03/09/2015 10:54 am ET Updated May 09, 2015

Aging Population

The world is getting older. Imagine a graph that looks like a steep mountain trail. We are climbing at a rapid rate to an unprecedented increase in the aging population. The world will contain 1 billion people over 60 by the year 2020.

These facts were spelled out for me at a symposium on aging at Oxford University, focused on emerging market states: Brazil, Russia, India and China.

On the one hand, living longer is a huge humanitarian achievement. People are getting older because of better education, nutrition and health care. This demographic shift is further influenced by the decline in fertility rates. Many countries used to have six or seven children. Now women have two or three because of access to education, the move towards emancipation, and the decline in infant mortality rates.

The ratio of the young, working population to the old, dependent population has tilted towards the old and the most rapidly growing subgroup: the old old -- that is, those over 80. Fewer taxpaying workers are being asked to support no-longer-taxpaying elders. The challenge for countries is how to provide adequate care, housing, and health care for parents, grandparents and great-grandparents.

This population shift has occurred in the last 25 years in the emerging market world. By comparison, it took the developed world 150 years to reach the same place. The decline of kin-based care or filial piety in countries such as China and India adds to the problem. Children move to the cities for work, leaving their children and their parents behind.

Gender. Visit any nursing home and you can observe gender differences. Women outlive men in every part of the world. Again, good news, but they may not live as well into old age as men. They are poorer, less educated and more dependent. And they are the majority of caregivers. Many women find themselves in the sandwich generation, caught between caring for their children and caring for their aging parents.

The most effective initiative to improve their lives that we can take is to reduce poverty. Before Social Security, Medicare and Medicaid, the poverty rate for the elderly was twice that of children.

Since these programs have existed, poverty rates have been turned upside down: The elderly have half the poverty rate of children. Good news for the elderly, not good for children.

The keys to achieving the so-called golden years are clear: access to health care and a livable income.

But we have to do more to assure that our growing elderly population enjoys a dignified and secure old age.