The aging demographic shift: How healthcare leaders can create new opportunities and improve their workforce

Bradley Schurman

Founder and CEO of The Super Age

The aging demographic shift: How healthcare leaders can create new opportunities and improve their workforce

30 March 2022 | 13min

Quick Takes

  • Individuals are living longer and birthrates are steadily declining, meaning fewer people are available to replace the aging workforce

  • Innovation has led to changes to social and economic conditions, particularly among women in the home and workplace

  • As societal and workplace norms continue to shift, healthcare leaders can utilize four strategies to support their employees of all ages

We are seeing an evolution of demographic changes amongst societies globally – people are living longer than ever before, but at the same time, having fewer children. As the world’s population will for the first time in recent history enter a decline, new workforce strategies have to replace current ones. But what does this aging population mean for healthcare? 

To discuss how healthcare leaders can adapt to this new transformation and the changes in societal and workplace norms, we sat down with Bradley Schurman to get his insight. He is the founder and CEO of The Super Age, a firm focused on helping organizations understand and harness opportunities to demographic changes, with a focus on population aging.  In his recently published book “The Super Age: Decoding Our Demographic Destiny” Bradley helps explain the coming Super Age and what it means for our collective future. 

The Super Age era and the healthcare industry

HT: Our communities are living longer than we did just a century ago. Health and technology are moving at incredibly fast rates enabling us to live well into our 80s, 90s, and beyond. In your new book, you talk about “The Super Age.” Tell us more about this new demographic.

Bradley Schurman: The Super Age is a novel period in human history when many of the world’s populations will be going over a tipping point where one out of five people will be over the age of 65. This is a first in all of our history. And it’s happened in a number of countries already– places like Japan, Germany, and Italy. By the end of this decade, 35 nations in total will become part of this club, including the United States.1 So it’s a big dynamic shift. 

Because there will be more older people in the population, we’ll have to adapt some of our norms to meet them where they are. Because as we know, the prevalence of chronic disease in particular and age-related decline does happen more later in life. So it’s simply a numbers game at the end of the day.

Great innovation comes from conflict. The innovation that we’ve had up until this point has really focused on solving infant and youth mortality. We typically don’t look at the fact that this actually caused the global population to quadruple in size from about 2 billion people roughly in 1900 to just shy of 8 billion people today.2 As we began to globalize, this explosion caused increases in the pool of labor all over the world, especially in the US and Europe. 

However, today the vast majority of the world does not have a replacement rate for their populations. In this century, the global population will stop growing, and we’ll start going into decline. It’s coming, and this will require us to have new workforce strategies.

HT: How will the “Super Age” and the ongoing demographic changes challenge and influence the future of healthcare?

Bradley Schurman: Within healthcare, there are some pretty dramatic changes that will happen relatively soon. The first and probably most prevalent is that we’ll have to address some challenges that we have towards treating older people within the healthcare system, particularly focused on the end of life. 

So let’s start there first. Focusing on the end of life, there will just be a significant increase in the number of older people that doctors, nurses, and healthcare staff will have to consider in later life. So take for example the boomers. There were 76 million boomers born in the United States.3 However, there are still 70 million of them alive today.4 That’s a lot of people to take care of. However, on the other end of the spectrum, we’re having far fewer births.

To put this into perspective, population aging actually happens when two megatrends collide – the increase in longevity and also this decrease in birth rates. The decrease in birth rates is happening almost everywhere in the world. To keep our populations afloat, standardized, and stable, every woman needs to have 2.1 children.6 Yes, the math is strange, but that’s an average.

We have dropped below that rate now for a significant period of time. In places like the United States, the birth rate is now around 1.6. However, in places like Taiwan, which has the lowest birth rate in the world, it’s down to 1.0.5 We’re producing fewer people on average, meaning there are going to be fewer individuals to take care of those that are older. 

So how will it influence the healthcare system overall? 

We’ll have to require more technologies to be brought in to help take care of people. In fact, we’re already seeing how this is happening in Japan’s long-term care system now, from monitoring technologies within nursing homes or using robotics and AI to engage with people in the same way a human does.

If we don’t take hold of it, the aging of our population and our bias against older populations will have a multiplier effect that will end up costing us money. It’ll get in the way of us innovating. In fact, Becca Levy out of Yale University found a few years ago that ageism within the healthcare system was costing the US $63 billion a year.7 So there’s a great opportunity here for health providers, in particular, to take the proverbial bull by the horns and get into the space in a more aggressive way.

Then, there are just the practical things that healthcare systems have to take care of both within a hospital or nursing center as well as within a pharmaceutical lab. We now have to employ people for longer periods of time because there simply aren’t enough people coming in to replace them. So when we consider what our employees want and need, we have to consider that we are desperate to get more years out of our employees if we want to stay sustainable as a company for longer periods of time.

Adjusting to changes within our social and scientific norms

HT: You talk about the increases in our aging population and how family dynamics are shifting, with people having fewer children. How does the Super Age relate to today’s society where women are both raising children and playing a significant role in the workforce?

Bradley Schurman: There’s always a drag between economic innovation and social innovation. Within the healthcare sector, for example, one of the most amazing things that we did as humans is finding new innovations for water and food safety, which all directly impacted health. We began fighting disease with drugs and vaccines. Then all of a sudden, it allowed a majority of children to make it from birth to adulthood. 

Prior to the early middle century, one out of three kids died before the age of three. Nearly half of them died before they made it to be a fully formed adult. Obviously, this meant there were more deaths in the 1920s.

On a personal note, my grandfather was born one of eight. But then his family was one of two – my mom and my uncle. Then, I was one of two. Today, my brother has two kids and I’ve had none. So birth rates have declined in large part because we’ve caught up our social norms to our scientific norms.

This plays into the workplace. We’ve left older women in many cases high and dry because the social norms require them to take care of the family, take care of the hearth and the home. Also, they’ve had to take care of both parents, sometimes their in-law’s parents, as well as their kids. And in some cases, their grandkids. So they’re already presented with this incredibly difficult burden. 

Yet the modern norms of today require them to also have a job. We saw during the pandemic that women, in particular middle-aged and late-middle-aged, fell out of the workforce at a pretty precipitous rate. All together these situations created unnecessary stressors for women, and it was simply too much for them to handle. 

Employers can play a vital role to help take off the pressure. “We understand your stressors and we can find ways to help you.” It builds empathy between the employer and the employee. At the end of the day, it’s a good thing for everyone. Everyone wins. 

Within our knowledge economy now, anyone can work anywhere. That means the “9 to 5” standard working hours for many individuals might be a thing of the past. If we’re tethering women in particular to a desk from 9 to 5 while they’re at home trying to take care of their mom or dad, and also their kids or even their grandkids, we’re doing them a pretty significant disservice at the end of the day.

The domino effect of innovation

The domino effect of innovation

HT: We continue to hear that the pandemic has enabled innovation at a rapid rate. We’ve also been able to adapt quickly to this innovation. When the pandemic begins to clear, do you still see the same rate of innovation, or do you think it’s going to slow down?

Bradley Schurman: Innovation might take a breather, but it won’t stop or slow down. We’ve hit a tipping point where people will always see the opportunity that sits before them. 

Demographic futurists look at the past to understand the future and make predictions based on data. The futurism element takes into account the science and technology that are happening now and the possibility of things to come. Past behaviors are often great predictors of future behaviors.

For example, the last pandemic and World War II are two events that catapulted global society into an incredible period of innovation, which was known as the third industrial revolution. We didn’t stop at tuberculosis and the pandemic in the early 1900s. We actually got catapulted into things like organ transplantation and vaccine development for polio. As a society, we continued to transform into the information age and how we communicated and transmitted across cultures. Scientific teams around the world could build solutions to global challenges. 

Right now we’re in the fourth industrial revolution. There are new opportunities in creating health systems that manage, maintain, and enhance this period of longevity that we’re entering into. It’s highly anticipated that the first person to live to 150 years old is already alive today. The innovations around longevity right now feeding into this idea that we can live longer has become a hotbed for investment right now. 

While this lengthening of life will come with its own challenges, it will breed new opportunities. It’s a domino effect or ripples in the water. One singular disruptive event, like COVID-19, can cause thousands of other things to occur.

Boosting employee retention to remain competitive

HT: With the new Super Age demographic, what are the key strategies healthcare companies can use to listen to the needs of their employees?

Bradley Schurman: ​​We need to remember and consider the fact that right now, right here in this place and time, we’re embroiled in what people are calling “The Great Resignation”. This is actually a mix of a number of different things that have come together to create this exodus from the workforce, including early retirements by older populations. That’s not just exclusive in the United States, it’s happening worldwide. It’s created an interesting, almost artificial hole in the labor market, and it’s one that we need to fill quickly.

We can support and encourage people to stay in their roles longer and there are good strategies to get there. Specifically, there are 4 tactics that have been used in different industries that can be applied to healthcare. 

4 tactics to boost employee retention

1 Compete for new talent with benefits and salary adjustments. There are certain parts of the healthcare sector that are struggling to recruit and retain people. Nursing is one of those areas that’s been challenged for some time. Talk to your nurses. Ask them what they want. I know it sounds simple, but it is a revolutionary approach to adjusting your norms to meet their needs. We need to compete better to secure talent, whether it be somebody fresh out of college or somebody who might be nearing traditional retirement. 
2 Augment your workforce with technology. This should be with artificial intelligence or machine learning. For example, Japan is leaning into robotics and artificial intelligence as a way to engage their aging populations. They’re using these methods to stay connected, helping people stay fit. They are monitoring floors within hospitals and healthcare centers to prevent falls from happening. 
3 Support your workforce with caregiving leave and flexibility. A great example of this is from Westpac bank in Australia. As older, female bank tellers were leaving the workforce at an alarming rate, Westpac asked them why they were quitting. It turns out the women wanted to care for their grandchildren. So Westpac put into place a very novel benefit – grandparent leave. This allowed employees a two-year sabbatical leave to take care of their grandchildren.
4 Provide an ergonomically friendly environment. This is particularly important for large portions of the healthcare sector since so much of it is a physical job. This can be done through machines and robotics, but also through minor interventions like stretching stations and new shoes that help people relieve the pressure on their feet. These strategies not only increase the lives of the oldest workers, but they really help get ahead of extending the working lives of younger employees too.

There exists this idea that there will be explosive growth, and suddenly, all these new young workers will come in and fill these jobs. That’s gone because population change, with decreased birth rates and replacement rates, is happening everywhere. Businesses will have to adapt to new demographic realities very soon. The future is already here.

What is extremely exciting is when you get an older, more diverse workplace within a company or health setting. All of a sudden, older workers working alongside younger workers can both impart wisdom and experience on both ends up and down, but also bring into the workplace a degree of empathy. Now, younger workers can see the challenges that the older workers are going through, which bleeds into product and service design. It’s really a win-win for everyone.

Dealing with cultural shifts

Dealing with cultural shift

HT: How can hospitals adapt to the Super Age era? How can healthcare leaders take away the fear from employees and approach their staff to get them ready for the change that is already happening?

Bradley Schurman: There’s always going to be fear. During any transformation, to some degree, there are winners and losers. If we know as leaders, as human resources execs in particular, that there are going to be certain departments that are going to be hit hardest by this transformation, we need to work with those people. We can help them get re-educated or re-skilled into what the new dynamic is going to look like.

It wasn’t long ago that we had men who’d walk up and down our streets and light the street lights at night. They were called lamplighters. But they haven’t been around for nearly 100 now. There are parts of healthcare that will likely become so antiquated that we won’t need them anymore. That doesn’t mean that we shouldn’t care about the folks that are working within our healthcare systems. It doesn’t mean that we shouldn’t consider them as part of our enterprise, or that we shouldn’t offer them other paths forward.

People are resistant to change in many industries, fighting against the future. But it does eventually come. Helping employees bridge that gap and get to the next step is a role in which hospital systems can really help people. While it’s a good thing to do, it doesn’t mean that everyone’s going to come on board. There are invariably people that are left behind in these changes. They’ll make their way eventually, but not everyone comes along during change.

Bradley Schurman is the Founder and CEO of The Super Age – a research and advisory firm specializing in helping organizations understand the challenges and harness the opportunities of demographic change with a focus on population aging. He is also the author of THE SUPER AGE: DECODING OUR DEMOGRAPHIC DESTINY. The Super Age works to ensure that these subjects are considered across organizational strategies from human resources, marketing and communication, and product and service design. Prior to launching The Super Age, Schurman was Co-Founder and Managing Partner of EconomyFour, where he led business development in Asia and Europe. Schurman has been instrumental in securing the topics of aging and longevity as focus areas at both the Organization for Economic Cooperation and Development (OECD) and World Economic Forum (WEF). He was also responsible for visioning and executing the Aging Readiness and Competitiveness Report- a groundbreaking collaborative research project between AARP and Foreign Policy Group. Schurman has been featured on NBC's TODAY Show and quoted in the New York Times, HuffingtonPost, and USA Today, as well as in local and national media outlets around the world. He speaks regularly at thought leader forums around the world, and has advised national governments and major businesses on their longevity strategies.

References

  1. Schurman B. (2022). The Super Age: Decoding Our Demographic Destiny. New York City: Harper Business
  2. Worldometer. (2020). Article available from https://www.worldometers.info/world-population/world-population-by-year/ [Accessed March 2022]
  3. Pollard K et al. (2014). Article available from https://www.prb.org/resources/just-how-many-baby-boomers-are-there/#:~:text=There%20were%20actually%20a%20total,leaving%20some%2065.2%20million%20survivors [Accessed March 2022]
  4. Yuen M. (2021). Article available from https://www.insiderintelligence.com/charts/united-states-population-by-generation/#:~:text=Baby%20boomers%20were%20the%20largest,people%20ages%2058%20to%2076. [Accessed March 2022]
  5. Brickier D. (2021). Article available from https://www.weforum.org/agenda/2021/06/birthrates-declining-globally-why-matters/ [Accessed March 2022]
  6. World Population Review. (2022). Article available from https://worldpopulationreview.com/country-rankings/total-fertility-rate [Accessed March 2022]
  7. Greenwood M. (2018). Article available from https://news.yale.edu/2018/11/13/health-costs-ageism-calculated-63-billion-annually-study-finds [Accessed March 2022]