Aging with purpose: Why meaningful engagement with society matters

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“Age is just a number: How older adults view healthy aging,” McKinsey, May 22, 2023. 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.²There is a distinct difference between “societal” and “social” participation. While we might count hanging out with your friends as “social participation,” we wouldn’t count it as “societal participation.” Equally, incidental encounters such as talking to a grocery cashier would not generally be considered “societal participation” according to our definition. 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.³The WHO defines healthy aging as “the process of developing and maintaining the functional ability that enables well-being in older age.” Functional ability comprises five abilities: the abilities to meet basic needs; to learn, grow, and make decisions; to be mobile; to build and maintain relationships; and to contribute to society. For more, see Decade of healthy ageing: Baseline report, WHO, 2021. 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.⁴Global roadmap for healthy longevity, National Academy of Medicine, June 2022.

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.⁵Martin Dewhurst, Katherine Linzer, Madeline Maud, and Christoph Sandler, “Living longer in better health: Six shifts needed for healthy aging,” McKinsey, November 11, 2022. At the local level, rural-urban divides will increasingly present countries with the challenge of balancing equitable aging experiences.⁶Achieving equitable healthy aging in low- and middle-income countries: The aging readiness & competitiveness report 4.0, AARP, February 2023. 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 trillion⁷Opportunity size represents the total potential GDP uplift. Several factors may determine how much of this opportunity a country may capture. For example, the degree to which a country pursues and captures the older-adult employment opportunity may be determined by structural characteristics of each country’s labor market, including rates of youth unemployment. 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).⁸This figure reflects 6.5 percent coming from older adults directly reentering the workforce and another 0.7 percent coming from freeing up carers of older adults to return to partial employment. The potential impact on national economies could be substantial (Exhibit 1a and Table 1b).⁹The McKinsey Health Institute’s sizing methodology translates unmet employment desires from the Global Healthy Aging Survey into incremental GDP opportunity through added labor income. Calculation of uplift from older adults reentering the workforce is the product of the uplift in total labor force (from getting those older adults who aren’t working but want to back into the labor force, assuming a natural rate of unemployment prevents full uptake) and the total annual GDP attributable to labor income, using 2021 GDP data from the World Bank Group, 2021 labor force composition data from the International Labour Organization (ILO), 2018–22 average labor share of GDP data from IHS Markit, and the 2015–19 average natural unemployment rate from Oxford Economics (ILO definition). Calculation of additional employment from under-55 carers is based on primary and part-time carer data from the Global Healthy Aging Survey and the same GDP assumptions as above. While the final figure takes natural unemployment into account, it does not consider other labor market frictions such as what proportion of those respondents wishing to work are employable. 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.¹⁰Data from the ILO, UN World Population Prospects, and the World Bank.

Table 1b. Key drivers of GDP uplift

Labor share of GDP	GDP uplift leaders China, Germany, India, Japan, and US have highest labor share of GDP (53%–68%) Saudi Arabia (13%) and United Arab Emirates (UAE) (28%) have lowest labor share of GDP (economies led by oil and gas, a capital-intensive industry) India’s carer uplift exceeds workforce reentry uplift; India has the highest % of nonprofessional primary carers (62%); China is second highest at (58%)
% of labor force aged 55+	Leading countries include Germany, Japan, Singapore, South Korea, and US (22%–31%) Egypt, Malaysia, Saudi Arabia, and UAE have lowest percentage of labor force aged 55+ (5%–10%); Malaysia has among highest percentage of older adults wanting to work who aren’t
% of population aged 55+ who want to work and aren’t	Leading countries for desire to work include Malaysia, Saudi Arabia, South Africa, South Korea, and UAE (26%–31%) South Korea’s uplift might largely be explained by a combined high labor share of GDP and a high desire to work

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).¹¹The McKinsey Health Institute’s sizing methodology translates unmet volunteering desires from the Global Healthy Aging Survey into aggregate sums of volunteering hours from adults aged over 55 across the 21 countries sampled. MHI determined the proportion of adults aged over 55 who are currently volunteering and the distribution of hours currently volunteered. It was then assumed that those who wanted to volunteer but weren’t at present would volunteer at a similar rate as those who currently volunteer. The final figure was adjusted to account for a “natural rate of unemployment” as applied to volunteering.

Table 2b. Key drivers of volunteering opportunities

Current population volunteers aged 55+	Countries with highest percentage of volunteers aged 55+ are Egypt, Nigeria, Saudi Arabia, and United Arab Emirates (UAE) (42%–46%) India has a high percentage of volunteers aged 55+ (38%) (volunteerism is a strong tradition in Hindu culture) High-income countries including France, Germany, Italy, Japan, and South Korea have the lowest percentage of volunteers aged 55+ (~8%–9%)
Volunteer hours/week of age 55+ volunteers	High-income countries (eg, France, Germany, Italy, Japan) tend to volunteer for fewer hours per week when they volunteer Countries with relatively high volunteer hours per week (eg, 11–15 hours per week) include China, Malaysia, Saudi Arabia, and UAE
% of those aged 55+ who want to volunteer and aren’t	Leading countries for desire to volunteer include Indonesia, Nigeria, and South Korea (38%–45%) Countries with relatively low desire to volunteer among those not currently volunteering include Australia, France, Germany, Japan, Sweden, and UK (19%–24%)

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.¹²Global roadmap for healthy longevity, National Academy of Medicine, June 2022.

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.¹³The data ranges reflect the differences between respondents from high-income-economy countries, upper-middle-income-economy countries, and lower-middle-income-economy countries. 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.¹⁴Global report on ageism, WHO, March 2021. 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.¹⁵Promoting an Age-Inclusive Workforce: Living, Learning, and Earning Longer, Paris, France: OECD Publishing, 2020. 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.¹⁶A mid-life employment crisis: How COVID-19 will affect the job prospects of older workers, Centre for Ageing Better, August 2020.

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.¹⁷Meeting the world’s midcareer moment, Generation, July 2021. 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.¹⁸Achieving equitable healthy aging in low- and middle-income countries: The aging readiness & competitiveness report 4.0, AARP, February 2023. 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.¹⁹UN decade of healthy ageing: Plan of action, United Nations, April 2020. 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.²⁰UN decade of healthy ageing: Plan of action, United Nations, April 2020. 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.²¹Interventions listed in the literature review included those specific to older workers (for example, midlife career reviews) and those not specific to but often recommended for older workers (for example, flexible working arrangements). The literature review findings were tested with experts and academics in the field of age-inclusive work who were external to McKinsey. 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 WHO age-friendly cities framework,” WHO, accessed October 17, 2023.

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.²³Global report on ageism, WHO, March 2021.

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“Hanoi, Vietnam: Hanoi’s Intergenerational Self-Help Clubs,” United Nations Human Settlements Programme, accessed October 9, 2023. Among all these benefits, 99.5 percent of club members reported the unity and solidarity in their communities improved.²⁵“Supporting disadvantaged older people by replicating intergenerational self-help club model in Vietnam”, HelpAge Vietnam, December 2020.

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.²⁶Leon Geffen et al., “Peer-to-peer support model to improve quality of life among highly vulnerable, low-income older adults in Cape Town, South Africa,” BMC Geriatrics, October 2019, Volume 19.

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,²⁷Laboratorio de Innovación Pública is the specific group within the university responsible for RedActiva. 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.²⁸Sebastián Negrete et al., “Service design and the co-production of public policies: The case of RedActiva,” Linköping University Electronic Press, June 18, 2018.

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.²⁹Living life to the fullest: 2023 action plan for successful ageing, Singapore Ministry of Health, January 2023. 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“Strategy for demographic change and ageing: A city for all times of life (2018-2030),” Barcelona City Council, July 2018. 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).³¹The new map of life, Stanford Center on Longevity, April 2022. 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“Legacy Programs,” CoGenerate, accessed October 9, 2023.

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,³³Lanshuang Chen, Yifei Ding, and Zhen Zhang, “The relationship between social participation and depressive symptoms among Chinese middle-aged and older adults: A cross-lagged panel analysis,” Frontiers in Public Health, 2022, Volume 10. 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.