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When we look historically and cross-culturally, we see that old age is a relative term, since few people in many of the societies we have discussed reach what most Americans would consider to be old, say 65 or older (or perhaps 50 or older, which entitles someone to membership in AARP, formerly called the American Association of Retired Persons). When we compare societies, we find that life expectancyThe average age to which people can be expected to live., or the average age to which people can be expected to live, varies dramatically across the world. As Figure 9.3 "Average Life Expectancy Across the Globe (Years)" illustrates, life expectancy in North America, most of Europe, and Australia averages almost 75 years or more, while life expectancy in most of Africa, where the San live, averages less than 55 years. In some African nations, the average life expectancy is under 45 years (Population Reference Bureau, 2009).Population Reference Bureau. (2009). 2009 world population data sheet. Washington, DC: Author.
Figure 9.3 Average Life Expectancy Across the Globe (Years)
Source: Adapted from Global Education Project. (2004). Human conditions: World life expectancy map. Retrieved from http://www.theglobaleducationproject.org/earth/human-conditions.php.
What accounts for these large disparities? The major factor is the wealth or poverty of a nation, as the wealthiest nations have much longer life expectancies than the poorest ones. This is true because, as Chapter 6 "Social Stratification" noted, the poorest or least developed nations by definition have little money and few other resources. They suffer from hunger, AIDS, and other diseases, and they lack indoor plumbing and other modern conveniences found in almost every home in the wealthiest nations. As a result, they have high rates of infant and childhood mortality, and many people who make it past childhood die prematurely from disease, starvation, and other problems. We return to these problems in Chapter 13 "Health and Medicine".
These differences mean that few people in these societies reach the age of 65 that Western nations commonly mark as the beginning of old age. Figure 9.4 "Percentage of Population Age 65 or Older, 2007" depicts the percentage of each nation’s population that is 65 or older. Not surprisingly, the nations of Africa have very low numbers of people 65 or older. In Uganda, for example, only 3% of the population is at least 65, compared to 13% of Americans and 20% of Germans and Italians.
Figure 9.4 Percentage of Population Age 65 or Older, 2007
Source: Adapted from Population Reference Bureau. (2007). 2007 world population data sheet. Retrieved from http://www.prb.org/pdf07/07WPDS_Eng.pdf.
Despite the international disparities we see in life expectancy, overall it has been increasing steadily around the world. It was only 46 years worldwide in the early 1950s but was 69 in 2009 and is expected to reach about 75 by 2050 (Population Reference Bureau, 2009; United Nations Population Division, 2009).Population Reference Bureau. (2009). 2009 world population data sheet. Washington, DC: Author; U.N. Population Division. (2009). World population prospects: The 2008 revision. New York, NY: Author. This means that the number of people 65 or older is growing rapidly: they are expected to reach almost 1.5 billion worldwide by 2050, three times their number today and five times their number just 20 years ago (United Nations Population Division, 2009).U.N. Population Division. (2009). World population prospects: The 2008 revision. New York, NY: Author. Despite international differences in life expectancy and the elderly percentage of the population, the world as a whole is decidedly “graying,” with important implications for the cost and quality of elder care and other issues (Hayutin, 2007).Hayutin, A. M. (2007). Graying of the global population. Public Policy & Aging Report, 17(4), 12–17.
In wealthy nations, older people (65 or older) now constitute 15% of the population but will account for 26% by 2050. Because so many people die so young, poor nations historically have had very low percentages of older people, but this percentage is expected to increase from about 6% now to 15% in 2050. Two factors will account for this growth. First, as in wealthy nations, life expectancy is increasing due to better health care and diets along with other factors, even if conditions in poor nations continue otherwise to be miserable overall. Second, poor nations are experiencing declining fertility; because fewer births means that a lower percentage of their populations will be young, a larger percentage of their populations will be older.
Older people now constitute 15% of the combined population of wealthy nations, but they will account for 26% by 2050.
By 2050, the percentage of older people in poor nations will equal the percentage of older people in rich nations today. The graying of their populations promises to pose special problems. As Adele M. Hautin (2007, p. 13)Hayutin, A. M. (2007). Graying of the global population. Public Policy & Aging Report, 17(4), 12–17. observes, “The rapid pace of aging in the less developed countries will require them to adjust much faster than has been necessary in more developed countries. Moreover, the sheer size of their populations will make their adjustments even more challenging.”
A major problem will obviously involve paying for the increase in health care that the increase of older people in these nations will require. Because these nations are so poor, they will face even greater problems than the industrial world in paying for such care and for other programs and services their older citizens will need. Another problem stems from the fact that many poor nations are beginning or continuing to industrialize and urbanize. As they do so, traditional family patterns, including respect for the elderly and the continuation of their roles and influence, may weaken. One reason for this is that urban families have smaller dwelling units in which to accommodate their elderly relatives and lack any land onto which to build new housing. As a result, families in poor nations will find it increasingly difficult to accommodate their elders. Moreover, elders in poor nations have not had a chance to acquire the financial assets enjoyed by many of their counterparts in the industrial world, making them more dependent on their children and grandchildren than the industrial world’s elderly. Yet in sort of a Catch-22, their children and grandchildren typically have few assets of their own and thus have trouble affording to care for their elders.
Life expectancy has been increasing in the United States along with the rest of the world (see Figure 9.6 "Changes in U.S. Life Expectancy at Birth, 1900–2010"). It rose rapidly in the first half of the 20th century and has increased steadily since then. From a low of 47.3 years in 1900, it rose to about 71 years in 1970 and 77 years in 2000 and will rise to a projected 78.3 years in 2010. Americans born in 2010 will thus be expected to live about 31 years longer (a gain of almost 66%) than those born 110 years earlier.
Figure 9.6 Changes in U.S. Life Expectancy at Birth, 1900–2010
Sources: Data from Arias, E. (2010). United States life tables, 2006. National Vital Statistics Reports, 58(21), 1–40.
Note that the average U.S. life expectancy in 1900 was similar to that seen today in many poor nations. A century ago, many Americans lacked proper sanitation and good nutrition and lived before the advent of modern medicine, when many deadly diseases were rampant. Many infants died before age 1 and many children died before age 10, lowering overall life expectancy. Improved public sanitation and the development of new drugs such as antibiotics helped greatly to reduce infant and childhood mortality in the first half of the 20th century and, in turn, to increase life expectancy (Haines, 2008).Haines, M. (2008). Fertility and mortality in the United States. In R. Whaples (Ed.), Eh.Net encyclopedia. Retrieved from http://eh.net/encyclopedia/article/haines.demography Declining death rates among the elderly also help account for the increase in life expectancy shown in Figure 9.6 "Changes in U.S. Life Expectancy at Birth, 1900–2010". In 1900, a 65-year-old person could expect to live another 11.9 years; the comparable figure for a 65-year-old now is almost 19 years, an increase of almost 7 years.
During the next few decades, the numbers of the elderly will increase rapidly thanks to the large baby boom generation born after World War II (from 1946 to 1964) that is now entering its mid-60s. Figure 9.7 "Past and Projected Percentage of U.S. Population Age 65 or Older, 1900–2050" shows the rapid rise of older Americans (65 or older) as a percentage of the population that is expected to occur. Elders numbered about 3.1 million in 1900 (4.1% of the population), number about 40 million today, and are expected to reach 89 million by 2050 (20.2% of the population). The large increase in older Americans overall has been called the graying of America and will have important repercussions for elderly care and other aspects of old age in the United States, as we discuss later.
Figure 9.7 Past and Projected Percentage of U.S. Population Age 65 or Older, 1900–2050
Source: Data from Administration on Aging. (n.d.). Projected future growth of the older population by age: 1900–2050. Retrieved from http://www.aoa.gov/AoARoot/Aging_Statistics/future_growth/docs/By_Age_65_and_over.xls.
We have seen that worldwide differences in life expectancy reflect global stratification. Inequality in life expectancy also exists within a given society along gender, race and ethnicity, and social class lines.
For gender the inequality is in favor of women, who for both biological and social reasons (see Chapter 13 "Health and Medicine") outlive men across the globe. In the United States, for example, girls born in 2007 could expect to live 80.4 years on the average, but boys only 75.4 years.
In most countries, race and ethnicity combine with social class to produce longer life expectancies for the (wealthier) dominant race, which in the Western world is almost always white. The United States again reflects this international phenomenon: whites born in 2007 could expect to live 78.4 years on the average, but African Americans only 73.6 years. In fact, gender and race combine in the United States to put African American males at a particular disadvantage, as they can expect to live only 70.0 years (see Figure 9.8 "Sex, Race, and Life Expectancy for U.S. Residents Born in 2007"). The average African American male will die almost 11 years earlier than the average white woman.
Figure 9.8 Sex, Race, and Life Expectancy for U.S. Residents Born in 2007
Source: Data from National Center for Health Statistics, U.S. Department of Health and Human Services. (2010). Health, United States, 2010, with special feature on the health of young adults. Retrieved from the Centers for Disease Control and Prevention Web site: http://www.cdc.gov/nchs/data/hus/hus10.pdf.