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The Longevity Imperative

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The last century saw a revolution in life expectancy. But instead of seeing this as a precious gift of extra life, we see it as a burden. Andrew J. Scott suggests we should seize the opportunity to pursue the evergreen agenda.

Image courtesy of interviewee. April 10, 2024

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This video video discusses the significant impact of increasing life expectancy on society and the economy, emphasizing the need to rethink aging. The speaker, an economist, critiques the prevailing negative perceptions of an aging population, often linked to health costs and economic burdens. Instead, he argues that society is on the cusp of a "second longevity revolution," where not only is life expectancy increasing, but the potential for a healthier, more engaging later life must also be recognized and capitalized on.

The speaker highlights the importance of moving beyond conventional understandings of aging, advocating for a 'longevity dividend' that encompasses healthier and more productive living in older age. He notes that demographic changes indicate that younger generations have a better than 50% chance of living into old age and suggests that this necessitates a shift in societal attitudes and policies towards aging.

He identifies ageism, lack of updated skills, and inadequate government support as barriers to making the most of longer lifespans. To address these challenges, he encourages a focus on preventative health measures and a deep societal investment in the capacity of older individuals, aiming to eliminate stereotypes associated with aging.

This video video argues that as more people live longer, society must shift its perspective on aging from a negative aspect to a process that allows for continuous development and reinvention. By embracing this approach, the potential benefits of a longevity society can be realized, transforming societal structures, economy, and personal experiences in later life.

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So I think we've got one of the biggest trends

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that's gonna influence our future wrong.

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Uh, and that's, how long we live for.

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We hear a great about an aging society,

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and as an economist, I can tell you the aging society is

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always a negative story.

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Basic says, but all these old people

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and there are problem, they don't work, they get ill,

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they health costs, and the economy can't afford it.

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And what's remarkable is that, you know,

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when we talk about big trends that shape our future, like AI

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and climate change, we have really engaged topics

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and conversations about how do we adapt, how do we adjust,

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how do we change the, seize the opportunities

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and avoid the problems You get none of that when it comes

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to an aging society.

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You know, at, at best we talk about adult diapers

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and care hugs or something like that.

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There's no energy, there's no enthusiasm.

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And you know, if you think about one of the things

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that's gonna turn your and I future, it's how we age.

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And I think that's because we've got this

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demographic story in mind.

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There's a lot more old people.

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There's a change in the age structure of the population.

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I think that's an incomplete story.

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The really big change

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that's happened is we can expect to live for longer.

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For the first time ever in human history, the young

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and the middle age now have a better than 50% chance

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of becoming the very old.

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And so we have to change how we age.

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We already have long lives,

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but we've gotta achieve what I call a three dimensional

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longevity dividend.

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We can make those long lives healthier for longer

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and also more productive and engaged for longer.

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We've never had to do that before we do now.

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And I can't, I say, think

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of anything more important individually

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and collectively than how we age.

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I think what's striking though is that as we've had

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this rise, the number of old people, as we ourselves,

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have more chance of becoming old, we've started to sort

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of be more negative about aging

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and more negative about older people.

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So at the very time when we need to say, Hey, I need

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to invest more in my future, we're actually downgrading

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and underestimating the capacity of older people

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and a later life, which is, you know, gonna get in the way

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of solving the problem, which is we have to

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recognize the potential.

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I, I read another book called The Hundreds of Life,

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which was a very popular book,

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sold over a million copper globally.

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And as a macro economist, I sort of wanted to think,

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delve deeper into this and really start focus on

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the economics of longevity.

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So, you know, I started doing the things academics do,

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publishing journals and working

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and kind of finding out empirically how aging is it all

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as bad as we say, is it as as negative as the,

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as the policy makers tend to make out.

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So that was a core part of it

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and kind of wanting

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to bring those results into a, a, a book.

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Um, but the other thing I really like about

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longevity is it covers everything.

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It's very multidisciplinary and I kind of like that.

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It's kind of one of my strands.

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So the other lovely thing about this was it enabled me

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to just read up about a whole bunch of issues outside

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of economics and not just health and medicine

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and the course of finance, but think about the politics

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and the philosophy and the psychology as well.

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So, you know, what I wanted to do with this book

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is make people aware that this is a single theme

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that brings together lots of issues.

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This is not just about, you know, biology,

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it's not just about your pension.

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This is a fundamental change to humanity.

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And so trying to bring all those different strands together,

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it's a very simple observation at the heart of the book.

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And, you know, I always give the, the concept of,

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in London, rain, you know, if there's a a 10% chance

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of rain, I don't bother packing a raincoat or an umbrella.

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If there's a 35% chance of rain, I'll pack one

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of those small little portable umbrellas in my bag.

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And if there's an 80% chance of rain,

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then I'm gonna take a raincoat

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and I'm gonna take an umbrella.

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10 35, 80%.

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That's a probability of a 20-year-old in Sweden under pretty

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conservative assumptions, making it

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to 80 in 18 51, 19 51.

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And today. So just as if the chance of rain is very high,

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we have to prepare ourselves for that.

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So the same thing now goes for society.

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We have to think more about investing in our future.

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So that's really the, the key concept.

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Now, of course, lifespan may get even longer.

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You know, we're seeing people more

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and more people live up beyond a hundred.

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But I say the really fundamental change is that in the uk,

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which isn't particularly good at this stuff,

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the government reckons 50% of children born today

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or live into their early nineties.

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And that's what I call the longevity imperative

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because you are now likely to become old.

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We fit getting old.

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We fear outliving our health, our wealth, our friendships,

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our skills, our purpose, our relationship.

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So what are you gonna do now

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to make sure that that doesn't happen?

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And that's, I think the thing about lifetime.

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We have to change how we age, which means you have

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to behave differently from your parents

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or your grandparents.

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And we're very focused on chronological age.

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I'm 58, but really what longevity says is that 58,

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I'm different from my father at 58, my grandfather at 58.

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'cause I had more years ahead of me.

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And that's, I think, the change we have

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to think about in our lifespan.

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So I call that the second longevity revolution

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because globally life expectancy is now over 70,

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which I think it's worth just stopping and reflecting.

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That's amazing. Global life expectancy over 70,

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we've sort of coming to the end of

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what I call a first longevity revolution due

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to fantastic improvements in medicine,

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health standard of living.

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The young can now expect to become old.

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But that I think then brings on a second longevity

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revolution, which is how do we age better?

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And that's a very profound change in human history

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when we get more and more infants getting to midlife or more

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and more midlife people becoming old.

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You know, that's a wonderful achievement that

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so many are doing it,

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but it's not quite as a profound as saying,

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wow, now I'm gonna get old.

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The most important thing is

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to age well, how do I age better?

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And that's what I call the second longevity revolution.

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That now begins the biggest global health burden now are all

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aging related diseases.

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Economists are saying, Hey,

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how do I support these, older people?

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We've gotta be more productive for longer.

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That's a profound change.

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You know, I said earlier that, you know,

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as we have more the people we're sort of valuing them less.

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Uh, although there's, that's

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that's not a little bit controversial.

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In, in the 20th century, we created a three stage life,

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education, work and retirement.

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And that creates a challenge, I think,

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because we're sort of what you do that third stage,

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it's not, I would say, a great deal of economic analysis

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around the retirement.

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Most economic models assume

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that all the economic decisions you take happen before then.

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So I, I think we're a sort of a, a weak point

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of social sciences where we've got loads

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of people now entering a stage of life,

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which has been relatively understudied.

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So lots to be done.

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And you know, one of the things I enjoyed reading,

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for this book was Simone Bei.

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And you know, she sort of paints a picture, which is

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society's lost her function for these older age groups.

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And I think as we get more,

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death becomes more of a taboo subject,

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as we've created more

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and more older people who get ill, we sort

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of made a much more negative concept

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of older age that has to change.

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Now, some of it's already happening.

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One of the things I always surprise people at is

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by telling them that in the high income countries

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around about 80% of employment growth,

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the last 10 years has come from people aged over 50.

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So something is already happening,

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older people are working more, and that's both

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because there's more older people,

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but them more likely to work.

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So change is definitely happening,

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even though there hasn't been much conscious thought,

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but a lot has to happen.

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And I think there's a, a few bunch of things here.

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The first is we've gotta get rid of ageism.

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Um, lots of people lose their jobs in their fifties

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and don't get another one.

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And that a lot of that is absolutely down to ageism.

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And secondly, if, you're gonna have to be working

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for longer, given how long life now is individuals have

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to think a little bit about their skills

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and the job they're doing,

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and have they updated their skills,

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can they carry on working rather 15, 20 years?

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And also, are they in an occupation that is age friendly?

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So by age friendly, I mean jobs that are, flexible,

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less physically demanding and provide more autonomy.

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And if you're in a occupation that's not one of those,

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then you've gotta start thinking about

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shifting to something different.

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Um, but then there's a third thing which is really

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important, which is government.

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It's not just firms. It's not just individuals.

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There's governments. And one of the things that I'm

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very keen to stress in the book is right now, I think a,

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a longer life, I think inevitably means working for longer

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Unless we get big increases in productivity.

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The only way you can maintain your standard

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of living if you live for longer is to work for longer.

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But that's a big career change.

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It's, and it's not just about raising the retirement age.

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So most governments are just changing the state pension,

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but that does nothing to help you be productive for longer.

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Uh, and I think this is the key thing.

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If you look at the labor market from around 50, people start

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to drop out the labor market at age 50.

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About 80% of people are working just

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before the state pension age is down to about a quarter.

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And for some that's about they can afford to retire,

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but for a large majority it's because they're ill.

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They've gotta care for someone who's ill,

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their skills are outta date

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or there's ageism in the workplace.

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And what we've really gotta do is keep people

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healthier and productive for longer.

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And that starts, I would say,

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from supporting workers from 50 to 65.

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And that's currently not a focus,

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but if you can, I think is the nearest thing

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to a macroeconomic free lunch.

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If we can get people healthy

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and productive from 50 to 65, that's a big increase in in,

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in in GDP

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and then, you know, raising the state pension age may have

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an impact, but right now it's really not the way

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to keep us more productive for longer.

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You know, the reason global life expectancy is now over 70

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is phenomenal improvements in health in our health system,

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but actually our health system is not about health,

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it's about disease.

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When you get ill, it intervenes.

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And when the majority of people, you know, were living black

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below 60, that works really well.

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But as we start to get older, as we have more

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and more people are living longer past 60,

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the biggest global health burden now is aging

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related diseases.

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The diseases where your risk increases age,

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cardiovascular disease, pulmonary disease, diabetes,

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dementia, all of these things, the biggest cancer,

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the biggest risk factor behind all of them, it's age.

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And the older you are, the more likely you are to get them.

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And if you intervene when someone has an aging related

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disease, it's not, it's not helpful, of course it is,

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but it doesn't keep people healthy.

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And so we really have to focus on preventative health

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and keeping people healthy.

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And I quote in the book, WH

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or who's quote roughly says, health is a thing

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that medicine knows nothing about.

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Uh, and I think that's a great quote.

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I speaking to a cardiologist the other day who said,

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health is just an incomplete diagnosis.

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Something will happen and we'll be able to then detect it.

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I think it's one of the great ironies of life

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that the World Health Organization is responsible

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for the international classification of diseases.

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Health is not just the absence of disease.

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And so we have to move very strongly

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to a preventative health system.

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That's the way we're gonna maintain our health along,

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which is incredibly valuable.

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It's also the way we make the health system sustainable

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because if we try

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and just respond to aging related

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diseases, we have a problem.

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Because once you get one aging related disease,

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the other one comes along pretty quickly

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and suddenly you've got a huge amount of money being spent.

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And this I think is a really profound issue.

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Changing how we age is about changing our health.

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Now, lots of things that can be done there.

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Some of that is public health.

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You know, we all know there are things we can do

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individually to age better.

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It's not a mystery. Reducing social inequality would be

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one way we can do it.

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And then there's lots of progress being made in the biology

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of aging, what's called RO science.

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And you know, it's still a very early stages,

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but I'm pretty sure that the next 30, 40 years

12:33.925 --> 12:37.145
we will see treatments come out that start to tackle some

12:37.145 --> 12:39.905
of these aging related to diseases and help us age better.

12:40.565 --> 12:43.065
And, you know, the sooner that happens, the better I think.

12:43.065 --> 12:45.705
So governments also need to be mindful of investing there.

12:46.245 --> 12:48.825
You know, we've, we've got millennia of thinking about

12:48.825 --> 12:51.185
what aging is like and what people should do.

12:52.005 --> 12:54.785
And so that's kind of where ageism comes from.

12:55.195 --> 12:59.075
We've, we've historically underestimated

12:59.075 --> 13:00.435
the capacity of older people.

13:01.245 --> 13:03.355
We've historically underestimated the

13:03.515 --> 13:04.675
capacity of our only to life.

13:05.855 --> 13:08.155
And so we haven't ensured

13:08.155 --> 13:10.075
that we have institutions to keep people engaged.

13:10.195 --> 13:12.955
I say we, I mean this is a bit UK US centric,

13:12.975 --> 13:15.955
but it, it's still pretty broad across most countries.

13:16.815 --> 13:19.315
Uh, and and so I think we also have to change our attitude

13:19.315 --> 13:20.515
to what it is to be old.

13:20.775 --> 13:23.635
And some of that is around recognizing

13:23.635 --> 13:27.515
that 65 may not be a good threshold to,

13:27.775 --> 13:29.915
administratively declare someone is old

13:30.615 --> 13:32.955
and recognizing that everyone over 65 is

13:32.975 --> 13:34.275
by no means the same.

13:34.465 --> 13:36.995
There's great diversity in how we age.

13:37.735 --> 13:39.755
And right now I think we have two problems.

13:39.755 --> 13:42.155
And I think these are cultural challenges.

13:42.175 --> 13:44.515
The first is, you know, we define

13:45.195 --> 13:46.235
everyone over six five is old

13:46.615 --> 13:49.075
and that aging is not malleable.

13:50.275 --> 13:52.795
I think what we really have to understand is

13:52.795 --> 13:54.475
that there's lots of concepts of age.

13:54.475 --> 13:55.915
One of 'em is chronological age,

13:56.495 --> 13:57.835
the other is prospective age.

13:57.835 --> 13:59.155
How many more years I've got to live.

13:59.615 --> 14:01.075
And the other is biological age.

14:02.015 --> 14:03.755
And once you look at prospective age

14:03.755 --> 14:05.915
and biological age, you start to see that we can change

14:05.935 --> 14:07.915
how we age because the return

14:07.935 --> 14:10.595
to me investing in my health at 58 is now greater than it

14:10.595 --> 14:12.035
was for my father and my grandfather.

14:12.135 --> 14:13.275
So I should be doing more.

14:14.055 --> 14:16.875
But also our biological age is malleable

14:16.875 --> 14:18.715
and neuroscience tells us that.

14:19.335 --> 14:21.435
So we've gotta move away from the notion

14:21.635 --> 14:22.955
that aging is a negative.

14:24.055 --> 14:26.595
Uh, I think we've medicalized old age,

14:26.595 --> 14:28.635
so we see it only in terms of decline.

14:28.635 --> 14:31.475
But we know that not everything declines with old age.

14:31.745 --> 14:33.035
There's lots of evidence just

14:33.035 --> 14:34.515
that older people are happier than there

14:34.515 --> 14:35.595
in middle age, for instance.

14:36.245 --> 14:38.555
We've gotta think about a longer life is about more time

14:38.555 --> 14:39.635
to develop as an adult.

14:40.535 --> 14:41.675
You know, when life is short,

14:41.925 --> 14:43.195
adult development happens quickly.

14:43.225 --> 14:45.235
When life is long, it can happen over a

14:45.465 --> 14:46.755
much longer time period.

14:47.215 --> 14:49.835
And all that means that aging is a process,

14:50.735 --> 14:51.735
Not an event.

14:51.865 --> 14:54.765
It doesn't suddenly happen at 65. Oh, you're old.

14:55.235 --> 14:57.245
It's a process that happens over time

14:57.825 --> 15:00.405
and at every age you can do something about how you age.

15:00.425 --> 15:02.085
And the earlier you start the better.

15:02.625 --> 15:04.565
So when I stress about a longevity society,

15:04.565 --> 15:06.165
it's not just saying, isn't old age great.

15:06.785 --> 15:08.805
Uh, I'm not gonna say that I I'm 58,

15:08.825 --> 15:10.525
I'm not gonna make a comment about old age.

15:10.795 --> 15:13.045
What I'm gonna say is the most important thing is we have

15:13.045 --> 15:14.765
to change how we aged to age better.

15:15.465 --> 15:18.285
And, and that is about a longevity society,

15:18.465 --> 15:19.925
not an aging society.

15:20.505 --> 15:22.725
And an aging society begins when you have lots

15:22.725 --> 15:26.285
of be ledged over 65 longevity society begins when you have

15:26.285 --> 15:28.885
lots of people who will live to be over 65.

15:29.525 --> 15:32.805
I think that that requires a very big rewiring,

15:32.805 --> 15:34.605
rather than just thinking there's some threshold

15:34.605 --> 15:36.165
where suddenly you become good

15:36.345 --> 15:37.605
and you can do nothing about it.

15:38.075 --> 15:40.645
That this topic is just as important as AI

15:40.645 --> 15:42.685
and climate change just as interesting

15:43.105 --> 15:44.285
and needs to be right up there

15:44.285 --> 15:45.525
as something that we have to think.

15:45.585 --> 15:46.605
How do we adapt

15:46.625 --> 15:48.565
and adjust in a really profound way

15:49.145 --> 15:51.085
to seize the advantages and avoid the problems.

15:51.365 --> 15:53.685
'cause if we continue to underinvest in later life,

15:53.705 --> 15:56.685
if we continue to underestimate the capacity of old people,

15:57.025 --> 16:00.325
we arrive in later life without resources that we need to,

16:00.385 --> 16:01.445
to make it a good one.

16:01.905 --> 16:03.125
Uh, and then to recognize

16:03.125 --> 16:05.685
that this is a really pivotal moment in human history

16:05.685 --> 16:08.605
because there's something quite different about this stage

16:08.605 --> 16:10.285
when we change how we age.

16:10.285 --> 16:11.765
Because, you know,

16:11.765 --> 16:15.765
when we get better at tackling infant diseases so that more

16:15.765 --> 16:17.045
and more infants reach midlife,

16:17.535 --> 16:19.645
we're no longer interested in infant diseases.

16:19.955 --> 16:22.045
When we get better at attacking midlife diseases

16:22.065 --> 16:23.325
and more people will come, well,

16:23.485 --> 16:25.085
less interested in midlife diseases.

16:25.665 --> 16:27.965
But as we get better at aging, we're gonna want

16:27.965 --> 16:30.845
to age even more when we become healthy in our eighties

16:30.845 --> 16:33.725
and nineties, we'll say bring on a hundred, 110.

16:34.105 --> 16:37.165
So this is a very profound change, I think in human history.

16:37.535 --> 16:39.765
Where we end up, who knows, is gonna be a battle

16:39.765 --> 16:41.965
between human ingenuity and human biology.

16:42.745 --> 16:45.645
But this is a radically different mind for human history.

Rethinking Aging: A New Perspective on Longevity

00:00:00 - So I think we've got one of the biggest trends that's gonna influence our future wrong. and that's, how long we live for. We hear a great about an aging society, and as an economist, I can tell you the aging society is always a negative story. Basic says, but all these old people and there are problem, they don't work, they get ill, they health costs, and the economy can't afford it. And what's remarkable is that, you know, when we talk about big trends that shape our future, like AI and climate change, we have really engaged topics and conversations about how do we adapt, how do we adjust,
00:00:34 - and avoid the problems You get none of that when it comes to an aging society. You know, at, at best we talk about adult diapers and care hugs or something like that. There's no energy, there's no enthusiasm. And you know, if you think about one of the things that's gonna turn your and I future, it's how we age. And I think that's because we've got this demographic story in mind. There's a lot more old people. There's a change in the age structure of the population. I think that's an incomplete story. The really big change that's happened is we can expect to live for longer.
00:01:08 - and the middle age now have a better than 50% chance of becoming the very old. And so we have to change how we age. We already have long lives, but we've gotta achieve what I call a three dimensional longevity dividend. We can make those long lives healthier for longer and also more productive and engaged for longer. We've never had to do that before we do now. And I can't, I say, think of anything more important individually and collectively than how we age. I think what's striking though is that as we've had
00:01:41 - have more chance of becoming old, we've started to sort of be more negative about aging and more negative about older people. So at the very time when we need to say, Hey, I need to invest more in my future, we're actually downgrading and underestimating the capacity of older people and a later life, which is, you know, gonna get in the way of solving the problem, which is we have to recognize the potential. I, I read another book called The Hundreds of Life, which was a very popular book,
00:02:10 - And as a macro economist, I sort of wanted to think, delve deeper into this and really start focus on the economics of longevity. So, you know, I started doing the things academics do, publishing journals and working and kind of finding out empirically how aging is it all as bad as we say, is it as as negative as the, as the policy makers tend to make out. So that was a core part of it and kind of wanting to bring those results into a, a, a book.
00:02:42 - longevity is it covers everything. It's very multidisciplinary and I kind of like that. It's kind of one of my strands. So the other lovely thing about this was it enabled me to just read up about a whole bunch of issues outside of economics and not just health and medicine and the course of finance, but think about the politics and the philosophy and the psychology as well. So, you know, what I wanted to do with this book is make people aware that this is a single theme that brings together lots of issues.

Preparing for the Second Longevity Revolution

00:03:13 - it's not just about your pension. This is a fundamental change to humanity. And so trying to bring all those different strands together, it's a very simple observation at the heart of the book. And, you know, I always give the, the concept of, in London, rain, you know, if there's a a 10% chance of rain, I don't bother packing a raincoat or an umbrella. If there's a 35% chance of rain, I'll pack one of those small little portable umbrellas in my bag.
00:03:45 - then I'm gonna take a raincoat and I'm gonna take an umbrella. 10 35, 80%. That's a probability of a 20-year-old in Sweden under pretty conservative assumptions, making it to 80 in 18 51, 19 51. And today. So just as if the chance of rain is very high, we have to prepare ourselves for that. So the same thing now goes for society. We have to think more about investing in our future. So that's really the, the key concept. Now, of course, lifespan may get even longer.
00:04:16 - and more people live up beyond a hundred. But I say the really fundamental change is that in the uk, which isn't particularly good at this stuff, the government reckons 50% of children born today or live into their early nineties. And that's what I call the longevity imperative because you are now likely to become old. We fit getting old. We fear outliving our health, our wealth, our friendships, our skills, our purpose, our relationship. So what are you gonna do now to make sure that that doesn't happen?
00:04:48 - We have to change how we age, which means you have to behave differently from your parents or your grandparents. And we're very focused on chronological age. I'm 58, but really what longevity says is that 58, I'm different from my father at 58, my grandfather at 58. 'cause I had more years ahead of me. And that's, I think, the change we have to think about in our lifespan. So I call that the second longevity revolution because globally life expectancy is now over 70,
00:05:20 - That's amazing. Global life expectancy over 70, we've sort of coming to the end of what I call a first longevity revolution due to fantastic improvements in medicine, health standard of living. The young can now expect to become old. But that I think then brings on a second longevity revolution, which is how do we age better? And that's a very profound change in human history when we get more and more infants getting to midlife or more
00:05:50 - You know, that's a wonderful achievement that so many are doing it, but it's not quite as a profound as saying, wow, now I'm gonna get old. The most important thing is to age well, how do I age better? And that's what I call the second longevity revolution. That now begins the biggest global health burden now are all aging related diseases. Economists are saying, Hey, how do I support these, older people? We've gotta be more productive for longer. That's a profound change. You know, I said earlier that, you know,

Rethinking Retirement and Aging Dynamics

00:06:22 - although there's, that's that's not a little bit controversial. In, in the 20th century, we created a three stage life, education, work and retirement. And that creates a challenge, I think, because we're sort of what you do that third stage, it's not, I would say, a great deal of economic analysis around the retirement. Most economic models assume that all the economic decisions you take happen before then. So I, I think we're a sort of a, a weak point
00:06:54 - of people now entering a stage of life, which has been relatively understudied. So lots to be done. And you know, one of the things I enjoyed reading, for this book was Simone Bei. And you know, she sort of paints a picture, which is society's lost her function for these older age groups. And I think as we get more, death becomes more of a taboo subject, as we've created more and more older people who get ill, we sort
00:07:25 - of older age that has to change. Now, some of it's already happening. One of the things I always surprise people at is by telling them that in the high income countries around about 80% of employment growth, the last 10 years has come from people aged over 50. So something is already happening, older people are working more, and that's both because there's more older people, but them more likely to work. So change is definitely happening, even though there hasn't been much conscious thought, but a lot has to happen. And I think there's a, a few bunch of things here.
00:07:59 - lots of people lose their jobs in their fifties and don't get another one. And that a lot of that is absolutely down to ageism. And secondly, if, you're gonna have to be working for longer, given how long life now is individuals have to think a little bit about their skills and the job they're doing, and have they updated their skills, can they carry on working rather 15, 20 years? And also, are they in an occupation that is age friendly? So by age friendly, I mean jobs that are, flexible,
00:08:32 - And if you're in a occupation that's not one of those, then you've gotta start thinking about shifting to something different. but then there's a third thing which is really important, which is government. It's not just firms. It's not just individuals. There's governments. And one of the things that I'm very keen to stress in the book is right now, I think a, a longer life, I think inevitably means working for longer Unless we get big increases in productivity. The only way you can maintain your standard
00:09:02 - But that's a big career change. It's, and it's not just about raising the retirement age. So most governments are just changing the state pension, but that does nothing to help you be productive for longer. and I think this is the key thing. If you look at the labor market from around 50, people start to drop out the labor market at age 50. About 80% of people are working just before the state pension age is down to about a quarter.

Improving Health and Productivity in Aging Workforce

00:09:32 - but for a large majority it's because they're ill. They've gotta care for someone who's ill, their skills are outta date or there's ageism in the workplace. And what we've really gotta do is keep people healthier and productive for longer. And that starts, I would say, from supporting workers from 50 to 65. And that's currently not a focus, but if you can, I think is the nearest thing to a macroeconomic free lunch. If we can get people healthy and productive from 50 to 65, that's a big increase in in,
00:10:01 - and then, you know, raising the state pension age may have an impact, but right now it's really not the way to keep us more productive for longer. You know, the reason global life expectancy is now over 70 is phenomenal improvements in health in our health system, but actually our health system is not about health, it's about disease. When you get ill, it intervenes. And when the majority of people, you know, were living black below 60, that works really well.
00:10:33 - and more people are living longer past 60, the biggest global health burden now is aging related diseases. The diseases where your risk increases age, cardiovascular disease, pulmonary disease, diabetes, dementia, all of these things, the biggest cancer, the biggest risk factor behind all of them, it's age. And the older you are, the more likely you are to get them. And if you intervene when someone has an aging related disease, it's not, it's not helpful, of course it is,
00:11:05 - And so we really have to focus on preventative health and keeping people healthy. And I quote in the book, WH or who's quote roughly says, health is a thing that medicine knows nothing about. and I think that's a great quote. I speaking to a cardiologist the other day who said, health is just an incomplete diagnosis. Something will happen and we'll be able to then detect it. I think it's one of the great ironies of life that the World Health Organization is responsible
00:11:36 - Health is not just the absence of disease. And so we have to move very strongly to a preventative health system. That's the way we're gonna maintain our health along, which is incredibly valuable. It's also the way we make the health system sustainable because if we try and just respond to aging related diseases, we have a problem. Because once you get one aging related disease, the other one comes along pretty quickly and suddenly you've got a huge amount of money being spent. And this I think is a really profound issue.
00:12:09 - Now, lots of things that can be done there. Some of that is public health. You know, we all know there are things we can do individually to age better. It's not a mystery. Reducing social inequality would be one way we can do it. And then there's lots of progress being made in the biology of aging, what's called RO science. And you know, it's still a very early stages, but I'm pretty sure that the next 30, 40 years we will see treatments come out that start to tackle some

Reframing Aging: Embracing a Longevity Society

00:12:40 - And, you know, the sooner that happens, the better I think. So governments also need to be mindful of investing there. You know, we've, we've got millennia of thinking about what aging is like and what people should do. And so that's kind of where ageism comes from. We've, we've historically underestimated the capacity of older people. We've historically underestimated the capacity of our only to life. And so we haven't ensured
00:13:10 - I say we, I mean this is a bit UK US centric, but it, it's still pretty broad across most countries. and and so I think we also have to change our attitude to what it is to be old. And some of that is around recognizing that 65 may not be a good threshold to, administratively declare someone is old and recognizing that everyone over 65 is by no means the same. There's great diversity in how we age. And right now I think we have two problems.
00:13:42 - The first is, you know, we define everyone over six five is old and that aging is not malleable. I think what we really have to understand is that there's lots of concepts of age. One of 'em is chronological age, the other is prospective age. How many more years I've got to live. And the other is biological age. And once you look at prospective age and biological age, you start to see that we can change how we age because the return to me investing in my health at 58 is now greater than it
00:14:12 - So I should be doing more. But also our biological age is malleable and neuroscience tells us that. So we've gotta move away from the notion that aging is a negative. I think we've medicalized old age, so we see it only in terms of decline. But we know that not everything declines with old age. There's lots of evidence just that older people are happier than there in middle age, for instance. We've gotta think about a longer life is about more time to develop as an adult. You know, when life is short,
00:14:43 - When life is long, it can happen over a much longer time period. And all that means that aging is a process, Not an event. It doesn't suddenly happen at 65. you're old. It's a process that happens over time and at every age you can do something about how you age. And the earlier you start the better. So when I stress about a longevity society, it's not just saying, isn't old age great. I'm not gonna say that I I'm 58, I'm not gonna make a comment about old age. What I'm gonna say is the most important thing is we have
00:15:15 - And, and that is about a longevity society, not an aging society. And an aging society begins when you have lots of be ledged over 65 longevity society begins when you have lots of people who will live to be over 65. I think that that requires a very big rewiring, rather than just thinking there's some threshold where suddenly you become good and you can do nothing about it. That this topic is just as important as AI and climate change just as interesting

Adapting to a New Aging Paradigm

00:15:44 - as something that we have to think. How do we adapt and adjust in a really profound way to seize the advantages and avoid the problems. 'cause if we continue to underinvest in later life, if we continue to underestimate the capacity of old people, we arrive in later life without resources that we need to, to make it a good one. and then to recognize that this is a really pivotal moment in human history because there's something quite different about this stage when we change how we age. Because, you know, when we get better at tackling infant diseases so that more
00:16:42 - we're no longer interested in infant diseases. When we get better at attacking midlife diseases and more people will come, well, less interested in midlife diseases. But as we get better at aging, we're gonna want to age even more when we become healthy in our eighties and nineties, we'll say bring on a hundred, 110. So this is a very profound change, I think in human history. Where we end up, who knows, is gonna be a battle between human ingenuity and human biology. But this is a radically different mind for human history.

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