Plenary 2

Democracy and the demographic transition

Organised by the European Health Forum Gastein

Europe is entering an era of profound demographic change that will bring a range of societal and political opportunities and challenges. New highs in life expectancy coupled with changing fertility patterns will mean a rapid expansion in the number and share of older people in the population, resulting in societies where there will be fewer working-age people for every retired person, and thus fewer taxpayers to fund public services and state pensions. We will be living longer but not necessarily healthier lives, meaning more health and social care will be required – but who will provide it given that we are already seeing high rates of attrition and dissatisfaction in public services, especially in the healthcare workforce? One option is to improve the working-age-to-retired ratio through higher levels of immigration, but this is not a simple solution, raising numerous ethical and practical questions. Young people will be particularly impacted: they may be compelled to remain employed longer as the ages of eligibility for state pensions rise, to pay higher taxes to fund under-resourced public services, and perhaps to take specific career paths where there are shortages of human labour. Much will depend on our greater adoption of healthy behaviours, a life course approach to health and well-being, and policies to realise the green transition and healthier environments, so that we are living longer actively and in good health. The extent to which medical advances, Artificial Intelligence (AI) and other digital technologies can support us will also be key. Our second plenary will host an inter-generational discussion that will probe some of these multi-faceted issues and consider the implications for health, democracy and intergenerational relations in light of major demographic shifts.