Sally Greengross

Globally, we are going through an extraordinary demographic transition. It is estimated that there will be 2 billion people over the age of 60 by the middle of the 21st century, and they will outnumber children (ie, those under 15) for the first time in history. In countries such as the UK, we are seeing not just growth in the numbers of older people but also an increase in the incidence of long-term conditions and co-morbidities.

While health services have seen a greater focus on preventative health in past years, there remain marked differences in the health outcomes of different groups – and they are growing. Although life expectancy has been on the increase, inequality in mortality is now greater than at any time since comparable records began, and the higher an individual’s socio-economic group, the longer they are likely to live.

These demographic realities call for far-reaching work, lifestyle, business and governmental changes, for we are still living with public policies and social infrastructures that were designed for a different time with different demographics.

However, rather than seeing longevity as a burden, we should celebrate the unprecedented triumph of

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