Europe is the only region in the world whose total population is projected to shrink by 2050. The “old continent” is also ageing faster than any other region, with the number of working-age people expected to decline steadily in relation to the elderly population. A recent World Bank report indicates that this demographic trend is particularly strong in Central Europe and the Baltics, where some countries have already been experiencing a declining population since the 1990s.

According to current trends, some of Europe’s strongest economies – including Germany, Austria, and the Netherlands – could experience severe labour shortages by 2050. The strains on pension and healthcare systems could also increase substantially, as Europeans live longer than ever before.

One of the countries feeling this trend most strongly is Latvia. Due to a combination of low fertility rates and high emigration, Latvia’s population has been shrinking since 1990. Latvia’s former Minister for Health, Ingrida Circene, has argued in an article in Europe’s World that confronting this issue should be one of the top priorities of EU policymakers.

In light of these challenges, our sister think tank, Friends of Europe, convened a Health Working Group in 2013 and 2014 in order to address the much needed changes to Europe’s health systems and policymaking. The final report outlines 21 policy recommendations to improve the health of Europe’s citizens in an evolving Europe.

But what do citizens think? We had a comment sent in by Bastian arguing that, while Europeans are living longer, they won’t necessarily be healthier. Bastian argues that health risks such as obesity are increasing among young people and, in future, Europe’s population could end up older and unhealthier than ever before.

To get a response to Bastian’s concerns, we spoke to Francesca Colombo, Head of the Health Division at the OECD. How would she respond to Bastian?

francescaColomboThe evidence we have is that, for the moment, people are living longer but in addition they’re also living in better health. So, for example, if we look at the trends for disability among the population, we see that disability among the elderly population is not getting worse, it’s getting better or staying the same.

However, the difficult part is that this applies to the elderly population of today. What happens in the future is pretty much an open question, and Bastian is right – there are some stresses, particularly with growing obesity levels. Obesity is responsible for the growth in certain chronic conditions that tend to kick off more in a middle or old age population. So, there is indeed a question mark over whether we will be able to sustain the gains not just in life expectancy but also in a life free of disabilities because of some of the challenges from the lifestyles of the population.

To get another reaction, we also spoke to Vytenis Andriukaitis, EU Commissioner for Health and Food Safety. Is Bastian’s grim scenario, of Europeans being older and unhealthier than ever before, a realistic assessment of the situation?

Will Europe’s healthcare systems be able to cope with the strain? We had a comment from Nikolai arguing that, given healthcare budgets are being cut in many countries, we may need to reduce expectations about what health systems can deliver:

citizen_icon_180x180Ultimately in order to support the aging populations, pensions and medical care et al., which are at the heart of many national systems, there will need to be a young working, tax paying population large enough to support all the elderly living ever longer – unless expectations on the state are reduced.

To get a reaction, we spoke to Kathrin Komp, Assistant Professor at the Population Research Unit of Helsinki University and Chair of the Research Network on Ageing in Europe. How would she respond?

kompOld people should not automatically be seen as a burden on healthcare systems. Many older people are also healthy and active, so more older people does not necessarily mean more frail people. Also, many old people are also contributing to overall healthcare and social care, because they are looking after their family members, including grandchildren, or looking after their partners who may need help or support. So, many elderly people actually improve the situation in healthcare and social care.

On the other hand, we might also need a different way of looking at healthcare. We might need to put more emphasis on prevention, so we start to support positive living habits in youth or middle age and we don’t bump into those problems when we people are older.

To get another response, we also put Nikolai’s comment to Francesca Colombo, Head of Health Division at the OECD. What would she say?

francescaColomboIt’s a very timely question. It’s timely because, obviously there is an economic and financial crisis and all of the countries are facing tough fiscal circumstances, and in some countries they’ve had to cut budgets, including in health. So, obviously, there are more demands on health systems to deliver better value for money, and to deliver better improved outcomes in tough fiscal circumstances.

It’s true that we cannot expect the health budget to continue to grow at the rate it has before the crisis, where health budgets were largely outpacing the growth of the economy. It might be that countries will need to reconsider allocations between health and other parts of the economy. At the same time, spending on health and what health delivers to citizens is something that people value a lot. There is a very strong willingness to pay, and there is a consideration that health is delivering very good results and that investment is worthwhile…

We also put the same question to Vytenis Andriukaitis, EU Commissioner for Health and Food Safety. How would he respond to Nikolai?

Finally, we had a comment sent in by Rita, arguing that more public money should be invested in prevention. At the moment, roughly 3% of total healthcare budgets in Europe are being spent on prevention. Instead of spending more money on hospitals, doctors and pharmaceuticals, should we be investing more in public health campaigns, free exercise structures in parks, more bike lanes, etc? How would Kathrin Komp respond?

kompI would absolutely agree with her. Because research shows that many of the habits you pick up over your life will influence your situation in old age. Which means that what you do as a child and a young person can already shape your health status in old age.

So, if you want healthier older people then we need to start working towards that goal when people are children or middle aged. We need to encourage people to develop healthy lifestyles and habits, such as doing sports, being outdoors, and maybe also having healthier eating habits. That’s something that needs to start earlier, so I would definitely agree with that.

Are we ready to cope with an ageing Europe? Let us know your thoughts and comments in the form below, and we’ll take them to policymakers and experts for their reactions!

IMAGE CREDITS: CC / Flickr – Rego Korosi

90 comments Post a commentcomment

What do YOU think?

  1. avatar
    Pedro Pais de Vasconcelos

    The system, in Europe and the US, is not marriage friendly, not family friendly, nor children friendly. It sacrifices too may important things for the sake of short term economy.
    But economists, politicians, and opinion leaders should think and understand the economic importance of family and of breeding children.
    In the long run, this is the only way to solve serious problems like social security, retirement and even immigration.
    This is becoming everyday more obvious. I am optimistic.

  2. avatar
    Dubravka Alic

    And Genocde and Crime against Humanity!! European Commission – Humanitarian Aid & Civil Protection (ECHO)

  3. avatar
    Darcy Brás da Silva

    Is Europe ready ? No, but we currently have a great opportunity to do the right thing in two fronts. Fix Asylum and migration, this will improve the quality of life of all the migrants running away from war and potentially make 2050 not so dramatic and buy us time to address schemes that incentives young people to have kids.

    • avatar
      Paul X

      “Higher immigration numbers will solve the problem, right?”

      Depends upon the quality of the immigrants………

    • avatar

      They will not. Unemployment rates of migrants from MENA show that on net, they are taking more from the system than they are returning. Don’t forget that the people coming are those willing to break the laws of Europe, pay criminal people smugglers, and enter illegally. A more targeted migration strategy focusing on skilled Eurasian workers would be a better idea rather than outsourcing immigration policy to people smugglers.

  4. avatar
    Nando Aidos

    No! Europe is not ready but needs to work on it. We all need to figure out what we will be looking for in 2050 and start working on it today!

  5. avatar
    Borislav Valkov

    Tax decrease for tohse who work and have more than 2 kids + social benefits as well cause uneducated jobless families with many kids aren’t solving any problem.

  6. avatar

    Keeping the economic stake high by greedy neocons, Globalization and Free Trade apostles, ruthless lobbyists and selfish bankers regardless local available capabilities and resources is just another neoliberal insane audacious ambition. Personally, I would rather shrink economically than importing manpower. What are they doing now is preparing the europeans for middle easterners, africans and orientals massive invasion, aka “desperately needed skilled workers for keeping the social benefits and pensions coming”. They found an “excuse” to modify the ethnic map across Europe. Let’s see some socio economic solutions without importing foreigners, lowering pensions or working to the bone the young. That’s why you guys from Bruxelles are payed for, are you ?

  7. avatar
    catherine benning

    Has anyone really questioned whether there really is a growing aging population of Europeans? Or, is it really the aged who have been allowed to enter Europe and settle here as immigrants for over forty years that has created the swell of elderly? Think about it. Where have all the aged come from? If you check the statistics you may be surprised. The indiginous population, prior to the influx of immigrants from outside our borders, shows the natural process of our aged change dramatically with mass migration. Why is that?

    You see you can’t run away from reality and facts. Much as you would like to. And so then we have to ask ourselves, why do we want to run away from the truth? What relief do we get from that move?

  8. avatar
    Rafael Mendes

    Nop because the established capitalism fucked everything up. And the riches aren’t able to fornicate enough

  9. avatar
    Paulo Especial

    NOT in the SOUTH of Europe and I don’t believe that they will, much longer, in the NORTH also!

    For when a COMMON Wealth Care System in the EU?

  10. avatar
    Thomas Beavitt

    In my view, there should be an active policy of reducing average life expectancy, not extending it. Quality not quantity!

  11. avatar
    Luisa Lima

    No, Europe needs to devoleped better policy for the upcoming aging population. In Europe are to many seniors living in poverty hoe leads to sickness and early death. I appy a debate for the problem about poverty betwin de upcoming aging emigrants.

  12. avatar
    Ivan Burrows


    We are having the same problem as some European countries, to many immigrants using the system before they have paid into it.

    Solution = Charge their country for their ‘Citizens’ using the NHS.

  13. avatar
    Rudi Špoljarec

    No , at the moment . Funds are empty . Each year governments have to lend money from banks and institutions in order to satisfy the health care funds . Governments do not have measures to repopulate countries and employ young people . To much bureaucracy is emptying all the funds each day . Unfortunately , each of us has to take care for himself alone , being informed how to preserve health untill the old age .

  14. avatar
    Natasha Antonie

    we pay taxes for the health system for nothing, we do not have any benefits, the hospitals are looking like in the middle eve, the doctors are emigrating for higher salaries in west European countries ..we don’t trust public health system and we prefer to give more money to the private sector for avoiding bribing & non professionalism. We are not encouraged to have a family because we believe we need to have a home, a car, a good job and. for doing this we need to commit to a bank credit for 30 years in order to be accomplished and self satisfied. that’s the reality we live…our grandparents are dying because the doctors do not recommend surgeries for old people and they simply let them die. That’s the reality from our beautiful Europe . Gruesse aus Rumaenien

  15. avatar
    Tony Kunnari

    In Finland we treat prisoners better than our everaging seniors. The longer we are unable as taxpayers to intervene malignant policies between the government, citizens and the market, we will witness the same things happen all over again. We need to make a total or at least near-total reformation of our taxation, investment, income and voting portions of our system of economics before it is too late to do a comprehensively preventative maneuver.

  16. avatar
    Ivan Burrows

    Natasha Antonie

    Just wait until you join the Eurozone, then it will get worse, much much worse.

  17. avatar
    Edgar Da Silva Carreira

    I’ve just read some comments, and I’m shocked: People still think that the problem is mainly economic, or that any European country is taking advantage, when the truth is that Europe as a whole (Russia as well) needs more and more migrants to face the ageing of the population. It’s not only a question of taking care of the retired persons and provide them quality services; it’s a question of have human capital (skilled but also not skilled) to perform well in the global economy, I guess. So, the basis of the problem is demographic. Not a mere question of money.

  18. avatar
    Harald Heidegger

    We need to have a SOCIAL system, not a public individual system. Everyone should pay his fair share and take an equal share in his old days.

  19. avatar
    Maria Celeste Raposo

    No. Because solutions have to be found and put into practice by older people themselves and after retirement they no longer have the possibility of doing it. So, we have solutions for ageing population imagined and implemented by young people who will never understand the problems of the older ones.

  20. avatar
    Ivan Vikalo

    This is really not a problem as it will benefit workers in the end.. Just a natural curve of change

  21. avatar
    Paul Moldovan

    Healthcare is one of the basic featuresof any society. All members of the society should have the expectation that health system to support him when he needs that support. If the quality of the support is not good enough, that is problem that cityzens should claim about.

  22. avatar
    Nando Aidos

    As to the health question, there is no need to be that way!
    As to population and economic growth, why is it bad? Why is everyone so bent on the unsustainable permanent growth model? Why does everyone believe that an ever growing world will continue to fit in the limited world resource pool?
    “Europe is the first continent to turn the page on the illusive permanent growth syndrome!”
    How is that for another perspective, another slogan?

  23. avatar
    Jaime Martins

    Ancient people were holding themselves to live without conditions and misery, lived in survival, today the young couples have another vision, like to give decent living conditions to their kids and your austerity is destroying it.
    Bankers don’t have children, but the money goes into their pockets.

  24. avatar
    eusebio manuel vestias pecurto

    not EU must take the values of freedom and equality and that joins will idea of solidarity between generations of workers form young ace middle aged lees individualism and more solidarity than current

  25. avatar
    Harald Heidegger

    No! We should try to find an agreement about social standards (illness, unemployment, retirement) all over the member states.

  26. avatar
    Ciobîcă Ovidiu

    Why should we approach this matter in such Terms? No, we should do everything for improving health care in Europe!

    • avatar
      Hasnae El Fahmi

      Sorry to disappoint you, both countries also face rapid decline in population. Moly european country that has a relatively high birth rate is France!

  27. avatar
    David Harrison

    Which is why there is now mass immigration on an unprecedented scale. To replace the dwindling European population.

  28. avatar
    Robert Santa

    No. Europe is neither ready (many countries still have pay-as-you-go pension systems) and is also incapable of attracting enough highly educated/skilled migrants (check the Eurostat report on first and second generation immigrants).

  29. avatar

    Europe needs to redesign itself.
    – it cannot continue sending productive citizens into retirement and depleting its valuable workforce;
    – it cannot keep filling the Earth with people just to have a larger workforce;
    – it has to value a workforce composed of people who live much longer than the previous generation.

    Europe has to have a sustainable wage earning policy that is consistent with its wage earning population. And the time to seriously redesign existing work age and job and retirement roles is now!

    All needs to be seriously evaluated – retirement ages, maternity and paternity leaves, etc.

  30. avatar
    Med Intex

    Keep your hearts young and your minds open to the New.
    Keep the Time on your side!
    A definition just It is!

  31. avatar
    Med Intex

    Keep your hearts young and your minds open to the New.
    Keep the Time on your side!
    A definition just It is!

  32. avatar
    Ariste Arvanitides

    No, absolutely not. In the past, the old were cared for by their children. Now everyone is working or unemployed, but without the family ties that used to exist. Also, medical care and medicine is expensive, and the elderly are not covered… at least not in Greece. After the PSI, where pensions were stolen by the TROIKA, retirement payments and medicines have been cut in half in terms of funds and quality.

  33. avatar
    Irena Leibovici

    I think that Europe, if does not accept the law level immigrant to destroy the standards, but they are obliged to be integrated, and if adopts more and more the IT&C systems in the medical field, part time work, entertainment, can successfully be an example for dealing with an bigger aging population! Medical telemonitoring is today no more a problem, old people afe happy to challenge with the new systems of telecommunication, they are ready learn and to remain in the active life till older than before. The only thing which the citizens cannot help is the monitoring of their own pension funds… This is in the hands of the governments, private insurance, banks, depending on such institutions If the politicians are making mistakes the aging population shall be the first one to suffer. QUESTION: What European Communit is making in order to protect, first of all, the pension funds if managed by governmental insitutions, privae organizations and banks….MAINLY the banks Today, from all the fortune of a person, only 100,000 Euro are protected!

  34. avatar
    Rudi Spoljarec

    No.Each of us should take care about health , keep informed , because nobody will care about us .

  35. avatar
    Hasnae El Fahmi

    Probably, but the individual policies per country are a result of this. it was not motivated to start a family when housing prices in capital cities sky rocketed in three housing bubbles, career wise it was not advised to start a family too soon and for the Netherlands and also some Southern European countries, costs of daycare for children can add up to be 40% of your net income. What do you expect, less people were and are motivated or had/ have the means to start a family. We will have an economy where you work until you die and rely on support from family like many developing countries!

  36. avatar
    Hasnae El Fahmi

    One solution, motivate cross border between eu countries to fill in the gaps in demographics!

  37. avatar

    The world will have to come to terms with an aging population at some point , and also deal with overpopulation in underdeveloped countries where education is bad. There will have to be serious talk of sustainability, due especially to climate change , and where water and food resources will be a major problem.
    Politicians will have to start understanding and adapting to sustainability if they do not want unrest in many countries.

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