The Business of Building Trust for a Healthier Community

While conversations about ageing societies can present the impending demographic shifts that will be seen around the world as a challenge to economies, healthcare, financial systems and families, this doesn’t tell the whole story. For some, an ageing population is a huge opportunity to change the way the world works and innovates. The term silver economy describes the sum of economic activity generated by the needs, spending and participation of people aged 60 and older. People in this age group are estimated to spend approximately $17 trillion (£12.5tn) annually, around 27% of all global consumer spending, according to emerging research.

The Global Coalition on Aging (GCOA) has spent more than a decade making the case that what appears to be a looming social burden is, in economic and fiscal terms, one of the largest untapped opportunities of the century. “Ageing matters to every single sector because it changes the marketplace,” says Melissa Gong Mitchell, executive director of GCOA.

Of that, the products and services specifically tailored to older adults represent a market estimated at $4.2tn (£3.1tn) in 2025, projected to grow at approximately 6.5% a year in real terms.

Even so, many sectors are only beginning to respond to the potential of that demographic and economic shift.

The demographic engine

According to the United Nations World Population Prospects (2024), the global share of people aged 60 and over currently stands at approximately 1.2 billion, representing around 15% of the world’s total population. That figure is projected to reach 2.1 billion by 2050, when the group is expected to account for more than a fifth of humanity. This age group has been growing at more than three times the rate of the overall population over the past 15 years.

What contributes to the ageing of society is less intuitive than it might appear. Nicholas Eberstadt, a demographer and senior fellow at the American Enterprise Institute, argues that longer life is not the main story. “As a simple matter of arithmetic,” he says, “it’s mainly the falling fertility part that’s driving the ‘greying’ of societies.” According to estimates in his research, global fertility rates fell by roughly half between 1965 and 2015. Separately, research published by the University of Pennsylvania suggests that 2023 may have been the first year in recorded history when the global fertility rate fell below the commonly cited replacement level of approximately 2.1 births per woman.

At the same time, the world has undergone what Eberstadt describes as a health explosion. Global life expectancy has risen from approximately 47 years in 1960 to around 73 years today. But it is not just lifespan that has extended. In Japan, according to Eberstadt’s analysis, the annual risk of death for a man aged 80 today is roughly comparable to what a 65-year-old Japanese man faced in the 1960s. Older people are not simply living longer. In many cases, they are living healthier.

From risk to opportunity

GCOA’s Mitchell says that the dominant response to these trends has been concern, where a closer reading of the data points to opportunity. The language of silver “tsunamis” and “demographic time bombs” has framed ageing primarily as a fiscal problem, with too many older people drawing on systems built for a different ratio of workers to retirees. But, according to Mitchell, that framing only concentrates on the negatives and lacks any imagination for changes in policy, markets and individual behaviors that can make this shift transformative for the positive.

“The biggest misconception is that it is only a challenge,” she says. “People get a picture of a lot of older people who are disabled and dependent and unable to contribute, when it’s actually the opposite.”

The coalition works with companies, governments and health and financial institutions across North America, Europe, Asia and Latin America to build a more proactive response to the opportunity. “You can’t just make sticking plaster  policy changes,” Mitchell says. “We really have to make complete structural shifts in how we think about the healthcare, workforce and even education systems where public policy is still stuck in the last century.”

The evidence that structural adaptation could be possible comes from Japan, a “super-ageing” society. Despite having a working-age population that has been shrinking for roughly three decades and a total population that has been in decline, Japan’s total workforce is currently estimated to be larger than it has ever been. As Eberstadt notes, this has been influenced by more people, including those over 65, choosing to remain economically active.  Eberstadt draws a parallel to the entry of women into the workforce in the latter half of the 20th Century, which prompted warnings of job displacement that proved unfounded. “A modern market economy generates demand by having people work and produce,” he says. “And that demand generates more work for everybody.”

Staying in work carries its own health logic. Social isolation may carry a bigger increased risk of death than smoking up to 15 cigarettes a day. For older adults who choose to remain economically active, continued engagement could be a decision that benefits health and finances, Eberstadt says.

Sectors in motion

GCOA advocates for a shift from what Mitchell calls sick care toward prevention across the lifespan, monitoring cardiovascular risk factors and other NCD indicators before a major event occurs, rehabilitating effectively afterwards and rethinking the role of vaccination for older adults, who stand to benefit considerably from preventive immunisation. The health and social revolution prompted by childhood immunisation in the middle of our 20th Century will result in our 21st revolution from a parallel approach to adult immunisation and other prevention investments, says Mitchell. “Nobody wants to live a longer lifespan where the last third of it is in poor health,” she says. “The goal is to increase the healthspan.”

In the financial sector, GCOA’s long-running partnership with banks illustrates what institutional adaptation can look like. GCOA have trained financial advisers at banks such as Bank of America to recognise the early signs of cognitive decline, because financial acuity can be among the first capacities to be affected by age-related conditions. And also redesigned employee benefits to include elder care giving provisions and support for women experiencing menopause, reflecting the growing share of older women in the workforce..

The picture looks similar in travel and hospitality. GCOA points to a growing trend in intergenerational travel, in which older consumers with disposable income and flexibility, fund shared experiences for their wider families. “The matriarch of the family will pay for a trip for their kids and their grandkids,” Mitchell says. The sector has historically treated older travellers as niche, she adds, yet she suggests they could be its future.

Planning for the long arc

Eberstadt argues that many of the institutional frameworks societies rely on were built for a demographic world that no longer exists. “These are conventions, not commandments,” he says. “We know how to routinise abundance. We just have to do it a little differently under different demographic circumstances. Understanding that, the lens of the age-demographic mega-trend is a driver of innovation and market expansion.”

Mitchell’s nine-year-old daughter could have a strong chance of living to 100. “She can’t be planning to live her life like her grandmothers lived theirs,” she says. The life that statistics imply is longer, more active and more complex than the one most existing systems were designed around.

“It isn’t like an asteroid strike,” Eberstadt says. “You can see it coming for decades ahead. And that gives you time to prepare.” GCOA is working to ensure that that time is used well.