 |
 |
|
|
|
The Graying of the Internet By Marcie Parker, Ph.D., CFLE mparker@uhc.com Welcome to a new column on health care, mental health and behavioral health issues! For the next year, I will be the editor of a new column on health care issues for of OnTheInternet. I’ve asked a number of experts to submit articles for this column, and I trust they will be interesting and challenging articles of global interest. I would also like to solicit articles from those who would like to write about an important issue in health care, mental health, or behavioral health that relates to the Internet; please see the end of this article for information on contacting me with your ideas. This first column focuses on demographic changes, already under way, that will affect the United States and the world throughout the first 50 years of the new millennium. I hope it will set the stage for how we read and consider the columns that follow; I think we will see that our health care issues, no matter where we live, are much more similar than dissimilar. I recently read Gray Dawn: How the Coming Age Wave Will Transform America and the World, a remarkable new book by Peter G. Peterson (Random House, 1999). It has changed completely how I think about and plan for the future; if you read only one book this year, consider making this the one. Peterson makes a number of demographic observations that are fascinating and sobering. He looks at demographics today, in 2030, and in 2050, in the United States and throughout the world, in both developing and developed nations. Almost every page contains a surprising fact or demographic gem that is then backed up by research and statistics. Peterson elaborates on three basic points in his book: there is currently a birth dearth, the world’s populations are aging, and many of those populations are becoming increasingly diverse—ethnically, racially, and culturally. Peterson starts by pointing out a very dramatic rise in average life expectancy as well as the existence of the huge baby boom generation—in the United States and in several other countries—now making its way through middle age. At the same time, he says, fertility rates are falling precipitously, and in some countries—including Japan and Italy—they are already well below the replacement rate, or the birth rate needed to replace today’s population, which is about 2.1. The impact of so few young people entering tomorrow’s tax-paying workforce at the same time that so many people are entering retirement and old age will be profoundly substantial for many nations. Global aging will make the world’s societies by far the oldest in history. For example, Peterson points out, just 30 years from now, one in four people in the developed world will be aged 65 or older, up from one in seven today. This global aging is occurring because people are living much longer and having fewer babies. It will revolutionize the architecture of the family by drastically narrowing and lengthening its shape. Demographers now project a dramatic deceleration in global population growth and an equally dramatic aging of societies worldwide. As the number of elderly people explodes, global aging will place an unprecedented economic burden on working-age people. By 2030, the developed world will gain nearly 100 million elders, while the number of working-age adults will continue to shrink. Peterson says that by 2050, the number of Chinese aged 65 or older is projected to reach 330 million; as recently as 1990, that was the elderly population of the entire world. Furthermore, the retirement age in all developed countries has fallen dramatically, and there will be fewer and fewer working-age adults available to support these retirees. Peterson predicts that unless the United States and other nations enact major policy changes, the typical working couple in 2030 will feel that burden; on top of all of their other taxes and responsibilities, they will, in effect, be required to fund the full cash and health care needs of at least one anonymous retiree—in addition to whatever voluntary support they also may provide their own parents. Many developed countries are projected to lose population over the next 50 years, and therefore they will make up a shrinking share of the total world population. In addition, the current share of ethnic and racial minorities in developed countries will rise steadily. As America grays, the minority share of its population will continue to rise in every age bracket. In the United States, the foreign-born share of people in their 20s is nearly twice the share of people in their 60s. Hispanics and nonwhites now make up 15 percent of the elderly and 28 percent of the nonelderly, respectively. By 2050, Peterson says, the U.S. Census Bureau expects those shares to rise to 34 percent of the elderly and 51 percent of the nonelderly. Global aging means that both immigration and the welcoming and accommodation of diverse populations will be major issues in many nations for decades to come. In the United States, benefit outlays for just five programs—Social Security, Medicare (health care for the elderly), Medicaid (health care for the poor), federal civilian pensions, and military pensions—will exceed total federal revenues by 2030. This means there will be not one penny left for any other purpose. The so-called "aging of the aged" is already a well-established trend—that is, the oldest old—those aged 85 and older— are becoming a rising proportion of the elderly. By 2040 the number of Americans aged 80 and older will more than triple, eclipsing the number of preschool children. This demographic trend places a huge burden on working Americans. Peterson identifies three significant trends worldwide: more and more women are joining the global workforce, women are the primary source of income in about 30 percent of the world's households, and affluent countries have socialized the cost of growing older while keeping private the costs of raising children. In response to these and other demographic trends, Peterson suggests some new strategies and solutions:
|
|
 |