A roadmap for greater longevity

Ensuring that populations globally are actively engaged in society while living longer, healthier lives will require an all-of-society approach — from governments and the private sector to individuals and families, according to a new report from the US National Academy of Medicine [NAM].

The report, part of the NAM’s Healthy Longevity Global Grand Challenge, provides a roadmap with recommendations for both addressing the needs of older people in the next five years and supporting actions to improve healthy longevity by 2050 in the areas of work, volunteering and education; social infrastructure; physical environment; and public health, health systems and long-term care.

Global Roadmap for Healthy Longevity says healthy longevity is the state in which years in good health approach the biological life span, with good physical, cognitive and social functioning. It says major disrupters to healthy longevity include ageism, disease, poverty, pollution and inequity.

The report says longer life spans result in the need to enable people to continue contributing to society, through various avenues such as helping younger generations, caring for grandchildren, mentoring, volunteering or working. Providing opportunities to increase workforce participation for people over age 50 in high-income countries who have the desire or need to work is the best way to harness healthy longevity in service to those countries’ economies, it states. Moreover, healthy longevity will contribute to growth in gross domestic product, personal savings and government coffers.

Removing structural barriers that prevent people from working as long as they want — such as age discrimination and higher taxes on wages earned after retirement age — and establishing incentives to encourage people to work have historically increased workforce participation, says the report. Employers can make employment more attractive by allowing people to transition incrementally into retirement. And governments can eliminate mandatory age-based retirement and provide incentives for job retraining.

It recommends that governments, in collaboration with the business sector, should develop new policies that ensure worker health and safety and legal and income protections (including for those working in the gig economy and during periods of disability), increase opportunities for part-time work and flexible schedules and promote intergenerational national and community service and career changes. In addition, governments, employers and educational institutions should prioritise investments in redesigning education systems to support lifelong learning and training, the report says.

Addressing age discrimination

The report further states that structural and individual age discrimination is a barrier to healthy longevity and productive engagement in society. And it says governments should develop evidence-based, multipronged strategies for reducing ageism and age discrimination, including intergenerational and cross-sector collaboration, public information campaigns and legal protections against age discrimination.

Moreover, it says, while many older people have strong social and family ties that keep them connected and engaged, at the same time an estimated 20 percent to 34 percent of older adults in China, Europe, Latin America and the United States identify as lonely. The effects of isolation and loneliness on mortality and health rival in magnitude those of smoking, alcohol misuse, and obesity. Evidence-based programmes to reduce loneliness and strengthen family, community and social ties can be scaled and replicated.

In the area of financial security, the commission calls on all governments to develop plans for ensuring basic financial security for older people by 2027 though retirement income systems. In addition, it calls for governments and employers to develop strategies for increasing financial literacy and mechanisms for promoting pension contributions, self-funded pensions and lifelong savings.

The report also covers affordable housing, public transport, access to public spaces and long-term, person-centred healthcare starting from an early age. The commission notes that while the need to address healthy longevity is universal, the best path forward in different parts of the world will differ, particularly due to variation in resources and political, economic, social and environmental forces. This variation is especially challenging in a world facing crises such as climate change, a pandemic, and threats to global political stability that will compete for the same resources needed to improve healthy longevity.

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