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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. 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 around 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 those 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 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, Medicaid, 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 those and other demographic trends, Peterson suggests some new strategies and solutions:

• Encourage much longer work lives for people in developed nations—well past age 70.
• Increase the size of the working-age labor force by getting more work from working-age citizens or by increasing immigration of working-age people from elsewhere.
• Raise more, and more productive, children.
• Stress filial obligation by encouraging children to support their own elder parents through informal family care.
• Target benefits on the basis of need.
• Require people to save much more aggressively toward their own old age.

Peterson says that by 2050, the 12 most populous nations will include only one of today's developed countries: the United States. The others will be India, China, Pakistan, Indonesia, Nigeria, Brazil, Bangladesh, Ethiopia, Congo, Mexico, and the Philippines.

Finally, Peterson says that these and other demographic trends will create huge business opportunities in a number of areas. The expanding areasof opportunity, with examples, include:

• Asset management, for example, financial planning
• Health care—specifically, geriatric services
• Professions with expertise related to the elderly, such as family counseling, legal services, and real estate advice
• Fountain-of-youth products and services, such as cosmetics, plastic surgery, and specialized exercise training and equipment
• Retirement lifestyles: lifestyle industries that target older age brackets, such as travel services and nursing home communities
• Personal transportation such as luxury automobiles and motor carts that allow mobility of elders
• Food and nutrition such as vitamin and nutritional supplements and restaurant chains that cater to the needs of elders
• Home repair and personal services such as home cleaning and grocery shopping services
• Grandparenting services for grandparents who are raising their grandchildren
• Ethnic markets such as international communications and ethnic restaurants
• Death care to help families plan for and finance death and dying and to find cemeteries and funeral homes

This is a challenging and thought-provoking book—one that surprised me at every turn with nuggets, demographic gems, and astounding facts. As world citizens, we will be asked to make decisions on all kinds of issues raised by these demographic changes: for instance, how to fund pensions and retirement years, how to pay for health care and education, and how to develop workable immigration policies. Even if only half of Peterson’s predictions come true, we are still in for some huge changes and challenges worldwide.

I urge you to read this book and think seriously about its implications for you as an individual and for your family, your community, your nation, and the world. This is one of the most eye-opening books I have read in a long time. If you get a chance to look at it, please let me know what you think. And please contact me if you would like to consider writing a column on some aspect of health care, mental health, or behavioral health related to the Internet, especially if the topic would be of interest worldwide.


Marcie Parker, Ph.D., CFLE
Senior Qualitative Researcher
Optum: MN010-S203
6300 Olson Memorial Highway
Golden Valley, MN 55427
U.S.A.

Phone (work): +1-612-797-2718
Fax (home): +1-612-474-3079
Home mailing address: P.O. Box 552, Excelsior, MN 55331, U.S.A.
E-mail: mparker@uhc.com