The Western industrial revolution of the 19th century brought improved agricultural production, improved standards of living, and also an increase in population size. Over time, there came a shift in the age structure of the population, known to demographers as the demographic transition. This was a shift away from a population with high fertility and high mortality to one of low fertility and low mortality. That population pattern is what we see today in the United States, Europe, and Japan. The result in all industrialized societies has been population aging: a change in the age distribution of the population.
Most countries in the developing world—in parts of Africa, Asia, and Latin America—still have fertility rates and death rates much higher than those of advanced industrialized countries. For the United States in 1800, as for most developing countries today, that population distribution can be represented as a population pyramid: many births (high fertility) and relatively few people surviving to old age (high mortality). For countries that are approaching zero population growth, that pyramid is replaced by a cylinder: Each cohort becomes approximately the same in size.
As we have seen, the increased number of older people is only part of the cause of population aging. It is important to remember that, overall, population aging has been brought about much more by declines in fertility than by reductions in mortality. The trend toward declining fertility in the United States can be traced back to the early 19th century, and the process of population aging has causes that date back even longer (Olshansky & Carnes, 2002). To complete the demographic picture, we need to point to other factors that influence population size and composition, such as improvements in the chance of survival of people at different ages or the impact of immigration into the United States, largely by younger people. But one conclusion is inescapable: Today’s increased proportion of people ages 65 and older springs from causes that are deeply rooted in American society. Population aging is a long-range trend that will characterize our society into the 21st century, driven largely by changes in immigration and the aging of the baby boomers, as well as the even larger millennial cohort. It is a force we all will cope with for the rest of our lives.
But how is American society coping with population aging? How are the major institutions of society—education, health care, government, the economy, the family—responding to the aging of a large number of individuals? The answer, in simplified terms, is rooted in a basic difference between individual and population aging. As human beings, we are all familiar with the life course process of individual aging. It is therefore not surprising that, as a society, we have devised many policies and practices to take into account changes that predictably occur in the later years, such as planning for retirement, medical interventions for chronic illnesses, and familiar government programs such as Social Security and Medicare.
Whether it involves changes in biological functioning or changes in work roles, individual aging is tangible and undeniable, a pattern we observe well enough in our parents and family members, not to mention in ourselves. But population aging is more subtle and less easily observed. We have many institutional policies and programs to deal with individual aging, but our society is just beginning to wrestle with the controversies generated by the population aging trends now emerging, with the prospect of even more dramatic debate and change in the decades ahead. These demographic changes are significant and are stimulating tremendous ferment in our society’s fundamental institutions. For that reason, this book is organized around controversies along with the facts and basic concepts that stand behind them.
Our society’s response to population aging can best be summed up in the aphorism that generals prepare for the next war by fighting the old one over again. That is to say, in our individual and social planning, we tend to look back to past experience to guide our thinking about the future. Thus, when the railroad was first introduced, it was dubbed “the iron horse.” But it wasn’t a horse at all, and the changes that rail transport brought to society were revolutionary, beyond anything that could have been expected by looking to the past.
The same holds true for population aging. We cannot anticipate the changes that will be brought about by population aging by looking backward. Population aging is historically unprecedented among the world’s societies. Moreover, we should not confuse population aging with the process of individual aging. An aging society, after all, is not like an individual with a fixed lifespan. Why is it that people are so often fearful when they begin to think about the United States’ future as an aging society? Part of the reason is surely that many of us are locked into images of decline that are based on prejudice or outdated impressions of what individual aging entails. Because our social institutions have responded to aging as a problem, we tend to see only losses and to overlook opportunities in the process of aging.
An important point to remember is that the solutions to yesterday’s problems may not prove adequate for the challenges we face today, or for those we’ll face in the future. For example, Social Security has proven vital in protecting older Americans from the threat of poverty in old age. But Social Security was never designed to help promote second careers or new forms of productivity among older people. We may need to think in new ways about pensions and retirement in the future. Similarly, Medicare has proved to be an important, although expensive, means of guaranteeing access to medical care for older people, but it was never designed to address the problems of long-term care for older people who need help to remain in their own homes. Finally, as the sheer number of people ages 65 and older increases—from 52 million in 2018 to a projected 95 million by 2060—the United States as a society will need to consider which institutions and policies are best able to provide for the needs of this growing population (Mather et al., 2019).
Social gerontologist Matilda White Riley pointed out that our failure to think deeply about population aging is a weakness in gerontology as a discipline. Gerontologists know more about individual aging than about opportunity structures over the whole life course. By “opportunity structures,” we mean that the way society is organized or structured affects an individual’s chance or ability to gain certain resources or meet certain goals. A good example is the way the life course has been shaped, with transitions from education to work to retirement. These transitions do not seem to prepare us for an aging society in the future. In effect, we have a “cultural lag” in facing the future (Katz, 2005; Riley & Riley, 1994). We know that in this century, the age of leaving the workforce to retire has been gradually going down, whereas the age for leaving schooling has been going up. Riley pointed out that, if we were to project these trends into the future, sometime in the 21st century, people would leave college at age 38 and immediately enter retirement. This scenario, of course, is not serious. But it does make a serious point. We must not take current trends and simply project them into the future.
Part of the problem is that we have less knowledge than we ought to have about the interaction between individual lives and the wider society. During the 20th century, nearly three decades on average were added to human life expectancy. Now more than a third of adult life is spent postwork. People ages 65 and older are healthier and better educated than ever before. Yet we lack opportunity structures to integrate this older population into major institutions of society such as education or the workplace. We have yet to design a blueprint for an aging society of the future. And there are important questions to be asking about what such a blueprint might look like. Today, we grow old and experience aging and later life differently than our grandparents did, and in a way differently than will our children, so it does little good to look backward as we move