Macroeconomic implications of population ageing and selected policy responses.
Macroeconomic implications of population ageing and selected policy responses.
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DOI：
10.1016/s0140-6736(14)61464-1
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发表时间：
2015-02-14
期刊：
影响因子：
168.9
通讯作者：
Smith, James P.
中科院分区：
文献类型：
--
作者：
Bloom, David E.;Chatterji, Somnath;Kowal, Paul;Lloyd-Sherlock, Peter;Mckee, Martin;Rechel, Bernd;Rosenberg, Larry;Smith, James P.
从现在到2030年，每个国家都将经历人口老龄化--这是一种既明显又史无前例的趋势。在过去60年里，世界各国60岁及以上人口所占比例仅略有增加，从8%增加到10%。但在接下来的40年里，这一群体预计将占总人口的22%--从8亿人跃升至20亿人。有证据表明，现在进入老年的人群比以前的人群更健康。然而，进展非常不平衡，表现最差的国家(塞拉利昂)和表现最好的国家(日本)在人口健康方面的巨大差距(以预期寿命衡量)表明，目前出生时预期寿命相差36岁，60岁时预期寿命相差15岁。人口老龄化对各国经济构成挑战，老年人口的健康状况令人担忧。老年人比年轻人有更大的健康和长期护理需求，导致支出增加。如果他们不健康，他们也不太可能工作，可能会给家庭和社会带来经济负担。像其他人一样，老年人需要物质和经济保障，但提供这些保障的负担将落在一小部分人口身上。养老金制度将面临压力，需要与退休政策一起重新评估。卫生系统过去没有着眼于老年人的各种健康问题和长期护理需要，也没有充分重视疾病预防，它们可以以不同的方式应对新的人口现实和人口健康方面的相关变化。除了个人和企业的行为适应，这种政策反应的性质将决定人口老龄化是否会导致重大的宏观经济困难。
Between now and 2030, every country will experience population ageing—a trend that is both pronounced and historically unprecedented. Over the past six decades, countries of the world had experienced only a slight increase in the share of people aged 60 years and older, from 8% to 10%. But in the next four decades, this group is expected to rise to 22% of the total population—a jump from 800 million to 2 billion people. Evidence suggests that cohorts entering older age now are healthier than previous ones. However, progress has been very uneven, as indicated by the wide gaps in population health (measured by life expectancy) between the worst (Sierra Leone) and best (Japan) performing countries, now standing at a difference of 36 years for life expectancy at birth and 15 years for life expectancy at age 60 years. Population ageing poses challenges for countries’ economies, and the health of older populations is of concern. Older people have greater health and long-term care needs than younger people, leading to increased expenditure. They are also less likely to work if they are unhealthy, and could impose an economic burden on families and society. Like everyone else, older people need both physical and economic security, but the burden of providing these securities will be falling on a smaller portion of the population. Pension systems will be stressed and will need reassessment along with retirement policies. Health systems, which have not in the past been oriented toward the myriad health problems and long-term care needs of older people and have not sufficiently emphasised disease prevention, can respond in different ways to the new demographic reality and the associated changes in population health. Along with behavioural adaptations by individuals and businesses, the nature of such policy responses will establish whether population ageing will lead to major macroeconomic difficulties.