The increasing social care demands of an ageing population

Michael Murphy explains why the population is steadily ageing and why men are making a comeback in their nineties

Britain was among the “oldest” countries in the world in 1950, but has been overtaken by countries such as Japan and Italy. The main cause of population ageing has been the same everywhere: the long-term decline in birthrate rather than improvements in longevity, which have tended to benefit infants and children most.

Population ageing is set to intensify in the coming decades, raising concerns about demand for care, health and financial resources. While the numbers of older people is important, population ageing usually refers to the proportion of older people. One simple measure is the median age of the population, the age at which half the population is above and half below. For the UK, this rose from 35 in 1985 to 40 today.

Age limits such as 15 and 65, which used to mark boundaries for education and retirement, have no biological meaning and are largely arbitrary. Around 1960, on average a man reaching the age of 65 would live for a further 11 years and a woman for 16; by 2010, they could expect to live for a further 21 and 25 years respectively. There are proposals to link the state pension retirement age automatically to longevity improvements, as happens in Sweden.

There is also aging within the older population. The proportion of “old, old people”, those aged 80 or 85 and over, is a growing fraction of the group. In the next two decades, the numbers of people aged 85 and over will more than double from 1.53 to 3.25 million. These people are much more substantial users of health and both formal and informal social care services.

Forecasts of the numbers of older people depend only on future trends of mortality since the other determinant – migration – is small at these ages. Official forecasts for many decades have substantially underestimated improvements in mortality among older people. More recent forecasts, however, appear to be more realistic.

Future population ageing will depend on the numbers of younger people, which is determined by fertility and migration, which have been historically difficult to predict.

There is also change in the gender composition of the older population. The higher mortality of men over the twentieth century meant that the gap in life expectancy between men and women increased. However, the gap has recently started to close, largely reflecting more substantial reductions in smoking by men than women. The proportion of older men will increase so, whereas in 2000, there were nearly four women for each man aged 90 and over, this is expected to fall to two to one by 2020.

Michael Murphy is professor of demography at the London School of Economics and Political Science