The best countries to live in when you are old

Quality of life for all ages.
Quality of life for all ages.
Image: Reuters/Enrique Castro-Mendivil
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The world’s elderly population has been growing for years, and it’s only going to increase thanks to longer lifespans. By 2050, there will be 2 billion elderly people living on the planet, making up about 20% of the population.

People over 60 have different social, economic, and medical needs than children or adults who are still in the workforce. Countries are going to have to adapt to their changing demographics, and it’s not clear yet how they will do so.

One way to start would be to look at nations that already seem to be handling these transitions well. In August of this year, a team of researchers and policy experts from the US, Singapore, and the Research Network on an Aging Society ranked 18 countries on a scale called the Aging Society Index (paywall). This index gives countries a score out of 100 based on different factors that show how well elderly populations are supported. Their work puts Norway in the top spot, followed by Sweden, the US, and the Netherlands.

The team worked with 18 of the 35 countries that are part of the Organization for Economic Cooperation and Development and had complete data. The index gives scores to each country based on five factors that represent different parts of a person’s life.

  • Productivity and engagement: how many opportunities are there for elderly people to contribute to society, calculated by retirement age, employment over 65, volunteer hours over 65, and informal educational opportunities;
  • Well-being: a measure of quality of life, calculated by life expectancy and surveys reporting life satisfaction over 50;
  • Equality: how fair life is to the elderly, calculated by the Gini index, poverty risk for the elderly, food security for the elderly, and educational opportunities for both young and old citizens;
  • Cohesion: how socially supported elderly people are, based on financial transactions between older and younger groups, the number of older people living with younger people, and surveys regarding younger people’s feelings toward older generations;
  • Security: a measure of the physical and financial security given to older people, measured by income, pension wealth, physical safety, and external government debt.

The team asked the Research Network on an Aging Society, a group of 14 specialists including geriatricians, sociologists, and economists, to weigh each of the categories based on their importance. After averaging the rankings, each category came in to be about a fifth of the scale, with well-being weighed the most at 25% and cohesion the least at 17%.

The table below shows how the countries stacked up in each category. The researchers used a method called goalpost scoring, which means that each country is scored against the other 17. Countries that performed the best in a particular category earned a 100 and countries that performed the worst earned a zero; countries halfway between the best and worse would have received a score of 50. In order to receive a score 100 or 0 for a category, a country needed to receive the highest or lowest marks in each of the factors that contribute to that domain.

“One of the things that was interesting in the results was that the US did pretty well,” says John Rowe, a geriatrician and public policy expert at Columbia University and lead author of the paper. Rowe says this was because the US has such a high population of people who are still working, even with flexible hours, which raises their productivity and engagement score. “Work is good for your brain and your body. It increases your economic security and saves your trust fund,” Rowe says. “We think policies that advance retirement age are generally good.” (Most economists agree on this point, but other research suggests retiring early (paywall) may come with health benefits.)

However, the US has a low equity ranking given that more than 20% of people over 60 are at risk for poverty, compared to 12.5% in the rest of the OECD countries. It also scored low on security because of US government debt levels and the levels of government medical care provided for those over 65. 

Countries that performed poorly tended to have lower life expectancies, decreased quality of life (which the study authors note could be cultural), and lower retirement ages. However, even the top-performing Nordic countries still have room for improvement, the study notes.

Considering that by 2020, there will be more people over the age of 60 than there will be children five years old or younger, national policies have to adapt for their populations. “It’s about time the world woke up and smelled the demographics,” Rowe says.