How to Tackle Ageing Societies

The world is experiencing a significant demographic change. Today, the global fertility rate stands at approximately 2.23 and is projected to drop as low as 1.61 around 2050, well below the 2.1 replacement level required for long-term population stability. Not only can this trend be seen in developed countries, with G20 members showing an average fertility rate of 1.5, but also where fertility is currently higher.[1] Just as importantly, in OECD countries the share of population over 65 was 7.7 per cent in 1950, climbed to 21.3 per cent in 2023 and is projected to rise to 25.1 per cent by 2050.

Albeit at times considered as two sides of the same coin, low fertility and increased longevity are actually distinct phenomena. The former is rooted in a series of societal and economic factors that have long been at play since the development of market economies. Changing norms, cultural shifts, unhealthy lifestyle[2] – as well as financial constraints – are indeed heavily influencing the choice of parenthood, delaying if not discarding it altogether.[3] Instead, a longer life expectancy is a positive outcome of the advancements over the last century in life sciences, medicine and technology.

The consequences of a longer life expectancy

But while longevity is primarily driven by positive factors, it does not come without consequences, the most relevant being that we live much longer in retirement. Indeed, time spent in retirement has surged across OECD countries, going from 14 years in 1980 to nearly 18 in 2022 for men and from 18 to 23 for women.[4] To be properly equipped for this new setting, two aspects seem to be particularly relevant. First, a solid saving rate throughout the working age. Second, a healthier lifestyle in the decades leading to retirement.

As per the first, a checkered performance emerges across the developed world,[5] complicating the journey toward financial independence and a sustainable retirement, both now and in the future. Now, because today families support their offsprings (who are progressively reaching financial stability and/or leaving the parental home later)[6] as well as their elders, who live longer than in the past and face increased cost for long-term care[7] – only partly covered by insurance policies; in the future, because low(er) savings rates in the working years might prevent parents from being self-sufficient in their old age.

As far as our lifestyle is concerned, not only are we living longer, but we are doing so in a particularly unhealthy way. In actual fact, a growing number of people is expected to live longer, but with more years spent in poor health or with some kind of disability.[8] This may be reflected in the fact that more than 41 million people annually die of non-communicable diseases.[9] Moreover, 80 per cent of these premature deaths are considered as preventable through a healthier lifestyle. As a consequence, (a) longevity seems to be progressing at a slower pace than in the past[10] and (b) improvements in healthy life expectancy (i.e., years spent without major health impediments) have been even slower,[11] further straining the economics of our retirement period.

What lies ahead

Going forward, we need to alleviate the pressure on the working class. To do so, it seems consequential to review our current ‘social contract’ to ensure that youngsters find it easier to enter the world of work and reach financial independence. Also, it is paramount to assuage the constraints affecting young families’ path to parenthood.[12] Lastly, we need to be sharper and in better form for a longer period of our lives – consistently following healthy living standards, lest incurring yet another case of free riding, this time on our healthcare system. In other words, after having mortgaged our children’s future through decades of public overspending, we should at least avoid reaching our old age in poor shape – hoping that someone else (that is, those in work) will foot the bill of our long-term care.

Clearly, we as individuals cannot do this autonomously. The policymaker’s intervention is indeed required. Following are some policy measures to address the ageing of our societies.

1. Implement women-friendly fiscal policies to foster childbearing. For instance, taxes paid in by women under 35 could go toward a separate, periodically accrued ‘maternity fund’ to be used, if a woman decides to become a mother, only on maternity-related goods and services via a personal credit card. Should the woman decide not to procreate before turning 35, the funds would be released and made available to the state.
2. Alongside levying heavier taxes on sugary drinks and food, which merely affect consumption, measures should be taken to foster prevention and improve the quality of food production by imposing stricter, lower limits on sugar content. Moreover, in sharp contrast with policies financing drugs which do little to promote well-being,[13] these fiscal revenues should be channelled toward investment in functional medicine, that is a comprehensive approach to better understand a patient’s genetic, environmental and lifestyle influences.[14] Also, policies should favour the repurposing of the tobacco industry[15] toward the production of natural medicine[16] as well as pharmaceuticals.
3. Apply tax reliefs/breaks/exemptions to single-income families, (a) reportedly the ones with a higher number of children in the US and elsewhere[17] and (b) those likelier to have the time needed to raise a child.
4. Support entry-level jobs policies and the containment of corporatist practices which delay market-entry for young graduates.[18] For instance, restrictions could be applied on the practice of unpaid internships, a widespread phenomenon (not only in the corporate world) which appears not only discouraging but also discriminatory, as it favours those who are not in an immediate need for remuneration – that is, those coming from a more affluent background.
5. Allow for longer grace periods (10/12 years?) on loans for young couples to incentivise first-time home buyers.
6. Promote a regulated rental market, with capped rents for couples under 35 and tax exemptions for homeowners.
7. Reduce the length of secondary high school, so to access internships/apprenticeships or proceed to tertiary education earlier – allowing youth to start working toward financial independence at an earlier stage in life. Relatedly, fiscal incentives should be applied to favour enrolment in technical high schools, so as to address the lack of ‘work-ready’ graduates for the manufacturing sector.[19]
8. Ensure that AI implementation does not undo one of the greatest achievements of our time (i.e. jobs for the masses), further eroding entry-level opportunities for the young[20] and concurrently affecting the chances of keeping many countries’ public debt on a sustainable path.[21]
9. Minimise practices such as oocyte cryopreservation (i.e., egg freezing) to proven medical reasons, as such measures do incentivise fertility in women[22] but (a) often at a later and therefore riskier stage in life[23] and (b) are neutral to the objective of living healthier.
10. To balance the fiscal reliefs/breaks/exemptions mentioned above, multiple sources of tax revenue for the state coffers could be identified: for example, in the form of higher taxation on earned income, dividend income, and wealth of the most affluent cohorts. In effect, these groups are allegedly getting richer across the world,[24] perhaps rendering an uptick in taxation of their wealth and income more palatable (and perhaps politically less contentious) for the wider public.

Some of the consequences of low fertility for geopolitics

Low fertility rates are perhaps one of the most glaring consequences of our current societal models, which tend to disregard the long-term effects of our choices. However, it should not be forgotten that millions of personal decisions (often induced by the relentless pursuit of short-termism – both at personal and professional level) can affect local communities and shape global issues. An often overlooked aspect at policymaking level, the postponement (if not downright erosion) of the childbearing age can in fact have meaningful impacts at geopolitical level. The transmission channel is rather straightforward: 1) low fertility rates make a population shrink; 2) a smaller population collects lower tax revenues; 3) lower tax revenues dent a country’s spending capacity; 4) smaller public budgets affect overseas development assistance,[25] hindering the attainment of many developing countries’ goals. Among them: reducing poverty, improving food security, stemming migratory flows, managing debt and accessing financial markets.[26] In a self-feeding loop, the lack of progress on these issues then circles back to the more developed polities, where migratory flows and the allocation of public funds are among the most fraught topics of the political discourse.

Looking for a new social contract

On the whole, a new ‘social contract’ is needed. One that, alongside our rights, calls for the application of our duties as well. Which is why, looking ahead, it would probably be overly complacent to think that either an increase in fertility rates or immigration could solve the problem of our ageing societies. Indeed, a wider youth cohort would not automatically change our longer life expectancy and unhealthy lifestyles. And without a thorough revision of our socio-economic model, immigrants would likely adapt to the conditions of the receiving community and therefore become less inclined to procreate. Ultimately, we must embrace the idea of reconsidering our unsustainable models. Conversely, should people’s habits remain unchanged and social systems based on last century’s way of life, our societies could be in for a rude awakening.


Simone Urbani Grecchi is a geopolitical analyst and Head of Geopolitical Analysis at Intesa Sanpaolo. Views expressed are his own. The opinions expressed here belong solely to him and do not reflect the views of his employer.

[1] Wilke, Carolyn, “What’s Driving Big Birth Rate Declines in Developing Countries? It’s Complicated”, in PNAS Journal Club, 20 October 2024, https://www.pnas.org/post/journal-club/s-driving-big-birth-rate-declines-developing-countries-s-complicated.

[2] Fertility Network UK website: Factors Affecting Fertility, https://fertilitynetworkuk.org/learn-about-fertility/factors-affecting-fertility.

[3] Safdari-Dehcheshmeh, Faranak et al., “Factors Influencing the Delay in Childbearing: A Narrative Review”, in Iranian Journal of Nursing and Midwifery Research, Vol. 28, No. 1 (January-February 2023), p. 10-19, https://doi.org/10.4103/ijnmr.ijnmr_65_22.

[4] OECD, Society at a Glance 2024. OECD Social Indicators, June 2024, p. 82-83, https://doi.org/10.1787/918d8db3-en.

[5] OECD Data: Indicators: Household Savings, https://www.oecd.org/en/data/indicators/household-savings.html#indicator-chart.

[6] Cournède, Boris and Marissa Plouin, No Home for the Young? Stylised Facts and Policy Challenges, Paris, OECD, June 2022, https://doi.org/10.1787/adbee321-en.

[7] Ghilarducci, Teresa, “How the Burdens of Family Elder Care Widen Socioeconomic Inequalities”, in Forbes, 21 December 2021, https://www.forbes.com/sites/teresaghilarducci/2021/12/21/how-the-burdens-of-family-elder-care-widen-socioeconomic-inequalities.

[8] Institute for Health Metrics and Evaluation (IHME), Global Life Expectancy to Increase by Nearly 5 Years by 2050 Despite Geopolitical, Metabolic, and Environmental Threats, Reports New Global Study, 17 May 2024, https://www.healthdata.org/node/11453.

[9] C3 Collaborating for Health website: Why NCDs and Why Prevention, https://www.c3health.org/?p=1137.

[10] Sample, Ian, “Rises in Life Expectancy Have Slowed Dramatically, Analysis Finds”, in The Guardian, 7 October 2024, https://www.theguardian.com/p/xvjtzt.

[11] IHME, Global Life Expectancy to Increase by Nearly 5 Years by 2050, cit.

[12] Beaujouan, Eva et al., “Why Are People Waiting Longer to Start a Family? Exploring the Trends, Challenges, and Choices behind Delayed Parenthood”, in IIASA Blog, 11 November 2024, https://iiasa.ac.at/node/3808.

[13] KFF, Gross Medicare Spending on Ozempic and other GLP-1s Is Already Skyrocketing, 23 March 2024, https://www.kff.org/?p=616585.

[14] Institute for Functional Medicine (IFM) website: Functional Medicine, https://www.ifm.org/node/77.

[15] Edwards, Richard et al., “Evaluating Tobacco Industry ‘Transformation’: A Proposed Rubric and Analysis”, in Tobacco Control, Vol. 31, No. 2 (March 2022), p. 313-321, https://doi.org/10.1136/tobaccocontrol-2021-056687.

[16] Zhang, Wenji et al., “Phytochemicals Derived from Nicotiana tabacum L. Plant Contribute to Pharmaceutical Development”, in Frontiers in Pharmacology, Vol. 15 (2024), Article 1372456, https://doi.org/10.3389/fphar.2024.1372456.

[17] Sullivan, Julie, “Comparing Characteristics and Selected Expenditures of Dual- and Single-Income Households with Children”, in BLS Monthly Labor Review, September 2020, https://www.bls.gov/opub/mlr/2020/article/comparing-characteristics-and-selected-expenditures-of-dual-and-single-income-households-with-children.htm; Gallo, Francesca and Maria Clelia Romano, “Intra-Household Income Distribution. Note by the Italian National Institute of Statistics”, in UNECE Working Papers, No. 5 (12 March 2025), https://unece.org/node/400144.

[18] Thierer, Adam and Trace Mitchell, “Occupational Licensing Reform and the Right to Earn a Living: A Blueprint for Action”, in Mercatus Policy Briefs, April 2020, https://www.mercatus.org/node/45836.

[19] Swanek, Thaddeus, “Few Hiring Managers Think High School Graduates Are Ready for the Workforce”, in US Chamber of Commerce Articles, 22 September 2025, https://www.uschamber.com/workforce/few-hiring-managers-think-high-school-grads-are-ready-for-the-workforce.

[20] Ellis, Lindsay and Katherine Bindley, “AI Is Wrecking an Already Fragile Job Market for College Graduates”, in The Wall Street Journal, 29 July 2025, https://www.wsj.com/lifestyle/careers/ai-entry-level-jobs-graduates-b224d624.

[21] Darvas, Zsolt et al., “How Demographic Change Will Hit Debt Sustainability in European Union Countries”, in Bruegel Policy Briefs, 18 September 2024, https://www.bruegel.org/node/10312.

[22] Lazzarin, Sara et al., “Predicting Vaginal Delivery in Pregnant Women of 45 Years and Older”, in European Journal of Obstetrics & Gynecology and Reproductive Biology, Vol. 310 (June 2025), Article 113965, https://doi.org/10.1016/j.ejogrb.2025.113965.

[23] Fertility Centers of New England, “How Egg Freezing Success Rates Vary by Age”, in Fertility Cares Blog, 8 December 2021, https://www.fertilitycenter.com/fertility_cares_blog/how-egg-freezing-success-rates-vary-by-age.

[24] Riddell, Rebecca et al., Inequality Inc. How Corporate Power Divides Our World and the Need for a New Era of Public Action, Oxford, Oxfam International, January 2024, https://doi.org/10.21201/2024.000007.

[25] OECD, “Cuts in Official Development Assistance. OECD Projections for 2025 and the Near Term”, in OECD Policy Briefs, 26 June 2025, https://www.oecd.org/en/publications/cuts-in-official-development-assistance_8c530629-en.html.

[26] Diwan, Ishac and Vera Songwe, “Developing Countries Are Paying Too Much to Borrow”, in Project Syndicate, 16 September 2025, https://prosyn.org/fgWJiZe.