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on Economics of Ageing |
| By: | Palacios, Robert J. |
| Abstract: | Public pension schemes that rely on payroll deductions have failed to achieve adequate coverage in low and middle-income countries, and population aging in many countries will outpace coverage expansion with serious social consequences. Policy responses must address the twin objectives of poverty alleviation and consumption smoothing. An integrated social pension financed with general revenues can reduce old age poverty while limiting the distortions caused by minimum pensions within contributory schemes. Consumption smoothing requires a new approach to replace wage-based contributions. Technological advances in tax administration that make individualized VAT payments possible facilitate a shift from wage to consumption-financed pensions (CFPs). Such a shift would automatically increase coverage and reduce reliance on increasingly problematic labor taxes. |
| Date: | 2026–09–30 |
| URL: | https://d.repec.org/n?u=RePEc:wbk:hdnspu:215545 |
| By: | Yi Fan; Shuangshuang Song; Yewen Yu |
| Abstract: | Population aging and fertility decline are occurring simultaneously worldwide, straining labor supply and pension systems. China began a gradual delayed-retirement (GDR) reform in 2025, raising statutory retirement ages on different schedules for men, female cadres, and female workers across birth cohorts. To evaluate its effects on older individuals and within the family, we develop a model of older adults' retirement, intergenerational transfers, and adult children's fertility decisions, with parameters estimated via fuzzy regression discontinuity at the pre-2025 statutory retirement ages. Counterfactual simulations show that, for mature reform cohorts, the GDR reform increases older employment and monetary transfers to adult children but reduces grandparental childcare. Because the reduction in childcare outweighs the increase in monetary transfers, fertility and older adults' welfare decline, with particularly large losses among lower-income women. Fully flexible retirement, mandatory partial retirement, and mandatory full-time work do not raise employment without similarly reducing fertility and welfare. Childcare subsidies can offset the declines in fertility and welfare, while restricting eligibility to women or lower-income women requires higher subsidy rates but reduces average fiscal expenditure. These findings suggest that evaluations of retirement policy should consider not only its direct effects on older adults' labor supply, but also its fertility effects through intergenerational transfers; childcare support can help mitigate these negative intergenerational effects of delayed retirement. |
| Date: | 2026–10 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2610.32455 |
| By: | World Bank |
| Abstract: | Thailand is undergoing one of the most rapid demographic transitions in the world and is on track to become a “super-aged” society—with more than 20 percent of its population over 65—by 2033. The shift is occurring in under two decades and at a far lower income level than peer countries experienced. This transformation poses significant macroeconomic and fiscal risks, driven by a shrinking and aging labor force, widening skills gaps, and a heavy burden of non-communicable diseases, costing nearly 10 percent of GDP annually. Without policy action today, economic growth could potentially decline by a third, increasing government debt and affecting Thais of all ages. Thailand has aging policies and plans in place, along with foundational strengths to build on, including its globally recognized universal health system and community-based care programs. What the country faces is a critical implementation gap, driven by fragmented institutional responsibilities, siloed agency mandates, and insufficient authority vested in the Department of Older People. Labor market and social security policies need to be redesigned to support longer, more flexible working lives rather than forcing people out of formal jobs from mid-career. To ensure that the population ages well, the focus of health programs and funding needs to shift from outputs to outcomes. Long-term care needs to be integrated across health and social security, central and local governments. Such reforms offer cost-effective solutions that will promote economic growth and development. Acting today can shift the national narrative from viewing older people as dependents to recognizing them as productive contributors to a burgeoning silver economy, benefiting Thais of all generations. |
| Date: | 2026–10–14 |
| URL: | https://d.repec.org/n?u=RePEc:wbk:hdnspu:215899 |
| By: | Aleksandar Andonov; Kristy A. E. Jansen; Joshua Rauh |
| Abstract: | Pension funds are long-horizon investors with predictable liability structures. As such, they are often perceived as investors who can provide liquidity and stabilize markets. However, pension funds increasingly face negative operating cash flows as benefit payments exceed contributions. Using aggregate data on U.S. public pension funds combined with granular holdings obtained through public records requests, we document three findings that challenge the conventional view of pension funds as stabilizing investors. First, pension funds with more negative cash flows do not adjust their target asset allocations and maintain low allocations to safe and liquid assets. Second, because of these limited safe asset buffers, pension funds meet cash flow shocks primarily by selling equities, absorbing $0.67 per dollar of shock through equity sales. At the security level, pension funds sell across equities rather than following a safe and liquid-assets-first approach. Third, pension funds sell equities even when equity returns are negative, indicating that these trades reflect liquidity needs rather than portfolio rebalancing. Together, these findings show that pension funds have become regular sellers in equity markets rather than contrarian, stabilizing investors. |
| JEL: | G11 G23 |
| Date: | 2026–10 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35896 |
| By: | World Bank |
| Abstract: | This paper aims to assess the case for a significant expansion of social pension coverage in Malaysia in light of global and Malaysian experience. It first defines social pensions and their diverse objectives. It then looks at global patterns of social pension coverage, adequacy, and spending, highlighting the diverse design trade-offs taken by different countries, including Malaysia. A key takeaway is that the umbrella term social pension encompasses a diverse set of programs where design differences are as important as common features. Following the global benchmarking, there is a discussion of the global evidence on the impacts of social pensions on a range of social indicators, including poverty, health and well-being, labor market behavior, and indirect effects on non-beneficiary household members. It then discusses specific design issues that need to be taken into account when considering expansion of social pensions. This is followed by analysis of the potential impacts on inequality and poverty in Malaysia of different social pension reform scenarios, presenting evidence of their potential positive distributional impacts. The paper concludes with suggestions for reforms of Malaysia’s social pension. |
| Date: | 2025–10–28 |
| URL: | https://d.repec.org/n?u=RePEc:wbk:hdnspu:206243 |
| By: | Lerch, Benjamin; Brändle, Thomas; Baur, Martin |
| Abstract: | Switzerland’s fertility rate fell below 1.3 children per woman in 2024 and has remained well below the replacement level for decades, reflecting a broader trend across advanced economies. This paper discusses the economic and fiscal implications of persistently low fertility, reviews its underlying causes and the extent to which family policy can influence fertility decisions, and presents policy options available for Switzerland. Low fertility slows growth of the domestic working-age population, accelerates population ageing, and reduces long-term economic growth potential. For public finances, it dampens tax revenues and social insurance contributions while increasing age-related expenditure, particularly on pensions and healthcare. The causes of low fertility are multifaceted, including the financial costs of having children, difficulties in reconciling work and family life, and broader changes in social norms and lifestyles. Evidence from OECD countries suggests that family policies can alleviate some constraints, but their effects on fertility are small and often temporary. Coherent and well-coordinated measures supporting families throughout the child-rearing years appear more promising than individual measures. As a sustained reversal of current fertility trends appears unlikely, economic and fiscal policy should focus on adapting to an ageing society by making better use of the domestic labour supply, facilitating labor-market-oriented immigration, and fostering productivity growth. Finally, reforms to strengthen the fiscal sustainability of pension and healthcare systems become even more important. |
| JEL: | J11 J13 H51 H55 |
| Date: | 2026–10–22 |
| URL: | https://d.repec.org/n?u=RePEc:bsl:wpaper:2026/09 |
| By: | Philippe De Donder; Mathieu Lefebvre; Marie-Louise Leroux; Quitterie Roquebert |
| Abstract: | This paper investigates how marginal utility varies with health status (i.e. health-state dependence) while allowing this relationship to differ across income levels. Building on the existing literature, we develop a framework that quantifies the income adjustments necessary to maintain individuals’ wellbeing when they become disabled. Using SHARE data, we empirically estimate how health affects the marginal utility of consumption across the income distribution for older adults in Europe. Our results show that health-state dependence is negative among low-income individuals, indicating that their marginal utility of consumption declines when their health worsens. In contrast, at the very top of the income distribution, health-state dependence is positive, implying that marginal utility of consumption rises as health deteriorates. |
| Keywords: | health-state dependence, marginal utility of consumption, income heterogeneity, SHARE survey |
| JEL: | D12 I1 J14 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_13096 |
| By: | Ji, Wenjing; Zheng, Jiacheng; Guan, Suzhen; Liu, Yang; Chen, Xi; Lin, Zhuoer; Costa-Font, Joan; Merchant, Reshma Aziz; Guariglia, Alessandra; Wang, Chenyan; Xu, Sen; Yang, Caijun; Shen, Mingwang; Jiang, Minghuan; Wang, Duolao; Fang, Yu; Lastuka, Amy |
| Abstract: | Importance Population aging is contributing to rising multimorbidity across physical, psychological, and cognitive domains, yet global evidence integrating health and economic burdens in older adults remains limited. Objectives To quantify the global health and economic burden of multimorbidity among adults aged 60 years or older and to assess trends from 2000 to 2023. Design, Setting, and Participants This economic evaluation used observational modeling of Global Burden of Disease study 2023 estimates as health inputs and integrated them with macroeconomic, health expenditure, and population data from World Bank Open Data, the World Health Organization Global Health Expenditure Database, and United Nations population data. Health burden analyses covered adults aged 60 years or older in 204 countries and territories from 2000 to 2023, and economic burden analyses covered 180 countries and territories. Data analyses were performed from January 27 to July 22, 2026. Exposures Cross-domain multimorbidity spanning physical conditions, psychological disorders, and cognitive disorders, operationalized as 78 multimorbidity combinations. Main Outcomes and Measures The main outcomes were years lived with disability (YLDs) per 100 000 population and economic losses. All economic indicators are reported in 2021 international dollars (USD) adjusted for purchasing power parity. Joinpoint regression characterized 2000 to 2023 trends. Results From 2000 to 2023, total YLDs increased from 2367.81 (95% uncertainty interval [UI], 1067.67-4969.59) to 2941.68 (95% UI, 1252.99-6816.95) per 100 000 population, while economic losses increased from $80.10 billion (95% UI, $59.60-$104.69 billion) to $363.25 billion (95% UI, $264.04-$502.74 billion). The highest 2023 YLD rate was observed for osteoarthritis and Alzheimer disease and other dementias (369.87 [95% UI, 163.86-752.23] per 100 000 population), whereas the largest 2023 economic loss was observed for osteoarthritis and anxiety disorders ($48.51 billion [95% UI, $31.68-$76.57 billion]). The fastest-growing combination was diabetes, anxiety disorders, and Parkinson disease, with a YLD average annual percentage change (AAPC) of 3.94% (95% CI, 3.79%-4.08%) and an economic loss AAPC of 9.92% (95% CI, 9.69%-10.13%). Conclusions and Relevance In this economic evaluation of the global health and economic burden of multimorbidity among adults aged 60 years or older, multimorbidity burden increased worldwide, with economic losses growing faster than YLDs. Heterogeneity across sex, country income groups, and disease combinations, together with divergence between disability and economic burden, suggest that policy priorities for aging populations should consider both health burden and economic vulnerability. |
| JEL: | J1 |
| Date: | 2026–10–21 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:141652 |
| By: | Liran Einav; Amy Finkelstein; Sehyun Hong |
| Abstract: | We examine how physical health, health behaviors, and mortality vary with income for prime-age adults. To do so, we leverage population-wide, individual-level cardiovascular health exams linked to income tax records and subsequent mortality for a representative sample of about 350, 000 Koreans aged 47--57. For both men and women, there is a negative disease-income gradient for high blood pressure, high blood glucose, and high body mass index, but not for high cholesterol. Disease-income gradients are steeper for women than men, and tend to be concentrated in the top half of the income distribution; similar patterns hold for health behavior-income gradients. Subsequent mortality-income gradients are also concentrated in the top half of the income distribution, but are steeper for men than women. Although physical health and behavior measures are highly predictive of subsequent mortality, differences in these measures by income explain very little of the income-mortality gradient, even for cardiovascular mortality. Our findings suggest that something other than differences in disease burden at prime age drives most of the income-mortality gradient at older ages. |
| JEL: | I12 I14 |
| Date: | 2026–10 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35880 |
| By: | R. Anton Braun; Daisuke Ikeda |
| Abstract: | Routine variation in household labor supply, consumption, saving, and portfolio choice decisions over the lifecycle influences aggregate economic activity in an aging society because the size of different age groups changes. In rapidly aging societies such as Japan, this mechanism produces an aging trap. The inflation rate is low or negative. Real interest rates and per capita output are also persistently low. Unlike inflation, they resist monetary and fiscal stimulus. Monetary policy can offset the decline in the inflation rate, but neither aggressive central bank interest rate policies nor large increases in the public debt–output ratio offset the persistent declines in real interest rates and output. |
| Date: | 2026–10 |
| URL: | https://d.repec.org/n?u=RePEc:cnn:wpaper:26-019e |
| By: | Jennifer L. Kao; Tamar Oostrom |
| Abstract: | During research and development, firms must decide which types of individuals to engage in developing and testing their products. We investigate how lowering the cost of including one group shapes its representation, subsequent innovation, and product adoption. In 2000, Medicare expanded coverage of clinical trial costs for elderly trial participants, a historically underrepresented group in drug development. This policy increases representation: trial sponsors expand trial eligibility to include elderly participants and increase the share of elderly participants. We find an immediate and large increase in the number of clinical trials for diseases common among the elderly, with the largest increase in drugs not yet approved and in approved drugs tested in new diseases. We document an increase in drug utilization of newly tested drugs among elderly individuals and analyze trial results, adverse events, and drug approvals. Our findings show how financial incentives can increase representation in product development and shift the rate, direction, and adoption of innovation to potentially benefit underserved groups. |
| JEL: | I14 I18 J14 O31 O38 |
| Date: | 2026–10 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35936 |
| By: | Fabian Buder (Nürnberg Institut für Marktentscheidungen); Tobias Biró (Nürnberg Institut für Marktentscheidungen) |
| Abstract: | Produkte, Start-ups und neue medizinische Ansätze rund um Longevity - verstanden als das Ziel, die eigene gesunde Lebensspanne zu maximieren - erleben derzeit große Aufmerksamkeit. Begleitet von unzähligen Medienberichten und einer umfangreichen Ratgeberliteratur hat sich ein ganzes Ökosystem an Produkten und Anbietern sowie vermeintlichen oder tatsächlichen Fachleuten rund um das Thema entwickelt. Unklar ist jedoch, wie stark Longevity als Ziel tatsächlich in der breiten Bevölkerung verankert ist. In der vorliegenden Studie wird die aktuelle Relevanz von Longevity analysiert. Darüber hinaus wollten wir wissen, welche Maßnahmen dahingehend bereits ergriffen werden und für welche sich zukünftig Potenzial zeigt. Schließlich soll gezeigt werden, welche Rolle der Staat dabei spielen soll und wofür Menschen zusätzliche gesunde Lebensjahre nutzen würden. Um die Erkenntnisse einordnen zu können, wurde die Befragung bevölkerungsrepräsentativ in fünf Ländern durchgeführt: Deutschland, die USA als Gesellschaft, von der der Trend ausgeht, Frankreich und Schweden als Vergleichsländer mit unterschiedlichen kulturellen Haltungen zu Prävention und staatlicher Verantwortung sowie Japan als alternde und technologisch aufgeschlossene Gesellschaft. |
| Keywords: | Longevity, Langlebigkeit, Gesundheit |
| Date: | 2026–07 |
| URL: | https://d.repec.org/n?u=RePEc:eoh:nimpul:nimpul-023 |
| By: | Morteza Meybodi (Leuven Economics of Education Research Centre (LEER), FEB, KULeuven); Vincent Vandenberghe (UNIVERSITE CATHOLIQUE DE LOUVAIN, Institut de Recherches Economiques et Sociales (IRES)) |
| Abstract: | This paper examines how career-long emotional/interpersonal work demands are associated with mental health among adults aged 50 and older. Using retrospective work histories from SHARE combined with ISCO-4-level occupational characteristics from O*NET, we construct employment trajectories capturing cumulative exposure to emotionally/interpersonally demanding work and examine its association with later-life depressive symptoms, measured by the EURO-D scale. Our findings show that careerlong emotional/interpersonal demands are associated with a higher risk of depression after age 50, although their relative importance is modest. Career instability, such as employment gaps, redundancies, and part-time work, emerges as a stronger predictor. Pre-labour-market factors, including childhood health and educational attainment, also play a substantial role, highlighting the lasting importance of early-life circumstances for later-life mental health. |
| Keywords: | mental health, depressive symptoms, working conditions, emotional/interpersonal demands, career arduousness |
| JEL: | J14 I1 J26 |
| Date: | 2026–10–28 |
| URL: | https://d.repec.org/n?u=RePEc:ctl:louvir:2026021 |
| By: | José L. Casco |
| Abstract: | Non-contributory pension schemes are increasingly prevalent as countries seek to combat poverty, yet their role in shaping inequality remains underexplored. This paper studies how such programs alter intra-household inequality using data from Mexican household income and expenditure surveys. The analysis first examines a local pension program in Mexico City, embedding an age-based quasi-experimental design to identify beneficiaries within a structural model of extended households. Results show that the program shifted resources from men to women and children, increasing women's bargaining power and improving the living standards of children and women by reducing their poverty rates. The paper then examines the national expansion of non-contributory pensions, exploiting regional variation in roll-out across states and the introduction of a federal program. The redistributive patterns observed in Mexico City are also evident nationally, although program effectiveness varies, with differential impacts on promoting gender equity and benefiting children. |
| Keywords: | Non-contributory Pensions;Resource Shares;Control of Resources;Inequality |
| JEL: | D10 J14 J16 J26 H55 |
| Date: | 2026–10 |
| URL: | https://d.repec.org/n?u=RePEc:bdm:wpaper:2026-06 |