In this episode of the Reframing Healthy Ageing podcast, IFA’s Dr. Jane Barratt is joined by Prof. Andrew J. Scott, author and Professor of Economics at London Business School, and Prof. Bradley J. Willcox from the University of Hawaii to discuss ageing well, harnessing longevity and the learned perspectives of centenarians.
30 is the new 20, 40 is the new 50, 50 is the new 60. It’s an adage we come to hear a lot these days, a popular discourse in media and amongst dinner table conversations. There is a clear hypothesis on the roots of this discourse. As lifespan increases and people continue to live longer and better, there is a need to rethink life stages, how we perceive ageing and how society defines “older people”. Whether it’s extended adolescence in our 20s or continuing our working lives into our 60s, longevity is retracing the map of life, and society now needs to adapt to make the most of the added years that advancements in technology and medicine have afforded us.
Despite ageing populations being presented as a problem (e.g., increasing the burden on healthcare systems, dwindling workforce, or declines in population health due to the increased risk of age-related diseases), increasing lifespans come with great societal and individual benefits, as long as it is accompanied by sustained health and well-being.
In this episode of the podcast series, the discussion with Prof. Scott and Prof. Willcox shared how ageing societies can be harnessed, the importance of reframing ageing as a positive not a problem and protecting function to truly reap the benefits of longer lives.
The problem of ageing
Prof. Scott began the conversation by explaining the difference between ageing societies and longevity societies. According to Prof. Scott, an ageing society focuses on demographic change and the change in the age structure of a population. In other words, declining birth rates coupled with increasing lifespans has led to a greater number of older people than younger people.
The repercussions of population ageing often make headlines with countries such as China and France increasing the age of retirement to reform pension systems in response to shrinking workforces. Despite the attention-grabbing policy changes in certain countries, population ageing is a global phenomenon, which all countries can expect to experience in the coming decades.
The discourse in China and France demonstrates Prof. Scott’s definition of ageing societies. It presents ageing as a problem and perpetuates the premise that ageing populations burden health and social systems without contributing to them, resulting in an economic downturn.
In contrast to prevailing narratives around population ageing, Prof. Scott introduces the concept of longevity societies, which focuses on the benefits of longer lives. “I like to look at the longevity society, which is about the fact that we’re living for longer. Global life expectancy now is over 72 years, which is quite remarkable. And in the high-income countries, the probability of living into your 90s is really significant. The UK government, which is certainly not the best of high-income countries, says a child today has a 50% chance of living into their 90s. So, for the first time ever, the young can expect to become the old and even the very old. And that’s the longevity society that we need to adapt to, we need to do things differently.”
There is indeed a need to do things differently, namely by reforming institutions, policies, and practices to support investment in later years and protect health across the life course. Healthy ageing must be a central priority and prevention and promotion are key.
Investing in later years
To improve healthy ageing, it is important to learn from global good practice and the lived experiences of older people. Japan has one of the world’s oldest populations. In 2021, Japan hit a record number of people 100 years or older, reaching 86,510 centenarians. Specifically, Okinawa, a chain of islands in southern Japan, can be examined to understand longevity and healthy ageing. Okinawa has one of the highest prevalence of centenarians in Japan and has been designated as a “blue zone”, an area of the world recognized for the long, healthy, and happy lives of its residents. Longevity trends in addition to its distinct culture, diet and social organization prompted the establishment of the Okinawa Centenarian Study, the world’s longest-running population-based study of centenarians. As a lead researcher in this study, Prof. Willcox has spent years researching this group to understand the factors that contribute to their longevity.
The practices of Okinawan centenarians provide lessons on individual daily habits, community practices and policy that support preventative health and foster healthy ageing. On an individual level, Okinawan practices such as maintaining active lifestyles, good diet, positive outlook, and social connection support living well, however additionally, health system reform can support prevention and healthy ageing. Prof. Willcox shared the example of universal health coverage in Japan and the common practice of preventative health checks. “Everyone gets a basic check. And then they can start prevention from an early, early stage, like say they’re pre-diabetic, well, now’s the time to work on it before you become a full-blown diabetic. So, I think that has a lot of health dividends.”
Such practices highlight opportunities and strategies to support healthy ageing across the life-course and the benefits of prioritizing prevention and promotion to invest in later years. Despite known good practice, there is still a need to shift the mindset about ageing to prompt action to enable and protect health across the life-course.
Redefining ageing to achieve policy change
The perspectives from Prof. Scott and Prof. Willcox support the need to reconceptualize ageing in order to invest in later years. “It’s about changing the map of life. So, in the 20th century, we invented teenagers and pensioners, and I think we’re seeing people behave now differently in their 20s. They’re working for longer; we need to adapt our life course. But of course, one of the most important things is to make sure we age well,” says Prof. Scott.
Prof. Willcox explains that ageing is celebrated amongst the Okinawans, and notes that it’s likely a key contributor to their longevity. “I think that in many ways the Okinawans have become among the most successful agers because ageing is celebrated. It’s not a problem. In fact, they have milestones they like to achieve. For example, the top milestone is living to be 97. They have a ceremony called “Kajimaya”, you’re celebrated all through the village, and it’s really something that people look forward to.”
Celebrating the lives of older people and valuing ageing is needed to achieve healthy ageing and the first step to creating environments, policies and programs that enable and support living longer and living well. Shifting the lens through which we look at ageing, including combatting ageism and recognizing the value of older people in society, is a first step in adapting policy and practice to invest in later years and supporting health span in addition to lifespan. The dialogue in this podcast episode demonstrates how healthy ageing can support the cross-sectoral goals of improving individuals’ health, population health and economies.
Recommendations from this episode
- Healthy life expectancy should be a central focus of policy initiatives. Just as Gross Domestic Product (GDP) is a measure of the success of governments, life expectancy should also be a central indicator of success.
- Institutions must be reoriented in structure and function to increase sustained investment into later years, to ensure continued opportunities for engagement and productivity in later years thus reaping economic and individual benefits of increased lifespan.
- Several key factors learned from centenarians, including finding purpose and community, celebrating ageing and access to preventative health services are central to increasing health span and should be the focus of policy initiatives and population health programs.