Inequality and Older Age

25/01/2016 11:38 GMT | Updated 24/01/2017 10:12 GMT

I am writing this on the flight home from this year's World Economic Forum meeting at Davos. Inequality was an urgent and recurrent theme throughout the four days. The agenda had again been set by Oxfam, with their skilful and well-timed publication of their analysis of the dramatically unequal distribution of global wealth. US Vice-President Joe Biden directly referenced Oxfam's report in his speech on Wednesday, the de facto keynote address of the entire conference.

I represent HelpAge International at Davos and am one of the civil society representatives invited to the meeting by the WEF. Our organisation is the secretariat to a global network of some 115 organisations working with and for older women and men nationally.

Population ageing is something of a grand Davos theme, an obvious megatrend of global significance. The world is ageing fast, with implications across so many key issues discussed at the global meeting - healthcare, economic productivity, gender, the future of jobs, social security systems, even robotics!

Commonly misconstrued as a "rich world" challenge, population ageing is actually a global phenomenon. With the exception of sub-Saharan Africa and South Asia, most regions will see the proportion of their total population composed of men and women aged 60 or more rise from around 12% now to 25% or even 30% by 2050.

There is a long-standing but instructive cliché that many emerging economies are getting old before they got rich - certainly, the frontline of global ageing is no longer confined to Japan and Western Europe, but now includes countries such as Vietnam, Brazil, China, and Bulgaria.

Inequality, arguably the core social and economic issue of our time, can be viewed effectively through a lens of older age. There are two dimensions of inequality and older age that I would like to explore here.

Firstly, and logically enough, as people age, the effects of accumulated hardship or opportunity manifest themselves ever clearer. Inequality usually widens between rich and poor with age. For rich people in rich countries, the talk at Davos rightly surrounded the tremendous opportunities offered by greater longevity in an age of unprecedented scientific discovery. There was an excellent and well-attended panel discussing what life will be like if (perhaps when) we see 150-year human lives. What would be the impact on life, love and work? At an "ideas lab" just next to the main centre, the Korea Advanced Institute of Science and Technology held regular presentations over the course of the week on "Biolotechnology Solutions for Ageing Populations", and demonstrated some of the extraordinary scientific discoveries that they are confident will shortly dramatically slow or even start to reverse the ageing progress in the 21st century.

Meanwhile, for the world's poorer older people (and there are hundreds of millions), and those caught up in crises such as Syria, women and men face enormous and specific health, income and protection challenges as they age, the result of hardships accrued through the life course, or of a sudden shock such as conflict and displacement.

For this large poorer segment of the world's older people, many live with zero or very limited access to some of the medical breakthroughs even of the late nineteenth century, such as the sphygmomanometer (the device that measures blood pressure). South Africa, for example, now has the highest level of adults over 50 living with hypertension ever recorded in a population, but still very low levels of blood pressure testing and management. Hypertension, despite being the biggest single cause of avoidable death and disability on the planet, is not a health sector priority for most emerging economy Ministries of Health with rapidly ageing populations, or for the international donor community in their development planning and programmes.

Women face very specific challenges as they age, again through gender inequality accumulated through the life course. One of the very many examples - in both developed and developing countries, lower pay when working, along with a de facto "care penalty" means fewer and smaller pensions, and therefore, much lower income, for women in older age than for men.

But there is a second dimension of inequality around older age, which is that older people, who may have seen a lifetime of poverty, poor health and exclusion, then face active or passive discrimination and disadvantage on account of simply being older, even within development and humanitarian programmes.

Syria's older population, pre-war, had broadly similar rates of type 2 diabetes and higher rates of hypertension than the United States - but almost five years and well over a billion dollars into the global humanitarian response, recent John Hopkins' research confirmed that the health needs of the older refugee population in Lebanon had simply not been catered for by the massive international response - "More than half of older refugees reported their health was very bad and about two-thirds said their health has gotten worse since arriving in Lebanon. Despite having many physical limitations and chronic health problems - most commonly hypertension, diabetes, heart disease, difficulty walking, and impaired vision - nearly all older refugees reported they were unable to obtain adequate medical treatment." I simply don't believe that any other age segment would have been overlooked in this way.

The momentum behind the gender equality movement is truly exciting, but how often do you see images or hear the voices of older women? How often are the specific health, income or protection needs of older women cited among the priority development interventions? How often do we see older women as among the potential entrepreneurs for whom better access to credit might transform their economic situation? The girl or young woman of today, abused by forced early marriage to a much older man, faces a huge statistical probability of living through an extended period of widowhood, often with specific protection threats surrounding this very status, yet global data on violence against women is not even measured for women once they pass the age of 49.

Ageism or age discrimination is arguably the last widespread, identity-based form of discrimination still to be tackled on a global scale. It perpetuates and heightens inequality, it dehumanises, and it holds us all back. Our human rights should not weaken as we age. We all hope to grow old. The 21st century will be an era of hyper longevity, so let's all come together to make our ageing world a great world to live in.