What is the strongest predictor of health and happiness in old age? A growing body of research suggests the answer is good relationships. These are relationships that impart a sense of purpose and meaningful connection—with each other and with society.
A recent McKinsey Health Institute (MHI) survey of adults aged 55 and older across 21 countries bears out those findings. It found that having purpose in life and meaningful connections with others were among the most important factors bolstering the health of older adults around the world.1 Respondents frequently cited personal fulfillment and social connection as primary motivators for working or volunteering. What were also deemed important were lifelong learning and participation in community organizations or activities.
These findings all align with the concept of “societal participation,” defined by MHI as “consistent involvement in deliberate activities that lead to meaningful engagement with one’s society and community.” This covers activities that older adults can pursue in their communities such as working, volunteering, pursuing lifelong learning, or participating in community activities.2 Through these activities, older adults can fulfill many of the factors that influence their health—from finding purpose to connecting with others and staying active.
The topic of societal participation is becoming increasingly relevant at both global and local levels and is frequently discussed as a core component for healthy aging agendas. The UN Decade of Healthy Ageing lists “ability to contribute to society” as one of its five functional ability domains required for healthy aging.3 Similarly, the National Academy of Medicine’s Global roadmap for healthy longevity outlines eight long-term goals to aspire toward, four of which relate to enabling societal participation of older adults.4
By 2050, the number of people over the age of 65 is expected to grow from 9.4 to 16.5 percent of the world’s total population.5 At the local level, rural-urban divides will increasingly present countries with the challenge of balancing equitable aging experiences.6 Solving for societal participation in our local cities and communities will be essential for building a future society where healthy aging flourishes—no matter where someone lives.
Why does societal participation matter?
Societal participation can be good for older-adult health. Among MHI survey respondents, those who participated in societal activities had a 4 to 8 percent uplift in overall perceived health compared with those who didn’t participate but wanted to. This finding aligns with existing literature. MHI analyzed more than 70 recent, peer-reviewed academic studies on the societal participation of older adults and found six thematic health benefits: reduced mortality rates; reduced cognitive disability; less functional disability and frailty; decreased loneliness and depression; increased physical activity levels, and enhanced meaning and quality of life.
Some of the strongest evidence to date comes from the decades-long Harvard Study of Adult Development. “The people who were the happiest, who stayed the healthiest as they grew old, and who lived the longest were the people who had the warmest connections with other people,” said Robert Waldinger, director of the Harvard study and author of The Good Life: Lessons from the World’s Longest Scientific Study of Happiness (Simon & Schuster, January 2023) in an interview for McKinsey’s Author Talks series. “In fact,” he said, “good relationships were the strongest predictor of who was going to be happy and healthy as they grew old.”
In addition to strong relationships and sense of purpose—priceless commodities in and of themselves—there is an economic benefit to societal participation. MHI estimates an almost US $6.2 trillion7 annual GDP opportunity across the 21 countries surveyed in our Global Healthy Aging Survey. This equates to an average uplift of approximately 8 percent if we could enable older adults who said they want to work but aren’t working to reenter the workforce. For the United States alone, this translates into a US $1.7 trillion opportunity (or 7.2 percent of 2021 GDP).8 The potential impact on national economies could be substantial (Exhibit 1a and Table 1b).9 And this is not even taking into account the contributions of older workers today—21 percent of the total workforce in higher-income economies today consist of workers aged 55 and older.10
Table 1b. Key drivers of GDP uplift
|Labor share of GDP
|% of labor force aged 55+
|% of population aged 55+ who want to work and aren’t
The MHI survey results also estimate that the 55-and-older population contributed almost 73 billion hours of volunteering across the countries sampled. Addressing the unmet demand for volunteering could potentially add more than 103 billion hours per year to this figure. Of that, almost 70 percent of this potential would be from China and India alone (Exhibits 2a and Table 2b).11
Table 2b. Key drivers of volunteering opportunities
|Current population volunteers aged 55+
|Volunteer hours/week of age 55+ volunteers
|% of those aged 55+ who want to volunteer and aren’t
While the size and distribution of these opportunities vary widely across countries—and our analysis only captures the opportunity from surveyed countries—the economic potential of the societal participation of older adults is without question. Beyond employment and volunteering, increased societal participation of older adults can also lead to better social harmony through improved intergenerational cohesion and inclusion of the voices of older adults in political discourse.12
There is a clear imperative to understand what barriers are inhibiting societal participation (including work), such as whether accessibility is a problem.
Barriers to societal participation
The MHI Global Healthy Aging Survey identified “difficulty landing a job” (49 to 66 percent of respondents) and “lack of attractive opportunities” (39 to 54 percent) as the most commonly cited barriers older adults faced when seeking employment.13 For those seeking volunteering opportunities, the most commonly cited barriers were “lack of attractive opportunities” (33 to 44 percent of respondents) and “health concerns” (16 to 40 percent). In addition to these findings, MHI’s literature review identified several societal barriers and misconceptions impeding progress for older adults seeking opportunities to get involved:
1. Outdated beliefs on age
One of the challenges is the ageist attitudes that assume old age is linked to a poorer ability to function effectively.14 Despite older people being healthier and more educated than ever before, these outdated beliefs can often lead to unfair biases against older adults seeking opportunities to participate.15 Prepandemic data in the United Kingdom, for example, shows that only 35 percent of workers aged 50 and older made redundant are employed again within three months—the worst percentage of any age group.16
2. Isolated efforts across sectors
Stakeholders implementing interventions for the societal participation of older adults often don’t consider the needs of other sectors involved. Some governments, for example, subsidize the wages of older workers to incentivize hiring of older job seekers, but one global survey found that wage subsidies were far less attractive to hiring managers than other interventions such as well-known industry certifications or attendance at highly reputable employment programs.17 A lack of coordination across sectors can mean well-intended efforts fall short of expectations.
3. Inequitable access to opportunities
Inequities left unaddressed can compound throughout a person’s life, diminishing access to quality societal-participation opportunities at old age. Women, for example, still lag behind men in literacy rates in lower-middle-income economies (54 percent vs 69 percent in lower-income economies and 70 percent vs 83 percent in lower-middle-income economies), which can prevent access to opportunities such as obtaining quality employment.18 This often means those older adults who could benefit most from high-quality societal-participation opportunities are missing out.
4. Gaps in structural support
While some countries have formal policies that promote the societal participation of older adults (for example, prohibiting use of mandatory retirement among employers), only 63 percent of UN member states have national legislation and enforcement strategies against age-based discrimination.19 The absence of these government policies and programs may preclude other sectors such as education from implementing their own (for example, providing older adults the opportunity to audit university courses without pursuing a degree).
5. Gaps in data
Three-quarters of the world’s countries have limited or no comparable data on healthy aging or on older age groups, according to the WHO.20 From a societal-participation perspective, this has implications for understating the contributions of older adults (not measuring national volunteering contributions from older people, for example) and unmet demands for participation opportunities (not measuring the percentage of older adults wishing to participate in community activities, for example).
6. An underresearched topic
Many interventions addressing societal participation of older adults are not backed by strong evidence bases. An MHI literature review of 22 commonly recommended age-friendly workforce interventions found that more than three-quarters of the recommendations had insufficient backing evidence.21 Some interventions had limited evidence of efficacy, while others extrapolated findings from workforce interventions aimed at other diversity and inclusion efforts. A stronger evidence base would enable stakeholders to select or design more effective interventions.
Cities as ideal platforms to address participation barriers
Many of the barriers outlined have their roots in societal attitudes and systemic gaps in understanding. Solving for these barriers will require a fundamental shift in the underlying infrastructure to become supportive and inclusive for people of all ages. To achieve the desired outcomes, this shift will need to extend across all aspects of infrastructure:
- social infrastructure—from fostering community norms where people of all generations work and socialize together to recognizing the important roles that older people play in local communities
- physical infrastructure—from designing the built environment with the mobility needs of all people in mind to improving access via transport systems and proximity of essential facilities
- political infrastructure—from authorizing policies protecting the rights of older people’s participation in society to budgeting for programs that create meaningful opportunities for older adults to engage in
Cities and communities serve as the intersection of these infrastructural elements, providing a platform to address older-adult societal participation at a local level. Indeed, the WHO recognizes the connecting role that cities play. In its Age-friendly Cities Framework, the WHO outlines how cities connect various domains of urban life. Of the eight domains listed in the framework, four of them directly relate to enabling societal participation of older adults: community and healthcare, social participation, respect and social inclusion, and civic participation and employment.22
The path to meaningful societal participation in cities
The remainder of this article explores what is required at a city level to address the barriers to societal participation of older adults and examples of how select cities have exemplified these approaches to positively benefit their communities.
1. Empower and motivate older adults to live up to their full potential
Empowering older adults to be active and visible in their local communities is a great way to gradually shift ageist beliefs toward a view that is more representative of the local older population. In fact, intergenerational contact strategies are among the most effective interventions for reducing ageism against older people.23
City example: Hanoi’s community-based organizations run by older people
In Hanoi, Vietnam, 94 intergenerational self-help clubs were established by the nongovernmental organization (NGO) HelpAge International as part of a project to support disadvantaged older people across Vietnam. Local older people could gather and make decisions around how they wanted to contribute to their local communities. In the three years of the project, club members have collectively raised VND 420 million (approximately $17,600) to maintain their own operations, successfully provided microcredit loans to 390 members for improving income-generating ability, and helped 97 local community members obtain home care services.24 Among all these benefits, 99.5 percent of club members reported the unity and solidarity in their communities improved.25
2. Look at programs that provide help to those who need it most
Older adults who may be struggling with financial, health, or housing challenges require dedicated efforts to embrace and engage them in society. This can be achieved through creating programs that specifically target such groups, reserving quotas in programs, and addressing the barriers that prevent the participation of these groups.
City example: Cape Town’s peer-to-peer support for older populations
In Cape Town, the peer-to-peer support program AgeWell was piloted as a low-cost means of supporting the needs of an expanding older-adult population. A nonrandom sample of 212 people aged 60 and older were selected from the township of Khayelitsha, where the local population was predominantly composed of disadvantaged, Black, and isiXhosa-speaking South Africans with limited resources and limited access to formal healthcare services. AgeWell clients were regularly visited by recruited volunteers (aged 60 and over themselves), who would befriend the clients and help refer them to relevant medical professionals and social service providers. AgeWell clients showed improvements in mental well-being scores throughout the program with a baseline average of 50 percent rising to 79 percent—an overall improvement of 58 percent.26
3. Encourage cross-sector collaborations wherever possible
Cross-sector collaborations can ensure the right expertise and resources are properly used in the effort to encourage the societal participation of older adults. Businesses can work with aging-related NGOs to incorporate age-friendly workplace practices. Governments can work with universities and community groups to amplify existing, lifelong learning opportunities.
City example: Santiago’s all-of-society solution for improving city accessibility
In the Chilean capital, Santiago, thousands of older adults wear RedActiva bands—red silicone bracelets that help them navigate the city. Wearers can use the band to request an extension of pedestrian crossing times at a traffic light, access free restroom facilities at participating businesses, and signal preferential stops for public transport. The RedActiva band was developed through a successful public–private partnership between the Universidad Católica de Chile,27 the Asociación de AFP de Chile, traffic authorities, and older citizens themselves. At approximately US $2 per unit, the RedActiva band is an example of innovative user-centric design and cross-sector collaboration.28
4. Invest in support structures for societal participation of older adults
Governments can lead by example when promoting societal participation of older adults. This could come in the form of creating programs in collaboration with other sectors, such as a local department of aging working with a chamber of commerce to explore volunteering opportunities for older adults, or putting in anti-age-discrimination protections.
City example: Singapore’s investment in its older workforce
The Singapore government has been investing in its older workforce across all steps of the employment journey. Older workers participating in reskilling programs can have up to 90 percent of course fees subsidized, employers are supported with funding and knowledge to redesign jobs for older workers and create age-friendly workplaces, and the government has specified a reemployment age to legally protect the rights of workers wishing to continue working at old age.29 Over 24,000 workers aged 50 and over have benefited from job design grants given out to over 2,500 companies while over 99,000 seniors have learned new skills from more than 1,000 courses offered through Singapore’s National Silver Academy. Employment rates of adults aged 65 and older grew from 17.1 percent in 2010 to 31 percent in 2022.
5. Improve measurements of societal participation
Availability of data on city-level participation, needs, and preferences of older citizens is the foundation for designing tailored interventions and tracking success. In line with local data policies, there are various means by which data can be collected: surveys, longitudinal studies, geocoded maps, wearable sensor technologies, and others.
City example: Barcelona’s data-driven approach to the societal participation of older adults
The Barcelona City Council approved its Strategy for demographic change and ageing in 2018 following an in-depth diagnosis of its local city population. Through this analysis, the local government identified several themes relating to societal participation of older Barcelona citizens: 65 percent of this group never attended any group activities, participation rates varied greatly between districts, and preference for attending community activities in local neighborhoods was disproportionately high among those aged 65 and over.30 Equipped with those data points, the Barcelona City Council designed an aging strategy to promote societal participation in line with local population preferences. Highlights include programming a wide breadth of activities, broadening senior access to local facilities such as music schools and museums, and involving older citizens in shaping the city’s public transit policies.
6. Generate evidence for promising societal-participation approaches
Formal assessments of existing interventions to improve societal participation of older adults can be a useful tool to help identify truly effective solutions. On the other side of the equation, implementing agencies can harness a strong, evidence-based approach to instill confidence among potential investors and sponsors.
City example: Philadelphia; South Bronx, New York; Minneapolis; Portland; and Port Arthur, Texas, and the origins of scaling evidence-based volunteering
A pilot program called Experience Corps was trialed in five US cities in 1996 to use older volunteers to help disadvantaged school children. The program was evaluated by researchers from Johns Hopkins University, who found demonstrable improvements in child literacy and teacher retention, as well as health benefits for the older volunteers (weight loss, blood pressure reductions, and improved cholesterol levels).31 Today, Experience Corps (now known as AARP Foundation Experience Corps) has expanded to encompass more than 2,000 volunteers serving more than 30,000 students across 21 cities.32
Creating opportunities to benefit all
Phrases such as “silver tsunami” often imply that older adults will be a drain on resources. They fail to recognize the value and potential of older adults in society. MHI believes greater societal participation of older adults benefits everyone: it can improve the social and mental health of older adults,33 boost GDP, and offer intergenerational connections for younger members of society.
Our research indicates that while there is universal unmet demand for older adults to be more actively engaged in their societies, there are also promising ways forward. As we have highlighted, encouraging societal participation of older adults requires an all-of-society approach: from governments investing in creating opportunities to employers shaping age-inclusive workplaces and older adults themselves propelling the changes they wish to see. Finding mediums that naturally convene stakeholders to work together—such as the cities we live in together—is imperative to creating a more vibrant, healthy society. More importantly, we must recognize that every member of society has a role to play in moving toward a more inclusive, more engaged future, regardless of age.