminate the
shortfall of skilled U.S. workers, have on these tensions?
2) Family (evolution, supports, changing roles). Families make up the front
line of our adaptation to an aging society. For the family, the core question of
the aging society relates to the uncertainty regarding its capacity to play its
traditional role as safety net and exhibit adaptive capacities to respond to a variety
of financial, social, and health-related needs. Factors threatening the family’s
role include the emergence of an array of family forms with different capacities
for support (such as a childless family unit), increased longevity, geographic dispersion,
economic challenges, and likely future reductions in entitlements.
Moreover, these changes are amplified by the growing diversity that results from
increased stratification. The strength and salience of intergenerational ties become
more prominent features in an aging society, and the traditional life course is
being altered in part because of increased longevity. The transition to adulthood
comes five or more years later than it used to, placing parents of young adults
in the challenging position of helping support their parents or even their grandparents
while launching their own children toward independence.4
Families with resources can manage this balancing act relatively well, but a growing
number of families will be overly burdened trying to contend with these competing
demands without proven ways of managing the more complex, intergenerational family
systems. Issues such as intrafamilial supports, housing, financial transfers, caregiving,
and new familial roles will also inform critical policy decisions surrounding the
changing face of U.S. families.
3) Productivity (work and retirement, functional status and disability, technology,
roles of older individuals in society). The future roles of older individuals
in society will have a dramatic impact on the likelihood that the United States
will be productive, cohesive, and equitable. This set of issues can be conveniently
divided between work and retirement matters and civic engagement matters, although
they are closely interrelated. The likelihood of a retiree volunteering is very
much influenced by whether that person volunteered while still in the workforce.5 Thus, approaches to encouraging
people to volunteer while still in the workforce – via modifications in time
and place of work, provision of opportunities for engaging in what individuals consider
meaningful activities, and development of paid volunteerism strategies – may
have a substantial positive effect on post-retirement engagement. Such engagement
is beneficial not only for retirees but also for the general population.
Technology bridges the worksite to areas of civic engagement and, depending on the
type of technology and its fit with the abilities and needs of older individuals,
can wind up either facilitating or inhibiting their participation. Substantial opportunity
exists for policy changes and technological and other worksite modifications and
educational interventions that will not only make retention of older workers more
attractive to employers, but will also take advantage of the many strengths older
workers offer. It is important for policy-makers to be aware of the “lump-of-labor”
fallacy and the growing body of empirical evidence indicating that older individuals
need not be moved out of the workforce to make room for younger workers.6 In addition, policy should be informed by
the most recent findings regarding trends in disability in populations of elders
and near-elders. Much of the most recent work suggests that the severe disability
rates (as measured by activities of daily living and instrumental activities of
daily living scales) are now stable in older individuals, having halted their decades-long
decline; and that, for unknown reasons, functional mobility impairments may be rising
in individuals aged fifty to sixty-five.7
It will be important for policy-makers to understand the likely influence of these
trends on the adequacy of the future U.S. labor force, as well as on the future
demand for personal care services.
4) Human capital development (such as lifelong education and skills training).
Some of the same societal forces that led to longer lives have also shortened the
half-life of knowledge in science and technology. How can human capital be expanded
at different points along the life course? Can the misalignment between education
and work that is aggravated by increasing longevity be improved through a closer
relationship between educational institutions and the workplace?
Stakeholders need to understand and employ the most effective approaches to keep
young individuals in school and to provide a coherent approach to lifelong learning
that gives individuals the skills and attitudes they need to continue to productively
evolve within overall societal and work environments. Although returning to school
– now common among younger adults – is still relatively rare among individuals
over forty, providing access to educational institutions for the near-old and old
is no less critical than keeping younger people in school. Education must be redefined
as a lifelong experience.
5) Health and health care. Although it might seem that the ongoing national
debate about health care reform may have exhausted this topic, the Network believes
that some important and often neglected areas of the discussion are directly related
to the demographic transformation. These include the development of a more geriatrically
sophisticated health care system in which most providers (physicians, nurses, dentists,
social workers, psychologists, pharmacists, and others) are competent in diagnosing
and treating medical diseases and syndromes that are common in old age, as well
as a strong reliance on new interdisciplinary models of care that are more effective
in managing the health care problems of frail older individuals with multiple impairments.
In addition, a reorientation to a life-course preventive health model is needed
to strengthen education about healthy lifestyles and intervention implementation
in at-risk groups so that future older individuals will enter the Medicare program
healthier and at higher levels of functioning than their predecessors. Finally,
the United States needs sustainable and clearly articulated policies that deal humanely
with care at the end of life.
6) Relevance to successful aging of individuals. Over the past fifteen
years, successful aging has been a major theme of gerontological research. Much
of the work in the field has been stimulated by the model of successful aging proposed
by the MacArthur Network on Successful Aging, which is focused primarily at the
level of the individual.8 It
is self-evident that the changes that occur at the societal level in response to
the demographic transformation may have major positive or negative effects on the
capacity of individuals to age successfully. While many of the issues and policy
options discussed in this volume are relevant to individuals, our primary current
focus is at the level of society. The interaction between societal change and the
status of aging individuals represents fertile territory for future research.
These major themes and recommendations are explored in depth in the essays found
in this issue of Dædalus. Among the essays are S. Jay Olshansky’s
“The Demographic Transformation of America,” which looks toward the
changing face of aging and life expectancy in America. Robert Hummer and Mark Hayward’s
essay “Hispanic Older Adult Health & Longevity in the United States: Current
Patterns & Concerns for the Future” explores the “Hispanic paradox”
– that first-generation Hispanic immigrants have a greater life expectancy
than both nonimmigrant Americans and residents of their native countries –
in addition to troubling health and well-being warning signs for the future Hispanic
population. Frank Furstenberg, Caroline Hartnett, Martin Kohli, and Julie Zissimopoulos
have written “The Future of Intergenerational Relations in Aging Societies,”
which examines the family’s capacity to respond to the growing challenges
and demands for support of a rapidly aging America; while Lisa Berkman, Axel Boersch-Supan,
and Mauricio Avendano point toward how adaptation of our expectations of the elderly
can lead to a more productive and resilient society in “Labor-Force Participation,
Policies & Practices in an Aging America: Adaptation Essential for a Healthy
& Resilient Population.”
In our essay “Productivity & Engagement in an Aging America: The Role
of Volunteerism,” Dawn Carr, Linda Fried, and I propose that the impact of
volunteerism in an aging population be recognized and invested into, and that programs
harness the social capital of older adults to improve the well-being of the elderly
and address critical needs of society as a whole. And S. Jay Olshansky, Dana Goldman,
and I contributed the essay “Resetting Social Security,” which considers
the critical financial safety net of social security and what impact might result
from further changes to its age of eligibility requirements.
In their essay “Global Population Aging: Facts, Challenges, Solutions &
Perspectives,” David Bloom, David Canning, and Alyssa Lubet provide an overview
of global population aging and its contributing factors; outline some of the major
challenges associated with widespread population aging; and describe current and
possible future responses to these challenges. Finally, Julie Zissimopoulos, Dana
Goldman, S. Jay Olshansky, John Rother, and I conclude the issue with “Individual
& Social Strategies to Mitigate the Risks & Expand Opportunities of an Aging
America.” This essay discusses the major risks associated with aging at both
the level of the individual and the level of society, and presents courses of action
for policy-makers in education, work and retirement, financial security, health
care, and social cohesion to promote the benefits and reduce the risks of longer
life. Taken together, these policy options provide a broad blueprint for successful
societal adaptation to the aging of America.
1 Pew Research Center, Attitudes
about Aging: A Global Perspective (Washington, D.C.: Pew Research Center,
2 Matilda Riley and John Riley,
“Structural Lag: Past and Future,” in Age and Structural Lag: Society’s
Failure to Provide Meaningful Opportunities in Work, Family, and Leisure,
ed. Matilda Riley, Robert L. Kahn, and Ann Foner (New York: Wiley-Interscience,
3 James Schulz and Robert Binstock,
Aging Nation: The Economics and Politics of Growing Older in America (Baltimore:
Johns Hopkins University Press, 2008).
4 Gordon Berlin, Frank F. Furstenberg,
Jr., and Mary Waters, “The Transition to Adulthood,” The Future of Children
20 (1) (Spring 2010): 1–18.
5 Barbara A. Butrica, Richard
W. Johnson, and Sheila R. Zedlewski, “Volunteer Dynamics of Older Americans,”
The Journals of Gerontology: Psychological Sciences & Social Sciences
64 (5) (February 2009): 644–655.
6 Axel Boersch-Supan, Reduction
of Working Time: Does it Decrease Unemployment? MEA Discussion Paper No.
2003 (Mannheim, Germany: University of Mannheim, Mannheim Research Institute for
the Economics of Aging, 2002); and John Gruber and David Wise, eds., Social Security
Programs and Retirement Programs Around the World: The Relationship to Youth Employment
(Chicago: University of Chicago Press, 2009).
7 National Research Council,
“Health and Disability in the Working-Age and Elderly Populations,”
in Aging and the Macroeconomy: Long-Term Implications of an Older Population
(Washington, D.C.: National Academies Press, 2012).
8 John W. Rowe and Robert L.
Kahn, “Human Aging: Usual and Successful,” Science 237 (4811)
(1987): 143–149; John W. Rowe and Robert L. Kahn, “Successful Aging,”
The Gerontologist 37 (4) (1997): 433–440; and John Wallis Rowe and Robert
L. Kahn, Successful Aging (New York: Pantheon Books, 1998).