The Best (and Worst) Countries to Grow Old

For the first time in history, most people in the world can expect to live past 60 years old. Life expectancy is rising around the globe, and many countries are bracing for dramatic increases in the size of their elderly populations. There are 66.5 million elderly U.S. residents, and as in many other wealthy nations, the number is expected to increase considerably over the next several decades. The world’s 60 and over population is expected to more than double by 2050.

International NGO and advocacy group HelpAge International’s Global AgeWatch 2015 Index ranked the social and economic well-being of older residents in 96 countries, which combined represent more than 91% of the world’s population. The report rated each country on four broad factors important to an aging population: income security, good health, employment and education, and the overall environment of older residents. Switzerland ranked as the best country for older people to live in, bypassing Norway, last year’s top-rated country. Meanwhile, Afghanistan ranked as the worst country for older people for the third consecutive year.

According to Clare Woodford, health policy advisor at HelpAge International, older people are often neglected in one form or another, and often it is difficult even to collect data on living conditions among a country’s elderly population. “They are presented as almost invisible [and] a lot of the time we don’t know what their needs are,” Woodford said.

According to the World Health Organization (WHO) World Report on Ageing and Health, the world’s rapidly growing aging population is poorly understood and underutilized — problems that arise even in the best countries for the elderly. “The loss of ability typically associated with ageing is only loosely related to a person’s chronological age,” the researchers said. “There is no ‘typical’ older person.”

As the WHO report, which Woodford described as very optimistic, argues, there may be alternatives to the traditional life trajectory embraced in most developed countries. According to surveys conducted in the United States, most Americans approaching traditional retirement age do not want to retire. As Woodford explained, providing adequate services and focusing on disease control are only the first steps. There is also the well-being of elderly people to consider, as well as opportunities for policymakers to develop new roles for aging populations.

Still, elderly people require more medical attention towards the end of life, and the question of who will take care of a country’s elderly population remains.

Caring for the elderly on a national scale requires a great deal of resources, and wealthier economies are better able to ensure services for the elderly. They are better able to provide not just health care and economic security, but also create positive environments where senior citizens can maintain their freedom, maintain meaningful relationships with friends and family, and find meaning through employment and education.

While a nation’s relative wealth is often a strong indicator that quality of life for the elderly will be better than in other countries, there is much to be improved upon even among the best-ranked nations, according to Woodford. For example, several of the top-ranked countries in the 2015 Global AgeWatch Index scored far outside of the top 10 for income security. The United States, for example, ranked 35th in pension coverage and has one of the higher poverty rates among the elderly of the nations reviewed.

While the nations with the highest quality of life for the elderly may have room for improvement, they are leagues above the nations at the other end of the spectrum — Afghanistan, Malawi, and the West Bank region — where the welfare of senior citizens seems more of an afterthought. “Those countries have experienced a lot of turbulence and a lot of economic change over few years, and in that sort of context, it is very difficult to provide services and support to older people,” Woodford said.

In most of these nations, only a small share of the population even reaches old age. It may be that a smaller elderly population is even less likely to be prioritized by officials allocating resources and services. In all but two of the worst nations for the elderly, 5% or less of the population is 60 and older. In the United States, more than 20% of the population is elderly.

To identify the best and worst countries for the elderly, 24/7 Wall St. reviewed HelpAge International’s 2015 Global AgeWatch Index of 96 countries. Each country was graded based on four measures: income security, health status, employment and education, and the overall environment for older residents. All data are for the most recent available period at the time the report was published.

These are the best (and worst) countries in which to grow old.

The Worst Countries for the Elderly

5. Pakistan
> Total population: 186.3 million
> Pct. population aged 60+: 6.6%
> GNI per capita: $4,557
> Life expectancy at 60: 17

Pakistanis 60 and older are expected to live just 17 more years, one of the shorter old-age life expectancies in the world. While shorter lives are not necessarily less happy lives, only 46% of Pakistani respondents 50 and older said they were satisfied with the freedom in their lives, and just 60% were confident that they had friends or relatives to help them when in need, both some of the lowest percentages of any country. Also, only 2.3% of Pakistan’s elderly population can expect regular pay after retirement, the lowest pension coverage in the world. Like many of the worst countries for the elderly, Pakistan is mired in regional conflicts. Not only does this make life more challenging for country residents, especially older individuals, but it makes it very difficult for local governments and outside organizations to even collect data on the population.

4. West Bank and Gaza
> Total population: N/A
> Pct. population aged 60+: 4.5%
> GNI per capita: $5,211
> Life expectancy at 60: 18

The West Bank and Gaza is one of the most conflict-torn regions in the world, and that lack of stability has, according to HelpAge International, had a disproportionately large effect on the quality of life for the elderly. Only 41% of West Bank and Gaza respondents 50 and older say they are satisfied with the freedom in their lives — the third lowest share of any country. Only 8% of residents 65 and older have pensions, one of the lowest coverage rates in the world. In countries without income security after retirement, access to work-related support networks through elderly employment is important. In West Bank and Gaza, however, only 29.2% of residents aged 55 to 64 were employed, one of the lowest elderly employment rate in the world.

3. Mozambique
> Total population: 26.5 million
> Pct. population aged 60+: 5.1%
> GNI per capita: $1,019
> Life expectancy at 60: 16

Six of the 10 worst countries for elderly people are in Africa — and Mozambique is one of them. Nearly 20% of Mozambique’s 1.4 million residents aged 60 and over live in poverty. A low pension coverage rate may partially explain the high poverty level among the country’s elderly population. Only 17.3% of the nation’s elderly residents received any income from a pension, a smaller share than in all but a handful of other countries. Those in the country who live to age 60 are expected to live an average of 16 additional years, the shortest old-age life expectancy among nations reviewed. While slightly more than 5% of the East African nation’s population is 60 and older, the share is projected to grow to 6.2% by 2050.

2. Malawi
> Total population: 17.6 million
> Pct. population aged 60+: 4.9%
> GNI per capita: $717
> Life expectancy at 60: 16

With a GNI per capita of just $717, Malawi is one of the poorest countries in the world. By contrast, The United States’ GNI per capita is almost 72 times that of Malawi’s. Just 4.1% of Malawians 65 and older received income after retirement, one of the lowest pension coverage rates worldwide. One positive note on the quality of life for the elderly in Malawi is the nation’s high employment rate of the elderly. In Malawi, 96.4% of residents aged 55 to 64 were employed, the second highest elderly employment rate of any country. Employment for senior citizens has been shown to result in a higher quality of life for the elderly, who have access to employment-based support networks and maintain a sense of purpose. After turning 60, Malawians can expect to live just 16 more years, one of the shortest old-age life expectancies worldwide.

1. Afghanistan
> Total population: 31.3 million
> Pct. population aged 60+: 4.0%
> GNI per capita: $1,703
> Life expectancy at 60: 16

All of the worst countries to grow old in are countries with relatively small concentrations of old people. Afghanistan has one of the smallest share of residents aged at least 60 and is the worst country in which to grow old. After turning 60, Afghans can expect to live just 16 more years, seven years fewer than the average American turning 60. A shorter life is not necessarily a less healthy life, but in Afghanistan it is. Of those 16 years, only 9.2 are expected to be lived in good health — one of the shortest healthy life expectancy in the world. A supportive environment is important for elderly well-being. Just half of Afghan respondents 50 and older said they felt that they had friends or relatives who could help them when in need.

The Best Countries for the Elderly

5. Canada
> Total population: 35.5 million
> Pct. population aged 60+: 22.3%
> GNI per capita: $40,799
> Life expectancy at 60: 25

Canada is one of the best countries in the world for the elderly. While just more than 22% of Canada’s population are 60 or older, the share is projected to spike by more than 10 percentage points to 32.4% by 2050. Those in the country aged 60 or over typically live to be 85, the second longest life expectancy of any country in the world.

Canada’s elderly population is also generally financially secure. Nearly 98% of the Canadian population over the age of 64 receives a pension. Also, only 6.8% of Canadians aged 60 and older live in poverty, a relatively small share compared to other countries.

4. Germany
> Total population: 81.1 million
> Pct. population aged 60+: 27.6%
> GNI per capita: $44,401
> Life expectancy at 60: 24

As one of the best countries in the world for old people, Germany is home to a rapidly aging population. While just over 22% of Germans are 60 and older, by 2050, nearly 40% of the German population is projected to be aged 60 and over. Although a larger elderly population may present an economic burden, it is also indicative of a healthy population.

Germany’s elderly residents are generally in good health both financially and physically. As is the case in many of the best countries for the elderly, all Germans 65 and older receive a pension. Additionally, a 60-year old German can reasonably expect to have roughly 18 more healthy years of life, a longer life expectancy than in all but a handful of other countries.

3. Sweden
> Total population: 9.7 million
> Pct. population aged 60+: 25.5%
> GNI per capita: $45,127
> Life expectancy at 60: 24

More than one-fourth of the Swedish population is 60 and older, one of the highest shares worldwide. Countries with large elderly populations generally have favorable conditions for aging. All Swedish citizens over 65 receive pension income, and only 5.3% of those 60 and older live below the poverty line compared to 18.8% in the United States. The Swedish elderly are among the healthiest in the world and can expect to live for 24 years after the age of 60, the third longest old-age life expectancy across the globe.

2. Norway
> Total population: 5.2 million
> Pct. population aged 60+: 21.8%
> GNI per capita: $64,241
> Life expectancy at 60: 24

As in other Scandinavian nations, Norway is one of the best countries for the elderly. People who live to age 60 in Norway are likely to live 24 additional years, one year longer than Americans who live to be 60. The country’s elderly residents also perceive Norway to be an especially safe place. Of the nation’s residents 50 and over, 86% said they feel safe walking in their neighborhood at night, a higher share than in all but two other countries.

Elderly people in Norway are also among the most financially secure of any other elderly population in the world. Only 1.8% of the people aged 60 and older lived in poverty, a smaller share than in all but two other countries. As is the case in most of the best countries for old people, all of Norway’s population over the age of 64 receive a pension.

1. Switzerland
> Total population: 8.1 million
> Pct. population aged 60+: 23.6%
> GNI per capita: $54,762
> Life expectancy at 60: 25

After turning 60-years old, the average Swiss citizen can expect to live 25 additional years, and 19 of these in good health. Only Japan has better old-age life expectancies than Switzerland. Like most of the best countries for growing old, all citizens 65 and older in Switzerland receive a pension. An enabling environment is important for elderly residents’ quality of life, and when asked about various aspects of their environment, citizens 50 and over responded positively. About 83% of respondents reported they were satisfied with the country’s public transit system, the second best percentage of any country. In another survey, 93% of respondents claimed to be satisfied with the freedom in their lives, one of the highest percentages in the world. By 2050, more than a third of Switzerland’s population will be 60 and older.