Why ageing Europe is gathering momentum and ready for a paradigm shift

Few people celebrate the first wisps of white in their hair. Politicians are likewise reluctant to address the passage of time.

They should, especially in Europe. The Old Continent is ageing. In many corners, its population is shrinking. But although this is part of a decades-long trend, it is barely mentioned by leaders, who try to treat the inevitable as a taboo. This is potentially disastrous: unless Europe tackles its demographic crisis, it could face a perilous future.

The facts are sobering: the share of the population aged 65 years and over is increasing in every EU member. Italy’s fertility rate fell from 2.37 in 1970 to 1.39 in 2013. Portugal’s population is projected to drop from 10.5 million now to 6.3 million by 2060. The UN predicts that by 2030, Germans in the workplace will drop from 61% to just 54% – a shortfall that can only be met by welcoming around 533,000 immigrants every year. There are parts of Spain where for every baby born, more than two people die.

Europe is greying

The EU-28’s median age is already the highest in the world, and rose from 38.3 years to 42.4 years between 2001 and 2015, according to Eurostat. The share of those aged 80 years or above will more than double between 2015 and 2080, from 5.3% to 12.3%, while over-65s will jump from 18.9% to 28.7%.

These changes will have profound effects on Europe’s economy and society. Older Europeans dependent on a younger working population will double in number: every person over 65 years today has four working age people to support them, but this will fall to just two working age people by 2060.

The changing age structure will affect not only economic growth but also public finances and labour markets. More old people means more bills for governments, while fewer babies means fewer taxpayers to pay for them.

The European Commission’s most recent Ageing Report, issued in 2015, says that EU-28 age-related expenditure – pensions, healthcare and long-term systems – will rise by 1.9% of GDP by 2060. The OECD says demand for labour in the European healthcare sector will double or even triple by 2050. Healthcare will shift to prevention methods like early cancer detection, long-term care insurance and integrated care. Health systems will adjust to deal more with chronic conditions and ‘multimorbidity’, from diabetes and heart disease to dementia.

How to work for longer

An obvious solution is to welcome immigrants, who bring new blood into the workforce and society. Even Pope Francis made this point when he addressed the European Parliament in November 2014, speaking of “a general impression of weariness and ageing, of a Europe which is now a ‘grandmother,’ no longer fertile and vibrant.” But although the past two years have seen record numbers of economic migrants and asylum-seekers trying to reach the EU, many Europeans don’t want them. While this mood may change, immigration is currently political poison.

Another solution is to keep people in the labour market for longer. Most EU countries have raised their retirement age to 65 or beyond and are making citizens contribute longer for a full pension. But reforms are slow to take root.

The Commission has valiantly attempted to concentrate EU minds on the issue. Its 2020 Strategy identified active ageing as a major societal challenge, and underlined that good health must be promoted throughout life. It has published research papers, hosted conferences, and gently prodded EU leaders to push ageing up the agenda. It has backed key projects, for example on self-care for minor ailments, and on self-management of chronic conditions. And through its European Group on Ethics in Science and New Technologies, the Commission has looked at issues like how to manage privacy in new health technologies.

Active ageing

One of the keys to dealing with ageing is to approach the advancing years as an opportunity. All too often, stereotypes about frail and dependent pensioners overlook the many contributions the elderly make, while exaggerating the demands they place on society. As the WHO says, older populations in general are very diverse and make many contributions to society, which far outweigh any investments that might be needed to provide the health services, long-term care and social security.

It ties into the concept of active ageing, which aims to extend healthy life expectancy and quality of life for all people as they age. Keeping them in work offers many benefits, including higher individual incomes, higher future pension entitlements, stimulation and retention of cognitive skills, and better mental health. Society also gains from higher tax revenues and social security contributions, coupled with lower social security expenditures and higher consumption.

The EU’s biggest research initiative in this field is the European Innovation Partnership on Active and Healthy Ageing (EIPAHA), which promotes new ideas about health and care. EIPAHA’s discreet projects effectively experiment with future healthcare systems: from integrated care and assisted living to preventing frailty and smart cities. With the support of millions of Euros in EU research grants, including Structural Funds and European Investment Bank aid, EIPAHA is helping regions test these new socio-medical, integrated care ideas.

EIPAHA’s Action Plans on ageing 2016-2018 aim to upscale existing innovative approaches, with priorities ranging from integrated care to medication adherence and prevention of functional decline. And EIPAHA is backing two upcoming Brussels events: a 27 April seminar addressing the challenges of multi-medication in an ageing population; and an 18 May conference on Innovation in care: How to improve quality of life and services for an ageing population?

Seize the moment

Turn the situation on its head, and there has never been a better time to be alive: people are living longer and in better health. Europe – and the world – can be proud that its populations are ageing in a way that was unthinkable a few generations ago.

The implications are huge, for society and the economy. There are opportunities for innovators in healthcare, lifelong learning, IT and other sectors to respond to ageing in the EU. Working to design an integrated model requires a forward looking, thought-through strategic approach and the EU ageing dimension offers that. The difficult exercise is to tailor the sea of initiative and knowledge and showcase practices ready for upscaling. Older Europeans will be more innovative, more integrated, more health literate, and have better self-management skills. The socio-medical environment needs to provide the right infrastructure to make this happen.

The momentum on ageing is not only societal, it is also an opportunity for business to partner and increase uptake of innovative ICT-based solutions for active and healthy ageing. It’s a public affairs strategy that connects, positions and tailors to purpose. Uptake cannot happen in isolation and the EU ageing opportunities need to be made sense of.

As ageing is at the end of our personal story, it is not one we like to dwell on. “In this world,” Benjamin Franklin wrote, “nothing can be said to be certain, except death and taxes.” Policy-makers across Europe recoil at suggesting the eventual decline and demise of their voters.

They should not. They need to rediscover that people are assets to foster, not liabilities to cope with. Even if the question of ageing is dauntingly complex, it is one that we need to make sense of. This is the moment to embrace the greying Europe.

Words Leo Cendrowicz, Anamaria Corca and Nicholas Elles
Photo CC/Shuttershock

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