2023年世界社會報告（英）

LeaNoBehAnWoWorldReporWORLDSOCiALREPORT2023:LEAViNGNOONEBEHiNDiNANAGEiNGWORLDDEPARTMENTOFECONOMiCANDSOCiALAFFAiRSWORLDSOCiALREPORT2023:LEAViNGNOONEBEHiNDiNANAGEiNGWORLDiiiDEPARTMENTOFECONOMiCANDSOCiALAFFAiRSTheDepartmentofEconomicandSocialAffairsoftheUnitedNationsSecretariatisavitalinterfacebetweenglobalpoliciesintheeconomic,socialandenvironmentalspheresandnationalaction.TheDepartmentworksinthreemaininterlinkedareas:(i)itcompiles,generatesandanalysesawiderangeofeconomic,socialandenvironmentaldataandinformationonwhichStatesMembersoftheUnitedNationsdrawtoreviewcommonproblemsandtotakestockofpolicyoptions;(ii)itfacilitatesthenegotiationsofMemberStatesinmanyintergovernmentalbodiesonjointcoursesofactiontoaddressongoingoremergingglobalchallenges;and(iii)itadvisesinterestedGovernmentsonthewaysandmeansoftranslatingpolicyframeworksdevelopedinUnitedNationsconferencesandsummitsintoprogrammesatthecountryleveland,throughtechnicalassistance,helpsbuildnationalcapacities.ST/ESA/379UnitedNationspublicationSalesNo.E.23.IV.2ISBN978-92-1-130458-9eISBN978-92-1-001968-2Copyright?UnitedNations2023Allr?ghtsreservedWORLDSOCiALREPORT2023:LEAViNGNOONEBEHiNDiNANAGEiNGWORLDiVFOREWORDOurworldischanginginfundamentalways.Onekeytrendisthegradualandlargelyirreversibleshifttowardsanolderpopula-tion,alreadyunderwayinmostcountries.becominglessandlessvalid.Yet,effectivesystemsofold-agesupportwillcontinuetobeneeded,aswilltheintergenerationalsolidarityrequiredtosustainthem.Thenumberofpersonsaged65yearsorolderworldwideisexpectedtodoubleoverthenextthreedecades,reaching1.6billionin2050,whenolderpeoplewillaccountformorethan16percentoftheglobalpopulation.Noteveryonehasbene?ttedtothesameextentfromthesocialandeconomicim-provementsthatdrivelongevity.Highandrisinglevelsofinequalitythreatentobecomeade?ningfeatureofpresentandfuturegenerations.Duetoacombinationofacutecrisesandunfavourablelong-termtrendsinemploymentandwages,successivegenerationsareincreasinglyunequalandeconomicallyinsecureinbothdevelopedanddevelopingcountriesdespiteongoingimprovementsinhealthandeducation.Withoutswiftandboldpolicyactiontocounterthistrend,futurecohortsofolderpersonsmaybeevenmoreeconomicallyunequalthanthosealivetoday.Butrisinginequalityisnotinevitable,andpolicymakerscanin?uencethefuturedirectionofinequal-ityaspopulationscontinuetolivelonger.Peoplearelivinglonger,healthierlives.Theriseinhumanlongevityisasuccessstorycausedbyimprovedsanitationandmedicaltherapies,greateraccesstoeducationandfamilyplanning,andstridestowardsgenderequalityandwomen’sempowerment.Thisshiftinthepopulationagestructurebringsintoquestioncurrentarrangementsofold-agesupportincountriesbothyoungandold.Asthehealthandwealthofso-cietiescontinuetoimprove,traditionalnotionsofdependencyatolderagesareVTheWorldSocialReport2023exploresthesocialandeconomicopportunitiesandchallengesthatpopulationageingpre-sents.AsGovernmentscometogethertomarkthetwentiethanniversaryoftheMa-dridInternationalPlanofActiononAgeing,theReportbuildsonthePlan’sframeworkofsupporttonationalpoliciestocreateequitable,fairandinclusivesocietiesforpeopleofallages.willbeleftbehind.Together,wecanad-dresstoday’sinequalitiesforthebene?toftomorrow’sgenerations,managingthechallengesandcapitalizingontheoppor-tunitiesthatpopulationageingbrings.QuestionsofintergenerationalequityinanageingworldneedtotakecentrestageastheworldpreparesfortheSustainableDevelopmentGoalsSummitin2023andtheSummitoftheFuturein2024.Nowisthetimetoplanforthelongterm,toprepareforthechallengesaheadandtakeadvantageofthenewopportunitiesthesedemographicshiftsbring.Itisthetimetostrengthensolidaritybetweenyoungerandolderpeopletodayandbetweenpresentandfuturegenerations.Policiestopromotehealthyageing,pre-ventpovertyandfosteremploymentandopportunitiesfordecentworkbeforepeo-plereacholderagesarevitaltoenhanceeconomicsecurityandreduceinequalityamongolderpersons.Takingadvantageoftheskills,expertiseandknowledgeofolderpersons,women,andothergroupsthathavetraditionallybeenexcludedfromordisadvantagedinthelabourmarketcangoalongwaytowardspromotingequityandensuringthatold-agesupportsystemsare?scallysustainable.AkeymessageoftheWorldSocialReport2023isthatpopulationageingandpoliciesimplementedinresponsetothishistoricglobaltrendcanbeharnessedtoupholdthepledgecontainedinthe2030AgendaforSustainableDevelopmentthatnooneLiJunhuaUnder-Secretary-GeneralforEconomicandSocialAffairsUnitedNations?WORLDSOCIALREPORT2023:LEAVINGNOONEBEHINDINANAGEINGWORLDViACKNOWL

ED

GEMEN

TSTheWorldSocialReportisthe?agshippublicationonmajorsocialdevelopmentissuesoftheDepartmentofEconomicandSocialAffairs(DESA)oftheUnitedNationsSecretariat.UniversityofSouthernCalifornia.AgroupofgraduatestudentsfromtheEdwardJ.BlousteinSchoolofPlanningandPublicPolicyofRutgersUniversity,undertheguidanceofProf.HalSalzman,alsopreparedabackgroundstudyforthereportaspartofastudioproject.The2023reportwaspreparedbyateamledbyJohnWilmothofthePopulationDivision,DanielaBasoftheDivisionforInclusiveSocialDevelopmentandShantanuMukherjeeoftheEconomicAnalysisandPolicyDivision,undertheguidanceofNavidHanif.Thereport’scoreteamincludedLinaBassarsky,JorgeBravo,DananGu,KristinnSv.Helgason,ZhenqianHuang,IsmaelIssifou,KennethIversen,MarenJimenez,YumikoKamiya,DaisukeMaruichi,JonathanPerry,JuliePewitt,MartaRoigandKarolineSchmid.TheteamisparticularlygratefultoJen-niferAilshire,DeborahCarr,CarlosGra-din,EmilyGrundy,TeresaMunzi,JorgNeugschwender,WarrenSandersonandAndrewScottfortheirreviewofearlydraftsandfortheirguidanceandadviceduringthepreparationofthereport.TheteamwouldalsoliketothankAmalAbouRafeh,HoiWaiJackieCheng,JuliaFerre,NicoleHunt,AlexJulca,CorneliaKalde-wei,MarceloLaFleur,TimMiller,WenyanYang,andotherDESAcolleaguesfortheirsubstantivecontributionstothereportandforcommentingondraftsduringtheinternalreviewprocess.TheanalysiscontainedinthereportbenefitedfrombackgroundpaperspreparedbyPeterLloyd-Sherlock,Sang-HyopLee,M.MahmudKhan,Renu-gaNagarajanandJean-MarieRobine.AbackgroundpaperanddataanalysiswerealsoprovidedbytheGatewaytoGlobalAgingDatateambased?attheThereportwasskilfullyeditedbyGretchenLuchsinger.Blossomprovidedthecoverdesignand?nallayoutsforalltext,tablesand?gures.ViiCONTENTSFOREWORDIVACKNOWLEDGEMENTSEXPLANATORYNOTESEXECUTiVESUMMARYiNTRODUCTiONVIXI210CHAPTER1.ANAGEiNGWORLD17A.OlderpopulationsarerapidlygrowingeverywhereB.ThepopulationagedistributionisshiftingsteadilyupwardC.Bettermeasurementimprovesunderstandingofageingsocieties1.Comparingchronologicalandprospectivemeasuresofold-agedependency2.Measuringageingfromaneconomicperspective182125262729D.DemographictransitionstemsfromlongerlivesandsmallerfamiliesCHAPTER2.TOWARDSLiViNGLONGER,HEALTHiERLiVESA.Alongerlifespanisasuccessstory35364041B.Womenhaveasurvivaladvantage–butitmaynotlastC.ManyfactorsdeterminehealthyageingD.Longerlivesarenotalwayshealthy,especiallyforwomenE.DisparitiesinhealthandlifeexpectancyintersectwithmultipleinequalitiesF.Prematuredeathshavedeclinedbutthefutureisuncertain424446CHAPTER3.WHATPOPULATiONAGEiNGMEANSFORECONOMiESANDiNTERGENERATiONALEQUiTY48A.Ageingopensdoorsandposeschallenges1.Twodemographicdividendscandrivegreatergrowth2.Ageinghasanimpactonproductivecapacity515253566064676769727373763.Aspeoplegrowolder,consumptionpatternschange4.Financingold-ageconsumptiondependsonreallocatingresources5.AdaptingtosustaineconomicgrowthovertimeB.Keepingupwithageingcallsforshiftingconsumptionandproductionstrategies1.Womenandolderworkersaddvalueinlabourmarkets2.Greaterlabourproductivitydependsoninvestinginskills3.Harnessingthepotentialofthetechnologicalrevolution4.Pronatalistpoliciesshowmixedresults5.Beyondborders:impetusfornewinvestment?owsC.CarefullytimedpoliciescansteerasuccessfultransitionWORLDSOCIALREPORT2023:LEAVINGNOONEBEHINDINANAGEINGWORLDViiiCHAPTER4.AGEiNG,POVERTYANDiNEQUALiTY,NOWANDiNTHEFUTUREA.Poverty,inequalityandexclusioninoldage:asnapshot1.Povertyriskscanrisewithage7677772.Inequalityneednotincreaseinoldage838485879090949595991011023.Savingforoldagestumblesovermultipleobstacles4.Genderdisparitiesmakeolderwomenpoorer5.Otherdimensionsofold-ageexclusionB.Inequalitiesoverthecourseoflifeaddup1.Healthdisparitiesamongolderpeopleoftenstartearly:educationiskey2.EmploymentcansupportordamagehealthC.Thefutureofageing:moreunequal1.Theemploymentcrisiswillbefeltacrossgenerations2.Inequalityisrising3.COVID-19alteredprospectsforeducationandlabourmarketsD.Reducinginequalityandprovidingsecurity–withoutbreakingthebudget1.Cuttingtherootsofold-agedisadvantageandill-health2.Improvingthelivesofolderpersonsthroughadequatepensions3.Thepotentialofprogressivetaxation102104109CHAPTER5.ACRiSiSOFCARE113115115117A.Aspopulationsage,carehasnotkeptup1.Careneedsaregrowing2.CareneedsarechangingB.Providingbettercare:determinants,statusandchallenges1.Ageingintherightplace1191191201211311311331331341351361372.Livingarrangementsde?necareprovision3.DemandforcareoutstripsthesupplyofcaregiversC.COVID-19cutadevastatingswathethroughlong-termcare1.Clusteredinfacilities,olderpeopleweremorevulnerable2.Long-termcaregiverspaidahighprice,manytimesoverD.Moreequitablecarecentresonwhatpeopleneed–anddecide1.Regulatingimprovementsincarequalityandconditions2.Investinginlong-termcare3.Helpingpeopleageinplace4.CreatinganenvironmentthatfostersbettercareiXBOXES1.1De?ningreplacement-levelfertility311.2Internationalmigrationcanbothslowandaddtopopulationageing32331.3Fromtaxcreditstobabybonuses,countriesconcernedaboutlowfertilityoffersupportforbearingandrearingchildren2.1COVID-19hasdisruptedsteadygainsingloballifeexpectancy3.1Accountingforunpaidcareinformspoliciesequippedtomanageanageingsociety3.2Howtoamplifyeconomicgrowthduringthedemographictransition3.3InJapan,ageingisreorganizingindustryandadvancingthedigitaleconomy4.1Challengesinmeasuringold-ageincomepoverty39667074794.2COVID-19,isolationanddiscriminationagainstolderpersons4.3Disparitiesindisabilitysignalunequalageing88931051184.4Thebuildingblocksofold-agepensionsystems5.1Acuteend-of-lifevulnerabilitiesrequirespecializedcareFiGURES0.1Agepatternsoflabourincomeandconsumption,averagedacross41countries,basedondatabetween1994and2016111.1Numberofpeopleaged65yearsoroverinmillions,worldandregions,1980,2021and2050211.2Percentageofpeopleaged65yearsorover,worldandregions,estimatesfor1950–2021andprojectionsfor2022–205022242728291.3Distributionoftheglobalpopulationinbroadagegroupsandtotaldependencyratios,estimatesfor1950–2021andprojectionsfor2022–20501.4Traditionalandprospectiveold-agedependencyratios,worldandregions,estimatesfor1990–2021andprojectionsfor2022–20501.5Economicold-agedependencyratios,worldandregions,estimatesfor1990–2021andprojectionsfor2022–20501.6Populationdistributionbyageandsex,crudebirthanddeathrates,andtotalpopulationsizeatdifferentstagesofthedemographictransition2.1NumberofdeathsbysexandageinDenmark,1835-2020372.2Lifeexpectancyandhealth-adjustedlifeexpectancyatage60,bysex,selectedcountries,2000–2019433.1Yearsmarkingthebeginningandendofthedemographicdividend(upperpanel)andaveragedurationofthe?rstdemographicdividend(lowerpanel),bothbyregion533.2Globallabourforceparticipationratebyageandsex,20195557573.3Labourforceparticipationratebyregionandagegroup(inyears),20193.4Percapitaconsumptionbyagerelativetotheconsumptionlevelamongthoseaged30to49,latestyearavailable,2005–20163.5Structureofconsumptionexpenditurebyage,EuropeanUnioncountries,20153.6TotalannualexpenditureonhealthasashareofGDPinOECDcountries3.7Sourcesofincomebyagegroup5859613.8Percapitataxesandsocialcontributionsacrossthelifecourse,selectedcountriesinEurope,AsiaandtheAmericas633.9Changesinthe?scalburdenduetopensionpromisesin32OECDcountries,percentageofGDP,2018–206064713.10Projectedcontributionsofthreefactorstoachievingtheannualaveragelabourproductivitygrowthrequiredforincomegrowthtargets,regionalaverages,2020–2050WORLDSOCIALREPORT2023:LEAVINGNOONEBEHINDINANAGEINGWORLDX4.1Shareofthepopulationlivinginrelativelypoorhouseholdsbybroadagegroup,late2010s(orlatestyearwithdata)814.2Differencesinrelativepovertyratesbetweenolderandworkingages,selectedcountries,2018(orlatestyearwithdata)82838586914.3Ginicoef?cientbyage,selecteddevelopedanddevelopingcountries,2018(orlatestyearwithdata)4.4Householdwealthbyage,selecteddevelopedcountries,2019(orlatestyearwithdata)4.5Shareofthepopulationlivinginrelativepovertybyageandsex,late2010s(orlatestyearwithdata)4.6Shareofolderpersonslivinginrelativepovertybylevelofeducation,2019(orlatestyearwithdata)4.7Shareofadults50andolderwithafunctionaldisabilitybyeducationlevel,selectedcountries,around201892944.8Effectofworkinginphysicallydemandingjobsonfunctionaldisability,adultsaged50orolder,selectedEuropeancountriesandIsrael,around20184.9Estimatedunemploymentratebyageandbirthcohort4.10Estimatedyouthlabourforceparticipationratebybirthcohort4.11Ginicoef?cientbybirthcohort96981001114.1.1Typesofassetsownedbypeoplelivinginrelativepovertybyageineightdevelopedcountries,2019(orlatestyearwithdata)4.1.2Logisticregressionpredictingfunctionaldisabilitybasedonworkhistory,bysex,adultsaged50andolderinEurope,20181121165.1Shareofwomenamonglong-termcarerecipientsininstitutionsotherthanhospitalsandathome,aged65oraboveandaged80orabove,selectedOECDcountries5.2Long-termcarerecipientsathomeandininstitutionsotherthanhospitals,selectedcountries,latestavailableyear1201221231241285.3Estimatednumbersandde?citsinformallong-termcareworkers,theworldandbyregion,20155.4Numberofinformallong-termcareworkersper100personsaged65orover,20145.5Thetimethatwomenandmenspendonunpaidcareworkforallhouseholdmembers5.6Numberofcountrieswithalong-termcarepolicy,plan,strategyorframework,standaloneorintegratedwithinanageingandhealthplan5.7Governmentspendingandhouseholdout-of-pocketpaymentsonlong-termcare,shareofGDP,latestavailableyear1291305.8Publicspendingonlong-termcareandlong-termcarebedsin2019(orlatestavailableyear)TABLES1.1Countriesandareaswiththelargestsharesofpeopleaged65yearsorover,1980,2021and205023402.1Lifeexpectancyatbirthbysex,world,regionsandincomegroups,1950,2021and2050XiEXPLANATORYNOTESThefollowingsymbolshavebeenusedintablesthroughoutthereport:Ahyphen(-)betweenyears,forexample,1990-1991,signi?esthefullperiodinvolved,includingthebeginningandendyears.Afullstop(.)isusedtoindicatedecimals.Adollarssign($)indicatesUnitedStatesdollars,unlessotherwisestated.Detailsandpercentagesintablesdonotnecessarilyaddtototals,becauseofrounding.Whenaprinteditionofasourceexists,theprintversionistheauthoritativeone.UnitedNationsdocumentsreproducedonlinearedeemedof?cialonlyastheyappearintheUnitedNationsOf?cialDocumentSystem.UnitedNationsdocumentationobtainedfromotherUnitedNationsandnon-UnitedNationssourcesareforinformationalpurposesonly.TheOrganizationdoesnotmakeanywarrantiesorrepresentationsastotheaccuracyorcompletenessofsuchmaterials.Thefollowingabbreviationshavebeenused:EconomicCommissionforLatinAmericaandtheCaribbean(ECLAC)GrossDomesticProduct(GDP)InternationalLabourOrganization(ILO)InternationalOrganizationforMigration(IOM)InternationalMonetaryFund(IMF)LuxembourgIncomeSurvey(LIS)OrganisationforEconomicCo-operationandDevelopment(OECD)Purchasingpowerparity(PPP)SustainableDevelopmentGoals(SDGs)UnitedNationsConferenceonTradeandDevelopment(UNCTAD)UnitedNationsChildren’sFund(UNESCO)WorldHealthOrganization(WHO)NOTESONREGiONS,DEVELOPMENTGROUPS,COUNTRiESANDAREASThedesignationsemployedinthispublicationandthematerialpresentedinitdonotimplytheexpressionofanyopinionswhatsoeveronthepartoftheSecretariatoftheUnitedNationsconcerningthelegalstatusofanycountry,territory,cityorareaorofitsauthorities,orconcerningthedelimitationofitsfrontiersorboundaries.Theterm“country”asusedinthisreportalsorefers,asappropriate,toterritoriesorareas.Inthispublication,dataforcountriesandareasareoftenaggregatedinsixcontinentalregions:Africa,Asia,Europe,LatinAmericaandtheCaribbean,NorthernAmerica,andOceania.Furtherinformationoncontinentalregionsisavailablefrom/unsd/methodology/m49/.Countriesandareashavealsobeengroupedintogeographicregionsbasedontheclassi?cationbeingusedtotrackprogresstowardstheSustainableDevelopmentGoalsoftheUnitedNations(see/sdgs/indicators/regional-groups/).Thedesignationof“developing”and“developed”,isintendedforstatisticalpurposesanddoesnotexpressajudgmentaboutthestageinthedevelopmentprocessreachedbyaparticularcountryorarea.DevelopedregionscompriseallcountriesandareasofEuropeandNorthernAmerica,plusAustralia,NewZealandandJapan.DevelopingregionscompriseallcountriesandareasofAfrica,Asia(excludingJapan),LatinAmericaandtheCarib-bean,andOceania(excludingAustraliaandNewZealand).Furtherinformationisavailableat/ohrlls/content/about-us.Theclassi?cationofcountriesandareasbyincomelevelisbasedongrossnationalincome(GNI)percapitaasre-portedbytheWorldBank.Theseincomegroupsarenotavailableforallcountriesandareas.Furtherinformationisavailableat/knowledgebase/topics/19280-country-classi?cation.EXECUTIVESUMMARY2EXECUTiVESUMMARYPopulationageingisade?ningglobaltrendofourtime.Peoplearelivinglonger,andmoreareolderthaneverbefore.Spectac-ularimprovementsinhealthandsurvivalandreductionsinfertilityhavedriventhismomentousshift,whichhasbegunorisex-pectedtobeginsooninallcountriesandar-eas.ThischangebringsbothchallengesandopportunitiesascountriesstrivetoachievetheSustainableDevelopmentGoals(SDGs).longerlivesandsmallerfamilies.Whiletheshifttowardsolderpopulationsislargelyirreversible,collectiveactionsandpolicydecisionsshapeitspathandconsequenc-es.Postponingcriticalmeasuresthatal-lowsocietiestobene?tfromandadapttopopulationageingwouldimposehighsocial,economic,?scalandhealth-relat-edcosts,forbothcurrentandfuturegen-erations.Bycontrast,withappropriateforesightandplanning,Governmentscanmanagethechallengesfrompopulationageingwhileenhancingopportunitiesforallpeopletothriveandensuringthatnooneisleftbehind.In2022,theworldmarkedthetwentiethanniversaryoftheadoptionoftheMadridInternationalPlanofActiononAgeing.Tocommemoratethislandmark,theWorldSocialReport2023explorestheeconomicandsocialimplicationsoftheageingofthehumanpopulation.ItbuildsonthePlanofAction’sframeworkfornationalpoliciestocreateequitable,inclusivesocietiesforpeo-pleofallages,providingrecommendationstoputtherightsandwell-beingofolderpersonsatthecentre,acrossthelifecourse.Aselaboratedinthisreport,populationageingneedstobewidelyunderstoodasmorethanjustasetofdiscreteconcernsmainlyforonegroupofpeoplewhohaveadvancedbeyondagivenage.Ageingtouchesallpartsofeconomiesandso-cieties,fromhealthcareandeducationtoemploymentandtaxation.Eachstageoflifecancontributetoordetractfromwell-beingatolderages.PopulationageingisaninevitableresultofthedemographictransitiontowardsWORLDSOCIALREPORT2023:LEAVINGNOONEBEHINDINANAGEINGWORLD3ANAGEiNGWORLDiSASUCCESSSTORYDecliningmortalitythroughoutthelifecoursehasdriventheincreaseoflifeex-pectancyatbirthinmostcountriesandglobally.Greaterlongevityhasaccompa-niedanarrowingoftheagerangeinwhichmostdeathsoccur.Inthepast,deathwascommonatallages.Manychildrendiedfrominfectiousdiseases,forexample,andwomenfrequentlyperishedinchildbirth.Inmostcountriestoday,“prematuredeath”beforeage60or70isrelativelyrare.Populationageingsignalsourextraordi-narycollectivesuccessinimprovinglivingconditionsforbillionsofpeoplearoundtheworld.Bettersanitationandmedicaltherapies,greateraccesstoeducationandfamilyplanning,andstridestowardsgenderequalityandwomen’sempower-menthaveallcontributedto,andinsomecasesbene?ttedfrom,thesteadymovefromhightolowlevelsoffertilityandmortality.Theseadvanceshaveusheredinanerawhererapidpopulationgrowthisslowlycomingtoanend,accompaniedbyagradualbutpermanentshifttowardsolderages.Overseveraldecades,boththenumberandpopulationshareofolderpersonshaverisenglobally,whilethenumberandshareofchildrenandyouthhavebeguntoshrink.By2050,thenumberofpersonsaged65yearsorolderisexpectedtodouble,surpassing1.6billion.Greatergloballifeexpectancyre?ectsunderlyingimprovementsinhealth.Incountrieswithavailabledata,thenumberofyearslivedingoodhealthhasclimbed,accountingformostoftheincreaseinyearslivedoverall.Statisticalaverageshidebroaddisparitiesinlifeexpectan-cy,however,includingbysexandsocio-economicstatus.Inalmostallsocieties,womenlivelongerthanmenonaverage,andtherichlongerthanthepoor.Thesedifferencesstempartlyfrompoornu-tritionandexposurestoenvironmentalandoccupationalhazardsthataremorecommonamongmenandpeoplewithlimitedincomeandeducation.Currently,populationageingisfurthestalonginEuropeandNorthernAmerica,AustraliaandNewZealand,andmostofEasternandSouth-EasternAsia.Inmostcountriesofthoseregions,thepropor-tionofolderpersons–byconvention,thoseaged65yearsorolder–exceeds10percentandinsomecases20percentofthetotalpopulation.Mostpartsofsub-SaharanAfricaandOceania(ex-cludingAustraliaandNewZealand)arestillinanearlystageofthistransition,whilemostcountriesinCentralandSouthernAsia,WesternAsiaandNorthernAfrica,andLatinAmericaandtheCaribbeanareatanintermediatestage.In2020,theWorldHealthOrganizationandtheUnitedNationsdesignated2021-2030astheDecadeofHealthyAgeing.Itspurposeistopromotestrategies,groundedinsolidevidence,thatsup-portwell-beingamongolderpeople.Itadvocatesfordevelopingandmaintain-ingfunctionalabilities,recognizingthatthesedependoneachindividual’sintrinsiccapacity,thesurroundingenvironmentandinteractionsbetweenthetwo.TheDecadebuildsontheMadridInternationalPlanofActiononAgeingandalignswiththetimingoftheSustainableDevelop-mentGoals.EXECUTIVESUMMARY4POPULATiONAGEiNGBRiNGSECONOMiCREWARDSANDCHALLENGESagedependencyratio–donotaccountforthesefactors,however(box1).Further,manyolderpeoplestillencounterobstaclesthatlimittheircontributions.Age-baseddiscriminationinthelabourmarket,forin-stance,undercutstheirfullparticipationintheeconomy.Levelsofeconomicproductionandcon-sumptionvaryoverthelifecourse.Typically,peopleinthemiddlephasesoflifeproducemorethantheyconsume,generatingasur-plustoprovidefortheirdependentchildrenandotherswhorelyonthemforsupportandcontributingtowardseconomicsecurityforthemselvesatolderages.Thedemograph-ictransitionincludes?rstanincreaseandthenadecreaseintheshareofworking-agepeopleinthetotalpopulation.Theinitialincreaseoccursfollowingasustainedre-ductioninfertility,whichlowerstheportionofchildrenandyouthinthepopulation.Thesubsequentdecreaseintherelativesizeoftheworking-agepopulationisdrivenbyrap-idgrowthintheproportionofolderpersons.Olderpersonsshouldhavetheoptionofcon-tinuingtoworkforaslongastheydesireandareabletodoso.Nevertheless,theabilitytoworkandgenerateincomewanessoonerorlateratadvancedages.Aspopulationsgrowolder,questionsarisearoundhowtosupportrisingnumbersofolderpeopleinthefaceofescalatingpension,health-careandlong-termcarecosts,particularlyifequitableandsustainablesystemsarenotinplacetodistributeresourcesamongagegroups.Themeansof?nancinggoodsandservic-esforolderpersonsdifferacrosscoun-tries.Inmoredevelopedregions,publictransfersystems,includingpensionsandhealthcare,provideovertwothirdsoftheconsumptionbyolderpersons.Inlessdevelopedregions,olderpersonstendtoworklongerandrelymoreonaccumulatedassetsorfamilyassistance.Countriesatal