This clearly offers enormous hope to society at large, but this note is tied to the outlook for capital markets and strategic allocation. In addition to the societal benefits, from a purely cold economic perspective it could counteract one of the largest secular headwinds to growth. The largest constraint on expected real growth rates over the next 10–20 years probably comes from the expected decline in the working-age population in the developed world and China. Absent a massive productivity increase (and forecasters have had a dismal time in predicting this), the change in the number of workers is the key determinant of growth. For the developed world, we expect the number of workers, assuming people continue to retire at 65, to decline by 4% between now and 2040. For China, the decline of nearly 10% is expected.
The US has a more favorable demographic trend; its working-age population is expected to rise by nearly 4% over the same time horizon. However, the US is not immune to other problems related to aging. As the population aged 75 and older increases, so does the need for long-term care, which impacts worker productivity in two ways. First, it diverts expenditure from research and development, infrastructure and education to healthcare and social assistance. Second, it increases the number of people needed in the care sector—an area that is especially hard to automate. So, the demographic projections imply an increasing share of the population either engaged formally in the care sector or falling informally out of the work force to care for elderly relatives.
In previous research, we have shown that the ratio of health and social care workers to the size of the US population over 75 has been relatively stable over the past 30 years. If this ratio remains constant, the aging of the population implies a sustained, significant increase in the share of the work force needed for care work. On this basis, the current 13% share would more than double by 2045, assuming that current labor-participation rates for the 15–65 years and 65–79 years cohorts stay the same as today.
Greater need for social care could be driven disproportionately by dementia (as with other diseases like cancer and heart disease, mortality occurs relatively late). Thus, if the incidence of dementia continues to decline, it would offset a meaningful share of productivity declines from aging and a need for more care workers.
In a similar vein, excessive weight has a high cost to society and a drag on productivity. It is associated with a higher incidence of diabetes, strokes and heart disease as well as greater risk of developing cancer. According to World Obesity Federation numbers in 2023, 14% of all people over five years old globally were obese, with another 24% overweight. According to its estimates, four billion people will likely be overweight or obese by 2035. The estimated annual cost would be $4 trillion by 2035 or 2.9% of global GDP, result of lost productivity and working hours as well as higher healthcare cost and premature deaths.
A new class of GLP-1 agonist weight-loss drugs have produced very positive signs, with early trials showing weight loss of 10–20%. What is more, some studies suggest that this class of drugs appears to have modulating effect on addictive behavior, such as smoking and alcohol consumption. If widespread adoption of these drugs can reverse the rising obesity trend, it would not only lead to material healthcare cost savings but enable millions of people to lead healthier, longer, more productive lives.
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