Growing Old In The United States Is Not For Sissies

There seems to be a notion floating around that elders in Europe and parts of Asia have access to services we do not have here, that we in the United States have overlooked our older citizens’ welfare and happiness where other developed countries have systems and services we do not. Is that the case? Maybe.

Finding answers to questions about wellbeing of elders is, interestingly, quite tricky. If we witness older adults who appear to be happy and thriving in their land, to what do we attribute that goodness? On the other hand, if we witness elders dying early, going hungry, or seemingly homeless, who or what is to blame?

The Familial and Cultural perspective

One can see clear evidence that values and norms play a huge role in how older people are treated in different areas of the world, but in some areas even that is changing. 

In Korea, it is a child’s duty, and an honorable one, to tend to their aging parents. The 60th and 70th birthdays are special and are typically celebrated with large family gatherings. In Japan, as well, filial piety, a Confucian principle, is expected of children. In India, elders are the head of the family and many Indians live in multigenerational households. In every part of Asia, to abandon one’s family is considered deeply dishonorable. 

However, In China, traditional values are apparently breaking down. In recent decades of rapid industrialization, younger people have been forced or enticed to leave their rural homes for urban areas where jobs are more prevalent and pay better.  But after establishing themselves in the cities, marrying, and starting families, many have found it difficult to embark on frequent trips to tend to their aging parents in far-flung rural villages. The government has taken notice and now places harsh penalties­–large fines to jail time–on those who neglect their parents. In China today, tradition no longer dictates how elders are treated by their offspring; it’s now the law.


Interestingly, France enacted a law protecting its older citizens as well. It is the only country in the western hemisphere to do so and it came about as a reaction to a statistic and a grisly event.  Sometime in the early 2000s, a report on elder suicide was released which named France has having the highest rate of pensioner suicides in Europe. Shortly thereafter, a heat wave killed 15,000 people in France, most of them elderly.  Some were not found until weeks after the event.

In southern Europe, with its Latin culture and Mediterranean influences, multiple generations sharing a home is a common sight. Typically, the oldest generation assists in caring for the youngest, while the middle generation serves as the breadwinners, usually laboring outside the home. In Greece, old age is honored and celebrated (a la Zorba the Greek).

By contrast, the United States and the U.K. tend to be youth-oriented, honoring attributes like independence, individualism, and hard work. The oldest generation in those cultures often get short shrift. 

Social Services Perspective

Looking at the welfare of older adults from an economic and health perspective turns up some very different answers.  In a 2020 global study, 105 countries were assessed in an effort to rank-order them from best to worst for older adults. In total, these countries represented more than 92% of the world’s population of those over 60 years of age. 

The rankings were based on a study of a wide range of reports and publications, as well as information from specific city sites.   The scores took into consideration how well a country performed in the following categories:

  • Average life expectancy
  • Health care 
  • Safety 
  • Happiness 
  • Cost of living
  • Property prices 
  • Pension starting age

According to this study, Finland is the best country in the world for older people. Denmark and the Netherlands came in second and third, followed by Switzerland, Australia, Austria, Canada, Norway, New Zealand and Spain, in that order. At the bottom of the chart was Iraq, preceded by Kenya, Ukraine, Venezuela, Cambodia, Nigeria, Iran, Egypt, Namibia, and the Dominican Republic.

One of the reasons many northern European countries came out ahead in the study above is that they tax their citizens at a much higher rate than the U.S. and much of that money is spent on services and safeguards for their citizens. The result is less disparity between the wealthiest citizens and the poorest.  Countries whose citizens are willing to take home less of what they earn during their working lives are passively funding a much more secure and comfortable existence when they are old.

So, where is the U.S. in this milieu? The United States was ranked at number 28, behind many other highly developed and wealthy countries. It certainly didn’t rank among the best countries from a health and social services perspective, even though we are among the wealthiest countries in the world, so it seems to come down to a combination of family values and culture along with wealth. In the U.S., people with money can (literally) pay for their own or a loved one’s safety and wellbeing. Elder care here is predominantly private pay. 

Because we don’t have a system like the Scandinavian countries, we will need to continue to rely on families to take care of their own older members. Judging by the increasing numbers of homeless older adults, it may appear that we are failing at that already.  More worrisome yet is the fast-increasing number of solo agers–elders who have no familial ties to rely on. How will we meet this impending crisis as a nation? The answer is more elusive than a chimera.

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