Saturday, 2 February 2013

Riding the changing age curve

By Kanwaljit Soin, Published The Straits Times, 1 Feb 2013

THE freshly released National Population and Talent Division's White Paper cites the following as the reasons behind Singapore's falling birth rates: rising rates of people remaining single; later marriages; and married couples having fewer children.

This is also happening in East Asian societies like Hong Kong, Japan and Taiwan.

In 2011, Singapore's total fertility rate (TFR) was 1.2 - way below the 2.1 replacement rate.

Many social and economic factors affect marriage and parenthood decisions. These cannot all be solved by dangling the carrot of money as the main attraction in the recently enhanced Marriage and Parenthood package. What we need are free quality preschool education that is as good as our present national school system, and highly subsidised child-care until the end of primary school to allow parents, especially women, to combine career and parenting aspirations.

At the same time as our birth rates have fallen, Singapore's life expectancy has increased from 66 years in 1970 to 82 years in 2010, making it one of the highest in the world. Should we celebrate the high life expectancy rates or mourn the low birth rates?

World of wrinkles, not pimples

AT CURRENT birth rates and without immigration, our citizen population will shrink from 2025 onwards. The median age of citizens will also rise from 40 years today to 45 in 2025. It will soon be the first time in the history of our planet that there will be more people over 65 than people under 15 - a world of wrinkles and not pimples.

What's so wrong with this new norm? The whole age curve will shift.

Also, older people are not the only beneficiaries of increased longevity. Life expectancy has increased also in a dramatic way for those in infancy, childhood, and even early adulthood due to improved medical breakthroughs especially in addressing problems of infectious diseases.

There have also been improvements in sanitation and nutrition and these are further reasons why most children survive to adulthood and why most adults live to a ripe old age.

The new mantra is that "the longer you live, the longer you are likely to live". Because of this new arithmetic, we will not necessarily have a shrinking population; people will live longer and new reproductive technologies like egg and sperm freezing will keep us going even longer.

Better health, more active lifestyles

THE number of citizens in the working ages of 20-64 will decline from 2020 due to more of them retiring and with fewer entering the workforce. The number aged 65 and above will triple to 900,000 by 2030 and they will be supported by a declining base of working-age citizens.

Tomorrow's older population will differ from those of past decades. They will enjoy longer lives, better health and more active lifestyles than previous generations.

A World Bank study showed that higher life expectancy is being accompanied by good health - health-adjusted lifespan increases approximately one for one with life expectancy.

A recent study by the Oxford Institute of Ageing and HSBC showed that 93 per cent of people in their 70s in Singapore felt they were in good health - only 7 per cent (compared to global average of 16 per cent in other countries) felt that their health was poor.

In our population debate, policy makers and businesses emphasise the importance of foreign labour because of the threat of small and medium-sized enterprises going abroad. So, why are we not doing some transformational thinking about how to encourage and prepare our older people to continue working?

With increasing life expectancy and better health, the working life expectancy and worker productivity can be increased and this is what we need to address in fixing our labour shortage.

Besides creating opportunities for Singaporeans to continue working till their seventies, we also need to educate and encourage employers to utilise the growing pool of experienced workers.

The longevity dividend

RECENT studies by prominent economists David Bloom and David Canning have shown that nations with a 10-year increase in life expectancy can expect a 1 per cent increase in GDP. Also each additional year of increase in life expectancy increases economic output by 4 per cent even after controlling for work experience and education.

Thus longevity and population ageing can generate wealth if health is maintained - capturing the longevity dividend.

Singapore is one of the fastest ageing countries but in large part, the healthy ageing agenda is largely missing. There is also a prevailing view that with ageing, health spending will go through the roof and the younger generation will have to bear this burden.

This incorrect view gives rise to intergenerational conflict. It is the health status rather than the age that is the predominant causal factor behind health-care spending. Many studies attest to this.

Furthermore, the actuarial projections that show catastrophic effects of ageing tend to be based on an "accounting" approach of ageing which assumes that age-specific behaviour remains constant and all the effects are presumed to arise from the change in the age structure only.

Researchers have correctly pointed out that population ageing can also change age-specific behaviour; they cite how lower fertility rates can lead to higher female participation in the labour force, or how longer lifespans can lead to longer working lives. This opens up the possibility of using incentives to promote behaviour that would maximise ageing's benefits and minimise its costs.

For this to happen, institutions and mindsets have to change quickly. Policy makers have to open their minds so that they can see the options staring them in the face and take real steps to keep older people, of all strata, productively engaged.

The writer, a consultant orthopaedic and hand surgeon, is the immediate past president of Wings, the Women's Initiative for Ageing Successfully.

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