Report calls for country to embark on collective 'national mission for ageing' to manage challenges and opportunities of an older society

Policy makers should take Japan and Sweden's approach of creating a 'national mission' to support England's near 'super-ageing' population, a major new report by The King's Fund and International Longevity Centre UK (ILC) has concluded.

The study compared the approaches taken by Japan and Sweden to their ageing societies with England's, by using international data and holding roundtables with experts from those countries to see what lessons could be learnt.

Japan was chosen as it is living in our 'demographic future': it has the world's largest share of older adults, with 31.7% of its population aged 65 or older, compared to 19% in the UK. Japan is also the top ranked country in the ILC's Healthy Ageing and Prevention Index when it comes to health span and life span. Sweden was chosen because it represents good practice England can aspire to - with it holding a comparable population size and health system whilst being in the top three for health ageing in the Index. The UK is ranked 14th.

The report makes several recommendations based on research and discussions with experts from both countries. One of the key themes that came through was the need for a 'national mission for ageing'. In Japan, the concept of an ageing population has been part of the national conversation with the public for decades stemming back to 1989-90 when the total fertility rate fell to 1.57, dubbed the '1.57 shock'. Since then, there has been a succession of policy programmes aimed at increasing fertility and many successful reforms to the way in which care and social services for older people are delivered and funded.

The historical legacy of all this policy work created a sense of 'national mission' around the challenges of population ageing in Japan and encouraged people to think holistically about ageing not as a discrete issue, but rather as a new terrain for policy making with implications across health, employment, immigration, social cohesion and a host of other areas. The media interest dating back to the '1.57 shock' means that the public is also part of the national conversation around these issues, increasing the opportunity for legitimacy and democratic consent to be brought into the policy making process.

The Swedish approach to their ‘national mission’ focusses more on meeting the challenge through prevention, with a legal framework designed to put prevention into the responsibilities of those providing public services and has sparked numerous initiatives to this end. One included offering 'health meetings' for older people to discuss their health behaviours. Sweden also took a longer-term approach, launching a 10-year strategy for older people in 2020 which provided targeted grants to areas so they could develop localised services to deal with their specific challenges related to ageing.

In the round tables, it was observed that 'our population [in England] enters middle age and older age with health in a much more parlous state [than in Sweden or Japan]'. It was also noted that the prevalence of conditions like obesity were damaging people's health, resulting in health service demand occurring earlier and for longer.

At the heart of creating this 'national mission for ageing' the report calls for bolder action from the government to deliver the shift to prevention in its 10 Year Health Plan by putting an increased focus of healthy ageing and considering more ambitious approaches through the publication of a national strategy to minimise the challenges of an ageing society so more of us can benefit from long lives.

Luca Tiratelli, co-author of the research and Senior Researcher at The King's Fund, said:

'As the realities of our demographic future begin to materialise there will be fewer people in work relative to the population and more people needing support as they develop medical conditions associated with getting older. This is an unescapable fact and one that needs serious consideration as to how we limit the pressure this will cause on the nation’s finances whilst ensuring that everyone can live their lives in dignity and independence for as long as possible.

‘So far that conversation has not received the focus it needs and other countries are proving to be both more ambitious and more successful in their attempts to address it. One of those areas is a sense of ‘national mission’ in tackling these issues that ensures by in from all elements of society to work towards a collective goal of healthy ageing. Without it, our already creaking health and care system risks collapsing and the prize of a population that can enjoy healthier and more independent lives for longer will be missed.

‘Policy makers need to work to create this ‘national mission for ageing’ and put allowing people to live healthier lives for longer at its heart. The government’s commitment to a prevention shift in its 10 Year Health Plan provides a strong foundation for this, alongside the opportunity to set out a clear national strategy that better supports people to live well in an ageing society.’

Notes to editors     

Initiated and funded by Daiichi Sankyo, and in partnership with the International Longevity Centre UK, we held roundtables with experts and policymakers from each country to ask: what can England learn from high-performing nations about meeting the challenge of an ageing society?

First reported by the Express.

The long read is linked here: What Can England Learn From Japan and Sweden About Meeting the Challenge of an Ageing Society? | The King's Fund.

ILC 'health span' definition: This is the number of years an individual can expect to spend in good health. This is measured at birth in years, using health expectancy measures obtained from WHO.

ILC’s Healthy Ageing and Prevention Index: United Kingdom, Sweden and Japan. (All data form 2022).

About ILC

ILC is the UK’s leading authority on the impact of longevity on society. We combine evidence, solutions and networks to make change happen.

We help governments, policymakers, businesses and employers develop and implement solutions to ensure we all live happier, healthier and more fulfilling lives.

We want a society where tomorrow is better than today and where future generations are better off. ILC wants to help forge a new vision for the 100-year life where everyone has the opportunity to learn across our lives and where new technology helps us contribute more to society.