Aging of the United States

Ongoing demographic trend

Population pyramid of the United States in 2022

In recent decades, the fertility rate of the United States has declined below replacement level, prompting projections of an aging population and workforce,[1][2] as is already happening elsewhere in the developed world and some developing countries.[3] Nevertheless, the rate of aging in the United States remains slower than that seen in many other countries,[4][5] including some developing ones,[3] giving the nation a significant competitive advantage.[6][7][8][9] Still, it remains unclear how population aging would affect the United States.

## History[edit]

The rate of population growth in the United States has fallen over the last few decades.

The birth rate in the United States has declined steadily since the beginning of the nineteenth century, when the average person had as many as seven children.[10] Americans of all ethnic groups and socioeconomic classes had fewer children towards the end of the nineteenth century.[11]

In a 1905 speech, President Theodore Roosevelt criticized Americans for having fewer children, and described the declining birth rate as a "race suicide" among Americans,[12] quoting eugenicist Edward Alsworth Ross.[13][14] During the 1930s, the Great Depression caused a substantial decrease in the birth rate, but this trend was reversed in the subsequent Baby Boomer generation,[15] thanks to highly favorable economic conditions.[16] Towards the end of the twentieth century, however, the prevalence of childlessness—voluntary and otherwise—increased.[16]

While U.S. fertility rates were roughly at replacement level during the 1990s and early 2000s, contrary to expectations, they never rebounded after the 2007-2009 Great Recession even though the U.S. economy had recovered.[17][18][19] During the second half of the 2010s, the rate of growth of the U.S. population was in steady decline.[20] Between the 2000s and 2020, all states except North Dakota saw a decline in fertility.[21] As of 2019, no states except North Dakota and Utah were at or above replacement fertility.[1] The 2020 Census reveals that the number of Americans aged five or younger is lower than in 2010.[22][23] More recently, the COVID-19 pandemic caused fertility to decline further,[15][24][25] a "bump" in 2021 notwithstanding,[26] while also increasing the death rate in the country.[27] At the same time, many women are choosing to delay childbearing or to forego having children altogether.[28][29] By 2022, the total fertility rate of the United States stood at 1.66.[30] The rate of population growth in the early 2020s was at a historic low, driven mainly by immigration.[31] Millennials are the most reluctant generation in history when it comes to reproduction.[32][33] Between 1990 and 2015, the number of married couples aged 18 to 34 with children dropped from 37% to 25%.[34] The number of American women who do not have children by the age of 30 has grown, breaking previous fertility trends where younger women made up the bulk of births. While only 10% of women were childless in 1976 at the end of their reproductive years, it is projected that 25% of those born in 1992 will reach the same benchmark in 2032.[35] Longitudinal analysis suggests that American women are not merely postponing having children but are increasingly avoiding it altogether.[5] However, among Millennial women who have given birth, the average fertility rate is about 2.02 children per woman.[33]

The United States is not aging as quickly as some other countries, such as Japan.

Regardless, U.S. birth rates have been on the decline across virtually all age groups, socioeconomic classes, and races since the late 2000s.[36] This trend could cause the general population of the country to age significantly in the future.[24] The oldest Baby Boomers, a large demographic cohort, had started to reach retirement age in the 2010s.[20] By the early 2020s, about one in six Americans are 65 or older.[37] In 2020, the median age of the United States is 38.8, up from 37.2 in 2010,[23] 35 in 2000, and 30 in 1980.[38] An increase in median age is seen among all ethnic groups, though European Americans are currently the oldest by that measure, followed by African Americans and Asian Americans (including Amerindians and Native Alaskans);[20] Hispanic and Latino Americans are the youngest.[23] Maine (median age 44.8) and New Hampshire (43.3) are the oldest states in the Union, while Texas (35.5), the District of Columbia (34.8), and Utah (31.9) are the youngest.[38]

In the modern world, it has become common for developed countries to fall below the replacement level of births or see population decline. Many of these countries have tried to launch government initiatives to combat this trend, including large cash incentives for having more children, but these programs have been largely ineffective.[39] Nevertheless, American women tend to have their first children at an earlier age and end up having more children than their counterparts from other developed countries even though the U.S. does not have social welfare programs that are as generous as other rich nations.[5][40]

Given 2020 demographic trends, it is projected that the U.S. population would grow slightly by 2100, while other countries, including China and India, would shrink.[3] However, the number of Americans aged 65 and over will exceed that of children below the age of 18, according the U.S. Census Bureau.[41]

## Causes[edit]

US birth rates from 1909 to 2008 showing the number of births per thousand people in the United States; the red segment is known as the Baby boom period (which coincided with the post–World War II economic expansion).

Population aging and falling birth rates in the U.S. is driven by a variety of factors, including increased access to birth control, growing awareness of the realities of parenthood (especially motherhood), and changing societal attitudes toward reproduction, resulting in lower fertility among modern Americans.[42][26][43] In the United States today, while the number of single parents has grown, most people still have children within wedlock.[44]

But even married couples are less likely to have children, at least not right away, as the childfree lifestyle continues to gain traction.[43] The number of unintentional pregnancies has decreased,[25][45] though the rate still stood at 45% in 2018.[46] Adolescent pregnancies, most of which are unintentional, also fell.[47] Compared to a peak of 96.3 births per 1000 females aged 15 to 19 in 1957, when people married and had children early, the adolescent birth rate plummeted to 17.3 in 2018.[48] (Black and Hispanic teenagers had the largest decline,[49] though they were still above whites and Asians.[48]) In 2022, it fell to 13.5, the lowest on record. An uptick in births among older women, especially those in their 40s, was only enough to keep the overall number of births in the United States approximately the same as before, close to 3.7 million.[50] Historically, the U.S. has had a high birth rate relative to other developed countries because of its anomalously high number of unintended pregnancies.[51] Twenty-first-century American youths are more likely to have access to effective and long-acting methods of contraception, such as an intrauterine device (IUD), and to be more cautious about sexual intercourse than their predecessors.[48][52]

While economic troubles and climate anxiety are commonly cited reasons,[53] data suggest they are not the primary factors behind falling fertility in the U.S. Rather, it is due to changing attitudes; today's young people, especially women, tend to prioritize and expect more from their careers and are less interested in having children.[54] According to the Pew Research Center, the number of non-parents aged 18 to 49 who do not expect to have any children has grown. Among them, a lack of interest in children, medical issues, and financial problems were the top reasons for their predictions.[55] Those who have children tend to do so later in life and they have fewer of them.[56]

As parenthood continues to lose its appeal, more and more Americans prefer their own careers, leisure time, savings, and personal freedom to having children and fewer consider children to be a source of happiness or fulfillment.[36][26][57] Among those with children, some have chosen not to have more either because they do not want them, because they would like to spend more time with the ones they already have, or because could not afford more children.[18][55] In fact, many admit that their financial circumstances would improve once their children leave the house and that they would be better off not having children.[26] Among those having fewer children than they would like, concerns over the state of the economy and personal financial security are common and many believe the cost of raising a child is too high.[18] More and more women are realizing that having children is an option they can ignore in favor of economic or educational opportunities; some worry that a woman's career might stall if she chooses to have children.[18][36][40] The number of American women earning university degrees has grown relative to men's since the late 2000s, coinciding with the long-term decline in birth rates.[36] Globally, gender equality is associated with lower fertility.[18]

In the early 2020s, as many as one in five American adults do not want to have children, with some reporting they had made their decision early on.[58][59] It remains unclear whether they would change their minds.[18] Data dating back to the 1980s show that this is part of a long-term trend, possibly starting with the Baby Boomers, who were the first cohort to begin questioning social norms on family formation. Furthermore, dedication to work and modern expectations of parents have increased the opportunity cost of having a child.[5][36] Because of the aforementioned reasons, the birth rates of women of all age groups (except those in their forties), races, and educational levels have fallen.[54] The number of European Americans has been shrinking since 2016 while the rates of growth of people of other races have fallen as well, except for those of mixed heritage. Overall, the fall of the European-American and youth populations is the biggest factor behind the aging of the United States. But this trend is moderated by the growth of non-white ethnic groups.[20]

Another major cause of population aging in the United States is the fact that the Baby Boomers, a large cohort, are getting older, adding a large group of older Americans to the population and causing the median age to move up. Although many Baby Boomers began reaching retirement age in the early 2010s, many of this cohort's youngest members are still several years away from retirement and remain successfully employed or are eligible for and seeking new jobs.[4][60]

## Impacts[edit]

Recent research studies have documented that between 50% and 80% percent of Americans aged 50 or older have personally experienced or witnessed at least one episode of age discrimination in the workplace, with roughly 20% excluded from hiring or promotion and nearly 10% terminated from their jobs due to their age, despite federal and state protections for workers over the age of 40.[61][62][63]

By 2030, 20% of Americans are projected to be 65 and older.[64] Both the overall population of the country and the average age are projected to increase over coming years. Given that older people tend to need more health services, some demographers have theorized a significant impact on the country resulting from these trends.[27] Population aging could create an increasing need for services such as nursing homes and care-giving.[27]

### Economy[edit]

U.S. labor participation by sex from January 1948 to present

U.S. labor participation by age group 1948 to present

Job openings per unemployed worker from 2001 to present

U.S. producer price index from 2005 to 2022

Population aging accelerates industrial automation

A shortage of workers is expected in the U.S. workforce due to a declining labor participation rate. Projections show that the demand for labor needed now is not being fulfilled, and the gap between labor needed and labor available will continue to expand over the future.[65][66] Owing to the relatively large size population size of those born between the end of WWII and the mid-1960s (referred to by some as the "Baby Boomers"), the number of people generally considered to be of working age is declining.[65][66] The retirement of members of the aging workforce could possibly result in the shortage of skilled labor in the future.[67][68] A majority of experienced utility workers and hospital caregivers, for example, will be eligible for retirement.[68]

By the late 2010s, the United States found itself facing a shortage of tradespeople,[69][70] a problem that persisted in the early 2020s despite the COVID-19 pandemic-induced recession and prospective employers offering higher salaries and paid training.[71] Having an aging population accelerates industrial automation.[72][73] Experts expect the labor crunch of the early 2020s to continue for years to come, due to not just the Great Resignation, but also the aging of the U.S. population,[74] the decline of the labor participation rate,[75] and falling rates of legal immigration.[75] During the Great Recession, population aging alone cost the United States 1.7 million workers, reckoned the Peterson Institute for International Economics.[76]

From a demographic point of view, the labor shortage in the United States during the 2020s is inevitable due to the sheer size of the aging baby boomers.[77][78] As the oldest economically active cohort,[78] the baby boomers comprised about a quarter of the U.S. workforce in 2018.[79] Though they were projected by economists to begin retiring in the 2010s,[77] 29% of older (65–72 years of age) baby boomers in the United States remained active in the labor force in 2018, a large portion compared to older cohorts at the same age.[80] Employment rates among workers aged 65 and over are increasing since the 1990s,[81][82] and, indeed, the share of people who continue working after turning 65 is relatively high in the US, when compared to other developed countries.[83] Seniors who choose to remain in the workforce tend to be highly educated and high-income earners. At the same time, technological innovations have made work more convenient, safer, and less physically demanding for (older) workers.[82] In any case, the official age of retirement in the United States had already been raised, and Baby boomers were incentivized to postpone retirement in part because it allowed them to claim more Social Security benefits once they finally retired.[80] Furthermore, large numbers would like semi-retirement arrangements or flexible work schedules.[84] There is an ongoing shift away from pension plans in favor of 401(k) or similar options, which do not mandate retirement at a certain age.[82]

The COVID-19 pandemic however, may have sped up the retirement of some baby boomers.[85] The Pew Research Center reported that the number of baby boomers in retirement had increased by 3.2 million in 2020, the largest annual increase in the previous decade.[85] But even before the pandemic, the United States had a gap between the number of job openings and the number of unemployed people.[86][75] Like most other members of the Organization for Economic Cooperation and Development (OECD), the U.S. has seen its productivity growth falter and its debt as a share of GDP increase due to demographic trends.[87] Having an aging population and a labor shortage makes it more difficult to curb inflation.[88]

A shrinking birth rate could exacerbate economic inequality by increasing the importance of family inheritance,[89] while an overall decrease in the population could shrink the economy by reducing the demand for basic goods like groceries and real estate.[90][91] On the other hand, having fewer or no children has enabled women to pursue more opportunities outside the home.[5] In fact, places with the highest job growths in the 2010s saw the biggest drops in fertility. For women in such places, the opportunity cost of having a child was higher.[36] Moreover, people without children do not need to save money to pass on to their children and as such can afford to work fewer hours per week and retire early.[92]

Nevertheless, unlike their counterparts in many other countries East and West, American Baby Boomers had many children of their own, the Millennials, who are a large cohort relative to the nation's population and are themselves having a relatively high birth rate, as of the 2010s.[93] Millennials and Generation Z have been responsible for a surge in labor participation in the U.S. as the same time as the contraction of the workforce of major economies.[94] Indeed, the U.S. workforce is projected to grow by 10% by 2040,[7] and should not decline before 2048.[95] However, young people are spending more time in education and training and are entering the workforce at a later age. A loss in skilled and capable workers has made it harder for employers to recruit new staff.[96] As of 2023-2024, there are not enough younger people to replace the retiring Baby Boomers in the American workforce. As a result, state legislatures across the country are focused retaining the workers they already have and to attract new ones from other states, especially in the education and healthcare sectors.[97]

Having a relatively young, diligent, and productive workforce means that the United States will continue to have a significant number of consumers, investors and taxpayers in the upcoming decades. This gives the nation an economic edge over others.[9][93] As of 2022, despite demographic trends, most U.S. states were in a fiscally healthy position; some even had budget surpluses.[21] However, a sustained sub-replacement fertility and low rates of migration will lead to an aging population, a potential indicator that the U.S. economy could be less dynamic, innovative, and productive than it was in the past.[91][2] By 2023, shortages of highly skilled workers are already jeopardizing the Joe Biden administration's plan to modernize public infrastructure and to rejuvenate the manufacturing sector.[98] In addition, some women could make the decision to give up working in order to take care of their family members, exacerbating the labor shortage.[99]

### Education[edit]

See also: Higher education bubble in the United States

Population pyramid of the United States from 2000 to projections up to 2100

By the early 2020s, enrollment in K-12 public schools has fallen, partly due to the switch to private schools and home schooling, but also due to a smaller number of school-aged children (5-17).[100]

In the 1970s, American colleges and universities saw a dramatic increase in enrollments due to the post-war baby boom and the growth of women in higher education and the work force. By the 1980s and 1990s, although the baby boom had long ended, institutions continued to enjoy good fortune due to growing demand. But this all changed in the aftermath of the Great Recession, which saw significant cuts in funding for education and falling birth rates.[101] Due to declining birth rates, the number of American high-school graduates is expected to drop after 2025, putting more pressure on institutions of higher learning at a time when many have already been permanently shut down.[102][103] The decline of college enrollment is projected to accelerate in the 2030s.[104] Many private colleges will not survive.[17] Public universities are struggling to convince state and local governments to keep funding them[17] and have downsized or merged to curb costs.[105] Demand for education from the nation's top 100 colleges and universities, however, is likely to remain high, in part because of rising numbers of Indian and Chinese Americans, for whom higher education is of utmost importance.[17] In any case, market trends are forcing the higher-education sector to innovate, which is something it has not traditionally been good at.[105] To survive, non-elite institutions will have to cut back or eliminate courses in the liberal arts and humanities, like gender studies,[106] and expand those in emerging fields, such as artificial intelligence,[107] and professional programs, such as law enforcement.[17] They might even have to lower their standards of admissions.[104] Some are also addressing untapped demands, such as mid-career training or continuing education.[105] In addition, Americans who work in higher education are older on average than the average American worker. In the future, this sector of the economy will need to find ways to retain staff or to encourage retirees to come back (part-time).[108]

There is some research supporting the idea that in well-educated countries, it might actually benefit the population to have a birth rate below replacement levels because people at different ages do not make the same level of economic contributions on average.[109] In the United States, birth rates among teenagers and the lower classes continues to fall, while women with higher incomes and higher education are having more children.[105]

### Environment[edit]

Carbon emissions reduction due to various lifestyle choices

Some demographers have suggested that a declining birth rate may have net positive effects on the country.[110] Many environmentalists see this trend more optimistically because it could help combat the perceived problem of overpopulation. The world population is expected to reach almost 10 billion by the year 2050, which could pose a burden to Earth's natural resources.[111]

Having fewer children has been shown to be an effective way to reduce environmental impact through reduced carbon footprint and higher populations could increase the effects of climate change in the future.[112][113] Having an expanding population of people who live longer and are wealthier may not be sustainable.[40] Though the details remain debated, in the 2020s, growing numbers of couples have cited climate change as a reason for having fewer or not having children at all.[114][53] However, personal independence remains the top reason.[115]

### Geopolitics[edit]

See also: Cold War II and Pax Americana

Many of America's allies—Canada, the United Kingdom, the European Union, Japan, South Korea, Australia, and New Zealand—are themselves aging.[8][95] For that reason, they would struggle to finance their own defense and would become even more dependent on the United States at a time when U.S. demographic advantage is fading.[8] Indeed, while the U.S. maintained a fertility advantage over other developed nations during the 1990s and 2000s, this edge faded away during the 2010s.[116]

To combat this problem, the U.S. needs to improve ties with emerging economies, such as the Philippines, Indonesia, and India,[8] though some of these countries are already in the process of transitioning towards an aging society.[117] The combined GDP of the United States and its allies has shrunk from 77% of the global economy in 2002 to just 56% in 2021, and this trend will likely continue.[95] Furthermore, an aging population will reduce the ability of the United States to participate in global affairs the way it once did.[6]

Nevertheless, because the United States is aging more slowly than any one of its main rivals, it will have an advantage in any future geopolitical contests.[93][118] Given current demographic trends, it is unlikely that the United States will lose its dominant position to China and Russia.[118][8]

China has a low fertility rate compared to the United States.[7] China's median age is expected to exceed America's by around 2020[119][needs update] and the Chinese population has already begun to decline since 2022.[120] China's number of people over 65 as a share of the population is predicted to exceed that of the United States by around 2035.[121] Furthermore, the United States has an advantage that China lacks—immigration. While the U.S. remains an attractive place for immigrants, very few would like to move to China.[7][121] In fact, projections of China's economic growth from the early 2020s taking into account China's population aging, among other problems facing the nation, tend to delay the date at which China's economy will surpass America's. Even if China were to overtake the United States, the latter would soon reclaim its position.[122][123][124]

By one estimate, China's rate of GDP growth will be below America's by the 2030s because its dependency ratio will exceed America's.[95] On one hand, China's demographic decline relative to the U.S. could prompt it to undertake more risky actions, for example with regards to the issue of Taiwanese independence.[125][126] On the other hand, continued U.S. superiority might deter adversaries from taking military actions against either the U.S. or its allies.[118] A "geriatric peace" might be at hand,[6] as the graying powers have an incentive to cooperate in order to maintain the global order before their demographic realities prevent them from doing so.[95]

### Occupational safety[edit]

Because of the many older adults opting to remain in the U.S. workforce, many studies have been done to investigate whether the older workers are at greater risk of occupational injury than their younger counterparts. Due to the physical declines associated with aging, older adults tend to exhibit losses in eyesight, hearing and physical strength.[68] Data shows that older adults have low overall injury rates compared to all age groups, but are more likely to suffer from fatal and more severe occupational injuries.[68][127] Of all fatal occupational injuries in 2005, older workers accounted for 26.4%, despite only comprising 16.4% of the workforce at the time.[127] Age increases in fatality rates in occupational injury are more pronounced for workers over the age of 65.[127] The return to work for older workers is also extended; older workers experience a greater median number of lost work days and longer recovery times than younger workers.[127] Some common occupational injuries and illnesses for older workers include arthritis[128] and fractures.[129] Among older workers, hip fractures are a large concern, given the severity of these injuries.[129]

### Social welfare and healthcare[edit]

Unlike in the past, senior Americans in the twenty-first century generally expect to work after turning 65.

An aging population has implications for social-welfare programs.[4] The U.S. federal social security system functions through collecting payroll taxes to support older citizens.[68] It is possible that a smaller workforce, coupled with increased numbers of longer-living elderly, may have a negative impact on the social security system. The Social Security Administration (SSA) estimates that the dependency ratio (people ages 65+ divided by people ages 20–64) in 2080 will be over 40%, compared to the 20% in 2005.[68] SSA data shows one out of every four 65-year-olds today will live past the age of 90, while one out of 10 will live past 95. Indeed, 60% of baby boomers are more worried about outliving their savings than dying.[130] Rising life expectancy may result in reductions in social security benefits, devaluing private and public pension programs.[68][131] Were there to be a reduction or elimination of programs such as social security and Medicare, many may need delay retirement and to continue working.[128] In 2018, 29% of Americans aged 65–72 remained active in the labor force, according to the Pew Research Center, as Americans generally expect to continue to work after turning 65. The baby boomers who chose to remain in the work force after the age of 65 tended to be university graduates, whites, and urban residents. That the boomers maintained a relatively high labor participation rate made economic sense because the longer they postpone retirement, the more Social Security benefits they could claim, once they finally retire.[132] However, given current trends (2023), U.S. federal expenditure on programs for the elderly will equal spending on education, research and development, transportation, and national defense combined by 2033. This compounds the problem of soaring public debt.[133]

By 2030, 20% of Americans are predicted to be past the age of retirement, which could pose a burden to the healthcare system. Older and retired people tend to need more health services, which must be provided by their younger counterparts, so some demographers have theorized that this could have a negative impact on the country.[27] Arthritis, cancer, diabetes, obesity, and cognitive issues are among the most common issues faced by Americans over the age of 65.[37] Older adults who have worked in the construction industry have shown high rates of chronic diseases.[131][134] Experts suggest that the number of geriatricians will have to triple to meet the demands of the rising elderly.[135] Demand for other healthcare professionals, such as nurses, occupational therapists, physical therapists and dentists is also projected to rise,[135] as well as for common geriatric healthcare needs, such as medications, joint replacements and cardiovascular operations.[135] Between 1966 and 2023, the number of people qualified for Medicare tripled to nearly 65 million, with 10 million seniors and disabled people being added to the system from 2013 to 2023.[136] In the early 2020s, among Americans aged 65 or older, 14% of all expenditures goes to healthcare, compared to 8% for the general population.[37] While some enjoy living by themselves, others suffer from physical or mental health issues being socially isolated.[137]

Between the late 2010s and early 2020s, Millennials and Generation Z joined the workforce in large numbers, allowing the U.S. to maintain a relatively large tax base, alleviating concerns over the financial sustainability of various social-welfare programs.[94] Furthermore, because American welfare programs are less generous than Europe's, they are also less vulnerable to demographic shifts.[76] Nevertheless, in 2023, both Medicare and Social Security as they stand are projected to run out of funds by the late 2020s and mid-2030s, respectively.[136] With the Inflation Reduction Act of 2022, the Joe Biden administration sought to curb the cost of medical care by allowing Medicare to negotiate lower costs for certain drugs and treatments, such as insulin.[136]

### Society[edit]

Population aging can potentially change American society as a whole. Many companies use a system, in which older, tenured workers get raises and benefits over time, eventually hitting retirement.[138] With larger numbers of older workers in the workforce, this model might be unsustainable. In addition, perceptions of older adults in society will change, as the elderly are living longer lives and more active than before.[135][139] Changing from a youth-focused culture to having a more positive attitude towards aging and being more respectful of seniors like Japan can help elderly Americans extend their life span and live out their sunset years in dignity. American society will have to confront the negative stereotypes of aging and ageism.[139] In order to win elections, politicians will have to be more attentive towards the elderly.[140]

In his work on elite overproduction, social scientist Peter Turchin notes that because given U.S. demographic realities, the youth bulge would likely not fade away before the 2020s, making this time period prone to sociopolitical turbulence.[141]

## Proposed solutions[edit]

Cities could make themselves friendlier towards the elderly by improving their mass transit networks.

Maintaining an active mind contributes towards healthy aging.

Investing in human capital could help offset population aging.

A number of solutions have been proposed to address the problems caused by an aging population. Investing in technological and human-capital development in order to enhance productivity might help the United States offset some of the economic effects of population aging.[5][30] Raising the retirement age, further automation, and encouraging higher labor participation rates among women could help alleviate the labor shortage, with the latter successfully done in Japan in the 2010s.[116] Policies aimed at raising workforce participation among those of prime working age in general is another potential solution,[76] as are giving older people incentives to continue working in appropriate sectors where there is a labor shortage, such as teaching,[41] and recruiting former convicts.[142] Cities could render themselves friendlier towards the elderly, for example by improving public transit,[143] promoting healthy lifestyle choices (physical activities, learning, and social engagement), adding green spaces and recreational facilities.[41] Initiatives such as communal grandparenting programs, found in Finland, could help engage the elderly on one hand and help young people on the other.[41] In Southeast Asia, self-help clubs offer seniors opportunities for friendship and social activities.[41] In Zimbabwe, the elderly are recruit to help younger people handle mental-health issues. (Those with serious problems are referred to professionals.)[41] To deal with the increased demand that could be placed on the healthcare system, telehealth and virtual health monitoring has arisen as a way to help support a larger population of older adults.[144][41] The Congressional Budget Office (CBO) has proposed 60 different policy options on how to save billions of dollars on Medicare, such as raising monthly premiums. As of 2023, members of Congress are considering various options to salvage Medicare and Social Security, such as addressing fraud in the Medicare Advantage program and raising the ages of legibility for Medicare and Social Security.[136] Unfortunately, neither raising taxes nor cutting services is politically palatable, something both major parties have learned from experience. Meanwhile, public debt continues to grow, reaching 250% of GDP by mid-century, according to a 2023 projection by the CBO. That year, it stands at 117% of GDP.[133] As has already been done in a number of European countries, the United States could streamline the process of tracking retirement savings, or 401(k).[41] In Japan, a national long-term-care insurance policy was introduced in 2000.[41]

Alternatively, some people have advocated for offering more paid parental leave and child care, thereby encouraging people to have more children.[90] These policies have already been employed in other areas of the world, but with limited results at best.[116] In some countries such as Germany and Czech Republic they successfully raised the birth rate,[145] but not enough to reach replacement level and at a significant cost.[5] On the other hand, such policies failed in Finland,[146] Singapore,[147] Taiwan,[148] Japan, and South Korea.[149] It is unlikely that similarly pro-natalist policies would work in the U.S.,[54] which maintains a relative high fertility rate despite not having social welfare programs that are as generous as some other developed countries.[5]

Some have argued that reduced immigration will have a larger impact on population growth than the declining birth rate.[150] Immigration has historically been a source of growth for the US, and some have suggested that it could slow or reverse the trend of population aging or decline.[151] However, studies have shown that immigrants from countries with high-fertility rates often have fewer children when they immigrate to a country where small families are the norm,[152] and this patterns also holds in the U.S.[19] It has also been shown that low-birth rates[153] and sudden increases in immigration often lead to increased levels of populism and xenophobia.[154] Arguments in favor of increasing immigration to combat declining population levels have sparked outcry from some right-wing political factions in the United States and some European countries.[2][155][156] In the United States, past episodes of domestic turmoil have led to moratoriums on immigration.[8] Furthermore, critics argue that the United States today struggles to integrate the various different ethnic groups already living in the country alongside new immigrants. Political scientist Robert Putnam argues that ethnic and cultural diversity has its downsides in the form of declining cultural capital, falling civic participation, lower general social trust, and greater social fragmentation.[157] Since 1996, there have been numerous failed attempts to introduce comprehensive immigration reforms,[121] and while many continue to view immigration as a net benefit to the nation, the American people remain mixed on whether or not they support more immigration in general.[158] Mass migration is politically problematic.[2] Still, high-skilled immigration, the type of immigration that tends to expand the tax base the most, as has been done in Canada, can help.[116] In fact, the U.S. currently faces a shortage of high-skilled workers in STEM, and foreign talents must navigate difficult hurdles in order to immigrate. Meanwhile, some other countries, such as Canada and the United Kingdom, have introduced programs to attract talents at the expense of the United States.[159]

Some states have relaxed restriction on child labor, but, like immigration, this has proven to be controversial.[142]

## See also[edit]

* Economics portal
* Society portal
* United States portal

* Aging of Australia
* Aging of Europe
* Aging of China
* Aging of Japan
* Aging of South Korea

## References[edit]

1. ^ a b Howard, Jacqueline (January 10, 2019). "US fertility rate is below level needed to replace population, study says". CNN. Retrieved May 6, 2023.
2. ^ a b c d Smith, Noah (May 5, 2021). "Why America's Population Advantage Has Evaporated". Bloomberg. Archived from the original on July 10, 2022. Retrieved April 9, 2023.
3. ^ a b c Gallagher, James (July 15, 2020). "Fertility rate: 'Jaw-dropping' global crash in children being born". BBC. Retrieved April 17, 2023.
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## Further reading[edit]

* Wells, Robert V. (1971). "Family Size and Fertility Control in Eighteenth-Century America: A Study of Quaker Families". Population Studies. Taylor & Francis. 25 (1): 73–82. doi:10.2307/2172749. JSTOR 2172749. PMID 11630442.
* Haines, Michael R. (1994). "The Population of the United States, 1790–1920" (PDF). Historical Working Paper (56). National Bureau of Economic Research. doi:10.3386/h0056. S2CID 129876349. SSRN 190393. Retrieved March 17, 2020. `{{cite journal}}`: Cite journal requires `|journal=` (help)
* Purvis, Thomas L. (1995). Balkin, Richard (ed.). Revolutionary America 1763 to 1800. New York: Facts on File. pp. 123–183. ISBN 978-0816025282.
* Shifflett, Crandall (1996). Balkin, Richard (ed.). Victorian America 1876 to 1913. New York: Facts on File. pp. 73–83. ISBN 978-0816025312.
* Purvis, Thomas L. (1999). Balkin, Richard (ed.). Colonial America to 1763. New York: Facts on File. pp. 128–167. ISBN 978-0816025275.
* Selcer, Richard F. (2006). Balkin, Richard (ed.). Civil War America 1850 to 1875. New York: Facts on File. pp. 114–141. ISBN 978-0816038671.
* Bailey, Martha; Hershbein, Brad J. (2015). "U.S. Fertility Rates and Childbearing, 1800 to 2010" (PDF). University of Michigan. Retrieved March 17, 2020. `{{cite journal}}`: Cite journal requires `|journal=` (help)
* Cain, Louis P.; Fishback, Price V.; Rhode, Paul W., eds. (2018). The Oxford Handbook of American Economic History, Volume 1. New York: Oxford University Press. ISBN 978-0190882617.