Three surveys explore the historical, social and political implications of greying populations for states and individuals. Anthea Tinker samples the long view.
All want to reach old age but nobody wants to be old" is the opening quotation in one chapter of The Long History of Old Age . This statement goes to the heart of discussions about ageing populations. In most nations, both the numbers and the proportions of old people are rising, and the numbers and proportions of very old people within this are increasing, too. The latest UN projections say the number of people aged 60 and above will double by the middle of the century. Today, one in ten of the world population is over the age of 60; in 2050, the figure will be just over two in ten. The equivalent figures for the UK are two in ten now and nearly three in ten in 2050. Even more startling are the figures for those who are 80 and over as a proportion of those who are 60 and over.
They are the fastest growing segment of the older population. Worldwide, the projected proportions are more than one in ten, and two in ten in 2050. In the UK, 21 per cent, two in ten, of the older population were over the age of 80 in 2006, and in 2050 this is expected to have risen to three in ten.
Behind this trend is a simple fact: fewer babies are being born and people are living longer. Low fertility rates and decreased mortality at older ages mean not only older people but fewer children (and subsequently, of course, fewer people of working age).
This age shift holds enormous implications for society and for individuals. The burden of ageing is often presented in articles with headlines such as "Demographic time bomb" and "They've got to eat, so let them work". But there are positive sides, too, as reported under headlines such as "Glad to be grey" and "One-legged octogenarian scales dizzy heights of wing walking". This summer, a man celebrating his 100th birthday was pictured in the firm where he worked, having applied for the job when he was 97. The Government is likely to use this sort of story to promote its policies of active ageing. By encouraging older people to enter the workforce or to stay on in employment, worker shortages can be counteracted. Similarly, active and healthy older people may make fewer demands on the health service.
The three books under review address these issues in different ways. Two are conventional single-authored books: Sarah Harper's Ageing Societies is a closely argued text that covers societies across the world; John Macnicol's Age Discrimination concentrates on the UK and the US and starts from the 1930s.
The most unusual book is the volume edited by Pat Thane. The Long History of Old Age offers a historical survey with a focus on Europe and countries colonised by Europe. It is lavishly illustrated, and every page is a joy to look at. Many of the images reflect on the ages of man, from the cradle to the grave. Had I not had this book to review, I would have put it on my Christmas list.
Thane, who contributes the first and last chapters, sums up the book in her opening paragraph: "Time and again today, we hear that people are living longer than ever before and that societies are growing older, with old people outnumbering the young. Everywhere this is presented gloomily. Old people are described as helpless dependants, imposing burdens on healthcare and pensions on a shrinking population of younger workers. In so far as old age is thought to have a history, it is presented as a story of decline: that in 'the past', a vague and unspecified time, few people lived to be old. Because they were few, and not very costly, they were valued, respected, cherished and supported by families as, it is said, they are not today."
That picture is challenged by the chapters that follow - on the Ancient Greek and Roman worlds (by Tim Parkin), the Middle Ages and the Renaissance (Shulamith Shahar), the 17th century (Lynn Botelho), the 18th century (David Troyansky), the 19th century (Thomas Cole and Claudia Edwards) and the 20th century (Thane). The contributors show the complexity of ageing and the dangers of generalising.
The book attempts to answer a number of questions. The first is: "How old is 'old'?" The UN defines it as 60 and older. In some places, however, such as medieval Castile and Florence, exceptions from some forms of public service came only at 70. Botelho describes the 17th-century vision that "one was considered old when one looked old", which resonates with much contemporary thinking. Ironically, in that time it was the better-off who often looked the oldest - they, for example, lost their teeth because they could afford the newly available sugar. In the main though, older people without resources were in a disadvantaged position, as all three books show.
In addressing the second main question - "How many people survived into old age?" - the book shows that large elderly populations are not just a modern phenomenon. In earlier centuries, high child mortality rates meant that some towns, such as Ravenna in 14, where people over the age of 60 made up 16 per cent of the population. Another very topical question is that of care for older people. In modern societies, there is much stress on declining family care, but "although it was common for the generations to live together in parts of southern Europe, our conviction that the older used to be more respected turns out to be wrong: throughout history the next generation has always been given priority".
Gender differences in old age are highlighted in all these books. In the 17th century, old women were generally held in contempt or feared. But the growing power of women also began to be asserted - Jas in the all-female households in Toulouse in the 17th and 18th centuries, where groups of women found lodgings together to maintain autonomy and share friendship.
Old men were often the butt of jokes and mockery, and the expression "there's no fool like an old fool" was axiomatic (especially over sexual matters) in this century.
Undoubtedly, as all the authors show, the paramount desire of older people is to keep some degree of independence. For many, this came with the introduction of pensions. Although these were mainly a 20th-century advance, there were various forerunners. In the 18th century, there were contracts on the marriage of a child so that the older relative was guaranteed support, including rights to particular houses, rooms and provisions of grain and wine. Today's equivalent is the legal obligation in contemporary Germany of children to give financial support to older relatives if needed.
Ageing Societies has the subtitle "Myths, Challenges and Opportunities". It is clearly written, wide-ranging and very well referenced. Harper starts with chapters on the meaning of ageing societies, the dynamics of population ageing, and understanding age and ageing, before moving on to a consideration of retirement. She argues that it is increasingly necessary to extend economic activity in later life.
Her next three chapters are on families. The first covers changing intergenerational relationships; subsequent ones deal with supporting families and elder care in developing countries. They conclude that the extended family does not necessarily imply a family that is supportive of older people. Harper argues that care and support by the family alone is becoming increasingly less effective, and that a limited public programme is needed to act as a safety net. She sees the state's role as supplementing the care that families give and helping them to give it. Another chapter discusses equal treatment, equal rights and ending age discrimination.
In Age Discrimination , Macnicol starts by distinguishing between ageism (in social relations and attitudes) and age discrimination (in employment and health services), terms that are often used interchangeably. He traces the history of the age discrimination debate in the UK and the US since the 1930s. Starting with a counter to the pessimistic views of an ageing population, he cites the social costs of a youthful population and lists the heroes of ageing, such as Winston Churchill, who became Prime Minister at 65 and William Gladstone at 82. Discussing age discrimination in health, he highlights a dilemma: "On the one hand, modern healthcare systems have increasingly become health systems for older people; on the other, they operate formal and informal procedures of age-based rationing that discriminate against older people. Any careful examination of this balance of positive discriminations must be a very difficult exercise."
He then turns to another thorny question: "If older people are healthier than ever, 'could' or 'should' they remain in work longer?" He first suggests that "health" is complex and difficult to define. He argues that the jury is out on whether older people could stay in work - given factors such as the state of the job market in a person's area and his or her skills - and says the real question is whether older workers should stay on in work. This is a political and moral issue that relates to distributive justice. And it also depends on how willing a society is to support its unwaged dependant populations.
Small points of criticism are the lack of a summary or conclusions and the inadequate index in Thane's book, and a less than complete index in Macnicol's book. But these are minor points compared with the overall excellence of all three books, which make a great contribution to gerontological literature.
While governments and academics argue about the role of older people, it is well to remember the words of Cicero quoted by Parkin: "Old age will only be respected if it fights for itself, maintains its rights, avoids dependence on anyone and asserts control over its own to the last breath."
Anthea Tinker is professor of social gerontology, King's College London.
The Long History of Old Age
Editor - Pat Thane
Publisher - Thames and Hudson
Pages - 320
Price - £25.00
ISBN - 0 500 25126 6