Is living longer always a good thing? The anomaly of longevity and human development in an ageing society

This article questions whether it is still appropriate to rely on life expectancy as an indicator of a long and healthy life. The authors challenge the UN’s assumption that rising life expectancy inevitably signals positive human development, without considering its interaction with other indicators such as GDP per capita. They draw attention to the shortcomings of any index that uses life expectancy as a comparative tool, either as a static measure for comparing one country to another or as a dynamic measure for comparing the progress of a country’s human development over time.

The paper argues that since both human development and population ageing are dynamic rather than static processes, life expectancy measures are only useful when we consider their change over time and the context in which they are taking place.

The interaction between the different rates of change of life expectancy and GDP provides a clearer picture of a country’s human development and takes account of the financial cost of an ageing society. This is important if the UN's Human Development Index (HDI) is to measure the quality and not just quantity of life and to ensure that the extra years gained by rising life expectancy are not lived in ill health or poverty.

The paper concludes that:

• life expectancy is not an accurate indicator of a “long and healthy life”: although life expectancy may have been a useful indicator of human development in younger countries, where it pointed at falling child and maternal mortality, in an increasingly ageing global society it no longer fills this purpose. It is essential to take account of the factors that may influence how extra years of life are lived. This should include the health and economic status of older people as well as the environment in which they live, all of which play a key role in their well-being
• the HDI assumes that longer lives are always better, regardless of circumstances, but longer lives are not always better than shorter ones if the extra years are lived in ill health, disability or suffering because an older person lacks access to adequate healthcare or does not have the resources to afford it. Figures showing higher levels of depression amongst older people in developing countries, often due to ill health, loneliness or chronic poverty, may lead the UN to reconsider whether living longer is always a good thing
• longer healthy lives require the fulfilment of basic rights: too often the rights of older people are neglected, with little attention to their basic needs, particularly in countries which cannot afford to provide basic healthcare and pensions and where older people run a high risk of living the end of their lives in poverty and ill health
• longer healthy lives require additional financial resources: the HDI has not been adjusted to consider the fact that rising life expectancy now points at an increasingly older population and that this ageing has costs, which cannot always be met in less developed regions. Countries experiencing population ageing without GDP growth are at serious risk of rising poverty at the end of the life course. The higher susceptibility of older people to poverty means that as populations age, unless adequate resources are dedicated to older people’s needs, poverty and social exclusion may be exacerbated
• there is a need for a better understanding of the quality of longer lives. The paper highlights the need for more research and better indicators of the quality of old age, including not just measures of health, but also measures of social protection (in terms of pensions and social assistance), the recognition of older people’s rights and the elimination of age discrimination in all spheres of society

Please note that this paper has been submitted to World Development for consideration, August 2005.