Cover

CONTENTS

EXECUTIVE SUMMARY

INTRODUCTION

LONG-TERM TRENDS: THE PROSPECT OF AGING, SHRINKING POPULATIONS, AND HIGHER AGE-RELATED EXPENDITURE

THE IMPACT OF DEMOGRAPHIC UNCERTAINTY ON FISCAL SUSTAINABILITY

A. Fertility

B. Mortality

C. Migration

POLICY OPTIONS TO ADDRESS THE FISCAL CHALLENGE OF SHRINKING POPULATIONS

A. Policies that Affect Demographics and Labor Markets

B. Reforms to Age-Related Spending Programs

CONCLUSIONS

APPENDICES

1. The Impact of Population on Economic Growth

2. The Impact of Growth on Fiscal Sustainability

3. United Nation Population Projections—Main Assumptions

4. Supplementary Figures and Tables

REFERENCES

BOXES

1. Impact of Demographic Changes on Pension and Health Care Expenditure

2. The Economic Impact of Migration

FIGURES

1. Countries with Declining Population, 2015–2100

2. Old Age Dependency Ratio, 2015–2100

3. Birth and Mortality Rates by Vintage of Projections, 1960–2015

4. Fertility Rate, 1955–2100

5. Crude Mortality Rate, 1950–2100

6. Net Migration Rate, 1950–2100

TABLES

1. Global Public Expenditure on Age Related Programs, Baseline Scenario 2015–2100

2. Impact of Demographic Uncertainty on Aging and Age-Related Programs for the More and Less Developed Economies, 2015–2100

3. Impact of Selected Policy Options on Aging and Age Related Programs for the More Developed Economies, 2015–2100

4. Impact of Selected Policy Options on Aging and Age Related Programs for the Less Developed Economies, 2015–2100